Upper Urinary Tract Anatomy Flashcards
How does the Urinary Tract pass urine from production to excretion?
The Kidneys produce urine which then moves to the ureters.
The Ureters drain the urine into the bladder.
The Bladder stores and empties the urine.
The Urethra excretes the urine (and semen in males)
What are the 2 parts of the Urinary Tract?
Upper Urinary Tract: Kidneys and Ureters
Lower Urinary Tract: Bladder and Urethra
Which parts of the Urinary Tract are located in the Abdomen?
Kidneys and Proximal Parts of the Ureters are located in the Retroperitoneum of the Abdomen
Which parts of the Urinary Tract are located in the Pelvis?
Distal Parts of the Ureters
Bladder
Proximal Part of the Urethra
Which parts of the Urinary Tract are located in the Perineum?
Distal Part of the Urethra
Which part of the Kidney is in direct contact with the Peritoneum?
Anterior Surface of the Kidney
What are the Medial Anatomical Relationships of the Kidney?
Medial aspect of the kidney has a Hilum.
This is where the: - Renal Vein - Renal Artery - Ureter enter and exit the Kidney
List the Renal Artery, Renal Vein and Ureter in the order to Most Anterior to Posterior
Renal Vein (Anterior)
Renal Artery
Ureter
What are the Lateral Anatomical Relationships of the Kidney?
Antero-lateral abdominal wall, which consists of the:
External Oblique
Internal Oblique
Transversus
List the Anterior Relationships of the Kidney from closest to the kidney to the furthest away
Renal Capsule (closest to the kidney) Perinephric Fat Deep Renal Fascia Paranephric Fat Visceral Peritoneum (furthest away)
What are the Posterior Anatomical Relationships of the Kidney?
Posterior Abdominal Wall, which consists of the Psoas Major and Quadratus Laborum muscles.
Ribs 11 and 12 (i.e. The Floating Ribs)
From which artery does the Renal Artery originate?
Abdominal Aorta
To which vein does the Renal Vein drain?
IVC
Are the IVC and Abdominal Aorta situated next to each other?
NO.
IVC sits more anterior to the Abdominal Aorta - important for CT Scans!
What are the Vertebral Levels for each kidney?
Left kidney: T12 - L2
Right kidney: L1 - L3 (situated lower due to the liver sitting superiorly)
Which Quadrant and Abdominal Region do the Kidneys lie in?
Right and Left Upper Quadrants.
Right and Left Lumbar/Flank Regions.
Should the Kidney be Smooth/Rough in Contour?
Smooth.
Rough is pathological.
Why do you ask the Patient to breathe in for Renal Examinations?
Breathing in will cause the kidneys to descend and therefore, be trapped between the palpating hands for examination.
How do you palpate the Right Kidney?
Anteriorly within the Right Upper Quadrant
How do you palpate the Left Kidney?
Posteriorly within the Left Lumbar/Flank Region, just inferior to Rib 12
What does the Left Kidney lie posterior to?
Stomach
Hilum of Spleen
Splenic Vessels
Tail of Pancreas
What does the Right Kidney lie posterior to?
Liver Hepatorenal Recess Ascending Colon Right Colic Flexure 2nd Part of the Duodenum
Why is the Hepatorenal Recess important?
This space between the Liver and Kidney is one of the deepest parts of the abdomen when the patient is supine, meaning that if there is abnormal fluid present, it will gather there.
What is the Arterial Supply to the Urinary Tract?
Renal Arteries supply the Kidneys
Ureters receive blood supply from Branches of the:
- Renal Arteries
- Abdominal Arteries
- Common Iliac Arteries
- Internal Iliac Arteries
- Vesical (Bladder) Arteries
Where does Lymph from the Urinary Tract drain?
Renal Lymph drains into the Lumbar Lymph Nodes, located around the Abdominal Aorta
Ureter Lymph Nodes drain into the Lumbar and Iliac Lymph Nodes
What is the difference between a Supra-Renal and Infra-Renal AAA?
Supra-Renal AAA is above the Renal Arteries
Infra-Renal AAA is below the Renal Arteries
Why is Renal Artery Stenosis associated with Infra-Renal AAA?
Atherosclerosis may cause Renal Artery Stenosis, which can lead to Infra-Renal AAA
Why is Renal Artery Stenosis associated with Supra-Renal AAA?
Supra-Renal AAA may lead to Renal Artery Stenosis
What are some Anatomical Abnormalities of the Urinary Tract?
Bifid Renal Pelvis Bifid Ureter Horseshoe Kidney Ectopic Pelvic Retrocaval Ureter
Name the 2 compartments of the Kidney
Outer Renal Cortex
Inner Renal Medulla
What is 1 Functional Unit of a Kidney called?
Nephron
Describe the drainage process of Urinary Filtrate from the Nephrons
Urinary Filtrate comes from the Nephron and initially collects in the Minor Calyx.
The Minor Calyces go on to form Major Calyces and eventually, the Renal Pelvis, through which the Urinary Filtrate is drained into the Ureter
What are the 3 Sites of Anatomical Constriction in the Urinary Tract?
- Pelviureteric Junction
- Ureter crossing the Iliac Bifurcation
- Ureteric Orifice
Why are the Sites of Anatomical Constriction important?
Renal Calculi (Stones) or Blood Clots could become lodged in these areas, leading to Ureter Blockage
If the Ureter is blocked, will both kidneys be affected?
No, only the corresponding kidney to the blocked ureter.
If the Bladder is blocked, will both kidneys be affected?
Yes
E.g. due to an Expanding Tumour compressing on both ureters
What are the consequences of Ureter Blockage?
Renal Failure
What is Hydronephrosis?
Renal enlargement due to fluid and pressure build-up in the kidney
What is the reason behind the Intense Pain in Hydronephrosis?
Enlarged kidney pressing on the rigid renal capsule
