Urinary Anatomy Flashcards

1
Q

What is the principle function of the kidney?

A

Maintains homeostasis by blood filtration

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2
Q

What is the ureter?

A

A distensible macular tube which transmits urine from the renal pelvis into the bladder

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3
Q

What is the urethra? Outline its sexual dimorphic anatomy

A

A tube which transmits urine from the bladder out of the urethral meatus. Common between the reproductive and urinary system in males but distinct in females

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4
Q

Describe the location of the kidneys

A

Lie in the paravertebral gutters on the posterior abdominal wall on either side of the vertebral column between vertebra T12-L3

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5
Q

What is the hilus of the kidney?

A

The part on the medial concave border of the kidney through which blood vessels enter/leave the substance of the organ

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6
Q

What plane do the hilum of the kidneys lie?

A

Transpyloric plane

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7
Q

At what vertebral level does the transpyloric plane occur?

A

L1

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8
Q

Note the kidneys do not occur at the same vertebral level; why is this?

A

The right is lower than the left due to the liver

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9
Q

The kidney is enclosed by four layers; what are they?

A
  1. Fibrous renal capsule
  2. Fatty renal capsule
  3. Renal fascia (fibro-fatty tissue)
  4. Pararenal fatty tissue (mainly posterior aspect of kidneys)
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10
Q

What is the significance of having fatty tissue around the kidney?

A

Insulation and protection

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11
Q

What are the three muscular posterior relations of the kidneys?

A
  1. Abdominal diaphragm
  2. Psoas major
  3. Quadratus lumborum
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12
Q

What implication does the kidney’s close relation to the diaphragm have on its position?

A

It will move with respiration

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13
Q

What is the peritonisation of the kidneys?

A

Partially peritonised depending on the peritonisation of its anterior relations

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14
Q

Name some of the anterior relations of the kidneys

A
RIGHT KIDNEY:
Suprarenal gland (R)
Liver (I)
Duodenum (distal 2/rds R)
Colon (Asc + Desc = R)
Jejunum (I)
LEFT KIDNEY: 
Suprarenal gland (R)
Stomach (I)
Spleen (I)
Pancreas ( R except for tail) 
Left colic flexure (TC = I)
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15
Q

Outline the nerve supply to the kidneys

A

Sympathetic T12-L1 spinal nerves pass through coeliac ganglia and along renal artery to organ

Parasympathetic nerves are derived from vagus

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16
Q

Describe the lymphatics of the kidney

A

Drain into the para-aortic nodes around the origin of the renal arteries at L1

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17
Q

How does horseshoe kidney occur?

A

Kidneys fuse together during embryological development

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18
Q

What is the consequence of horseshoe kidney?

A

Higher risk of stone formation and cancer

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19
Q

What is the consequence of double ureter?

A

Increase risk of UTIs and blockages

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20
Q

What can be said about the histological different between renal cortex and renal medulla?

A

Outer cortex is much denser than medulla

21
Q

What are the histological features of the:

  • Glomerulus
  • Convolute d tubules
  • Loops of Henle
  • Collecting ducts
A
  • Glomerulus - circular
  • Convolute d tubules - thick walled
  • Loops of Henle - thin-walled ascending and thick walled descending within the medulla
  • Collecting ducts - very large
22
Q

What are they two histological layers of the glomerulus?

A

Parietal and visceral (podocytes)

23
Q

Which layer of the glomerulus makes up the greater part of the cell population?

A

Visceral

24
Q

What space lies between the parietal and visceral layers of the glomerulus?

A

Bowmann’s space

25
Q

At what vertebral level are the paired renal arteries given off from the abdominal aorta?

A

L1-L2

26
Q

How many branches does the renal artery produce when it enters the substance of the organ?

A

5

27
Q

Describe the location of the abdominal aorta?

A

Slightly left of the midline along the vertebral bodies

28
Q

With the location of the aorta in mind; describe the course of the left renal artery and vein

A

Renal artery = short and direct

Vein = travels anterior to the aorta and is relatively long

29
Q

With the location of the aorta in mind; describe the course of the right renal artery and vein

A

Renal artery = travels posteriorly to the IVC and is relatively long
Vein = direct and short

30
Q

What vein travels up from the left renal pelvis anddrains in to the left renal vein?

A

Left gonadal artery

31
Q

Describe the course of the right gonadal vein

A

Does not drain into the right renal vein but instead drains directly into the IVC

32
Q

What is the peritonisation of the ureter?

A

Retroperitoneal

33
Q

What two body cavities does the ureter traverse?

A

Anterior - abdominal cavity

Posterior - pelvic cavity

34
Q

As the ureter descends, what muscle does it lie on?

A

Psoas major

35
Q

The ureter crosses the bifurcation of what arteries anteriorly?

A

Common iliac

36
Q

In males, what other tubular structure crosses the ureter superiorly?

A

Vas deferens

37
Q

What structure crosses the ureter superiorly in females?

A

Uterine artery

38
Q

There are three constrictions of the ureter; what are they?

A
  1. Pelvi-Ureteric junctions
  2. Pelvic brim
  3. Vesico-ureteric junction
39
Q

From which part of the bladder does the urethra exit?

A

Neck of the bladder

40
Q

What structure is the origin of the median umbilical ligament?

A

The apex of the bladder

41
Q

What is the median umbilical ligament a remnant of?

A

Urachus (allantois)

42
Q

CAUTION:

A

Do not get the mediaN umbilical ligament confused with the mediaL umbilical ligament

43
Q

What kind of tissue comprises the wall of the bladder?

A

Muscular

44
Q

Identifythe bony joint immediately anterior to the urinary bladder?

A

Pubic symphysis

45
Q

What kind of epithelium lines the urinary bladder and ureter?

A

Transitional epithelium

46
Q

What is the benefit of having transitional epithelium lining the bladder and ureter?

A

Stratified layers in which the shape of the surface cells change can allow stretching

47
Q

On a plain radiograph, the course of the ureters roughly follow what easily identifiable structures?

A

The tips of the lumbar transverse processes

48
Q

What is a CT-KUB?

A

CT of the kidneys, ureters and bladder