The Urinary System Flashcards
What organs are apart of the urinary system
- RT and LT kidney
- A ureter for each kidney
- Urinary bladder
- Urethra
Kidneys and ureters make up the _____ urinary tract
upper
Urinary bladder and urethra form the _____ urinary tract
Lower
Anatomy of the kidneys..
- Bean-shaped
- Retroperitoneal
- Lie on each side of the spine between the peritoneum and psoas muscles
Kidneys lie in the lower thoracic and lumbar area between ______ thoracic and ______ lumbar vertebrae
12th and 4th
Liver places the _____ inferiorly
Right kidney
LK is ______ than the RK
Higher
Deep inspiration will cause the kidneys to move _____
Inferiorly by 1”
RK relationship to right adrenal
Right adrenal is anterior, superior, and medial to the RK
RK relationship with RLL
The right liver lobe is anterolateral
RK relationship with 2nd part of duodenum
2nd part of duodenum is anterior and medial
RK relationship with Hepatic flexure
Hepatic flexure and jejunum are anterior and inferior
LK relationship with tail of pancreas
Tail of panc is anterior and medial
LK relationship with left adrenal gland
Lt. adrenal gland is anterior, superior & medial
LK relationship with spleen
Spleen is anterior, superior & lateral
LK relationship with jejunum
Jejunum is anterior & inferior
LK relationship with stomach
-Stomach is anterior & superior
LK relationship with splenic flexture of colon
Splenic flexure of colon is anterolateral
Diagram of relationships to the kidneys
Diaphragm is _____ and ______ to the kidneys
Posterior and superior
Psoas muscle is ________ and ________ to the kidneys
Posterior and medial
The transversus muscle is _______ and _______ to both kidneys
Posterior and lateral
The quadratus lumborum muscle is _______ between _____ and ______
Posterior, between lateral and medial
Kidney size..
9 – 12 cm length
2.5 – 4 cm A/P
4 – 6 cm width
If a patient has only one kidney, it is larger than normal because of increased workload. This is called..
Compensatory Hypertrophy
Anatomy of the kidney
Several protective coverings of the kidney
- Renal capsule (true capsule)
- Perirenal fat
- Gerota’s fascia
- Pararenal fat
Renal capsule/true capsule/fibrous capsule is..
closest to the kidney (not attached to the kidney)
Perirenal fascia/ Perinephric fascia/fascia of gerota is..
continuous with the fat in the renal sinus
Pararenal fat/ pararenal body is..
A double layer of fat allows for movement
Two primary functions of the urinary system
Urine production and homeostasis
Other functions of the kidney
- Detoxification
- Maintain blood volume
- Maintain blood pressure
Each kidney functions..
Independently
Urine is made up of..
95% water
5% nitrogenous waste and inorganic salts (byproducts of metabolism)
Filtered blood pathway
Glomerulus > efferent arteriole > Peritubular capillaries > Interlobular vein > arcuate vein >interlobar vein > renal vein > IVC
The parenchyma of the kidney is ____
Cortex and medulla
Outer portion that contains the renal corpuscle and proximal and distal convoluted tubules of the nephron; area of filtration
Cortex
Bands of cortical tissue that separates the pyramids
Column of Bertin
Inner portion that contains medullary pyramids and loops of Henle; area of reabsorption
Medulla
Triangular shaped structures with a narrow tip (apex) and a broad base
Medullary pyramids
-Apex sits within minor calyx located in renal sinus
- Base is against the renal cortex
-Pyramids are separated by columns of Bertin
number of medullary pyramids =
number of minor calyces
normal level is 8- 10
Filtration happens in the
Glomerulus in cortex
Central portion of the kidney
Contains the collecting system composed of the infundibulum (minor and major calyces) and renal pelvis; secretion of waste products
Renal sinus
Reabsorption happens in the..
Medulla
Secretion happens in the..
Sinus- waste products
Calyx =
1
Calyces =
More than 1
Minor and major calyces
Infundibulum
Upper expanded end of ureter
Receives urine from major calyces
Renal pelvis
Medial portion of the renal sinus, where the renal artery enters the kidney and the renal vein and ureter exit
Renal Hilum
Main renal arteries arise from
Abd ao
Main renal arteries are..
Segmental
Interlobar
Arcuate
Interlobular
Renal veins drains into..
IVC
LRV receives blood from ________
Left suprarenal and gonadal veins
Blood flow through the kidney
Main renal artery
Segmental artery
Interlobar arteries
Arcuate arteries
Interlobular arteries
Afferent arteriole
Glomerulus of nephron
Blood flow leaving the kidney
Efferent arteriole
Peritubular capillaries
interlobular veins
Arcuate veins
Interlobar veins
Segmental veins
Renal vein
IVC
Adult renal capsule appears..
