Session 1 - Anatomy of the Urinary system Flashcards

1
Q

Why is the urinary system important?

A

• It is vital in the maintenance of homeostasis

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2
Q

What is the main function of the Urinary system?

A
  • Controls excretion of a wide range of ions and small inorganic molecules
  • Controls the concentration of key substances in ECF
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3
Q

Where is fluid located in the body?

A
  • Intracellular fluid (ICF) or cytosol(~25L)

* Extracellular fluid (ECF)(~15L)

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4
Q

What fluid does ECF include?

A
  • Interstitial fluid (~12L)
  • Intravascular(Plasma)(~3L)
  • Lymph
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5
Q

How do the kidneys effect ICF?

A

• By moderating the ECF

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6
Q

What happens if kidneys fail to control ECF volume?

A
  • Changes in BP
  • Tissue fluid
  • Cell function
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7
Q

What happens if kidneys fail control ECF osmolarity?

A

• Cells shrink or swell

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8
Q

Describe the structure of the Urinary system

A

• Kidneys connected to the bladder by the ureters, which then expels urine via the urethra.

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9
Q

Where are the kidneys found?

A

• In the retropritoneal area (outside of the peritineum), at the level of T12-L3. Enclosed with Renal fascia and surrounded by perineal fat.

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10
Q

What muscle can be used as a reference point to find the right and left kidney?

A

• Psoas major

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11
Q

Where is the bladder found in males?

A

• The base of the bladder lies between the rectum and pubic symphysis. It is superior to the prostate and separated from the rectum by rectovesical pouch.

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12
Q

Where is the bladder found in females?

A

• The bladders sits inferior to the uterus and anterior to the vagina - thus its maximal capacity is lower than in males.

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13
Q

Where is the prostate found?

A

• situated in the pelvic cavity, below the lower part of the pubic symphyisis, above the superior fascia of the urogenital diaphragm, and in front of the rectum

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14
Q

Outline the course of the Ureters

A

• The ureters arise from the renal pelvis on the medial aspect of each kidney, before descending towards to bladder on the front of the psoas major muscle. The ureters cross the pelvic brim near bifurcation of the iliac arteries. They then run under the uterine artery/ductus deferens, down the pelvic sidewall and inset in the posterior surface of the bladder

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15
Q

Give three possible points along the course of the ureter where kidney stones can develop

A
  • Where the ureters cross the pelvic brim
  • At the ureterovesical valve (bladder entry)
  • At the pelvouteric junction (where the renal pelvis meets the ureter in the renal hilum)
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16
Q

How does the path of the ureter differ between males and females

A

• In males it passes under the vas deferens, and in females in passes under the uterine arteries

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17
Q

How much of the cardiac output do the kidneys supply?

A

• Roughly 20-25%

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18
Q

Where do the kidney receive blood from?

A

• The left and right renal arteries which branch directly from the abdominal aorta

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19
Q

Describe the divisions of the renal arteries

A
  • Divide first into interlobar arteries which penetrate renal capsule
  • Then supply arcuate arteries that run into the boundary of the medulla and cortex
  • These supply interlobular arteries that feed into afferent arterioles
  • Afferent go into glomerulus and drain via efferent
  • Efferent into afferent
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20
Q

Describe the venous drainage of the kidney

A
  • Efferent -> Peritubular capillaries (cortical nephron)/Vasa recta (juxtamedullary nephron)
  • Interlobular veins
  • To arcuate veins
  • Interlobar veins
  • Renal vein
  • Inferior vena cava
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21
Q

Why is moderation of salts and waters by the kidneys important?

A

• In a constant state of flux, due to variable ingestion

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22
Q

Do kidneys have a direct effect on ICF?

A

• No, only effect ECF

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23
Q

What is osmolality?

A

• Solute per kilogram of solvent

24
Q

What is osmolarity?

A

• Number of osmoles of solute per litre

25
Q

What ions are concentrated in ECF?

A

• Cl- and Na+

26
Q

What ions are concentrated in ICF?

