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Semester 4 Anatomy > The Urinary System > Flashcards

The Urinary System Flashcards

1
Q

What vertebral levels do the kidneys lie at?

A

T12-L3

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2
Q

Which kidney lies slightly lower and why?

A

The right one, due to the presence of the liver

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3
Q

What are the anterior relations of the right kidney?

A 
Suprarenal Gland 
Liver
Duodenum (2nd part)
Right colic flexure 
Small intestine
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4
Q

What are the anterior relations of the left kidney?

A 
Suprarenal Gland
Spleen
Stomach 
Pancreas 
Left colic flexure 
Descending colon 
Jejunum
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5
Q

What are the posterior relations of the left and right kidney?

A

Diaphragm
Psoas major, quadratus lumborum, transversus abdominus
Ribs (right 12th) (left 11-12th)
Sub costal, iliohypogastric and ilioinguinal nerves

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6
Q

What are the kidneys surrounded by (from internal to external)?

A

Renal capsule
Perirenal (periphrenic fat)
Renal fascia
Pararenal (paraphrenic fat)

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7
Q

What are the structures that enter at the hilum of the kidney (from front to back)?

A

Renal vein
Renal artery
Ureter

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8
Q

Describe the passage of drainage from the renal pyramid to the ureter?

A

Renal papilla
Minor calyx
Major calyx
Renal pelvis

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9
Q

What are renal columns?

A

They separate each renal pyramid

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10
Q

What is a renal lobe?

A

An area of the kidney consisting of a renal pyramid and its overlying renal cortex

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11
Q

What vertebral level do the renal arteries arise at?

A

Between L1 and L2

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12
Q

Which renal artery is longer and why?

A

Right renal artery, because the abdominal aorta lies slightly to the left of the midline

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13
Q

Which of the renal veins is longer?

A

The left renal vein, because the IVC lies slightly to the right of the midline

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14
Q

Does the right renal artery pass the IVC anteriorly or posteriorly?

A

Posteriorly

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15
Q

What are the 5 segmental branches of the renal artery?

A 
Apical (superior)
Anterosuperior
Anteroinferor 
Inferior 
Posterior
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16
Q

Describe the pathway of arterial supply once it enters the kidney

A

Segmental arteries > Interlobar arteries > arcuate arteries > interlobular arteries > afferent arterioles >glomerulus > efferent arterioles > vasa reta/peritubular capillaries

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17
Q

What is the difference in the blood supply in the cortical nephron compared to that of the juxtamedullary nephron?

A

Cortical nephron - peritibular capillaries

Juxtamedullary nephron - vasa recta

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18
Q

What is the venous drainage of the kidney?

A

The vasa recta and peritubular capillaries both drain into:

  • Interlobular vein
  • arcuate vein
  • Interlobar vein
  • Renal veins
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19
Q

What is the lymphatic drainage of the kidneys?

A

They drain into the para-aortic lymph nodes (located around the renal artery)

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20
Q

What is the sympathetic innervation of the kidney?

What does it cause?

A

Least splanchnic nerve
Aorticorenal ganglion

Sympathetic stimulation leads to constriction of the vessels

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21
Q

How long are the ureters?

A

25cm

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22
Q

What are the three most likely points for kidney stones to become lodged and why?

A

Uteropelvic junction
Pelvic inlet - As the ureters cross the common iliac vessels
Ureter entrance to bladder

These are the 3 constriction points along the course of the ureters

23
Q

How much urine can the bladder hold?

A

Up to 600mL

24
Q

How is the bladder connected to the umbilicus?

A

From the median umbilical ligament by the apex

25
Q

How is the neck of the bladder fixed in place in males and females?

A

Males: puboprostatic ligament
Females: pubovesical ligament

26
Q

Which relations to the bladder are the same in both males and females?

A

Anterior and lateral relations

27
Q

What is the area called on the bladder which has smooth walls?

Where is it located on the bladder

A

The trigone

On the fundas/base

28
Q

What are the three openings of the trigone

A

Two superior - right and left ureters

One inferior - exit of urethra

29
Q

What is the muscle of the bladder called?

What kind of muscle is this?

A

Detrusor muscle

Specialised smooth muscle

30
Q

How does the internal urethral sphincter differ in males and females?

A

Males - smooth muscle fibres under autonomic control

Female - functional sphincter with no muscle present, formed by the anatomy of the bladder neck

31
Q

What kind of control is the external urethral sphincter under?

A

Voluntary control

32
Q

What is the arterial supply to the bladder?

A

Internal iliac artery branches:

  • superior vesicular
  • inferior vesicular (males only)
  • vaginal arteries (females only)
33
Q

What is the venous plexus called that drains the bladder?

A

Vesical venous plexus

34
Q

Where does the sympathetic nerve supply to the bladder come from?

A

Preganglionic fibres arise from spinal cord T10-L2
Fibres are transmitted in the lumber splanchnic nerves
Preganglionic fibres terminate in the hypogastric ganglion
Postganglionic fibres arise from the nerve cell bodies in the hypogastric plexus

35
Q

What does sympathetic innervation do to the bladder?

A

Relaxes the detrusor muscle
Closes the internal sphincter

Promotes urine retention

36
Q

Where does the parasympathetic supply to the bladder arise?

A

From spinal cord segments S2-S4
Fibres are transmitted in the pelvic splanchnic nerve
Fibres pass through the inferior hypogastric plexus without synapsing

37
Q

What does parasympathetic supply to the bladder result in?

A

Contraction of the detrusor muscle
Inhibition of internal sphincter - causes it to open

This stimulates micturition

38
Q

Which nerve supplies somatic innervation to the bladder?

Which part does it innervate?

A 
Pudendal nerve (S2-S4)
Innervates the external urethral sphincter
39
Q

What is the pelvic pain line?

What kind of pain afferents come from above and below?

A

Above the pelvic pain line - pelvic organs in contact with peritoneum, pain follows sympathetic fibres
Below the pelvic pain line - pelvic organs that do not contact the peritoneum, pain follows parasympathetic fibres

40
Q

How long is the female urethra?

A

4cm

41
Q

What are skene’s glands?

A

Two small paraurethral mucous glands associated with the lower end of the female urethra

42
Q

How many times does the male urethra bend along its course?

A

Twice

43
Q

How long is the male urethra?

A

20cm

44
Q

What are the 4 parts of the male urethra?

A

Preprostatic
Prostatic
Membranous
Spongy

45
Q

In which part of the male urethra is the internal urethral sphincter?

A

Preprostatic part

46
Q

In which part of the male urethra is the seminal colliculus located?

A

The prostatic part

47
Q

Where do the prostatic glands drain into the urethra?

A

At the prostatic sinuses in the prostatic part of the urethra lateral to the urethral crest

48
Q

Which part of the male urethra contains the external urethra sphincter?

A

Membranous part

49
Q

Which part of the male urethra do the bulbourethral glands open into?

A

The spongy part

50
Q

What are the four histological zones of the prostate?

A

Central zone
Transitional zone
Peripheral zone
Fibromuscular structure

51
Q

Which zone of the prostate is prostate carcinoma most likely to occur?

A

The peripheral zone

52
Q

In which zone of the prostate would you most likely get benign hyperplasia (BPH)?

A

Transitional zone

53
Q

Which zone of the prostate is felt on a DRE through the rectum?

A

The peripheral zone

Semester 4 Anatomy (9 decks)

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