Renal - Anatomy Flashcards by Ailsa Ferguson

What constitutes the upper urinary tract?

Kidneys and ureters

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What constitutes the lower urinary tract?

The bladder and the urethra

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Where might an upper urinary tract infection spread to?

The kidneys

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What type of urinary tract infection involves the urethra and bladder?

Lower urinary tract infection

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Where do the kidneys and proximal ureters lie?

The abdomen

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Which parts of the urinary tract lie in the pelvis?

Distal ureters
The bladder
Proximal urethra

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Where does the distal urethra lie?

The perineum

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Are the kidneys intraperitoneal or retroperitoneal?

Retroperitoneal

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What structures are found at the renal hilum?

Renal artery
Renal vein
Ureter

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Which 3 muscle layers make up the anterolateral abdominal wall?

External oblique
Internal oblique
Transversal abdominis

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What are the layers of peritoneum, fat and fascia around the kidneys?

Anterior to posterior:
Visceral peritoneum
Paranephric fat
Renal fascia 
Perinephric fat
Renal Capsule
Kidney

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Is the IVC closer to the right or left kidney?

Right

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Which kidney sits higher? Left or right?

And why?

Left

Because the right is pushed down by the liver

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What vertebral levels fo the kidneys sit at?

Left = T12-L2
Right = L1-L3

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Do the kidneys move superiority or inferiorly on inspiration? And why?

Inferiorly
This is because the lungs inflate which pushes the diaphragm inferiorly which in turn pushes the liver/spleen inferiorly which pushes on the superior poles of the kidneys pushing them inferiorly.
Therefore they move superiorly on EXpiration

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What does the right kidney sit posteriorly to?

The liver (and hepatorenal recess of the peritoneal cavity)
2nd part of the duodenum
Ascending colon
Right colic flexure/hepatic flexure

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What does the left kidney lie posterior to?

Stomach
Tail of the pancreas
Hilum of the spleen
Splenic vessels

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Which lies anterior the renal veins or arteries?

VEINS anterior to ARTERIES

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Are the common iliac arteries anterior or posterior to the common iliac veins?

Arteries anterior, veins posterior

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At what level does the abdominal aorta bifurcate at?

And what does it bifurcate to form?

The level of the umbilicus

Become the right and left common iliac arteries.

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Where does lymph from the kidneys drain?

And where are these nodes found?

The lumbar nodes

Found around the abdominal aorta and IVC

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Which two places does lymph from the ureters drain to?

And where are these located?

The lumbar nodes:
Found around the abdominal aorta and IVC
AND
The iliac nodes:
Found around the common, internal and external iliac vessels

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Branches from which arteries make up the ureteric arterial supply? (Blood supply to the Ureters)

Renal artery
Abdominal artery
Common iliac artery
Internal iliac artery
Vesical (bladder) artery

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Which two types of abdominal aortic aneurysm can cause renal artery stenosis and why?

Infra-renal AAA:
Both the AAA and the stenosis cause by atherosclerosis
Supra-renal AAA:
Aneurysm causes an occlusion of the proximal renal artery

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What are the names of the outer and inner parts of the kidney?

Outer cortex | Inner Medulla

What is found within the medulla of the kidneys?

Renal pyramids containing around 50,000 nephrons each

What is the order of the parts of the nephron?

``` Glomerulus Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting duct ```

What is the job of the glomerulus?

Ultrafiltration of the blood arriving from the branches of the renal artery

Where does the urine pass through after leaving the collecting duct of the nephrons because it gets to the ureter?

``` Collecting duct Minor calyx Major calyx Renal pelvis Ureter ```

Where are the main sites that the ureter can become constricted?

Pelviureteric junction (where the ureter begins at the renal hilum) Where the ureter crosses anteriorly to the common iliac artery Ureteric orifice (Where the ureter drains into the bladder)

What can renal calculi (stones) be formed by?

Urine calcium salts

What does the ureter do when there is a obstruction?

Increased peristalsis proximal to the obstruction (to try and remove it to the bladder) in waves resulting in colicky pain

What is hydronephrosis?

“Water inside the kidney” Urine back pressure into the kidneys causing renal failure and an enlargement of the kidney and stretches the renal capsule

What constitutes the ‘fake pelvis’?

