Urinary Flashcards
Where do the kidneys lie?
Paravertebral gutters
At what thoracic level do the kidneys lie?
T12-L3
At what level does the hilus of the kidney lie?
Transpyloric plane (L1)
What are the fascial coverings of the kidney?
Fibrous renal capsule
Fattt renal capsule
Renal fascia
Pararenal fatty tissue (on post aspect)
What muscles lie posteriorly to the kidney?
Diaphragm
Psoas major
Quadratus Lumborum
Describe the anterior relations of the right kidney.
Liver
Duodenum
Colon
Jejunum
Describe the anterior relations of the left kidney.
Stomach Pancreas Spleen Area of small bowel Left colonic flexure
What renal vein is the longest?
Left
What renal artery is the longest?
Right
What is the sympathetic nerve supply to the kidneys?
T12 and L1
What is the parasympathetic nerve supply to the kidneys?
Vagus
What nodes drain lymph from the kidneys?
Para-aortic lymph nodes
Name two embryological abnormalities of the kidneys.
Horseshoe kidneys
Duplicated ureter
Describe the internal structures of the kidneys.
Renal pyramid - minor calyx - major calyx - Rena pelvis
What structures are found in the cortex of the kidney?
Bowman’s capsule, RCT, PCT
What structures are found in the medulla?
Loop of Henle and collecting ducts
What layer of the bowman’s capsule has podocytes?
Visceral
How are the proximal and distal convoluted tubules distinguished in histology?
Proximal are “fuzzy” due to presence of villi
Where do the renal arteries come off the aorta?
L1 and 2
How many segmental arteries are present in the kidney?
5
How are ureters peritonised?
Retroperitoneal
What muscle does the ureter lie on?
Psoas major
When does the ureter cross anteriorly?
At bifurcation of common iliac
What crosses the ureter superiorly in a man?
Vas deferns
What crosses the ureters superiorly in a woman?
Uterine artery
What is the median umbilical ligament a remnant of?
Urachus (from Allantois)
What is the name of the smooth muscle found in the bladder wall?
Detruser muscle
What lies anteriorly to the bladder?
Pubic symphysis
What attaches anteriorly at the apex of the bladder?
Median umbilical ligament
What part of the bladder lies at angle to the urethral orifice?
Trigone
Where are the three most common regions for stones?
Origin of the ureter
Pelvic brim
Vesico-ureteric junction
At what angle do the ureters enter the bladder?
Posterosuperior angle
What type of epithelium is found in the bladder?
Transitional epithelium
What type of endothelium lines the ureters?
Transitional
Why is transitional endothelium beneficial in the bladder?
No leakage since tight junctions
Can stretch to accommodate volume fluctuations
When looking at the ureters on imaging, what do they align with?
Transvers processes of lumbar vertebrae
What can be easily seen on an abdominal X-ray with regards to the urinary system?
Kidney stones
What is a CT KUB useful for?
Stones
Dilation of ureters
Identifying psoas major
Hydronephrosis
What are renal MRIs good for?
Soft tissue abnormalities e.g renal cyst
What dies can be added to a renal MRI?
Gadolinium
What type of epithelium is found in the parietal layer of the Bowman’s capsule?
Simple squamous
What is located in the centre of the Bowman’s capsule?
Mesangium
What type of epithelium is found in the distal and proximal convoluted tubules?
Simple cuboidal
What kidney is lower?
Right
What vein travels up from the pelvis to drain in to the left renal vein?
Left gonadal vein
Where does the right gonadal vein drain into?
The IVC
