Urinary System Flashcards
What is the function of the urinary system?
To regulate body fluid volume and electrolyte balance
What two processes allow the urinary system to carry out its functions?
Blood filtration
Blood pressure regulation
In what two cavities are the urinary system located?
Abdomino-pelvic cavity
Perineum
In which gender are the reproductive and urinary stern connected? Through which structure are they connected by?
Males
Urethra
List the four components of the urinary system
Kidneys
Ureter
Bladder
Urethra
What is the function of the kidneys?
They maintain homeostasis by blood filtration
What is the function of the ureter?
It carries urine from the kidneys to the bladder
What is the function of the urinary bladder?
It stores urine, allowing urination to be controlled
What are the two functions of urethra?
It carries urine from the bladder to the external urethral orrifice (outside the body)
It carries semen outside the body
Where are the kidneys located?
They lie in the paravertebral gutters on the posterior abdominal wall on either side of the vertebral column
At which vertebral level are the kidneys located?
Between T12-L3
What is the hilum of the kidney?
The section of the kidney through which blood vessels and the ureter enter and exit
Where is the hilum of the kidney located?
On the medial concave border of the kidney
At what plane is the hilum of the kidney situated?
Transpyloric plane
What is the transpyloric plane?
It is an imaginary plane located at L1
It lies halfway between the jugular notch and the superior border of the pubic symphysis
Name four structures that lie on the transpyloric plane
Pylorus of the stomach
Duodenal-jejunal flexure
Pancreas neck
Hilum of the kidneys
What kidney is lower? Why?
Right
It sits underneath the liver
What are the four layers that enclose the kidney - in order from innermost to outermost?
Fibrous renal capsule
Perirenal fatty tissue
Perirenal fascia
Pararenal fatty tissue
Where is the pararenal fatty tissue of the kidney mainly located?
The posterior aspect of the kidney
Why is it important that there is fatty tissue around the kidneys?
This provides protection to the kidneys from trauma and damage
What three muscles are related posteriorly to the kidney?
Transversus abdominis
Psoas major
Quadratus lumborum
What respiratory structure is the kidney closely related to?
Diaphragm
What is the position of the kidney during inspiration and expiration?
They move with respiration, changing from a supine to erect position
How are the organs of the urinary system peritonised?
Retroperitoneal (partially - as it depends upon the organs it is in contact with)
What two parts of the GI tract are retroperitoneal?
Ascending colon
Descending colon
What is the anterior surface of the kidneys related to?
The viscera of the GI system
How many structures is the right kidney in contact with?
Five
What are the five structures that the right kidney are in contact with?
Suprarenal gland
Liver
Duodenum
Right colic flexure of ascending colon
Descending colon
How many structures is the left kidney in contact with?
Six
What are the six structures that the left kidney are in contact with?
Suprarenal gland
Spleen
Stomach
Tail of pancreas
Duodenum
Descending Colon
Where do the sympathetic nerves of the kidney originate? Where do the sensory afferent nerves of the kidney originate?
T10 - L1 spinal segments
T11 - L5 spinal segments
How do the sympathetic nerves travel to the kidney from their origin?
They pass through the coeliac ganglia and along the renal artery
Where do the parasympathetic nerves of the kidney originate?
Vagus nerve
Which lymph nodes drain the kidneys? Where are these located?
Para-aortic lymph nodes
Origin of the renal arteries, around L1
What embryological structure do the kidneys develop from?
Urogenital ridge
What embryological structure does the ureter develop from?
Urerteric bud
What are three embryological complications that involve the kidney?
Development of one kidney
Duplicate ureter
Horseshoe kidney
What are the three internal regions of the kidney?
Renal cortex
Renal medulla
Renal pelvis
What are the three structures that make up the renal medulla?
Renal pyramids
Renal columns
Renal papillae
What are the renal pyramids?
The pyramidal masses of renal tissue
What are the renal columns?
The spaces between the renal pyramids, through which blood vessels pass
What are the renal papillae?
The tips of the renal pyramids that point towards the renal pelvis
What are the two callices of the renal pelvis?
Major calyx
Minor calyx
What is the function of the callices of the kidney?
