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Anatomy class > Unit 10: Kidneys and urination > Flashcards

Unit 10: Kidneys and urination Flashcards

1
Q

What is the flow of waste from the kidney in the collecting system out of the body?

A

Minor calyx
Major calyx
Renal pelvis
Ureter
Bladder
Urethra

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2
Q

What ribs cover the posterior aspect of the kidney?

A

Ribs 11 and 12

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3
Q

What is the gross structure of he kidney?

A

Concave medial border
Convex lateral border
Adrenal gland on superior pole
Inferior pole
Hilum - VAN, lymphatics and ureter etc

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4
Q

What muscles does the kidney sit on posteriorly?

A

Quadratus lumborum
Psoas major
Transverse abdominus muscle

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5
Q

What is the role of the peri and pararenal fat?

A

Thermal insulation
Fixes into structure
Protection
Perirenal fat also invades into the hilum of the kidney.

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6
Q

What are the layers surrounding the kidney?

A

Perirenal fat
Renal fascia
Pararenal fat

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7
Q

What is the arterial blood supply to the adrenal glands?

A
  1. Superior suprarenal - branch from inferior prhrenic
  2. Middle suprarenal - branch from AA
  3. Inferior suprarenal - branch from renal artery
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8
Q

What is the venous drainage of the adrenal glands?

A

Left suprarenal vein - empties into left renal vein
Right suprarenal vein - empties directly into IVC

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9
Q

What is located anteriorly to the right kidney?

A

Liver
Second part of duodenum
Ascending colon and hepatic flexure

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10
Q

What are the important anatomical relationships to the left kidney?

A

Spleen - superior - located by splenorenal ligament

Anteriorly:
Splenic flexure and descending colon
Jejunum
Stomach
Pancreas

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11
Q

What are the division of the renal artery in the kidney?

A

Segmental arteries
lobar arteries
Interlobar arteries
Arcuate arteries
Interlobular arteries
Afferents capillary
(Glomerulus capillary)
Efferent capillary

peritubular capillaries
vesa recta (arounf loh)
interlobular veins …..

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12
Q

What are the three points on constriction along the ureter?

A
  1. When the ureter leaves the kidney
  2. When the ureter crosses the pelvic brim and crosses over the common illiac vein/artery
  3. Where it enters into the bladder
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13
Q

What are the walls of the ureter made of?

A

Smooth muscle - allows peristalsis

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14
Q

What region of the bladder do the ureters enter into?

A

THe base

(think of flat endge of triangle)

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15
Q

Why is the constriction of the ureter important clinically?

A

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

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16
Q

What is the blood supplt to the ureter?

A

Ureteric branch of the renal artery (proximally)
Ureter branch of gonadal artery (distal)
Ureter branch of superior mesenteric artery (more distally)

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17
Q

What forms the posterior abdominal wall?

A

The lumbar vertebrae, the pelvic girdle and the posterior abdominal wall muscles

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18
Q

What are the five posterior abdominal wall muscles?

A

The quadratus lumborum
Iliacus
Psoas major
Psoas minor
Diaphragm

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19
Q

What is the function, innervation and location of the illiacus muscle?

A

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

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20
Q

What is the function, innervation and location of the Psoas major?

A

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

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21
Q

What is the function, innervation and location of the of the psoas minor?

A

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

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22
Q

What is the function, innervation and location of the quadratus lumborum?

A

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

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23
Q

What are the different components of fascia in the posterior abdmonial wall?

A

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

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24
Q

What structures does urine flow through within the kidney after exiting the nephron?

