S1 L2 Anatomy (L1 was intro) Flashcards
Briefly, what happens at each part of the nephron?
Functions of the kidney and urinary tract
- 4
• Excretion – Waste products and drugs
• Regulation – Body fluid volume and ionic compounds. Major role in homeostasis and acid-base balance
• Endocrine – Synthesis of renin (blood pressure and sodium balance), erythropoietin (erythrocyte production) and prostaglandins (involved in regulation of renal function)
• Metabolism – Vitamin D is metabolized to its active form. Major site for catabolism of low-molecular-weight proteins.
Including:
– Insulin – Parathyroid hormone – Calcitonin
- *Anatomical location**
- In relation to the peritoneum
- Size of the kidney
- Location of the kidney
- Kidney is protected by what…?
- Hilum at which level?
- Which kidney is higher? and why?
In relation to the peritoneum
Retroperitoneum on the posterior abdominal wall, either side of the vertebral column.
Size of the kidney
11cm long x 6cm wide - 140g
Location of the kidney
Located between the T12 and L3 vertebrae
Kidney is protected by what…?
Partially protected by ribs 11 and 12
Hilum at which level?
Hilum at L1
Which kidney is higher? and why?
Left kidney is higher than right kidney, this is because the liver pushes the right kidney down
- *Layers that surround the kidney**
- 5 layers
Blood supply to the kidney
Kidney - label anatomical
Nephron -> Minor calyces -> Major calyces -> Renal pelvis -> Ureter
2 types of nephrons
- differences between them
- label the glomerulus arteries and Bowman’s capsule
- Cortical (85%) - short LoH (loop of Henle)
- Juxtamedullary - long LoH (loop of Henle) Much longer loop of Henle, better at concentrating urine as morespace for water to be absorbed
Label the nephron and the arteries
Juxtaglomerular apparatus
- label
- Role of the 3 cells (3rd, 4th, 5th label)
Macula densa cells: These work out how salty the fluid is in the dct to workout how much flow there should be through the glomerulus - sends signals to granular cells
Extraglomerular mesangial cells: Support MDC and provide network to hold the capillaries
Granular cells
Blood supply to kidney area
- key landmark of arteries…
Superior mesenteric artery runs over the top of left renal vein
Blood supply of the kidneys:
- List the 14 vessels involved (including the aorta and inferior vena cava)
- Difference in vessels between the two types of nephrons
S
I
A
I
A
Vasa recta - associated with loop of Henle in the Juxtamedullary nephron
Ureters
- Where are they?
- What lines them?
- How long is the ureter?
- Position in the abdominal cavity?
- 3 segments name
- Most common area of injury?
Where are they?
Connect kidney’s to the bladder
What lines them?
• Smooth muscle fibres that propel urine (peristaltic waves) to the urinary bladder
How long is the ureter?
• Ureter is 25 –30 cm long diameter ~ 1.5 mm in females, 4cm in males
Position in the abdominal cavity?
• Retroperitoneal
3 segments name
• Ureter beyond the pelviureteric junction (PUJ) divided into: proximal (abdominal), middle (pelvic) and distal part (intramural)
Most common area of injury?
• Most common areas of ureteric injury is near the pelvic brim
Bony Landmarks - of the hilium to bladder
Which bony landmarks could you use on an X-ray to approximate the course of the ureter? (Hilum to bladder)
• L1 ~ the hilum
• Ureter runs along close to the tip of lumber transverse processes
• Often crosses the sacrum at approximately the SI joint and descends into the pelvis.
• The ischial spine is a secondary bony land mark that shows the approximate point at which the ureter ‘kink’ towards the bladder
• The ureters then run around the pelvis and enter the bladder posteriorly.
Bladder
- How does the ureter enter the bladder?
- Name of this junction?
- What stops urine moving up the ureter?
- Which muscle makes up the bladder
- Name of the ‘triangle’ in the bladder, and what makes up the corners?
- *Bladder**
- Folds are called…?
- Lined with what cells?
- When the bladder is empty, what does it rest on?
- Position of the bladder in women and men?
Folds are called…?
Muscular folds called rugae – contract and expand
Lined with what cells?
Lined with transitional epithelium – urothelium
When the bladder is empty, what does it rest on?
When empty the bladder rests on the symphysis pubis
Position of the bladder in women and men?
• Women – In front of vagina, uterus and rectum
• Men – in front of rectum
Label - urinary area…
State the urethral divisions in a female
- This flap stops the urine reflux back up the ureter. As urine in the bladder stops reflux
State the urethral divisions in a male
