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Anatomy > Urinary > Flashcards

Urinary Flashcards

1
Q

What are the anterior relations of the left kidney? (6)

A
  • Left adrenal gland
  • Spleen
  • Splenic flexure
  • Jejunum
  • Stomach
  • Pancreas
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2
Q

What are the anterior relations of the right kidney? (5)

A
  • Hepatic flexure
  • Liver
  • Jejunum
  • Right adrenal gland
  • Duodenum (2nd part)
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3
Q

What are the muscles that posteriorly relate to the kidneys? (4)

A
  • Quadratus lumborum
  • Psoas major
  • Transversalis abdominus
  • Diraphragm
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4
Q

What are the nerves that posteriorly relate to the kidneys? (3)

A
  • Ilioigunas
  • Iliohypoglossal
  • Subcostal (T12)
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5
Q

What are the bones that relate posteriorly to the kidneys?

A
  • 11th and 12th rib (right)

- 12th rib (left)

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6
Q

What type of epithelium lines the kidneys?

A

Stratified Transitional

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7
Q

What is the order of the kidney hilum contents anterior to posterior?

A
  • Renal vein
  • Renal artery
  • Renal pelvis
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8
Q

Label internal structure of kidney

A

See notes

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9
Q

Label kidney capsules

A

See notes

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10
Q

Describe the lymphatic drainage of the kidney

A

Paraaortic nodes —> Lumbar lymph trunk —> cisterna chyli —> thoracic duct

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11
Q

Name the 4 kidney capsules in order

A

1) Renal/fibrous capsule
2) Perirenal fat
3) Renal fascia
4) Pararenal fat

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12
Q

What is the renal/fibrous capsule adherent to?

A

Kidney surface

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13
Q

What is perirenal fat made up of?

A

Solid and protective adipose tissue

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14
Q

What is renal fascia a continuation of?

A

Extraperitoneal fascia

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15
Q

At what level do the afferent sympathetic nerves from the kidney enter the sympathetic chain?

A

T11-T12

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16
Q

What does the sympathetic chain connect to to innervate the kidneys?

A

Renal plexus

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17
Q

What vertebrae to the kidneys extend over?

A

T12 - L3 (3 vertebrae in length)

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18
Q

What artery gives rise to the renal artery?

A

Superior mesenteric artery

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19
Q

What level does the superior mesenteric artery give rise to the renal artery?

A

L1

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20
Q

What vein gives rise to the renal vein?

A

Inferior vena cava

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21
Q

What level does the IVC give rise to the renal artery?

A

L2

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22
Q

Why is the left renal vein shorter than the right venal vein?

A

Due to anatomical position of aorta slightly to the left of midline

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23
Q

Why is the right kidney inferior to the left kidney?

A

Presence of liver

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24
Q

Label vasculature of kidneys

A

See notes

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25
Q

What vertebral level are the adrenal glands at?

A

T12

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26
Q

What kidney capsule layer are the adrenal glands found in?

A

Renal fascia

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27
Q

What covering other than the renal fascia are the adrenal glands found in?

A

Perinephric fat

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28
Q

What are the posterior relations of the left adrenal gland?

A
  • Stomach

- Pancreas

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29
Q

What are the posterior relations of the right adrenal gland?

A

Liver

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30
Q

Label adrenal gland layers

A

See notes

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31
Q

What is the shape of the right adrenal gland?

A

Pyramidal

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32
Q

What is the shape of the left adrenal gland?

A

Semi lunar

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33
Q

Blood supply to the adrenal gland comes from branches of which 3 arteries?

A
  • Aorta
  • Renal artery
  • Inferior phrenic artery
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34
Q

Label diagram of posterior abdominal wall

A

See notes

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35
Q

Label diagram of abdominal sympathetic plexi

A

See notes

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36
Q

How long is the ureter?

A

25cm

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37
Q

What is the diameter of the ureter?

A

3cm

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38
Q

What type of epithelium lines the ureter?

A

Stratified transitional

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39
Q

What type of tube is the ureter?

A

Muscular

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40
Q

What are the 3 parts of the ureter?

A
  • Abdominal
  • Pelvic
  • Intravesical
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41
Q

Is the abdominal ureter intra/retroperitoneal?

