Unit 8: Urinary system Flashcards by Elizabeth McCabe

What is the main function of the kidney?

To filter blood and produce urine

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What structures does urine flow through from the nephron the the ureter?

Nephron
Renal papilla
Minor calyx
Major calyx
Renal pelvis
Ureter

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Draw a diagram to represent the different branches of the lumbar plexus and where the originate.

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What is the origin and function of the iliohypogastric nerve?

L1
Sensation to the skin of the hypogastric region and some motor innervation to the internal oblique and transverse abdominus

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What is the origin and function of the ilioinguinal nerve?

L1
Sensation to the labia/scrotum and some motor inervation of the internal oblique and transverse abdominus muscle

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What is the origin and function of the genitofemoral nerve?

Originates from L1 and L2
Provides sensory innervation to the skin of the genitals and the thigh
Motor innervation to the cremaster muscle

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What is the origin and function of the lateral cutaneous nerve of the thigh?

Originates from L2 and L3
Provides sensory innervation to the thigh

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What is the origin and function of the femoral nerve?

L2 L3 L4
Motor innervation to the anterior compartment of the thigh

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What is the origin and function of the obturator nerve?

L2 L3 L4
Motor innervation to the medial compartment of the thigh

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What structures make up the posterior abdominal wall?

The lumbar vertebrae
The pelvic girdle
The posterior abdominal wall muscles and their associated fascia

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What makes up the pelvic girdle?

The fused bones of the ischium, ileum and the pubis

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What are the five muscles of the posterior abdominal wall?

Quadratus lumborum
Psoas major
Psoas minor
Iliacus
Diaphragm

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What is the attachment of the quadratus lumborum?

Iliac crest to the iliolumbar ligament, L1 to L4 and 12th rib
Superiomedial fibre direction

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What is the function of quadratus lumborum?

Extension and lateral flexion of the spine
Flexion of rib 12 during inspiration (allows for more efficient contraction of the diaphragm)

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What is the innervation of quadratus lumborum?

T12 to L4

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What is the attachment of psoas major?

From transverse process of T12 to L5, travels under the inguinal ligament to fuse with the iliacus muscle and attach to the lesser trochanter of the femur

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What is the function of psoas major?

Lateral flexion of the spine
Flexion of the hip
Lateral rotation of the hip

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What is the innervation of psoas major? Nerve roots

L1 to L3

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What is the attachment and function of psoas minor?

Transverse process of T12 and L1
Flexion and lateral rotation of the thigh at the hip joint

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What is the innervation of the iliacus muscle?

Femoral nerve L2 L3 and L4

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What is a psoas sign?
What can a positive psoas sign indicate?

A positive psoas sign is when the patient experiences pain in their posterior abdominal wall on flexion of the hip
A right positive psoas sign can indicate appendicitis.

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Where is the fascia of the abdominal wall found?

Is continuous with the facis of the anterolateral abominal wall
Found between the pariteal peritoneum and the posterior abdominal wall muscles.

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What are the different sections of the fasica of the posterior abdominal wall?

is one continuous sheet but is named after the different muscles that it covers
- psoas fascia: streteches from lumbar vertebra to cover psoas major
-thoracocolumbar fascia

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What are the different layers of the thoracocolumbar fascia and how does this relate tho the muscles that they surround>

Split into anterior, middle and posterior layer
The quadratus lumborum muscle is found between the anterior and middle layers
The deep back muscles are found between the middle and posterior layers
The psoas major muscle in anterior the the anterior layer.

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Where do the different layers of the thoracocolumbar fascia meet and what ligaments are they continuous with?

Meet are the transversalis muscle and the internal oblique muscle Are continuous with the lateral arcuate ligament and the iliolumbar ligament

Draw a diagram to show the orientation of the different posterior abdominal wall fascia and how this relates to the muscles they surround

Quadratus lumborum instead of latissimus dorsi

Draw a diagram identifying the macroscopic features of the kidney

What bony structures provide protection to the kidney?

The ribs Rib 11 and 12 on left kidney Rib 12 on the right kidney

Describe the shape of the kidney.

Concave medial border - contains the hilum. Convex lateral border

What three muscles do the kidneys sit on?

Psoas major Quadratus lumborum Transverse abdominus

Where is the left renal vein located compared to the abdominal aorta?

Anterior Prevents the vein from being compressed by the abdominal aorta

Which kidney is often used in a transplant? Why?

Left kidney Longer renal vein, allows more room for the surgeon to access and utilise during transplant.

Where is the spleen in realtion to the left kidney?

Superior and slighlty posterior

How can you distinguish between the left and right adrenal glands?

