Renal Anatomy Review Flashcards
Where are the ureters located?
• what muscle do they run along?
• Where do they cross the pelvic brim?
• where do they enter the bladder?
- Found on Posterior Abdominal Wall on the surface of PSOAS MAJOR
- Cross Pelvic Brim at the BIFURCATION of the ILIAC arteries
- Enter POSTERIORLY into the bladder at the TRIGONE
Give Anterior to posterior order of the structures extending from the medial surface of the kidney.
Anterior to Posterior:
• Renal Vein
• Renal Artery
• Ureter
Area = Hilum
What structures divide the kidney into the pyramids?
• what do the pyramids empty into?
Columns extending down from the cortex
• Pyramids empty into the MINOR calyx
Kidneys • Retroperitoneal or Intraperitoneal? • Location Relative to Vertebrae? • Relative to ribs? • Relative to GI?
- Kidney = RETROPERITONEAL
- TV12 - LV3
- Right = Rib 12
- Leff = Ribs 11 and 12
• GI = TRANSPYLORIC Plane
Why is one kidney lower than the other?
• RIGHT kidney is usually lower due to its relationship with the LIVER
What space are the Kidney’s Located in?
• If you got stabbed in the left between the 11th and 12th ribs, what layers would the knife have to penetrate to get to the peritoneum?
Paravertebral Gutters
Superficial to Deep: • Erector Spinae • Quadratus Lumborum • Transversalis Fascia • Paranephric Fat • Renal Fascia • Paranephric Fatº • Kidney • Paranephric Fatº • Renal Fascia • Peritoneum
How do the kidneys move with inspiration?
• They move Downward when you breathe in, they are allowed to do this because FASCIAL LAYERS ARE OPEN INFERIORLY
What prevents contralateral spread of infection between kidneys?
• what barriers are there to inferior spread of infection?
- Renal Fascia attaches to the Renal Vessels and Ureter at the hilum preventing contraleral spread
- Downward spread is much easier because of need of downward movement during inspiration - NO Barriers - this means infection can easily spread from kidney to PELVIC region
What is nephroptosis?
• how is it distinguished from an ectopic kidney?
Nephroptosis:
• When Kidney Falls down in to the pelvis - may be somewhat painful when renal vessels are stretched
Distinguish from an ectopic kidney because of URETER THAN IS NORMAL LENGTH with coiling and kinks due to it being more proximal to the bladder
What 3 structures are in contact with the anterior side of the right kidney?
- Liver (top 1/2)
- Right Colic (hepatic) Flexure
- Duodenum (in contact with the hilum)
What 4 structures are in contact with the anterior side of the left kidney?
- Stomach (top 1/3)
- Spleen (sliver of upper lateral surface)
- Pancreas (middle 1/3)
- Descending Colic Surface
What is the relative location of the following structures and why is this a clinically relevant relationship?
• R and L renal aa.
• R and L renal vv.
• SMA
R and L renal aa. are equal in length and extend from the aorta at the level of the SMA
R renal vein is shorter than the L renal vein because the IVC is located to the right of the midline
^ means the SMA extends over the Left Renal Vein and can compress it causing SMA/ NUTCRACKER syndrome
What are some symptoms of nutcracker syndrome?
- Hematuria
- Proteinuria
- Abdominal (left flank pain)
- Left Testicular Pain
- VARICOCELE (bag of worms in the perivascular plexus of the spermatic cord)
What is the result of sympathetic and parasympathetic stimulation on the kidneys?
• where does this come from?
Sympathetic from T12 (LEAST THORACIC SPANCNIC N. - SYNAPSE IN AORTICORENAL GANGLIA)
• Vasoconstriction
• Decreased Urine Production
Parasympathetic from VAGUS NERVE
•Vasodilation
• Increased Urine Production
What lymph nodes drain the kidney?
• Lateral Aortic or Caval nodes
