Topography of the Urinary System

Question 1

What is the urinary system made up of

Answer 1

kidneys, ureters, urinary bladder, and urethra

Question 2

What is the main function of the kidney (3)

Answer 2

• remove unwanted substances from the body, which are then eliminated via the urine (produces urine)
• the kidney has an endocrine function through the production of renin and erythropoietin.
• when circulating glucose levels are low, the kidney is a site of gluconeogenesis.

Question 3

Describe the pathway of urine

Answer 3

Urine passes from the kidneys via the ureters to the bladder for short-term storage prior to micturition (pissing), when urine passes from the bladder to the exterior via the urethra.

Question 4

Describe the shape & location of kidneys

Answer 4

Bean-shaped retroperitoneal organs located posterolaterally in the paravertebral gutters. They extend from vertebral levels T12 to L3

Question 5

Why is the right kidney at a different level to the left kidney

Answer 5

The right kidney is at a slightly lower level due to the large right lobe of the liver

Question 6

At what level in the hilum of the kidney found

Answer 6

The hilum of the kidney lies at the level of L1.

Question 7

What are the kidneys enclosed by

Answer 7

Both kidneys are enclosed by a fibrous capsule and are surrounded by perinephric fat and renal fascia

Question 8

Describe the internal structure of kidneys

Answer 8

Each kidney has an outer cortex and an inner medulla. In the medulla, there are pyramids that converge at the minor calyces. Major calyces unite to form the renal pelvis, which then continues as the ureter.

Question 9

What structures enter the hilum of the kidneys

Answer 9

From anterior to posterior, these structures are: the tributaries of the renal vein, branches of the renal artery and the renal pelvis

Question 10

What are the ureters and what are the 3 parts

Answer 10

2 long muscular tubes (25-30 cm) that convey small volumes of urine from the kidneys to the bladder by peristalsis. They have three parts: abdominal, pelvic, and intravesical.

• abdominal ureter: from therenal pelvisto the pelvic brim
• pelvic ureter: from the pelvic brim to the bladder
• intravesicalorintramural ureter:within the bladder wall

Question 11

which part of the ureter is retroperitoneal

Answer 11

abdominal part

Question 12

describe the pathways of the ureters (could be an SAQ)

Answer 12

• Each ureter runs inferiorly from the renal pelvis anterior to psoas major (in radiographs, this will be seen in line with the tips of the transverse processes of vertebrae L1 to L5), sacroiliac joint and ischial spine.
• It then passes anterior to the bifurcation of the common iliac arteries.
• On the left side, the ureter enters the pelvis at the apex of the sigmoid mesocolon.
• From the ischial spine, it runs anteromedially along the pelvic floor to enter the base of the urinary bladder.
• The pelvic part crosses the uterine artery in females and the ductus deferens in males.

Question 13

Where does the pelvic ureter cross in males vs females

Answer 13

The pelvic part crosses the uterine artery in females and the ductus deferens (sperm duct) in males.

Question 14

what are the 3 sites where the ureters are narrowed & what’s the clinical correlation of this

Answer 14

1. pelvic-ureteric junction
2. crossing of the pelvic brim (where common iliac bifurcates)
3. uterovesical junction

Ureteric stones can become lodged in these locations, causing ureteric pain. This is referred pain that typically radiates from the loin to the groin.

Question 15

What is the urinary bladder

Answer 15

a muscular reservoir of urine

Question 16

Is the bladder extra or retro peritoneal

Answer 16

it is an extraperitoneal organ situated in the pelvic cavity in adults, posterior to the pubic symphysis

Question 17

how does the location of the bladder change with age

Answer 17

At birth, it is abdominal, but descends into the pelvic cavity with age, and becomes fully pelvic in adults.

Question 18

what is the average adult bladder capacity

Answer 18

Bladder capacity in normal adults is variable, being approximately 300 ml.

Question 19

where can you access the bladder when it is filled

Answer 19

When overfilled, it extends into the abdominal cavity, where it can be accessed extra peritoneally.

Question 20

where do ureters enter the bladder

Answer 20

superolateral angles

Question 21

• where does the urethra start

Answer 21

inferior angle

Question 22

what is the superior surface of the bladder covered with

Answer 22

peritoneum

Question 23

what muscle supports the inferolateral surfaces

Answer 23

• leaver ani

Question 24

where is the neck of the bladder

Answer 24

where the two inferolateral surfaces and base merge; directed inferiorly; the most fixed part of the bladder.

Question 25

Empty urinary bladder