The renal calyces are chambers of the kidney through which urine passes
What do the minor calyx fuse to form?
Major calyx
What do the major calyx fuse to form?
Renal pelvis
What component of the kidney is more dense - inner medulla or outer cortex?
Outer cortex
On a histological image of nephrons, how do we locate the Bowman’s space?
It is the space located between the visceral and parietal layer of the glomerulus
What arteries supply the kidneys?
Renal arteries
What veins drain the kidneys?
Renal veins
What are the renal arteries a branch of?
Abdominal aorta
Where do the renal veins drain into?
Inferior vena cava
Where is the IVC located in relation to the abdominal aorta?
The IVC is on the right hand side of the body
The abdominal aorta is on the left hand side of the body
At what level do the renal arteries branch off the abdominal aorta?
L1-L2
What happens to the renal arteries at the hilum of the kidney?
They divide into five segmental arteries which supply each of the five renal segments; apical, anterosuperior, anteroinferior, posterior and inferior
What renal vein is longer?
Left renal vein
How does the left renal vein travel relative to the aorta?
It travels anterior to the aorta
What renal artery is longer?
Right renal artery
How does the right renal artery travel relative to the IVC?
It travels posterior to the IVC
What veins drain into the left renal vein on the left side and the IVC on the right side?
Gonadal veins (ovarian/testicular)
Adrenal veins
Where does the proximal portion of the ureter lie?
Abdominal cavity
Where does the distal portion of the ureter lie?
Pelvic cavity
Where does the ureter originate from?
The renal pelvis
How is the ureter positioned in relation to the renal vessels?
Posterior
Which muscle does the ureter lie on?
Psoas major
What arterial structure does the ureter pass as it travels towards the bladder?
The bifurcation of the common iliac arteries
What male structure passes over the ureter superiorly?
Vas deferens
What female structure passes over the ureter superiorly?
Uterine artery
Where are the three constrictions of the ureter positioned?
Ureteropelvic junction, which is the junction between the ureters and renal pelvis
Pelvic brim
Bladder wall
Why are the three constriction points of the ureter clinically important?
In these locations, kidney stones tend to lodge
What are the three openings within the urinary bladder referred to as?
Right ureteric orifice
Left ureteric orifice
Urethral orifice
What is the trigone of the urinary bladder? What forms it?
The trigone is a smooth triangular region of the urinary bladder
The two ureteric orifices and the internal urethral orifice
What is the function of the trigone in the urinary bladder?
The area expands and once stretched to a certain degree, it signals the brain that it needs emptied
Where does the ureter enter the urinary bladder?
Ureteric orifices in trigone
What part of the urinary bladder does the urethra exit?
The neck of the urinary bladder
What is the function of the apex in the urinary bladder?
It is the site from which the medial umbilical ligaments ascend to the umbilicus
What is an embryological remnant of the urinary bladder apex?
Urachus
What are the two sphincters within the urinary bladder? Which is voluntary and involuntary?
Internal urethral sphincter - involuntary (smooth muscle)
External urethral sphincter - voluntary (skeletal muscle)
What are the four tissue types that make up the urinary bladder walls?
Serosa
Smooth muscle
Submucosa
Mucosa
What bone lies immediately anterior to the urinary bladder?
Pubic symphysis
In males, list three reasons for an enlarged bladder?
UTI
Enlarged prostate
Weak bladder muscles
What are three symptoms of an enlarged bladder?
Painful urination
Abdominal pain
Urinary incontinence
What type of epithelium lines the urinary bladder and ureter? Why?
Specialised transitional epithelium
It can stretch as the bladder fills and is impermeable to water
What part of the urinary bladder does the urethra arise from?
Inferior
Describe the course that the urethra travels through
The pelvic diaphragm and into the perineum
What do the ureters align with? Why is this clinically relevant?
The transverse process tips of the lumbar vertebrae
This allows us to identify ureters on x-ray images
Why do the kidneys enlarge when there is a stone present in its ureter?
There is a build up of fluid in the kidneys
What contrast is used to highlight structures on an MRI?
Gadolinium
How can we easily differentiate between T1 and T2 weighted MRIs?
