Urinary 1.2 Flashcards
1) What are the 4 main components of the urinary system?
2) Whre is the urinary system located?
3) What does it mean when the urinary system is described as RETROPERITONEAL?
1) kidneys, ureters, bladder, urethra
2) Abdominopelvic caviy
3) Located behind peritoneal lining of abdominal cavity
1) What is the shape of the kidneys? Where are they located in terms of vertebral levels?
2) WHY IS THE RIGHT KIDNEY POSITIONED LOWER THAN THE LEFT KIDNEY?
1) Bean shaped. Between L3 and T11/T12
2) Right kidney lower because liver on right side taking up sapce, pushing kidney down
1) What is the transpyloric plane?
1) Axial plane located midway between jugular notch + superior border of pubic symphysis
1) What organ marks the aneterior surface of the right kidney?
2) What organs mark anterior surface of left kidney?
3) What structures mark posterior surface of both kidneys?
1) Liver, duodenum, colon
2) Stomach, spleen, pancreas, colon
3) Diaphragm, psoas major, 11th and 12th, rib, TRANSVERSUS ABDOMINIS MUSCLE, QUADRATUS LUMBORUM MUSCLE
- THORACOLUMBAR FASCIA (A strong connective tissue that covers and supports the muscles of the lower back., separates the muscles of the back, particularly the erector spinae and quadratus lumborum)
State the three posterior muscular relations of the kidney
1) What is perinephric (perirenal) fat and where is it located?
2) What is the role of perinephric fat?
3) What is the renal fascia?
True or false. All of the urinary tract is retroperitoneal
1) Accumulation of extraperitoneal fat that completely surrpounds the kidney and the outside renal capsule
(between renal capsule + renal fascia)
2) Cushioning, protect kidneys, structural support + INSULATES
3) Thin layer of connective tissue, encloses perinephric fat + provides additional support for kidneys
1) What is the function of ureters?
2) What is the ureterpelvic junction?
3) What anatomical structures to ureters cross at the pelvic brim?
4) Where do the ureters descend?
5) How is the renal pelvis formed?
1) Tranposrt urine from kidneys to bladder
2) Point where renal pelvis becoems ureter
3) External iliac arteries
4) Medial aspect of psoas major muscle
5) Condensation of sevral minor calices (The minor calices are small funnel-shaped structures that collect urine from the renal pyramids (the parts of the kidney that filter blood and produce urine).
Each minor calyx collects urine from a single renal pyramid.)
Why is the location of ureters clinically significant?
It shows us where kidney stones may lodge
It shows us where the ureters are at risk during surgical procedures such as hysterectomy.
How can we determine where the ureters would be located?
you can measure 6cm from the spine and then measure all the way down to the pelvis.
1) What are the three points of constriction in the ureters?
2) Why are the constriction points clinically significant?
3) What is the uretopelvic junction and wht is it important?
There are 3 common sites of relative constriction where renal stones can lodge due to the non-uniformity of the ureter lumen.
1) Uretopelvic junction
Pelvic inlet
Entrance into bladder
2) Common sites where kidney stone can become lodged, causing pain + urinary obstruction
3) Renal pelvis narrowws into ureter. Kidney stones can get stuck at this point
The vasculature of the left kidney (anterior view)
Be aware of locations of renal vein, renal artery, ureter, abdominal aorta…
1) Where do the renal arteries arise from?
2) Where do renal veins drain to?
3) Why is the left renal vein longer than right renal vein ?
4) What is the clinical significance of the left renal vein passing under the SMA?
1) Lateral branches of aorta, arise below superior mesenteric artery
2) IVC (pass anterior to renal arteries)
3) Because IVC lies slightly to the right, left renal vein needs to be longer to reach left kidney. PASSES UNDER SMA
4) The left renal vein can become compressed between the superior mesenteric artery and the abdominal aorta.
This is called Nutcracker Syndrome.
What is nutcracker syndrome
Path of blood flow through renal blood vessels
1) What is the function of the urinary bladder?
2) Where is the bladder located when empty and when full?
3) What anatomical structure crosses over the ureter in males?
4) What anatomical structure crosses over femail ureter?
1) Subperitoneal reservoir, for storing urine
2) When empty: lesser pelvis. When full, extends into abdomonal cavity
3) Ductus deferens, crosses over ureter posterior to urinary bladder
4) Uterine artery crosses over ureter, lateral to cervix (BLADDER LIES ANTERIOR TO UTERUS IN WOMEN)
When is the bladder palpable?
- During filling, bladder rises from pelvis to abdomen, so it is only palpable when adequately
1) What is the bladder trigone?
2) What is the vesico-uretic junction?
1) Smooth, TRIANGULAR AREA inside bladder, marked by openings of ureters (two openings at the vesico-uretic junctions) interneal urethral orifice (this is a single opening where urethra exits bladder)
2) Where ureter enters bladder, angled to prevent urine flowing backwards
1) What happens to the peritoneum when the bladder is empty
2) What happens to the peritoneum when the bladder is full?
3) What allows the peritoneal cavity itself do not get into direct contact with the urine?
1) Peritoneum covers SUPERIOR SURFACE of bladder when empty
2) Expands upwards into abdominal cavity, pushes peritoneum further upwards
3) Bladder is sub peritoneal. Beneath peritoneal layer
1) What is the relationship between the bladder, uterus and rectum in the female pelvis?
2) How long is the female urethra, and how does it compare to the male urethra?
3) Why do females have an increased risk of urinary tract infections (UTIs) compared to males?
1) Bladder is anterior to uterus, rectum is posterior to uterus
2) The female urethra is approximately 4 cm long, much shorter than the male urethra.
3) Shorter urethra, easy for bacteria to enter
1) What important connection exists in the male pelvic cavity?
2) What are the two major glands associated with the male reproductive system?
1) Connection between urinary + reproductive tracts
2) Prostate + seminal vesicles
Diagram of male urethra
- Preprostatic urethra:
first section of male urethra, just before prostate. This part of urethra closest to bladder - Prostatic urethra: Passes through prostate gland.
- Membranous urethra (non-distensible):
Shortest + least flexible part of urethra. Voluntary urination
Internal urethral sphincter: involuntary urination
External urethral sphincter (found in membranous urethra): voluntary control of urination
What is the most likely consequence of an enlargement of the prostate?
Why?
URINARY OBSTRUCTION
(specifically BENIGN PSOTATIC HYPERPLASIA)
Why?
- Enlarged prostate compresses urethra, making it harder for urine to flow from the bladder
- BENIGN HYPERPLASIA TENDS TO OCCUR IN CENTRAL ZONE
1) What is the vertebral venous plexus and why is it important?
2) What are Batson’s veins, and why are they clinically significant?
1) Valvless veins around spine, allow bidrectional blood flow
2) Valveless veins, allow blood to flow freely vetween vertebral venous plexus and other systems (.e.g prostatic venous plexus). Can facilitate spread of prostate cancer to spine
