Urinary System

Question 1

What sits on top of each kidney?

Answer 1

• The adrenal (renal) gland

Question 2

What does the kidney touch posteriorly?

Answer 2

• Diaphragm
• The Quadratus Lumborum
• The Psoas Major Muscles

Question 3

What does the Kidney relate to Medially? (on each side)

Answer 3

Hilum which contains:

• Renal Artery (from the abdominal aorta)
• Renal Vein (draining into IVC)
• Renal Pelvis (beginning of the ureter, not the ureter itself)

Question 4

What is different about the left and right kidney?

Answer 4

Left Kidney
- Touches stomach and spleen
Right Kidney
- Touches IVC and Liver

Question 5

What are the 4 layers of connective tissue that surround the kidneys?

Answer 5

• Fibrous Capsule
• Peri-renal Fat
• Renal Fascia
• Para-renal Fat

Question 6

Describe the Fibrous Capsule of the Kidney?

Answer 6

• Starts from the kidney

- Dense Irregular Fibrous CT called the renal capsule

Question 7

Describe the structure of the Peri-renal Fat of the Kindey?

Answer 7

• Layer of fat outside of this capsule and cushions the kidney (absorbs trauma shock)
• Helps maintain the temperature

Question 8

Describe the Renal Fascia (gerota’s fascia) of the kidney?

Answer 8

• Loose connective tissue

- keeps the kidney and adrenal glands in place in relation to surrounding organs

Question 9

Describe the Structure of the Para-renal fat of the kidney?

Answer 9

• The fat layer outside of renal fascia (up to 3” thick)

Question 10

What are the External Features of the Kidney?

Answer 10

• Two Bean-Shaped: 1296cm
• Retroperitoneal structures resting on the posterior abdominal wall
• right kidney is situated slightly lower (rib 12) than the left (rib 11 and 12) (because of the liver)
• Hilum

Question 11

What are the Internal Structures of the Kidney?

Answer 11

• Renal Cortex
• Renal Medulla
• Renal Columns
• Renal Lobe
• Renal Papilla
• Renal Sinus
• Renal Hilum

Question 12

Where is the Renal Cortex and what does it consist of?

Answer 12

Location
- Right Underneath the Renal Capsule
Consists of
- Initial portion of nearly 1 million tube-like structures called nephrons

Question 13

Where is the Renal Medulla located? what does it consist of?

Answer 13

Location
- Deep to the cortex
Consists
- 8 - 18 pyramidal structures

Question 14

What does the Renal Lobe Consist of?

Answer 14

• Pyramids and half the adjacent column

- Roughly 8-18 in each kidney

Question 15

Where is the Renal Papilla located? What does it consist of?

Answer 15

Location
- Pointy tip of the pyramid that points to the hilum
Consists
- Thousands of collecting ducts that empty urine to the minor calyx
- The major Calyx
- The renal Pelvis

Question 16

What joins together to form the major calyx?

Answer 16

• The neighboring minor calyces

Question 17

Where is the Renal Sinus located?

Answer 17

• In the space containing all the calyces and renal pelvis

Question 18

What is the structure of the Renal Hilum?

Answer 18

Contains

• Renal Pelvis
• Renal Artery
• Renal Vein

Question 19

What is the Structure and Function of the Ureter?

Answer 19

Structure
- A muscular tube (smooth muscle): 25cm long
- Start from the renal pelvis until the urinary bladder
- The outside diameter is about 5-6mm, and the inside is about 1mm in the normal state. It can stretch and pass kidney stones as big as 6mm.
Function
- Passes and pushes urine produced in the kidney towards the bladder mainly by peristalsis

Question 20

What are the 3 critical narrow points on the course of the ureter?

Answer 20

• Uretero-pelvic junction (at L1 level)
• When passing over the pelvic rim or the common iliac artery (at sacroiliac joint level)
• When entering the bladder (at S2 level)

Question 21

Is the Urinary Bladder Retroperitoneal or Intraperitoneal organ? Where is it located?

Answer 21

• Retroperitoneal
  Located
• On the true pelvis or lesser pelvis

Question 22

How much fluid can the bladder hold? When do you get warnings to empty it?

Answer 22

Maximum 
- 700-800mL 
Warnings
- First: 150mL
- Second: 350mL
- Final: 500mL

Question 23

What is on the Superior Surface of the Bladder in Males?

Answer 23

• Covered by the peritoneum: separates the small intestinal loops from the bladder

Question 24

What is on the Posterior Surface of the Bladder in Males?

Answer 24

• Close proximity to the seminal vesicles and vas deference, as well as rectum
• Called the Base of the Bladder

Question 25

What is on the Inferior surface of the bladder in males?

Answer 25

• Sits on top of the prostate gland

Question 26

What does the Bladder touch anteriorly in males?

Answer 26

• The Pubis Symphysis

Question 27

What is on the superior surface of the Bladder in Females?

Answer 27

• covered by the peritoneum and in touch with the small intestine
• Touches the Uterus

Question 28

What is on the Posterior Surface of the Bladder in Females?

Answer 28

• Touches the Vaginal canal, cervix, and rectum

Question 29

What is on the inferior side of the bladder in females?

Answer 29

• The urethra Starts there

- No prostate gland

Question 30

What is the inside of the bladder covered by?

Answer 30

• The urothelial epithelium

Question 31

What is the Muscles of the wall of the bladder called?

Answer 31

• The detrusor Muscle

Question 32

What is the bladder trigone?

Answer 32

• a triangular area that is formed between the ureter orifices and the urethra (the apex of triangle)

Question 33

What is the Internal Urethral Sphincter?

Answer 33

• an Involuntary smooth muscle sphincter controlled by the sympathetic nervous system
• some believe that this sphincter does not exist in the female bodies, which could explain the higher prevalence of incontinence in females

Question 34

What is the External Urethral Sphincter?

Answer 34

• The voluntary striated muscle sphincter controlled by the pudendal nerve, present in both males and females