A

Retroperitoneal

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42
Q

Where does the abdominal ureter lie? (2)

A
  • On medial aspect of psoas muscle

- Anterior to transverse process of lumbar vertebrae

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43
Q

Where does the pelvic ureter begin?

A

When ureter enters the pelvis

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44
Q

Where does the pelvic ureter enter the pelvis?

A

At the pelvic brim at L4 level of common iliac bifurcation

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45
Q

What is anterior to the pelvic ureter entering the pelvis?

A

Sacroilliac joint

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46
Q

Where does the pelvic ureter cross anteriorly and medially?

A

Level of ischial spine

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47
Q

Where does the pelvic ureter enter the bladder?

A

Vesicouteric junction at the posterolateral bladder wall

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48
Q

What does the ureter lie close to in males?

A

Seminal vesicles

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49
Q

What does the ureter lie under in males?

A

Vas deferens

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50
Q

Where does the ureter run laterally to in females?

A

Cervix

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51
Q

What does the ureter run under in females?

A

Uterine vessels

52
Q

When does the ureter become the intravesical ureter?

A

When it enters the bladder wall

53
Q

What angle does the intravesical ureter enter the bladder wall at?

A

Oblique

54
Q

How long does the intravesical ureter run in the bladder wall?

A

1cm

55
Q

Why does the ureter run obliquely in the bladder wall?

A

1 way valve to prevent urine backflow because of high intramural pressure

56
Q

Where does the intravesical ureter open into the bladder?

A

Internal uteric orifice

57
Q

The local arteries and veins that supply/drain the ureter branch from what vessels? (5)

A
  • Internal vesical
  • Internal iliac
  • Gonadal
  • Aorta
  • Renal
58
Q

Where does the lymph from the ureters drain to?

A

Paraaortic nodes

59
Q

What innervates the ureters?

A

Autonomic plexuses

60
Q

Name wheRe 3 positions where the diameter of the ureter is the narrowest

A
  1. Uteropelvic junction (renal pelvis and ureter)
  2. Pelvic brim (ureter entering pelvis and crossing over common illiac bifurcation
  3. Vesicoureteric junction (ureter obliquely enters bladder wall)
61
Q

Why are the 3 ureter constrictions clinically significant?

A

Most likely locations of renal/uteric calculus obstructions (stones)

62
Q

Label ureter

A

See notes

63
Q

Label bladder

A

See notes

64
Q

What muscle forms the bladder?

A

Detrusor muscle

65
Q

What type of muscle is detrusor muscle?

A

Smooth

66
Q

What are the folds of the bladder known as when it is empty?

A

Rugae

67
Q

What type of epithelium lines the bladder?

A

Transitional

68
Q

What embryological remnant is attached to the bladder apex?

A

Urachus

69
Q

What is the urachus?

A

Obliterated allantois - connected foetal bladder to yolk sac

70
Q

Where is the urachus attached?

A

Bladder apex

71
Q

What folds does the urachus continue in?

A

Median umbilical folds

72
Q

What are the median umbilical folds?

A

Peritoneum fold on anterior abdominal wall

73
Q

What is found in the medial umbilical folds?

A

Medial umbilical ligament

74
Q

What does the bladder sit in when empty?

A

The true pelvis

75
Q

What is the bladder posterior to when empty?

A

Pubic symphisis

76
Q

What does the bladder become when it expands in volume?

A

Intraabdominal

77
Q

Where can the bladder be palpated when full?

A

Suprapubic regions

78
Q

What is the capacity of the bladder?

A

500ml

79
Q

What lies inferior to the bladder in men?

A

Prostate

80
Q

What lies inferior to the bladder in women? (2)

A
  • Perineal membrane

- Pelvic fascia

81
Q

What lies superior to the bladder? (5)

A
  • Uterus
  • Vagina
  • Peritoneum
  • Coils of ilium
  • Sigmoid colon
82
Q

What lies lateral to the bladder?

A
  • Obturator internus

- Levator ani

83
Q

What is the arterial blood supply to the bladder?

A

Internal and external vesical arteries

84
Q

What are the internal and external vesical arteries branches of?