A

Nephron
Renal papilla
Minor calyx
Major calyx
Renal pelvis
Ureter

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25
What are some important gross features of the kidney?
Renal pyramids (nephrons) Renal columns (connective tissue) Renal cortex Renal medulla Renal capsule
26
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
27
What is the arterial supply to the kidney? Which artery is longer?
Right renal artery - from AA - longer Left renal artery - from AA - shorter
28
What are the different branches of the renal artery within the kidney?
Segmental arteries Lobar Interlobar artery Arcuate artery Interlobular artery Afferent arteriole - glomerulus - efferent arteriole
29
What level is the renal hilum?
L2
30
What are the different layers surrounding the kidney?
Perirenal fat - margined off by the anterior and posterior renal fascia Pararenal fat - this is borders by the transversalis fascia posteriorly and the retroperitoneal organs and eventually the parietal peritoneum anteriorly.
31
How can you differentiate between the right and left adrenal gland?
Right is party hat shaped or pyramid shaped Left is shaped like a demilune
32
What is the venous drainage of the adrenal gland?
Right suprarenal - from IVC directly Left supradrenal - from renal vein
33
What is the arterial supply to the right adrenal gland?
Each adrenal gland has Superior adrenal artery - from inferior phrenic artery Middle adrenal artery - from the AA Inferior adrenal artery - from the renal artery
34
What structures overly the right kidney?
Liver most superiorly Duodenum near the hilum Hepatic flexure mid laterally Ileum - over the inferior pole
35
What structures overly the left kidney?
The spleen most superiorly The stomach - medial and superiorly The colic flexure - mid laterally Descedncing colon - lateral and inferiorly jejunmun - inferior pole
36
Where are the three constrictions over the ureter?
1) the uteropelvic junction (helim of the kidney) 2. where it crosses the pelvic brim over the common illiac artery 3. the utero vesical junction (entrance to the bladder)
37
Where are kidney stones most likley to be found? Why?
The three constrictions of the ureter The renal calcyces The renal pelvis Due to their narrower diamter
38
What is the ureter blood supply?
Abdominally from the common illiac mainly Middle - gonadal arteries branches (contributes to above and below) pelvic region - internal illiac or vesical artery branches
39
What is the function of the bladder?
Temporary storage or urine and assist in expulsion of urine
40
What features allows the bladder to accomodate up to 400-600ml of urine?
Folded internal lining - rugae - allow expansion of bladder wall
41
What are the external features of the bladder?
Apex - points superiorly towards the pubic symphysis Body - main part located between the apex and the fundus Fundus of base - triangle shape most posteriorly Neck - formed by convergence of fundus and the two inferolateral surfaces, is continuous with the urethra
42
Where do the ureters open into the bladder?
Enter by orifices, in the fundus of the bladder Orficies are marked internally by the trigone (smooth muscle wall due to different embryological origin) enter at an angle and are relatively superior.
43
What is the key musculature in the bladder?
Detrusor muscle - smooth muscles orientated in multiple direction so retains structural integrity when stretched
44
When might the detrusor mucsle become hypertrophic?
Conditions that onstruct urin flow such as prostate enlargement Increase work of detrusor to generate more flow to help pass urine
45
What is the main arterial supply of the bladder?
Superior vesical branch of the internal illiac artery is found in both sexes - may also have contribution from the obturator and inferior gluteal arteries Females - contribution from vaginal artery Males - inferior vesical artery
46
What is the venous drainage of the bladder?
Vesical venous plexus - empties into the internal illiac veins Males - this is continuous with the prostate venous plexus in teh retropubic space (recives blood from dorsal vein of penis)
47
How does the bladder shape change when filling?
Extend superiorly - becomes suprapubic
48
How does the bladder shape change during pregnancy?
Early - increased urination due to growing foetus Mid pregnancy - little change - may return to normal Later pregnancy - increased urination - as foetus descends Due to expansion of uterus, push the bladder anteriorly and inferiorly but pulled with umbilcus by the median umbilical ligament so becomes narrow/flattend. The urethra become streteched and distored. Muscles of the bladder become less effective - lead to stress incontinence - as are stretched
49
What are the different peritoneal pouches?
Females Rectouterine - between uterus and rectum Vesicouterine - between uterus and rectum Males Rectovesical - between rectum and bladder
50
What is the location of the internal urethral sphincter?
Males - circular smooth muscle, autonomic control located in neck of bladder wall as fuses with urethra Females - functional sphincter (no muscle), formed by the bladder neck and the proximal urtethra
51
What is the location of the external urethra sphincter?
Skeletal muscle found in the perineal membrane
52
What is the innervation to the bladder?
Sympathetic - hypogastric nerve T12-L2 relax detrusor Parasympathetic - pelvic splanchinc nerve S2,3,4 Somatic - internal pudendal nerve S2,3,4 - contract external urethral sphincter Sensory afferents - from brain to bladder
53
What ligaments hold the proximal urethra/ neck of bladder in place?
Females - pubovescial ligaments Males - puboprostate ligaments Wraps around the urethra and anchors to the pubic bone
54
Describe the passage of the female urethra?
4cm long Curved course Pass inferiorly through the pelvic floor into the perineum, passes through the deep perineal pouch and perineal membrane (receives conncetionf from paraurethral gland) before opening into the vestibule between labia minora Opening is superior and posterior to the clitoris, anterior to vagina
55
Describe the passage of the a=male urethra.
Long - 20 cm Bends twice along course Pass through prostate, deep perineal pouch, perineal membrane and immediately etners the root of the penis by being anteriorly in its course (this angle changes when the penis is flaccid) Has a pre-pubic and infrapubic angle - this creates a 90 degree angle between the membranous and spongy urethra
56
What are the different sections of the male urethra?
Preprosatic Prostatic - pass through prostate Membranous - through perineal membrane Spongy or penile
57
Label the bladder
Ureters opening of ureters Trigone Urethra INternal urethral orifice
58
Label the bladder
Trigone Superior surface Median umbilical ligament Apex Inferolateral surfaces Urethra Base Ureters
59
Label the posterior abdominal wall muscles
Green - quadratus lumborum Yellow - illiacus Pink - psoas minor Red - psoas major
60
label this image
Seminal vesicle Ductus defernes Prostate Ejaculatory duct Urethra Bladder Anal aperture Rectum
61
Label this image
Uterine tube Ovary Uterus Vagina Bladder Urethra Anal apeture Anal canal Rectum
62
What are the different angles of the uterus?
Anteflexion - describes how body of uterus points anteriorly and superiorly over the bladder Angle of anteversion - angle pointing inferiorly from the cervix to the vaginal canal
63
What are the different terms used to describe the location of the uterus?
Retroversion - fundus points superiorly - increased risk of prolaspe Retroflexion - fundus points posteriorly, can compress onto rectum
64
Label the image of the male urethra and associated structures
Internal urethral sphincter Prostate External us Penis Navicular fossa External urethral orifice Spongy urethra Membranous urethra Bulbo-urtheral gland and duct Perineal membrane Deep perineal pouch Prostatic part of urethra Preprostatic part of urethra
65
Label the image of the female urethra and the associated structures
External urethral sphincter Deep perineal pouch perineal membrane Glans clitoris External urethra orifice Duct of paraurethral gland Vaginal opening Greater vestibular gland Paraurethral gland

Anatomy class (42 decks)

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