- Hyperechoic thin
- Continuous highly reflective line
Adult renal cortex appears…
- Mid gray
- Medium to low-level homogenous echo pattern
- Hypo- to iscoheoic to normal liver or spleen
- Hyperechoic “dots” are arcuate vessels
Adult renal medulla appears..
- triangular, round, or blunted anechoic areas (filled with urine)
- Anechoic pyramids have a distinctive and readily identifiable appearance
Adult renal sinus appears..
- Bright, echo-dense, ovoid central portion of the kidney with irregular borders
Pediatric renal cortex appears..
- Hyperechoic
Pediatric renal medulla is..
- Easily visible
- anechoic
Primary functions of the urinary system..
Urine production and homeostasis
Urinary system ______ metabolic waste and _______ blood volume and blood pressure
Excretes and maintains
Each kidney functions..
Independently
Filter approx ________ ml/day and produces approx ________ of urine/day
1,200 ml/day
1500 ml/day
What is a nephron
structural and functional unit of the kidney
Facts on nephrons
- over 1 million in each kidney
- uses osmotic pressure (high concentration to low concentration for metabolic products)
- Regulates the amount of water and soluble substances by filtering the blood
The glomerulus is where..
Part of the nephron where filtration takes place
Filtered blood pathway..
Glomerulus>efferent>peritubular capillaries>interlobular vein>arcuate vein>interlobar vein>renal vein>IVC
Normal adult kidney length..
9 -12 cm
Normal neonatal kidney length..
3.5cm -5.0cm
Normal uterus length..
28-34cm
Normal female urethra length..
4cm
Normal male urethra length..
20cm
Urinalysis lab tests
PH
Protein
Glucose
Ketones
Nitrate
Leukocytes
RBC’s
WBC’s
Epithelial cells
BUN measures..
Degree of renal function
Creatinine measures..
Degree of renal function; more sensitive than BUN
Normal Variants
- *Dromedary hump (common variant of cortical thickening)
- Hypertrophied column of Bertin
-*Double collecting system (renal sinus is divided and each sinus has a renal pelvis, double ureter, and larger kidney)
- Horseshoe kidney (Kidneys are connected usually at the lower poles, connection is termed an isthmus)
- Renal ectopia
- Crossed renal ectopia
- Crossed fused renal ectopia
- Extrarenal pelvis
- Junctional parenchymal defect
Sonographic applications
Masses
Cysts
Infection
Stones
Renal transplant
Trauma
Ureters are..
Tubular
Retroperitoneal
Ureters begin as a…
widening called the renal pelvis in the renal hilum
Ureters extend ______ along the psoas muscle from hilum to abdominopelvic and enter the urinary bladder _______
Inferiorly and posteriorly
3 layers of the ureter tissue..
- Inner mucosal layer
- Medial layer of smooth muscle
Outer fibrous layer
Rt ureter is _______ to duodenum, terminial ileum, rt. colic, ileocolic, and gonadal vessels
Posterior
Lt. Ureter is _______ to the colon, lt. colic, and left gonadal vessels.
Posterior
Ureteral peristalis transports..
Urine to the urinary bladder
In the male, the urinary bladder is ________ to seminal vesicles & rectum; _______ to prostate
Anterior and superior
In the female, the urinary bladder is _______ to vagina and rectum
Anterior
The urinary bladder is _____ to the symphysis pubis
Posterior
4 layers of urinary bladder
- Inner mucosa
- Submucosa
mucosa folds when bladder is empty,
become smooth when distended - Muscularis
Comprised of 3 layers of smooth muscle
called the detruser muscle - Outer serosa
On superior portion only, part of the
peritoneum
Adrenal glands are..
endocrine glands
Adrenal glands are located..
Superomedial border of the kidney
Normal adrenal in adults..
Should not be seen since it is hyperechoic
The adrenal glads are enclosed in..
Gerota’s fascia
Function of adrenal glands
- Works closely with the hypothalamus
- Stress , “fight or flight”; adrenaline (epinephrine) & noradrenaline : heart rate, - blood pressure
- Metabolism
- Kidney function
- Supplements sex hormones
- Blood sugar levels
- Sodium & potassium levels
Adrenal gland labs
Aldosterone
DHEA-S
Serum cortisol
sono appearance of adrenal glads in adult vs. neonate
Small, indistinct, low-gray structures that are hypoechoic relative to adjacent anatomy. In some cases, only the highly reflective fat that surrounds them is seen
Thin, hyperechoic core surrounded by a thick, anechoic zone
