Spleen & Kidneys (317-330)

Question 1

Name the ligaments of the spleen;

Answer 1

Splenorenal (leiorenal) ligament (hilum spleen with left kidney),
Gastrosplenic ligament (hilum spleen with greater curvature of stomach),
Phrenocolic ligament (spleen sits on top of it)

Question 2

What structures are contained within the ligaments of the spleen?;

Answer 2

Splenorenal ligament- splenic artery splenic vein, tail of pancreas. Gastrosplenic ligament- left gastroepipoleic artery, left gastroepipoleic vein, short gastric arteries and veins, lymphatics.

Question 3

What are the layers of the kidney?;

Answer 3

Superfical to deep- pararenal fat, renal fascia (aka gerota’s fascia), perirenal fat, renal capsule

Question 4

What are the structures in the hilum of the kidney and what are their relations?;

Answer 4

Hilum left kidney at L1. Hilum right kidney at L1-2. Structures at hilum (anterior to posterior)- renal vein, renal artery, ureter.

Question 5

Which arteries branch off the renal artery and supply different segments of the kidney?;

Answer 5

Renal artery-> interlobar arteries (5)-> arcuate arteries -> interlobular arteries -> interlobular veins -> arcuate veins -> interlobar veins -> renal veins

Other branches (very difficult to see)- inferior adrenal artery, ureteric artery

Question 6

What are the common types of kidney cancers? Classic triad kidney cancer sx?;

Answer 6

Renal cell carcinoma- clear cell (most common 80%), papillary type 1 & type 2 (15%).
Classical triad- haematuria, flank pain, palpable mass.

Question 7

Into where do the left and right testicular veins drain?;

Answer 7

Left testicular vein drains into left renal vein. Right testicular vein drains into IVC. (Reasonal need to assess for left RCC if varicocele present)

Question 8

What are the parts and zones of the prostate gland?;

Answer 8

5 lobes- 1 anterior, 2 lateral, 1 medial, 1 posterior.

3 Histological zones- 70% peripheral zone, 25% central zone, 5% transition zone.

Question 9

What is the blood supply to the prostate gland?;

Answer 9

3 vessels (all branches from anterior division of internal iliac artery). Upper part- inferior vesicle artery. Middle part- middle rectal artery. Lower part- internal pudendal artery.

Question 10

What is the lymphatic drainage to the prostate gland?;

Answer 10

To obturator lymph nodes -> internal iliac lymph nodes.

Question 11

What are the parts of the adrenal gland?;

Answer 11

Zona golmerulosa. Zona fasciculata. Zona reticularis. Medulla

Question 12

What hormones are secreted by the adrenal gland?;

Answer 12

Zona golmerulosa- aldosterone (mineralocorticoids).
Zona fasciculata- cortisol (corticosteroids).
Zona reticularis- androgens.
Medulla- adrenaline (catecholamines)

Question 13

What is the arterial supply to the adrenal gland?;

Answer 13

Superior adrenal artery (branch of inferior phrenic artery).
Middle adrenal artery (branch of abdominal aorta).
Inferior adrenal artery (branch of renal artery)

Question 14

What is the venous drainage of the adrenal gland?;

Answer 14

Right adrenal vein drains into inferior vena cava. Left adrenal vein drains into left renal vein.