urinary Flashcards
Kidney funtion
Exocrine (sexcretion of water and organic & inorganic substances-urine!)
Endocrine - erythropoietin, 1,25hydroxycholecalciferol derived vitamin D, renin.
Function of erythropoietin?
promotes production of red blood cells from precursors in bone marrow,
Function of 1,25-hydroxycholecalciferol derived vitamin D
Ca metabolism
Function of renin?
–> angiotensin 2. plays role in blood vessel constriction thus INCREASING blood pressure
Kidneys location?
retroperitoneal. embedded in perineal fat which iin turn is then embedded in FIBROUS renal fascia. Right kidney is 1cm lower and more lateral than left (liver). Superior pole slightly closer to midline.
Kidney internal structure.
Nephrons (corpuscle - dilture urine, tubules - conc. urine), COllecting ducts (through cortex, medulla and pyramid to papilla). Then empty into minr caylx, (7-13)–> major caylx (2-3) –> pelvis (extendsd to outside hilum - to inf borders) –> carrows and becomes ureter.
what are calices and pelvis lined with?
mucosa ith extensible epithelium - TRANSITIONAL EPITHELIUM & smooth muscle wall
Kidney anterior relations.
Right (4) - R suprarenal, liver, duodenum, right colic flexure
Left (6) - L suprarenal, stomach, left colic flexure, spleen, pancreas, jejunum
Kidney posterior relations.
Diaphragm, psoas, quadratus lumborum, medial & lateral arcuate ligaments
Inferior relations of kidneys?
Iliac crests are 2.5 cm below
Renal vessles?
Renal arteries from aorta. one main artery per kidney in 70% individuals. accessory from above or below main or coeliac, superior mesenteric or common iliac
ureters function?
urine transport - peristalsis
Ureters locatino?
25-30cm long - vertically from transpyloric plane, across psoas & around wall of lesser pelvis to level of pubic tubercles where they enter base of bladder
Ureters constrictions?
- at junciton of pelvis and ureter. 2. at pelvic brim. 3. junctionwith bladder.
Bladder location
anteroinferior lesser pelvis- extends into abdomen when full.
Bladder surfaces
Superior - with PERITONEUM
apex - directed anterosuperiorly - extending into median umbilical lig. (urachus) which ascends on anterior abdom wall to umb. (remmnant of allantois)
two inferolateral sides - embedded in retropubic fat
base/fundus & neck - lowest part, opens into urethra. in males neck is in contact with base of prostate
Bladder relations
Superior - small intestine, sigmoid colon, uterus in female
LATERAL -retropubic fat
Posterior - male: seminal vesicles, ampulla, retrovesicular pouch, rectum. female: uterovesicular pouch, cervix, upper vagina
Bladder internal features
- transitional epithelium on interlacing smooth detrussor muscle in bladder walls. folded mucosa when bladder empty, smooths out as fills. TRIGONE at internal base of bladder - marked by openings of ureters and urethra.
What muscle is found in the bladder wall? what kiind of muscle?
detrussor. smooth.
What epithelium is found in the bladder?
transitional epithelium
What marks the trigone in the bladder?
Opening for ureters and urethra. Trigonal muscle is always smooth. Muscle bundles of trigone are small and continue into ureters and urehtra.
Sphincter of bladder/urethra
Internal and external at opening of urethra
Internal urethral sphincter in MALES
smooth muscle in bladder neck forms complete collar extending into preprostatic urethra. supplied with SYMPATHETIC fibres causing muscle to CONTRACT during EJACULATION - to prevent retrogade flow of semen into bladder. - urinary continence a little bit
Internal urethral sphincter in FEMALES
smooth muscle oblique at neck and extends obliquely into upper urethra. also compressor urethrae?
What muscle is the External urethral sphincter? role?
Ring of STRIATED muscle. Tone (constriction) of this muscle plays major role in CONTINENCE. (note also pelvic floor muscles involved -esp females)
Urination?
Contraction of detrussor. Relaxation of sphincter. Triggered by stretch receptors in bladder wall.
Where is hilum kidneys? (surface anat)
Transpyloric plane & about 5cm from midline.
Upper pole kidney surface anat.
Right - deep to 11th rib (body T11)
Left - level of 11th intercostal space.
Lower pole kidneys surface anat.
Body L3
Ureters surface anat.
Cross Tv process of L3, midpoint of scroiliac joint, enters bladder at level of pubic tubercle.
Bladder surface anat.
Apex/median umbilical at level of upper margin of pubic symphysis.
Which kidney is 1cl lower and more left?
Right (liver)
At what level do the ureters enter the bladder>
at elevel of pubic tubercles
