Urinary Anatomy

Question 1

What level does the right kidney sit at?

Answer 1

L1-3

Question 2

What level does the left kidney sit at?

Answer 2

T12 - L2/3

Question 3

Are the kidneys intra or retroperitoneal?

Answer 3

Retroperitoneal

Question 4

What are the layers of fat/fascia surrounding the kidneys? (superficial to deep)

Answer 4

Pararenal fat
Renal fasica
Perirenal fat
Renal capsule

Question 5

Where does pararenal fat lie?

Answer 5

Posterolateral aspect of the kidney

Question 6

What is the arterial supply to and in the kidneys and venous drainage?

Answer 6

Aorta
Renal artery 
Segmental artery 
Lobular artery 
Arcuate artery 
Interlobular artery 
Afferent arteriole 
Glomerulus
Efferent arteriole 
Peritubular capillaries
Interlobular vein 
Arcuate vein 
Lobular vein 
Segmental vein 
Renal vein 
IVC

Question 7

In the abdomen where is the aorta in relation to the IVC?

Answer 7

IVC = right 
Aorta = left

Question 8

What is the functional unit of the kidney?

Answer 8

Nephron

Question 9

What are the main parts of the nephron?

Answer 9

Glomerulus 
Bowmans capsule 
Proximal convoluted tubule 
Loop of Henle 
Distal convoluted tubule 
Collecting duct

Question 10

What happens at the PCT?

Answer 10

Site of reabsorption

• glucose + AAs
• water
• bicarbonate

Question 11

What is the role of the loop of Henle?

Answer 11

Maintains counter current flow

Question 12

Which part of the loop of Henle is permeable to water?

Answer 12

Descending limb

Question 13

What happens at the DCT?

Answer 13

Variable site of reabsorption

• Na
• Cl
• Mg
• Ca

Question 14

What happens at the collecting duct?

Answer 14

Controls concentration of urine

Question 15

Which lymph nodes drain the kidneys?

Answer 15

Para-aortic lymph nodes

Question 16

What is the course of the ureters?

Answer 16

Arise from renal pelvis

Descend along tips of transverse processes

At sacroiliac joints - cross into pelvic cavity

Cross above common iliac arteries

At level of ischial spines - turn anteromedially

Enter bladder

Question 17

Are ureters intra or retro peritoneal?

Answer 17

Retro until sacroiliac joints then intra

Question 18

What is the nervous supply to the ureters?

Answer 18

Renal plexus
Testicular/ovarian plexus
Hypogastric plexus

Question 19

What level do sensory fibres from the ureters enter the spinal cord?

Answer 19

T11 - L2

Question 20

What is the arterial supply to ureters in the abdomen?

Answer 20

Renal artery
Ovarian/testicular artery
Ureteral branches from AA

Question 21

What is the arterial supply to the ureters in the pelvis?

Answer 21

Superior vesical artery

Inferior vesicle artery

Question 22

What anchors the bladder?

Answer 22

Median umbilical ligament

Question 23

What is the trigone?

Answer 23

Area of bladder with smooth walls with corners from ureteric meatuses

Question 24

What muscle is found within the bladder walls?

Answer 24

Detrusor

Question 25

What is the arterial supply to the bladder?

Answer 25

Superior vesicle branch of the internal iliac artery

Question 26

What is the venous drainage of the bladder?

Answer 26

Vesicle venous plexus - empties into internal iliac veins

Question 27

What lymph nodes drain the bladder?

Answer 27

Superolateral bladder = external iliac Neck + fundus = internal iliac, sacral + common iliac

Question 28

What is the sympathetic nervous supply to the bladder?

Answer 28

Hypogastric nerve

Question 29

What spinal levels does the hypogastric nerve originate?

Answer 29

T12 - L2

Question 30

What is the parasympathetic supply to the bladder?

Answer 30

Pelvic nerve

Question 31

What spinal levels does the pelvic nerve originate?

Answer 31

S2-4

Question 32

What is the somatic nervous supply to the bladder?

Answer 32

Pudendal nerve

Question 33

What spinal levels does the pudendal nerve originate?

Answer 33

S2-4

Question 34

What are the 2 sphincters in the urethra?

Answer 34

Internal urethral sphincter | External urethral sphincter

Question 35

What is the IUS in males?

Answer 35

Consists of circular smooth muscle fibres under autonomic control Prevents seminal regurg

Question 36

What is the IUS in females?

Answer 36

Functional sphincter formed by the bladder neck and proximal urethra

Question 37

What is the EUS?

Answer 37

Skeletal muscle under voluntary control

Question 38

What lines the urethra?

Answer 38

Stratified columnar epithelium

Question 39

How long is the male urethra?

Answer 39

15-20cm

Question 40

What are the main parts of the male urethra?

Answer 40

Prostatic urethra Membranous urethra Bulbous urethra

Question 41

What is the course of the prostatic urethra?

Answer 41

Begins as a continuation of bladder neck Passes through the prostate gland

Question 42

What opens into the prostatic urethra?

Answer 42

Ejaculatory ducts | Prostatic ducts

Question 43

What is the widest part of the male urethra?

Answer 43

Prostatic urethra

Question 44

What is the course of the membranous urethra?

Answer 44

Passes through pelvic floor and deep perineal pouch Surrounded by EUS

Question 45

What is the narrowest part of the male urethra?

Answer 45

Membranous urethra

Question 46

What is the course of the bulbous urethra?

Answer 46

Passes through bulb and corpus spongiosum of penis Ends at urethral meatus

Question 47

What opens into the bulbous urethra?

Answer 47

Bulbourethral glands

Question 48

What is the navicular fossa?

Answer 48

Narrowing of the urethra in the glans

Question 49

What is the artery supply to the prostatic urethra?

Answer 49

Inferior vesicle branch of internal iliac artery

Question 50

What is the arterial supply to the membranous urethra?

Answer 50

Bulbourethral artery - branch of the internal pudendal artery

Question 51

What is the arterial supply to the bulbous urethra?

Answer 51

Internal pudendal artery

Question 52

What is the nerve supply to the male urethra?

Answer 52

Prostatic plexus

Question 53

What is the lymphatic drainage to the male urethra?

Answer 53

Prostastic/membranous = obturator + internal iliac Bulbous = deep + superficial inguinal nodes

Question 54

How long is the female urethra?

Answer 54

4cm

Question 55

What is the course of the female urethra?

Answer 55

Begins at neck of bladder Passes inferior through perineal membrane and pelvic floor Urethra opens into perineum

Question 56

What are Skene's glands?

Answer 56

Mucous glands that lie either side of the urethra in females

Question 57

What is the arterial supply to the female urethra?

Answer 57

Internal pudendal arteries | Vaginal arteries

Question 58

What is the nervous supply to the female urethra?

Answer 58

Vesicle plexus | Pudendal nerve

Question 59

What is lymphatic drainage to the female urethra?

Answer 59

Internal iliac nodes