Renal Anatomy

Question 1

What is the vertebral level of the kidneys?

Answer 1

T12-L3

Question 2

Which kidney is lower and why?

Answer 2

The R, because of the position of the liver

Question 3

What is the innervation of the kidneys?

Answer 3

Thoracic splanchnic nerves

Question 4

What is the lymphatic drainage of the kidney?

Answer 4

Lumbar nodes

Question 5

What fascia encloses the kidneys?

Answer 5

Gerota fascia

Question 6

What are the muscles of the posterior abdominal wall?

Answer 6

Psoas major; psoas minor; iliacus; quadratus lumborum

Question 7

To what are the psoas major, psoas minor and iliacus collectively referred?

Answer 7

Iliopsoas muscle

Question 8

What is the mneumonic SAD PUCKER used to refer?

Answer 8

The retroperitoneal structures

Question 9

What does SAD PUCKER stand for?

Answer 9

S = suprarenal glands
A = aorta
D = duodenum
P = pancreas (except the tail)
U = ureters
C = colon (ascending and descending)
K = kidneys
E = esophagus
R = rectum

Question 10

What is contained within the medulla of the kidneys?

Answer 10

Renal pyramids; renal papillae; minor calyces; major calyces

Question 11

What is the drainage order of the kidneys?

Answer 11

Renal pyramids — renal papillae — minor calyces — major calyces — renal pelvis — ureter

Question 12

What is the course of the ureters?

Answer 12

1st = cross UNDER the gonadal arteries
2nd = in the pelvis, pass ANTERIOR to the external iliac artery at the point it branches from the common iliac artery
3rd = crosses UNDER the uterine artery/vas deferens (F/M) (water UNDER the bridge)

Question 13

Where in the ureters are kidney stones most likely to form?

Answer 13

1. Utero-renal pelvic junction
2. Where the external iliac artery cause constriction of the ureter
3. Vesico-uteric junction

Question 14

What makes up the points of the trigone?

Answer 14

2x ureters + 1x urethral orifice

Question 15

What type of epithelium lines the bladder?

Answer 15

Transitional epithelium

Question 16

What are the segments that make up the male urethra?

Answer 16

Prostatic + membranous + penile

Question 17

What is the epithelium of the prostatic urethra?

Answer 17

= transitional

Question 18

What is the epithelium of the penile urethra?

Answer 18

= pseudostratified columnar, then stratified squamous

Question 19

Where is the external urethral sphincter located?

Answer 19

Surround the membranous urethra

Question 20

What are the Littre glands?

Answer 20

Glands that open along the penile urethra to secrete mucus

Question 21

Which is the longest segment of the male urethra?

Answer 21

Penile

Question 22

What are the zones of the prostate?

Answer 22

Transitional, central and peripheral

Question 23

In which segment of the prostate does BPH occur?

Answer 23

Transitional

Question 24

What is a nephron composed of?

Answer 24

Renal corpuscle + tubular system

Question 25

What is the renal corpuscle composed of?

Answer 25

Glomerulus + Bowman's capsule

Question 26

What supplies, and what drain the glomerulus?

Answer 26

Afferent arteriole = supply | Efferent arteriole = drain

Question 27

What type of endothelium does the glomerulus have?

Answer 27

Fenestrated

Question 28

What is the filtration barrier composed of?

Answer 28

1. Fenestrated capillary endothelium 2. Basement membrane 3. Slit diaphragms between adjacent foot processus of podocytes

Question 29

What are the layers of the Bowman's capsule?

Answer 29

1. Visceral layer - involved in filtration | 2. Parietal layer - NOT involved in filtration

Question 30

What lines the PCT?

Answer 30

Simple cuboidal epithelium

Question 31

What are the functions of the PCT?

Answer 31

Reabsorption of all glucose + amino acids, and most of the Na+, H20, HCO3-, Cl- and PO43-

Question 32

What occurs in the descending limb of the LoH?

Answer 32

Passive reabsorption of H20 | Impermeable to Na+

Question 33

What occurs in the ascending limb of the LoH?

Answer 33

Impermeable to H20 | Actively pumps out Na+, i.e. Na+ is reabsorbed

Question 34

What lines the DCT?

Answer 34

Simple cuboidal epithelium

Question 35

What are the functions of the DCT?

Answer 35

Impermeable to H20 | Actively reabsorbs Na+ (i.e. functions the same as the ascending limb of the LoH)

Question 36

What lines the collecting tubules?

Answer 36

Simple cuboidal epithelium

Question 37

What does aldosterone cause the reabsorption of?

Answer 37

Na+ - it being reabsorbed in exchange for K+ and H+

Question 38

What does ADH cause the reabsorption of?

Answer 38

H20

Question 39

Where do aldosterone and ADH act?

Answer 39

Collecting tubules

Question 40

What is the JGA made up of?

Answer 40

Macula densa + juxtaglomerular cells

Question 41

What is the function of the JGA?

Answer 41

Functions to maintain he GFR in response to changes in BP in the afferent arterioles

Question 42

Where are the macula dense cells found + what do they do?

Answer 42

In the thick ascending limb and DCT (coming into close contact with the afferent and efferent arterioles). The cells are sensitive to changes in Na+ concentration and rate of flow, and regular GFR though the action of locally active hormones.

Question 43

Where are the juxtaglomerular cells found + what do they do?

Answer 43

In the afferent arterioles. Act as baroreceptors, monitoring changes in BP, then maintain GFR through the release of renin (part of RAAS).