SUGER 2 - Kidneys Flashcards
Is the kidney a retroperitoneal or intraperitoneal organ? Why?
retroperitoneal - sits behind the peitoneum with only one layer of peritoneum on its anterior surface
At what level do the kidneys lie? What is the difference between the two?
T12-L3 - right is lower than left due to liver
Name the layers the kidneys are covered by
What is their purpose?
- renal capsule
- perirenal fat
- renal fascia
- pararenal fat
- purpose = anchor the kidney onto the posterior abdominal wall
What is the transversalis fascia? When its splits, what does it form?
Fascia in between the parietal peritoneum and the inner surface of the transversus abdominis
splits forming the renal fascia - enclosing the kidneys
What lies in front of the right kidney?
liver, duodenum, small intestines
What lies in front of the left kidney?
stomach, pancreas, spleen
Blood supply and venous drainage of the kidneys
- renal arteries (come off aorta at L1)
- renal veins
Where do the right suprarenal vein and right gonadal vein drain into?
IVC
Where do the left suprarenal vein and the left gonadal vein drain into?
left renal vein - (this then drains into IVC)
Outline the drainage of the medullary pyramids into the ureters
- medullary pyramids
- renal papilla (apex of pyramids)
- minor calyx
- major calyx
- renal pelvis
- ureter
What collects urine from the renal pyramids?
minor calyx
What do the ureters do?
transport urine from the kidneys/renal pelvis to the bladder
The glomerulus and the convoluted tubules are parts of the nephrons found in the..
renal cortex
What structures are found in the renal medulla?
- loop of henle
- collecting ducts
- collecting tubules
Where is the hilum of the kidneys and what does it contain?
- L1
- renal artery, renal vein, renal pelvis, nerves and lymphs
From anterior to posterior, name the structures at the hilum of the kidneys
- renal artery
- renal vein
- renal pelvis (retroperitoneal)
What are the 2 muscles that the kidney lies on?
- psoas major
2. quadratus lumborus
Outline the pathway of the ureters down to the bladder
- renal pelvis (lies on psoas)
- travels under gonadal veins
- travels medial to sacroilial joint
- curves into pelvis
- crosses anteriorly to bifurcation of common iliac artery
- travels UNDER vas deferens and uterine arteries
Where are the ureters in relation to the ovaries?
runs posterior to ovaries
What is the ureter made of and what does that allow it to do?
- smooth muscle
- allows peristaltic waves to propel urine into the bladder
Name some structures which the mesoderm gives rise to
kidneys, ureters, bladder, urethra
What do the adrenal glands consist of?
- capsule
- cortex
- medulla
Which fascia encloses the kidneys and the adrenal glands? What does it do?
renal fascia - attaches the glands to the crura of the diaphragm
The adrenal glands are covered in perirenal fat. What does this do?
seperates the glands from the kidneys
Name the 3 adrenal arteries that supply the adrenal glands
- superior adrenal arteries (arise from inferior phrenic artery)
- middle adrenal arteries (arises from abdominal aorta)
- inferior adrenal arteries (arises from renal arteries)
What is the venous drainage of the adrenal glands?
left and right adrenal veins
Layers of the adrenal cortex
- zona glomerulosa
- zona fasciculata
- zona reticularis
What overlaps and lies in front of the R adrenal gland?
- IVC overlaps it medially
- liver lies in front
Where does the L adrenal gland lie?
Behind the stomach and the pancreas
Which adrenal gland is harder to remove and why?
- right
- it lies underneath the liver and IVC crosses in front of it
What forms the IVC and at what level?
L & R common iliac veins at L5
What are the crura of the diaphragm?
two tendons that anchor the muscular part of the diaphragm to the lumbar vertebra
Name the 3 arcuate ligaments of the diaphragm
- medial arcuate ligament - thickening of fascia over the psoas major
- lateral arcuate ligament - thickening of fascia over the QL
- median arcuate ligament - formed by left and right crura - transmit aorta
What are the structures passing through the median arcuate ligament?
- aorta
- azygos vein - (drains posterior chest)
- thoracic duct
What structures pass through the lateral arcuate ligament?
- quadratus lumborus
- subcostal VAN
The psoas major and sympathetic trunk pass through the…
medial arcuate ligament
What is the posterior abdominal wall made up of?
- lumbar spine
- quadratus lumborum
- psoas major
Quadratus lumborum - O-I-A-In
- O: iliac crest
- I: inferior border of 12th rib
- A: extension and lateral flexion of vertebral column
- T12 - L4
Where is the quadratus lumborum and the psoas major located?
QL: laterally in post. abdominal wall
PM: near midline of posterior abd wall
Psoas major - O-I-A-In
O: T12-L5
I: lesser trochanter of the femur
A: flexion of the hip
In: L1 - L3
Where is the iliacus located? What does it combine with?
inferiorly on the posterior abdominal wall
- combines with psoas major to form the iliopsoas
Iliacus - O-I-A-In
O: surface of iliac fossa
I: lesser trochanter of the femur
A: flexion of the thigh
In: femoral nerve (L2-L4)
Psoas minor - O-I-A-In
O: T12-L1
I: superior ramus of pubic bone
A: flexes vertebral column
In: L1
Genitofemoral nerve (L1-L2)
- 2 branches
- GENITAL: passes through deep inguinal ring - supplies cremaster muscle
- FEMORAL: passes under inguinal ligament - sensory innervation of the thigh
What is a polar artery?
an accessory renal artery supplying the lower pole of the kidney
Where can an abdominal aortic aneurysm be palpated
epigastric region of abdomen