A

Internal iliac artery

85
Q

What is the venous drainage of the bladder?

A

Vesical venous plexis

86
Q

What does the vesical venous plexus go to in men?

A

Prostatic plexus

87
Q

Where does the vesical venous plexus ultimately drain to?

A

Internal iliac veins

88
Q

Where does the lymph of the bladder drain to?

A

Internal and external iliac nodes

89
Q

What is the sympathetic innervation of the bladder via?

A

Sympathetic trunk

90
Q

What is the parasympathetic innervation of the bladder via?

A

Pelvic splanchnic nerves (S2-S4)

91
Q

What plexus directly innervates the bladder?

A

Pelvic/inferior hypogastric plexus on each side of the bladder

92
Q

What action of the bladder causes urination?

A

Contraction

93
Q

Label urethra diagram

A

See notes

94
Q

What length is the female urethra?

A

4cm

95
Q

Where is the female urethra embedded?

A

Anterior wall of vagina

96
Q

Where is the external urethral meatus opening/orifice?

A

Vulvar vestibule

97
Q

What is the length of the male urethra?

A

20cm

98
Q

What is the different in shape between the male and female urethra and why is this clinically significant?

A

Males curves more, female=direct. Harder to catheterise a male

99
Q

List the parts of the male urethra

A
  • Preprostatic urethra
  • Prostatic urethra
  • Intermediate/membranous urethra
  • Penile/spongy urethra
100
Q

Where is the preprostatic urethra found and what are its boundaries?

A

Found in bladder neck

Internal urethral orifice to prostate

101
Q

Where is the prostatic urethra?

A

Within prostate

102
Q

What merges in the prostatic urethra?

A

Reproductive (prostatic) and ejaculatory ducts

103
Q

Where do the prostatic ducts open in the prostatic urethra?

A

In the prostatic sinus either side of uretheral crest

104
Q

How many prostatic ducts open in the prostatic urethra?

A

15-20

105
Q

Where do the ejaculatory ducts open in the prostatic urethra?

A

Either side of the prostatic uricle

106
Q

What does the intermediate/membranous urethra pass through?

A
  • Pelvic floor
  • Penrineal membrane
  • External urethral sphincter
107
Q

Where is the penile/spongy urethra?

A

Corpus spongiosum and bulb of penis

108
Q

What type of tissue is the penile/spongy urethra?

A

Erectile

109
Q

Where is the external urethral orifice/external urethral meatus found?

A

Glans of penis

110
Q

Label a prostatic urethra

A

See notes

111
Q

What type of muscle is the internal urethral sphincter?

A

Smooth

112
Q

What is the internal urethral sphincter innervated by sympathetically?

A

Inferior mesenteric ganglion from sympathetic trunks

113
Q

What is the internal urethral sphincter innervated by parasympathetically?

A

Lumbar splancnic nerves (L1-L2)

114
Q

What is the purpose of the internal urethral sphincter?

A

Contraction prevents urination and reflux of semen into bladder during ejaculation

115
Q

What type of muscle is the external urethral sphincter?

A

Skeletal

116
Q

What is the purpose of the external urethral sphincter?

A

Continence

117
Q

What nerve and nerve type supplies the external urethral sphincter?

A

Pudendal nerve (somatic motor)

118
Q

What muscle aids in continence?

A

Levator ani

119
Q

Where can the hilum of the kidneys be palpated?

A

Left=L1
Right=L2
3 fingerbreaths from midline

120
Q

What type of pain do the kidneys produce?

A

“Loin to groin pain”

121
Q

What dermatome is kidney pain referred to?

A

T12

122
Q

Why is kidney pain referred to T12 dermatome?

A

Visceral afferents in least splanchnic nerve enter spinal cord at T12

123
Q

What abdominal regions does kidney pain correspond to?

A

Flanks and pubic region

124
Q

What type of pain is caused by a ureter stone and what is it caused by?

A

Waves of peristalsis cause spasmic pain

125
Q

Where is the pain from a ureter stone felt?

A 
Male = scrotum
Female = labia majora/minora
126
Q

Label bladder/ureter/uretheral system overall

A

See notes

Anatomy (10 decks)

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