Retroperitoneal structures: kidneys and ureter Flashcards
what does retroperitoneal mean
a structure that lies posterior to the parietal peritoneum - held against the body wall with one surface covered by peritoneum and one surface in contact with the body wall
what is a primary retroperitoneal structure
formed on the body wall during development and maintain this relationship with body wall in adult form
give 4 examples of primary retroperitoneal structures
kidneys
suprarenal glands
vessels (aorta, IVC)
nerves
what are secondary retroperitoneal structures
develop out with the peritoneum but become covered by peritoneum by end of development and seen that way in adult form
give 5 examples of secondary retroperitoneal structures
most of duodenum
pancreas
ascending colon
descending colon
upper 2/3 rectum
the kidneys are primary/secondary retroperitoneal
primary
the pancreas is primary/secondary retroperitoneal
secondary
the ascending colon is primary/secondary retroperitoneal
secondary
the upper 2/3 of the rectum are primary/secondary retroperitoneal
secondary
the suprarenal glands are primary/secondary retroperitoneal
primary
the descending colon is primary/secondary retroperitoneal
secondary
most of the duodenum is primary/secondary retroperitoneal
secondary
what are the 4 components of the urinary system
kidneys
ureters
bladder
urethra
the hilum of the kidneys lies at what vertebral level
L1
which kidney lies slightly lower than the other and why
right kidney lies slightly lower due to large size of the liver
what are the anterior relations of the right kidney
suprarenal gland
liver
2nd part of duodenum
right colic flexure
the upper pole of the right kidney is protected by what posteriorly
rib 12
the right kidney lies on the surface of what
quadratus lumborum
where does quadratus lumborum pass between
muscle of posterior abdominal wall that passes between 12th rib and iliac crest
what are the posterior relations of the right kidney
diaphragm
rib 12
psoas
quadratus lumborum
transversus abdominis
subcostal nerve
the upper pole of the left kidney is protected posteriorly by what
ribs 11 and 12
what are the anterior relations of the left kidney
suprarenal gland
spleen
stomach
tail of pancreas
left colic flexure
jejenum
what are the posterior relations of the left kidney
diaphragm
ribs 11 and 12
psoas
quadratus lumborum
transversus abdominis
subcostal nerve
describe the gross appearance of the kidney
red-brown
smooth outer capsule
10-12cm long
6-8cm wide
what is found at the renal hilum
renal artery
renal vein
renal pelvis that becomes ureter
(also lymph and sympathetic fibres)
what are the most posterior structures of the hilum
renal pelvis that becomes the ureter
is variation of the renal arteries or veins common
variation of veins is rare, but renal artery variation is relatively common
what is the name of an extra arterial vessel that enters the kidney outwith the hilum
supernumerary renal artery
how is a supernumerary renal artery formed
non-regression of vessels during development
what lies under the capsule of the kidney
paler cortex
what is found in the cortex
glomeruli
what is below the cortex
darker medulla
what is contained in the medulla
loop of henle
collecting ducts
the ____ collect urine and channel it to the renal pelvis which becomes the ureter
minor calyces –> major calyx –> renal pelvis
what surrounds each kidney
large peri-renal fat pad
where are the renal arteries derived from
lateral branches of abdominal aorta at L1 vertebral level
describe the divisions of the renal arteries
each artery divides into anterior and posterior branches and then smaller segmental arteries
which renal artery is longer and why
right renal artery is longer than left as it has to travel across from the aorta which is slightly to left of midline
the right renal artery passes where in relation to IVC
posterior to IVC
what is the arterial supply like inside kidneys
lobar arteries
interlobar arteries
arcuate arteries
afferent glomerular arterioles
renal veins drain where
IVC
lymph from kidneys drains where
lateral aortic nodes (para-aortic nodes) around origin of renal artery (L1)
nerves for the kidney and suprarenal glands comes from where
renal sympathetic plexus
afferent fibres from kidney enter spinal cord where
T10-12
which renal vein is longer and why
left renal vein is 3x longer because it has to pass from left kidney across midline to reach IVC which lies to right side of vertebral bodies
the left renal vein lies _____ to the SMA
inferior
the left renal vein passes ____ to the pancreas
posterior
the left renal vein passes behind what 2 structures
splenic vein
body of pancreas
what 2 veins drain into the left renal vein
left gonadal
left suprarenal
the right renal vein passes _____ the descending duodenum
behind
where does the right gonadal vein drain
directly into IVC
where do the ureters pass between
renal hilum to the bladder
the ureters descend the posterior abdominal wall on what
anterior surface of the psoas muscle
as the ureters enter the pelvis they cross what
bifurcation of common iliac artery anterior to sacro-iliac joint
the ureters travel towards the ischial spine along what
lateral wall of pelvis
where do the ureters enter the bladder
inferior surface of bladder as part of trigone area
what propels urine towards the bladder
contractions of ureter wall and filtration pressure from glomeruli
what are the ureters
long smooth muscle tubes that pass from renal hilum to the bladder
what are the 3 constrictions of the ureters
1) at the junction of the ureters and the renal pelvis
2) where the ureters cross the pelvic brim
3) as they enter the bladder wall
what landmark can be used to identify the ureters
they cross the bifurcation of the common iliac artery as they enter the pelvis
in an xray when the psoas muscles cannot be seen, how are the ureters described passing
passing the tips of the transverse processes of lumbar vertebra
the proximal parts of the ureters receive/drain blood from where
renal vessels
the middle parts of the ureters receive/drain blood from where
gonadal vessels (ovarian or testicular)
the distal parts receive/drain blood where
superior vesical vessels (also supply/drain bladder)
lymph from the ureters drains where
para-aortic nodes and iliac nodes
afferent nerve fibres from the ureters goes where
L1-L2
pain from the ureters is referred where
inguinal region at top of thigh
nerves to the ureters come from where
renal, testicular (or ovarian) and hypogastric plexuses
where are the supra-renal glands found
superior pole of kidney
what is the gross appearance of the supra-renal glands
yellow cortex
brown medulla
the right supra-renal glands is what shape
pyramid shaped
the left supra-renal glands is what shape
crescent moon shape
the cortex of the supra-renal glands makes what
corticoids (fluid, electrolyte)
glucocorticoids (carbohydrates, fats, proteins)
the medulla of the supra-renal glands makes what
epinephrine and norepinephrine
where is the right supra-renal gland found
behind right lobe of liver
where is the left supra-renal gland found
behind pancreas, stomach and lesser sac
the supra-renal glands are what kind of glands
endocrine
describe the blood supply of the supra-renal glands
3 arteries on each side: a superior suprarenal, a middle suprarenal and an inferior suprarenal
the superior suprarenal artery is a branch of
inferior phrenic artery (first abdominal branch of aorta)
the middle suprarenal artery is a branch of
direct from aorta
the inferior suprarenal artery is a branch of
renal artery
there is usually _ veins on each side
1
the suprarenal vein drains where
directly into IVC on right
into renal vein on left
the lymph from the suprarenal glands drains where
paraaortic nodes at L1
