Renal anatomy 2 Flashcards
Where do the right and left adrenal glands lie?
Both lie close to the upper pole of each kidney
The right adrenal gland lies behind the liver and inferior vena cava
The left adrenal gland lies behind the stomach and pancreas
What is the arterial supply and venous drainage of the adrenal glands?
Superior adrenal artery - a branch of the inferior phrenic artery
Middle adrenal artery - a branch of the abdominal aorta
Inferior adrenal artery - a branch of the renal artery
The right adrenal vein drains directly into the inferior vena cava whilst the left adrenal vein drains into the left renal vein first, then the inferior vena cava.
What hormones do the cortex and medulla of the adrenal gland produce?
Cortex- produces cortisol, aldosterone and testosterone
Medulla- Adrenaline
How big is the kidney? Is it intraperitoneal or retroperitoneal? Where are they located?
11cm long, 4 cm thick and 7cm wide
It is retroperitoneal (or extra peritoneal)
They are located on either side of the upper lumbar vertebrae
What are the layers of fat surrounding the kidney?
It is embedded in perinephric fat which is covered by renal fascia
Paranephric fat is found outside the renal fascia.
Where and what is the renal hilum? What is the kidneys arterial supply and venous drainage?
The hilum is located on the medial border of the kidney. This is where renal vessels, nerves, lymphatics, and ureter enter or leave the kidney
The left and right renal arteries branch off from the abdominal aorta whilst the left and right renal veins drain directly into the inferior vena cava.
What are the main functions of the nephrons?
Filtering blood, reabsorbing water and solutes, and secreting and excreting waste products as urine.
Which part of the kidney is the glomeruli, bowman’s capsule, proximal and distal tubules, loop of henle and collecting ducts in?
Cortex- glomeruli, bowman’s capsule, proximal and distal tubules and part of collecting ducts
Renal medulla (arranged into pyramids)- loop of henle and rest of collecting ducts.
What is the path of urine?
At the end of the collecting duct, the filtrate becomes urine which travels down the renal pyramid towards the renal papilla (apex) where it enters the minor calyx → minor calyces merge to form a major calyx → major calyces merge to form the renal pelvis which is continuous with the ureter → the ureters transport urine to the urinary bladder via peristalsis of muscular walls.
Where does the ureter run and where do they enter? What runs over the ureters? What do they supply?
Lateral to the sympathetic trunks (on either side of the lumbar spine), It runs anterior to the psoas muscle (on its surface) on the posterior abdominal wall and crosses the pelvic brim to enter the pelvis.
They enter the bladder on its inferomedial aspect
Gonadal vessels run down over the ureters to supply the gonads (testes or ovaries)
Where does the posterior abdominal wall extend from and what does it consist of?
It extends from the attachments of the diaphragm above to the pelvic brim below.
It consists of the lumbar spine, psoas muscle (both major and minor) and quadratus lumborum muscles
What are the structures running along the posterior abdominal wall?
Inferior vena cava
Abdominal aorta with associated plexus (lumbar plexus) and lymph nodes
Sympathetic trunk on either side of the lumbar spine
What forms the lumbar plexus and what does it supply? What branches does it have?
Spinal nerves from L1-L4 form the lumbar plexus (T12 also contributes)
The plexus gives rise to several branches that innervate the skin and muscles of the abdominal wall and thigh.
Iliohypogastric and ilioinguinal nerves- supply the anterior abdominal wall muscles and skin of the external genitalia
Genitofemoral nerve- supplies the skin of the external genitalia
Lateral femoral cutaneous nerve- (lateral cutaneous nerve of the thigh) → supplies skin over the lateral thigh
Femoral nerve- Large nerve- supplies muscles and skin of the anterior thigh. (often target for nerve blocks to provide pain relief for lower limb fractures or surgery (relatively easy to locate in the inguinal region using ultrasound)
Obturator nerve- supplies the muscles and skin of the medial thigh
Where does the thoracic aorta pierce the diaphragm to become the abdominal aorta, where does the abdominal aorta run relative to the posterior abdominal wall and where does it terminate (at which level also)?
Thoracic aorta pierces diaphragm at T12
It descends on the posterior abdominal wall just left of the midline
It terminates at the level of L4 where it bifurcates into the left and right common iliac arteries.
What are some paired and unpaired branches of the abdominal aorta?
Paired: renal, adrenal, gonadal and lumbar arteries
Unpaired: coeliac trunk, superior mesenteric and inferior mesenteric arteries