A

• A- and K+

27
Q

What does the pH of ECF depend on?

A

• Depends in part on the concentration of HCO3-

28
Q

What are the 4 roles of the kidney?

A
  • Control volume
    – Control osmolarity
    – Help to control pH
    – Excrete some waste products
29
Q

What is ultrafiltrate?

A

• Filtered fluid produced by kidney, contains water and ions - NO CELLS

30
Q

How often is each litre of ECF filtered per day?

A

• Ten times

31
Q

How much urine is produced per day on average?

A

• 1.5L

32
Q

Name a substance actively secreted by kidney

A

• H+ ions

33
Q

How much blood flow does the kidney need?

A
  • 4ml.g.min

* 25% cardiac output

34
Q

What are the two main parts of the kidney?

A

• Cortex and medulla (parenchyma, together)

35
Q

What is the functional unit of the kidney?

A
  • Nephron, filter unit connected to a long tube for absorption
  • 1.5 million
36
Q

What is the glomerulus?

A

Highly specialised filter, tuft into which blood forced by filtration pressure

37
Q

How is the position of the right kidney different from the left?

A

Slightly lower than the left due to position of the liver

38
Q

How far can the kidneys move as a result of breathing?

A

3cm

39
Q

What are the tops of the kidneys protected by?

A

• 11th and 12th ribs

40
Q

Which way does the bladder distend when filled with urine?

A

• Upwards

41
Q

What passes through the prostate, and why can this be clinically significant?

A
  • Urethra passes through it

* If the prostate undergoes hypertrophy, urination can be prevented

42
Q

Give three possible points along the course of the ureter where kidney stones can develop

A
  • The junction of the renal pelvis and the ureter
  • The point at which the ureters cross the brim of the pelvis
  • Where the ureters pass into the wall of the urinary bladder
43
Q

How does the path of the ureter differ between males and females

A

• In males it passes under the vas deferens, and in females in passes under the uterine arteries

44
Q

What structure surrounds the kidney?

A

A fibrous capsule

45
Q

What is found in the renal pyramids? (2)

A
  • Glomerulus

* Bowman’s capsule

46
Q

What is the renal medulle split into?

A

• Sections known as “pyramids”

47
Q

What do the renal pyramids empty into?

A

• Minor calyxes

48
Q

At what point do the renal pyramids empty into the minor calyx?

A

• The papilla

49
Q

What do the minor calyxes join together to form?

A

• Major calyxes

50
Q

Where do the kidney receive blood from?

A

• The left and right renal arteries which branch directly from the abdominal aorta at the level of L1/L2

51
Q

Which renal artery is the longest?

A
  • The right

* Due to position of aorta and IVC

52
Q

Give the divisions of the renal arteries

A
  • Segmental
  • Divide into interlobar arteries which penetrate renal capsule
  • Then supply arcuate arteries that run into the boundary of the medulla and cortex
  • These supply interlobular arteries that feed into afferent arterioles
  • Afferent go into glomerulus and drain via efferent
  • Efferent into afferent
53
Q

Describe the venous drainage of the kidney

A
  • Efferent -> Peritubular capillaries (cortical nephron)/Vasa recta (juxtamedullary nephron)
  • Interlobular veins
  • To arcuate veins
  • Interlobar veins
  • Renal vein
  • Inferior vena cava
54
Q

Give the divisions of the renal arteries

A
  • Segmental
  • Divide into interlobar arteries which penetrate renal capsule
  • Then supply arcuate arteries that run into the boundary of the medulla and cortex
  • These supply interlobular arteries that feed into afferent arterioles
  • Afferent go into glomerulus and drain via efferent
  • Efferent into afferent
55
Q

Describe the venous drainage of the kidney

A
  • Efferent -> Peritubular capillaries (cortical nephron)/Vasa recta (juxtamedullary nephron)
  • Interlobular veins
  • To arcuate veins
  • Interlobar veins
  • Renal vein
  • Inferior vena cava