Right is party hat shaped (pyramid) Left is demilune (cresent) shaped

Compare the lengths of the renal veins. Why is this?

The left renal vein is longer than the right Both are direct branches from the IVC, the IVC is located more towards the right

Compare the lengths of the renal arteries. Why is this?

The right renal artery is longer than the left. Borth are direct branches from the AA. The AA is located on the left side of the body

What is the arterial supply to the adrenal glands?

Arterial supply is identical to each adrenal gland. Inferior adrenal is a branch of the renal artery Middle adrenal is a branch of the abdominal aorta directly Superior adrenal is a branch of the inferior phrenic directly

What is the venous drainage of the adrenal glands?

The right adrenal gland is drained by the right adrenal vein which is a direct branch of the IVC The left adrenal gland is drained by the left renal vein which is a branch of the left adrenal vein which than drains into the IVC

What are the different main branches of the abdominal aorta?

Coeliac Superior Mesenteric Renal Gonadal Inferior mesenteric Common illiac Canned soup - really good in cans

What vertebral level are the renal arteries?

What vertebral level are the gonadal arteries?

What three places in the ureter are kidney stones most likley to form?

The uteropelvic junction (hilum of kindey) Where the ureter crosses over the common iliac artery The uterovesical junction (in the bladder)

What is the main component of the ureter?

Smooth muscle

What is the basic route of the femoral nerve?

Found inferior and lateral to psoas major, travels deep to the inguinal ligament to enter the anterior thigh by the femoral triangle

What is the basic route of the obturator nerve?

Found inferior and medial to the psoas major Transverse the pelvic cavity Exits by the obturator foramen

What are the different branches of the lumbosacral plexus and their nerve roots?

The superior gluteal L4 L5 S1 The inferior gluteal L5, S1, S2 The Sciatic Nerve L4 L5 S1 S2 S3 The posterior femoral S1 and S2 (can ignore this ) The pudendal nerve L2 L3 L4

What is the basic route of the pudendal nerve?

Exits the pelvis by the greater scaitic forman Reenter the pelvis by the lesser scaitic foramen, in between the sacrospinal and sacrotuberus ligament Enters the perineum

What does the pudendal nerve innervate?

THe external anal sphincter The external genitalia

What is a good way to locate the kidney using surface antomy?

Places fingers over the costal margin in the midaxillary line Place fingers over the spin at the same level Hold thumbs of both hand together Where thumbs meet is the location of the kidney

Desrcibe the location of the kidenys in relation to the transverse colon

Posterior to the splenic and hepatic flexure

Describe the different layers that surround the kidney (may draw a diagram)

Kidney is surrounded by the perirenal space (mainly adipose tissue and adrenal glands) This space is margined by the anterior and posterior renal fascia Outside this layer of fascia is pararenal space (adipose tissue) This space is border by the transversalis fascia posteriorly and the retroperitoneal organs and the parietal pleura eventually The pararenal space can be split into anterior and posterior sections by the lateral conal fascia (continuation of the posterior renal fascia)

What retroperitoneal organs is the kidney in close assocaition with?

The descending/ ascending colon (depending on side) The pancrease medially

Identify the key features in this crosssectional image.

1. psoas major 2. Quadratus lumborum 3. kidney

Identify the key features in this cross-sectional image

Purple is the kidney Blue dashed line marks the renal fascia Deep to the renal fascia is the perirenal space Superficial to the renal fascia is the pararenal space

What vertebral level is the hilum of the kidney?

What is the renal sinus?

Invagination in the kidney (near the hilum) Cavity containing the renal pelvis and the calyx

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

The segmental arteries (x5) The interlobar artery The arcuate arteries The interlobular arteries The afferent arterioles Glomerulus

What are the branches of the renal vein in the kidney from the glomerulus outwards?

The glomerulus The efferent arterioles The interlobular veins The arcuate veins The interlobar vein The segmental veins

What are the different layers surrounding the kidney? What vertebral level is this section at

What are the effects of sympathetic innervation of the bladder?

Increase capacity to hold urine Contracts the internal urinary sphincter

What are th effect of the parasympathetic innervation on the bladder?

Decreases capacity to hold urine Relaxes the internal urinary sphincter

From which direction does the blood supply to the ureter arise in the abdomen?

From renal arteries and some from the common iliac and gonadal

From which direction does the blood supply to the ureter arise in the pelvis?

Some from the commmon iliac and gonadal and rest from the internal iliac

Which part of the diaphragm connects to the vertebral columns what are the different vertebrae is attachest to?

Right crus L1 to L3 Left crus L1 to L2

What structures lie anterior to the kidney in these positions