URINARY Flashcards
Role of urinary
- Removes metabolic waste from blood by filtration and excretion
- Regulates plasma electrolytes and blood pressure (by renin angiotensin mechanism)
- Helps to stabilize the PH
- Involves with re-absorption
Vertebral level of kidneys
retroperitoneal position, at the level of T12-L3
anterior relations of the kidneys
SUPERIOR: DIAPHRAGM
RIGHT -suprarenal liver renal hilum and contact w/ duodenum SI; right colic flexure ureter
LEFT suprarenal contact w/ stomach and spleen left hilum contact w/ pancreas SI; descending colon ureter
INFERIORLY: QL
posterior relations of the kidneys
a12th rib
subcostal nerve
iliohypogastric nerve
iliolingual nerve
*psoas - QL - trans. abdo.
KIDNEY ARRANGEMENT
- renal capsule
- perinenal fat: surrounds kidney and glands
- renal fascia: covers QL, p maj.
- pararenal fat:
CORTEX
-renal columns: extensions and pass between pyramids
INNER MEDULLA
- pyramids: apex opens into papilla into the MINOR CALYX
- RENAL PAPILLA: opening of ducts, > calyx system
- Maj calyx join together to form RENAL PELVIS
- RENAL PELVIS GIVES RISE TO URETERS
RENAL LOBE
- interlobular arteries either side of pyramid
- both cortical and medullary layer (one pyramid)
Ureters
a: renal, ovarian/testicular/ abdo ao.
v: drain into renal and ovarian/testicular veins
n: symp + para; visceral sensory by T12 to L2
stone = referred pain to areas covered by T12 to L2
* posterolateral abdo, below 12th rib, to iliac crest area
= bakc pain
*genitalia: scrotum, labia majora areas pain + anterior thigh
CONSTRICTIONS = points of stone lodging
1) lower pole at ureter pelvic junction
2) pelvic rim, ureter crosses commoniliac vessels
3) ureter entrance to bladder
Kidney Hilum Structures
anterior-posterior
V
A
P
Vasculature of Kidneys
SEGMENTAL BRANCHES
to INTERLOBAR BRANCHES
to ARCUATE BRANCHES @ medulla and cortex junction
to INTERLOBULAR; non-anastamosing end-arteries
- lymphatic drainage: lateral aortic LN
- nerve: symp. RENAL PLEXUS T10-L1, sens T11-L5
BLADDER
superior surface
two inferolateral surface
base + apex
inner:
trigone, lined by smooth muscle, folded mucus lining
3 openings: x2 ureters and urethra; internal urethral orifice
outer:
MEDIAN UMBILICAL LIGAMENT @ inferolateral surface
origin: embryonic urachus
MEDIAN UMBILICAL FOLDS of parietal peritoneum, (they are occluded umbilical arteries)
inferior to epigastric vessels
Bladder in females and males
superior surface of bladder covered by visceral peritoneum
female:
VESICLE UTERINE POUCH
RECTOUTERINE POUCH
*peritoneal folds
POUCH OF DOUGLAS: pus accumulation; rectal route or posterior vaginal fornix
internal and external urethral sphincter - urethra is short
male: peritoneum covers bladdder POUCH OF DOUGLAS = rectovesical pouch preprostatic part prostatic part intermediate membranous part spongy penile part internal sphincter (smc, coming out bladder; autonomic) ext. sphincter (skel., supplied by pudenal nerve)
BLADDER VASCULATURE
a: int. iliac art. branches
v: into internal iliac veins
n:
T11-L2 (symp) = constrict internal sphinct.
S2-S4 (para) = motor to detrusor muscle
pelvic and hypogastric fibres = pain/distension
pudenal nerve = somatic
lymph:
ext. iliac LN > subrapubic
int. iliac LN > infrapubic
What innervates the detrusor muscle
S2-S4 para = constriction
meanwhile somantic PUDENDAL nv = external sphincter opening
Male prostatic urethra
recieves ejaculatory duct (vas deference + seminal vesicle)
What nerve constricts detrusor muscle during micturition?
Parasymp nerve (pelvic sphlancnic nerve)
