Session 13 - Lecture 1 - Revision Lecture Flashcards
3 - Learning Outcomes
- Describe the structure and relationships of the kidneys, ureters, bladder and urethra in both the male and female
- Describe the development of the urinary system and understand how congenital abnormalities of position and renal vessels occur
- Describe and explain the neuronal control of the bladder
- Explore the links between abnormal physiology/pathology and clinical symptoms/signs
4 - Kidney anatomy
- Caval hiatus (T8)
- Inferior vena cava
- Aortic hiatus (T12)
- Abdominal aorta
- Right crus
- Central tendon of the diaphragm
- Esophageal hiatus (T10)
- Muscular portion of the diaphragm
- Esophagus
- Diaphragm
- Left crus
- Quadratus lumborum m.
- Psoas minor and major mm.
- Iliac crest
- Iliacus m.
- Inguinal ligament
- Iliopsoas m.
- Inferior vena cava
- Abdominal aorta
- Quadratus lumborum m.
- Psoas minor and major mm.
- Iliac crest
- Iliacus m.
- Inguinal ligament
[Quadratus lumborum muscle. Attaches to the iliac crest, lumbar transverse processes, and the 12th rib. The quadratus lumborum muscle is the bed on which the kidneys lie. The muscle laterally flexes the vertebral column and stabilises the 12th rib during breathing. The subcostal and lumbar intercostal nerves provide innervation.
Psoas major muscle. Attaches to the lumbar vertebrae superiorly …]
“Where the kidneys interrelate with the MSK system – remember kidneys have a muscular bed that they sit on, usually thought of as quadratus lumborum muscles – allow us to bend lumbar trunk. Psoas major and minor running down – remember these are innervated by L3 spinal nerves (L1-L3 I think); so we’re sitting in the lumbar region here, and if we think about where are kidneys are - T12 to L2/L3 – there is our muscular bed that the kidneys are sitting on.”
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- Celiac Trunk
- Left Gastric Artery
- Common Hepatic Artery
- Right Renal Artery
- Gonadal
- Aorta
- Right Common Iliac Artery
- Right External Iliac Artery
- Phrenic Artery
- Spleen
- Splenic Artery
- Suprarenal
- Left Renal Artery
- Superior Mesenteric Artery
- Inferior Mesenteric Artery
- Left Internal Iliac Artery
[The renal arteries: normally arise off the left interior side of the abdominal aorta, immediately below the superior mesenteric artery, and supply the kidneys with blood. Each is directed across the crus of the diaphragm, so as to form nearly a right angle.
See:
Renal artery lies behind the vein as it crosses vertebral column
Left and right renal artery …]
{So then we need to think about the blood supply for the kidneys – diagrammatic representation of the blood supply – renal arteries coming off just below coeliac trunk laterally, almost at right angles to abdo aorta – coming off – think of man with arms outstretched are renal arteries – but renal arteries are actually behind our vein structures – venous structure overlies and our renal artery has to disappear behind that and that arrangement continues across as renal arteries and veins drop either side of spinal column, and both vessels entering into the hilum – coeliac trunk – SMA, key landmark, hooking over the top of our renal vein as it comes across, and remember that we’ve got different lengths of renal veins: the left one is v long. And it’s really useful and the key element that we q often choose the left kidney if we’re doing voluntary transplant for donor – left one choose bc of length of the left vein – makes plumbing process when reattaching much easier if we have rly long vein. Other thing we can see on this diagram is appreciating how the kidneys drop back – we get this impression they’re in horizontal plane but they’re not, they’re at 45 degree angle dropping back down the ridge of vertebral column – they do hang on renal vessels.}
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