Unit 10: Kidneys and urination Flashcards
What is the flow of waste from the kidney in the collecting system out of the body?
Minor calyx
Major calyx
Renal pelvis
Ureter
Bladder
Urethra
What ribs cover the posterior aspect of the kidney?
Ribs 11 and 12
What is the gross structure of he kidney?
Concave medial border
Convex lateral border
Adrenal gland on superior pole
Inferior pole
Hilum - VAN, lymphatics and ureter etc
What muscles does the kidney sit on posteriorly?
Quadratus lumborum
Psoas major
Transverse abdominus muscle
What is the role of the peri and pararenal fat?
Thermal insulation
Fixes into structure
Protection
Perirenal fat also invades into the hilum of the kidney.
What are the layers surrounding the kidney?
Perirenal fat
Renal fascia
Pararenal fat
What is the arterial blood supply to the adrenal glands?
- Superior suprarenal - branch from inferior prhrenic
- Middle suprarenal - branch from AA
- Inferior suprarenal - branch from renal artery
What is the venous drainage of the adrenal glands?
Left suprarenal vein - empties into left renal vein
Right suprarenal vein - empties directly into IVC
What is located anteriorly to the right kidney?
Liver
Second part of duodenum
Ascending colon and hepatic flexure
What are the important anatomical relationships to the left kidney?
Spleen - superior - located by splenorenal ligament
Anteriorly:
Splenic flexure and descending colon
Jejunum
Stomach
Pancreas
What are the division of the renal artery in the kidney?
Segmental arteries
lobar arteries
Interlobar arteries
Arcuate arteries
Interlobular arteries
Afferents capillary
(Glomerulus capillary)
Efferent capillary
peritubular capillaries
vesa recta (arounf loh)
interlobular veins …..
What are the three points on constriction along the ureter?
- When the ureter leaves the kidney
- When the ureter crosses the pelvic brim and crosses over the common illiac vein/artery
- Where it enters into the bladder
What are the walls of the ureter made of?
Smooth muscle - allows peristalsis
What region of the bladder do the ureters enter into?
THe base
(think of flat endge of triangle)
Why is the constriction of the ureter important clinically?
Areas where kidney stones are most likely to build up
This can be very painful and smooth muscle undergoes spasm
Cause hematuria
Urinary obstruction
Infection
Severe cases - renal failure
What is the blood supplt to the ureter?
Ureteric branch of the renal artery (proximally)
Ureter branch of gonadal artery (distal)
Ureter branch of superior mesenteric artery (more distally)
What forms the posterior abdominal wall?
The lumbar vertebrae, the pelvic girdle and the posterior abdominal wall muscles
What are the five posterior abdominal wall muscles?
The quadratus lumborum
Iliacus
Psoas major
Psoas minor
Diaphragm
What is the function, innervation and location of the illiacus muscle?
F: flexion and lateral roation of the thigh at the hip joint
Innervation: femoral nerve L2 to L4
Basic location: surface of illiac fossa and AIIS combines with tendons of psoas to insert on the lesser trochanter
What is the function, innervation and location of the Psoas major?
F: fllexion of the hip, lateral flexion of the vertberal coloum
I: anterior rami of L1-L3
L: transverse process of vertebral bodies of T12 to L5, travel deep to inguinal ligament and attaches to lesser trochanter of femur
What is the function, innervation and location of the of the psoas minor?
F: flexion of the vertberal column
I: antior rami of L1 spinal nerve
L: vertebral bodies of T12 and L1, attaches to pectineal line of the pubic bone
What is the function, innervation and location of the quadratus lumborum?
F: extension and lateral flexion of the vertberal column, depress and fix the 12th rib during inspiration
I: Anterior rami of T12-L4
L: superior from 12 rib, transverse process of L1-L4, inferiorly to the illac crest
What are the different components of fascia in the posterior abdmonial wall?
Psoas fascia - most anterior and covers psoas major
Thoracocolumbar fascia - divided into posterior, middle and anterior layers, deep back muscles are contained within the middle and posterio layers, the quadratus lumborum is between the middle and anterior
THis fascia fuses with the fascia of the internal oblique and transverse abdominal laterally, as it does so it covers latissimus dorsi.
Superiorly thickens to form the lateral arcuate ligament
What structures does urine flow through within the kidney after exiting the nephron?
Nephron
Renal papilla
Minor calyx
Major calyx
Renal pelvis
Ureter
What are some important gross features of the kidney?
Renal pyramids (nephrons)
Renal columns (connective tissue)
Renal cortex
Renal medulla
Renal capsule
What is the venous supply to the kidney?
What renal vein is longer?
Left renal vein drains into IVC (longer)
Right renal vein drains into IVC