Upper Urinary Tract Anatomy Flashcards
what is the main function of the kidney
production of urine
what part of the kidney is in contact with the peritoneum
only the anterior part as it is a retroperitoneal structure
where is the left kidney located
opposite T12-L2 vertebrae
where is the right kidney located
opposite L3-L1 vertebrae
which kidney is lower down and why
the right is lower down due to displacement by the liver
what ribs are posteriorly related to the kidneys
11 and 12
what regions of the abdomen are the kidneys in
the lumbar regions and upper quadrants
what is the medial part of the kidney called
the hilum
meaning route eg, route of the kidney where main vessels and structures enter
what vessels pass through the hilum on the kidney
renal vein - anterior
renal artery -in middle
ureter -posterior
what are the 3 anterolateral abdominal wall muscles and where do they lie in relation to the kidney
external oblique
internal oblique
transverses abdominis
lateral to the kidney
what are the 6 layers that surround the kidney anteriorly
visceral peritoneum paranephric fat renal fascia perinephric fat renal capsule
what muscles lie posterior to the kidney
left quadrates lumborum
left psoas major
what causes pain when kidneys increase in size
the tight layer of the renal capsule being stretched as it does not stretch well
what fat layer is liquid so allows the kidneys to float in it
perinephric fat
which fat layer is solid
paranephric fat
on what side to you find the aorta on CT
LEFT
where do you find the IVC on CT
RIGHT sits much more anterior to the aorta
what does the renal artery look like on CT
artery coming off the aorta and snaking round to the kidney on the left
what does the renal vein look like on CT
snaking vessel coming of the vena cava on the right
what are the dimensions of a normal kidney
12 cm long
6 cm wide
what should a regular kidney feel like
smooth
regular
firm
what structures does the right kidney sit behind (is posterior to)
the liver hepatorenal recess the 2nd part of the duodenum the ascending colon the right colic flexure
what structures does the left kidney sit behind (posterior to)
the stomach
tail of the pancreas
hilum of the spleen
the splenic vessels
what is the deepest part of the peritoneal cavity when the patient is lying on their back
the hepatorenal recess
the renal arteries run anterior to the renal veins true/false
false
renal veins run anterior to renal artery
the common iliac vein is anterior to the common iliac artery true/false
false
the common iliac artery runs anterior
the veins/arteries swap over as they get more posterior
at what level does the abdominal aorta bifurcate
the umbilicus
where does the lymph from the ureter drain into
lumbar and iliac nodes
what arterial vessels supply the ureter
branches from the: renal artery abdominal aorta common iliac artery internal iliac artery the vesicle artery (bladder)
what is an infrarenal AAA
An abdominal aortic aneurysm which starts inferiorly to the renal arteries
what is a suprarenal AAA
An abdominal aortic aneurysm which starts superiorly to the renal arteries
what causes renal artery stenosis when its associated with infrarenal AAA
atherosclerosis - causes both AAA and renal artery stenosis
what causes renal artery stenosis when associated with suprarenal AAA
occlusion of the proximal renal artery by the aneurysm
what are some anatomical variations seen in the kidneys
solitary kidney bifid renal pelvis bifid ureter and unilateral duplicated ureters retrocaval ureter horseshoe kidney ectopic pelvic kidney
what are some causes of a solitary kidney
agenesis (failure to develop)
nephrectomy due to pathology
nephrectomy due to donation
what 2 things are the main parts of the kidney
outer cortex
inner medulla
what is the most outside layer of the kidney
renal capsule
what makes up the inner medulla of the kidney
renal pyramids
what makes up the renal pyramids
nephrons - around 50,000 per pyramid
what gives the pyramids their striped appearance
regularly arranged nephrons
what do nephrons drain into
collecting duct
what do collecting ducts drain into
minor calyx
what does the minor calyx drain into
major calyx
what does the major calyx drain into
renal pelvis
what does the renal pelvis drain into
ureter
where in the urine drainage tubes is there a constriction
the pelviureteric junction
the wide renal pelvis becomes the narrower ureter
what are the 3 anatomical sites of ureteric constriction
pelviureteric junction
ureter crossing the common iliac arteries
ureteric orifice (opening into one mourner of the trigone on the floor of the bladder)
why are the anatomical sites of ureteric constriction of clinical importance
bc this is where renal stones (calculi) get stuck
where does lymph drainage from the kidneys go
LUMBAR NODES
how can we view renal calculi
on an x-ray
what 2 things can cause a ureteric obstruction
internal obstruction - renal calculus or blood clot
external compression - an expanding mass eg. tumour
what does the ureter do in response to an obstruction
as the walls are made of smooth muscle it initiates increased peristalsis above the blockage in an attempted to flush it into the bladder
why do renal calculi cause pain that comes and goes (colicky)
the waves of peristalsis from the urethra trying to flush out the stone comes and goes
what happens to urine when there is a blockage in the ureter
it back up in the tract towards the kidneys
what happens if there is obstruction in the bladder
unilateral or bilateral kidney problems
what happens if there is obstruction in the urethra
by lateral kidney problems
what happens to the kidneys if urine production continues and the pressure in the urinary tract continues to rise
it eventually exceeds the pressures favouring filtration at the glomerulus
this can lead to renal failure
what is renal failure
failure of the kidneys to adequately filter the blood to produce urine
