Renal and Urology Flashcards
difference between ureter and urethra
ureter between kidneys and bladder
what structure do kidneys lie within
posterior abdominal wall
which ribs overlie kidneys
left - XI and XII
right - XII
at what vertebral level are the hila of the kidneys
left - IVD of L1/2
right - body of L2
which nerves overlie the kidneys and why is this important clinically
upper nerves of lumbosacral plexus - subcostal, iliohypogastric, ilioinguinal
need to not damage in surgery
order these from superior to inferior
iliohypogastric, subcostal, ilioinguinal
subcostal
iliohypogastric
ilioinguinal
what four layers surround the kidney from closest to the kidney to the peritoneum
renal capsule
perinephric fat
renal fascia
paranephric fat
describe the fluid flow through the kidneys
cortex → medulla → papilla → minor calyx → major calyx renal pelvis → ureter
which structure sit more anteriorly - venous or arterial
venous
which structure sits on the left of the other - IVC or abdominal aorta (in the body not when you are looking at it)
aorta
which artery emerges from the aorta just superiorly to the right renal vein
superior mesenteric
which is longer the right or left renal vein
left
which is longer the right or left renal artery
right
what are the ureters
muscular tubes
how is urine moved through ureters
by peristalsis and gravity
how long are ureters
25-30cm
what aspect of the kidneys do ureters emerge from
posteroinferior
what are the three common constrictions and why are they clinically important
sites where renal stones commonly develop and get lodged
1. uteropelvic junction
2. crossing pelvic brim/common iliac bifurcation
3. entrance to bladder
why is where the ureter passes the common iliac bifurcation a common constriction
pulsing of blood slows flow in ureter
ureter blood supply
top - renal arteries
middle - common iliac a. (and sometimes gonadal a., abdominal aorta, peritoneal branches)
bottom - vesical arteries
what muscle makes up most of the bladder wall
detrusor muscle
layers of detrusor muscle
inner longitudinal layer
middle circular layer
outer longitudinal layer
which part of the bladder is under voluntary control
external urethral sphincter
what kind of muscle and control is the detrussor muscle
smooth muscle
autonomic control
what is the non contractile area of the bladder wall called
trigone
what is the purpose of the trigone
ensures openings to the bladder - ureteric and internal urethral openings - stay open when muscle contracts
what is the name of the hole in the inferior aspect of the bladder leading to the urethra
internal urethral orifice
what muscle surrounds the internal urethral orifice
internal urethral sphincter
is the internal urethral sphincter voluntary or involuntary
involuntary
where does the blood supply to the bladder arise from
the anterior trunk of the internal iliac artery
what arteries supply the bladder
superior vesical artery
inferior vesical artery/vaginal artery
in females - branches from uterine artery
what is the blood supply to the bladder from the internal iliac a.
- internal iliac a. → anterior trunk of internal iliac a. → umbilical artery → superior vesical artery
- internal iliac a. → anterior trunk of internal iliac a. → inferior vesical artery
what type of tube is the urethra
fibromuscular
what structure originates from the neck of the trigone
urethra
where does the urethra terminate
external urethral orifice
length of female urethra
3-4cm
which direction does the female urethra curve
slightly anteriorly
who is more at risk of UTIs and why - male or female
female as shorter urethra
length of male urethra
20cm
what are the two curvatures of the male urethra and what are the clinical implications
complicates catheterisation
infra-pubic - anterior - at bulb of penis
pre-pubic - inferior - at base of penis
what are the four regions of the male urethra
pre-prostatic
prostatic
membranous
spongy
where is the membranous segment of the male urethra found
within pelvic cavity
which region of the kidney stains darker
cortex
what are medullary rays in kidney
collections of tubules/ducts travelling together through into the medulla
what type of cells form bowmans capsule
simple squamous epithelium
where do blood vessels enter and exit bowman’s capsule
vascular pole
does the basic mucosa of the urinary system have a similar structure from the renal papilla to urethra
yes
what cells line the urinary tract
umbrella cells
how does the uroepithelium change towards the bladder
no. of intermediate layers increase closer to the bladder
How many smooth muscle layers are found in different parts of the ureter and what orientation are the layers
2 proximally - longitudinal and circular
3 distally - longitudinal, circular, longitudinal
what are the layers of the bladder
urothelium
- high no. of IC layers
lamina propria
3 layers smooth muscles
- longitudinal, circular, longitudinal