CSF is dark on T1-weighted imaging and bright on T2-weighted imaging
What predominant tissue type makes up the urinary bladder?
Smooth muscle
What is the most posterior structure at the hilum of the right kidney?
Ureter
Where is the adrenal gland located in an ectopic kidney?
In its usual position
What lymph nodes drain the urinary bladder?
The external iliac lymph nodes - suprapubic part
The internal iliac lymph nodes - infrapubic part
Which structure lies most anteriorly at the hilum of the left kidney?
Left renal vein
Which structure is not directly related to the left adrenal gland?
Lesser curvature of the stomach
What is the primary site of venous drainage of the urinary bladder?
Vesicoprostatic plexus
What is the renal sinus?
A fatty compartment located within the medial aspect of the kidney
What does the renal sinus communicate with?
The perinephric space
What main structure is contained within the renal sinus?
The renal hilum
Which two nerves run obliquely on the posterior surface of the kidney?
Iliohypogastric nerve
Illioinguinal nerve
What nerves supply the ureter?
The visceral, sensory fibres of T12-L2
What three arteries supply the ureter?
Renal artery
Gonadal arteries
Abdominal aorta
Which two veins drain the ureter?
Renal veins
Gonadal veins
What is the structural relationship of the renal hilum - from anterior to posterior?
Vein
Artery
Ureter
What aspect of the urinary bladder is peritonised?
The superior aspect
What are the two pouches of the urinary bladder peritoneum (female)?
Vesicle uterine pouch
Rectouterine pouch, also known as the pouch of Doulglas
Why is the pouch of Douglas clinically significant?
If there is an accumulation of fluid in the pouch of Douglas, it can be approached via the posterior vaginal fornix for drainage
Which pouch of the urinary bladder peritoneum is present in males?
Rectovesical pouch, also known as the pouch of Doulglas
What are the four divisions of the male urethra?
Preprostatic part of the urethra
Prostatic part of the urethra
Membranous part of the urethra
Spongy part of the urethra
What nerve supplies the urethra?
Pudendal nerve
What is the widest division of the male urethra?
Prostatic part of the urethra
What is the narrowest division of the male urethra?
Membranous part of the urethra
What artery supplies the urinary bladder?
Internal iliac artery branches
What vein drains the urinary bladder?
Internal iliac veins
What sympathetic nerves supply the urinary bladder?
T11-L2
What parasympathetic nerves supply the urinary bladder?
Pelvic sphlanic nerves, S2-S4
What somatic nerve supplies the urinary bladder?
Pudendal nerve
What autonomic nerve supplies the urinary bladder?
Hypogastric nerve
What nerves innervate the internal urinary bladder sphincter?
Autonomic nerves
What nerves innervate the external urinary bladder sphincter?
Pudendal nerve
Which cells line the visceral layer of the Bowman’s capsule?
Epithelial cells, known as podocytes
Which cells line the parietal layer of the Bowman’s capsule?
Simple squamous epithelium
What is the uriniferous tubule?
The nephron and collecting tubule
What is a nephron?
The renal corpuscles and renal tubules
What is a renal corpuscle?
The glomerulus and Bowman’s capsule
What are the three renal tubules?
Proximal convoluted tubule
Distal convoluted tubule
Loop of Henle - ascending and descending segment
Which epithelium lines the proximal and distal convoluted tubules of the kidney?
Cuboidal epithelium
Which epithelium lines the loop of Henle?
Squamous epithelium
Which epithelium lines the collecting duct?
Cuboidal epithelium
What structures of the uriniferous tubule lie in the cortex of the kidney?
Glomerulus
Bowman’s capsule
What structures of the uriniferous tubule lie in the medulla of the kidney?
Loop of Henle
What two structures form the upper urinary tract?
Kidneys
Ureters
What three structures form the lower urinary tract?
Bladder
Prostate (males only)
Urethra
What happens to the renal vessels as the kidneys move up during embryological development?
They break down and reform
What artery lies superior to the SMA?
Coeliac artery
What is the function of the vas deferens?
It carries semen from the testes to the urethra
Do we disturb the peritoneum during suprapubic catheterisation? Why?
No
Peritoneal pouches