From the iliac crests to the pelvic inlet

What constitutes the ‘true pelvis’ (pelvic cavity)?

Pelvic inlet to pelvic floor

What are your pelvic floor muscles?

Levator ani (pelvic diaphragm)

What is the perineum?

Shallow compartment between pelvic floor and skin

At what level do the ureter enter the posterior aspect of the bladder?

Ischial spine

In what direction do the ureters enter the bladder and why?

Inferomedial direction to prevent reflux of urine when the bladder contracts

What is another name for the pouch of Douglas? And where is it?

Rectouterine pouch | Pouch in the peritoneal cavity that sits between the rectum and the uterus

What is the name of the pouch in the peritoneal cavity anterior to the pouch of Douglas?

The vesicles-uterine pouch (between the uterus and the bladder)

What does the ureter run inferiorly to in males and females respectively?

``` Males = Vas deferens Females = Uterine tubes and uterine artery ```

The arteries entering the pelvis are mainly branches from which artery?

Internal iliac artery

Where do veins from the pelvis drain to?

Internal iliac vein

What is the ‘trigone’ and what makes it up?

Triangle shape on the internal aspect of the bladder formed by: 2 ureteric orifices Internal urethral orifice

Where does the prostate lie in relationship to the bladder in the male pelvis?

Prostate inferior to the bladder

What is the name of the muscle that makes up the main bulk of the bladder?

Detrusor muscle (de-trouser to pee)

What is the muscle that the detrusor muscle forms at the top of the urethra? And what does it do in men during ejaculation and why?

Internal urethral sphincter muscle | Contracts during ejaculation to prevent retrograde ejaculation of semen back into the bladder

What are the two methods of catheterising a patients bladder?

Urethral | Suprapubic

What are the different parts of the male urethra?

``` Internal urethral orifice Internal urethral sphincter (involuntary) Prostatic urethra External urethral sphincter (voluntary) Spongy urethra External urethral orifice ```

Where do the testes move from and to during feral development?

From the posterior abdomen through the inguinal canal to the scrotum

What structure are found in the spermatic cord?

``` Testicular artery Testicular vein Vas deferens Lymphatic vessels Nerves (autonomic and somatic) ```

What 2 parts make up the nephron?

The renal corpuscle and the renal tubules

What makes up the renal corpuscle?

The glomerulus and the bowmans capsule (squamous epithelium)

What are podocytes?

The special endothelial cells that lie on top of the glomerular capillaries

What is the epithelium of the thick ascending limb on the loop of Henle?

Simple cuboidal epithelial cells

What are the vasa recta?

Thin blood vessels surrounding the loop of Henle

Where is the loop of Henle found?

In the medulla of the kidney

Where are the proximal and distal convoluted tubules found?

The renal cortex

What is the difference between the simple cuboidal epithelial cells of the proximal and distal convoluted tubules?

The proximal convoluted tubule cells have a brush border of microvilli and the DCT cells do not.

What three components make up the juxtaglomerular apparatus?

The macula densa Lacis cells Juxtaglomerular cells

What type of epithelium layers the conducting parts of the urinary tract? (Minor calyx, major calyx, renal pevis etc.)

Transitional epithelium (aka urothelium)

What is the name of the sac that the testes sit in?

Tunica vaginalis

What is the name for given to excess fluid within the tunica vaginalis?

Hydrocele

What does the spermatic cord contain?

Vas deferens Testicular artery Pampiniform venous plexus

Where do the right and left gonadal veins drain to?

``` Right = straight into IVC Left = Left renal vein ```

What passes through the deep inguinal ring?

``` Testicular artery Testicular vein Vas deferens Lymphatic Nerves ```

Where would you find the epididymis and what tubules come before it and drain into it?

The posterior aspect of the testis | Seminiferous tubules

What are the 3 tissue sections in the body of the penis?

Right and left corpus cavernosum | Corpus spongiosum

Branches from which artery supply: 1. The penis? 2. The scrotum?

1. The internal pudendal artery | 2. Internal pudendal AND external iliac artery

Where does lymph from the scrotum and most of the penis (not the glans) drain to?

Superficial inguinal lymph nodes

Where does lymph from the testes drain to?

The lumbar nodes around the abdominal aorta