SDL - Kidneys & Suprarenal Glands

Question 1

What are the kidneys largely under the cover of?

Answer 1

Costal margin

Question 2

Which kidney sits at a higher level?

Answer 2

Left

Question 3

What is the perinephric fat?

Answer 3

A layer of fat that surrounds kidney

Question 4

What is the paranephric fat?

Answer 4

A layer of fat that sits lateral to perinephric fat but separated by perinephric fascia

Question 5

On what ribs do the left and right kidneys lie?

Answer 5

11 and 12

Question 6

Which organs lie in contact with the anterior surface of the right kidney?

Answer 6

Liver, hepatic flexure duodenum

Question 7

Which organs lie in contact with the anterior surface of the left kidney?

Answer 7

Spleen, splenic flexure, stomach

Question 8

What are the important posterior relations of each kidney?

Answer 8

Quadratus lumborum muscles, ribs

Question 9

What is a renal corpuscle?

Answer 9

The blood-filtering component of the nephron. It consists of a glomerulus - a tuft of capillaries composed of endothelial cells, and a glomerular capsule known as Bowman’s capsule.

Question 10

Where are the renal corpuscles found?

Answer 10

Renal cortex

Question 11

What structures unite to form the ureteric pelvis?

Answer 11

Major calices

Question 12

What is the relation of structures to each other in the hilum?

Answer 12

Renal vein most anteriorly

Renal artery middle

Ureter most posteriorly

Question 13

What is the renal sinus?

Answer 13

Space which allows for structures to pass into and away from the kidney. It is filled fat.

Question 14

What are accessory renal arteries?

Answer 14

Most commonly accessory renal arteries arise from the abdominal aorta and supply the inferior pole of the kidney.

Kidneys develop in pelvis and then ascend so foetal blood supply may persist

Question 15

Which arteries supply the suprarenal glands?

Answer 15

3: superior, middle, inferior suprarenal arteries

Question 16

Where do the superior suprarenal arteries arise from?

Answer 16

Branch of inferior phrenic artery (usually 6-8)

Question 17

Where do inferior phrenic arteries arise from?

Answer 17

Usually separately from abdominal aorta (can arise as common stalk from aa or coeliac trunk)

Question 18

Where do the middle suprarenal arteries arise from?

Answer 18

The middle suprarenal arteries are two small vessels which arise, one from either side of the abdominal aorta (between inferior phrenic and renal artery)

Question 19

Where do the inferior suprarenal arteries arise from?

Answer 19

Directly from aorta or from renal artery

Question 20

Why do the suprarenal glands have such a rich blood supply?

Answer 20

Very important gland; enabling rapid movement of hormones in to the circulatory system

Question 21

Which veins drain into the left renal vein?

Answer 21

Left gonadal vein, suprarenal vein

Question 22

Describe the course of the ureter

Answer 22

The ureter runs down onto the psoas muscle. It leaves psoas at the bifurcation of the common iliac artery, which lies over the sacro-iliac joint, and passes into the pelvis where it turns anteriorly and medially to enter the bladder.

Question 23

Along their course from kidney to bladder, the ureters cross a number of bony landmarks. What are these?

Answer 23

Transverse processes of lumbar vertebra

Sacroiliac joint

Pelvic brim

Ischial spine

Question 24

What structures cross the ureter in males and females?

Answer 24

Females - uterine artery

Male - vas deferens

Question 25

What is the blood supply to the ureters?

Answer 25

Abdominal ureter: Branches from renal and gonadal artery, abdominal aorta, and common iliac arteries

Pelvic ureter: Branches from uterine and vesical arteries

Question 26

How can ureters be identified during an operation?

Answer 26

A small tap will send a wave of peristalsis both towards and away from the kidney

Question 27

Where are the three narrowest points of the ureter? What is the clinical significance of these narrowings?

Answer 27

1. Leaving kidney (renal pelvis)
2. Crossing pelvic brim: when the ureters pass the brim of the pelvic inlet at the bifurcation of the common iliac artery
3. Entering bladder

Question 28

Between which vertebral levels does the abdominal aorta extend?

Answer 28

T12 - L4