urinary system Flashcards
what is the hilum
part of organ where the vessels and nerves enter or leave
where do the kidneys sit in relation to the transpyloric plane
- the hilum of the left kidney is 5cm lateral to the spinous process just above the level of the transpyloric plane
- the hilum of the right kidney is 5cm lateral to the spinous process just below the level of the transpyloric plane
why does the hillum of the right kidney sit just interior to the level of the transpyloric plane
the large liver moves the right sided organs down a bit
what vertebral level does the transpyloric and supracristal plane discect the vertebrae at
transpyloric = T12/L1
supracristal = L3/4
describe the location of perinephric and paranephric fat in relation to the kidney
perinephric fat = fat that sits within the renal fascia
paranephric fat = fat that sits outside the renal fascia around then kidney
what is nephroptosis and what causes this
- kidney drops down into the pelvis when the patient stands up.
- due to renal fascia not being fused at the inferior side
what are the glands found Sitting on top of the kidneys and what do they do
- suprarenal glands
- produce hormones that regulate metabolism, bp, response to cortisol (stress) etc
what 4 hormones are made by suprarenal glands and there function
aldosterone (salt control in blood and body)
adrenaline
cortisol (Helping control your body’s use of fats, proteins and carbohydrates, or your metabolism.)
testosterone
estrogen
find an image of the kidney and label its structure
- cortex
- medulla
- major/minor calyx
- papilla
- renal pelvis
- ureter
- pyramid
- renal column
- renal capsule
where does the kidney originate/ ascend from
pelvis
what is renal ectopia and what is a common pathology because of this
- kidneys fail to ascend resulting in a pelvic kidney
- as they now have a shorter ureter they are more likely to develop vesicourethral reflux (urine travels wrong way)
- this can cause UTI or urine incontinece
why are people with pelvic kidneys more prone to blunt trauma
they dont have protection of perinephric fat and ribcage
what do you call a kidney that ascends too high
thoracic kidney
what is the role of the renal capsule
tough, fibrous layer for protection (structural role)
what is the role of the cortex of the kidney
contains most of glomeruli where plasma is filtered from blood into filtrate that travels through tubules in nephron to become urine
what is the role of the medulla in kidney
has stripped apperance of collecting ducts,
- regulates concentration of urine
how does the medulla regular urine concentration
it has lots of ions so water will leave the collecting ducts via osmosis as it heads towards the minor calicoes through the papillae
where do hormones act in the kidney to increase or decrease amount of water in urine/ also used as site for drug tests
collecting ducts
note the minor calyx drains into the major calyx then into the renal pelvis
how many pyramids (renal tissue that helps with blood filtration and water conc) is found in each medulla
10-18
why is there a greater chance of stones in a horseshoe kidney
due to stasis (slowing or stoppage or normal flow) in abnormal drainage of kidney
why does a horseshoe kidney face more anteriorly
- as they fuse underneath the inferior mesenteric artery, so they wrap around it and the ureters face more anteriorly
what is persistent fatal lobulation (normal variant)
incomplete fusion of the developing metal lobules
(can stimulate renal tumours in ultrasonography)
note that it is a normal variant to have only 1 accessory renal artery
25% of population has this
which direction do the vessels come from in the pelvis and abdomen
in abdomen = vessels come medially
in pelvis = vessels come lateral
what are done with the ureters during surgery to insure they dont break
moved medially in the abdomen or laterally in pelvis (towards the vessels)
what is a urinary calculi/ stag horn or struvite stones, what causes it
- solid particles in the urinary system
- caused by repetitive UTI
( consists of calcium oxalate etc)
what causes uric acid stone / gout
form when the levels of uric acid in the urine are too high, and/or the urine is too acidic on a regular basi
what do kidney stones look like on xray
ginger knobs
compare the 3 types of kidney stones: struvite, uric acid and cystine
struvite = contains mainly calcium/magnesium, caused by UTI infections
uric acid = increased uric acid levels can form urate crystals in urine that end up getting settled in kidney developing stones
cystine = inability to reabsorb cystine (amino acid) and it gets deposited in kidney, this eventually forms cystine stones
what are 3 common sites obstruction of renal tract
- pelvic-ureteric junction
(renal pelvis/ureter region) - crossing of iliac vessels
- vesicle-ureteric junction
(bladder/ureter region)
if the bladder fills, what structure does it push higher
peritoneum
why should you not place a suprapubic catheter in when the bladder is empty
you can end up piercing the bowel
why are women more susceptible to UTI’s than males, what can this eventually manifest as
- they have a shorter urethra
- cystitis, infection of the bladder
what do you call the structure where urine exits the urethra in male and females
external urethral orifice, is the opening where urine exits the male and female urethra.
what is a suprapubic catheter used for
hollow flexible tube that is used to drain urine from the bladder through a cut in the abdomen
in embryo, the bladder drains through a tube going through the umbilical cord called what
urachus
note the bladder moves downwards into pelvis, Sits below the pelvic brim when empty, when full arises above pubic bone
what is a urachal cysts and what pathology can this lead to and how can u treat this
- when the Uranus doesnt fuse properly when umbilical cord is cut
- prone for infection, sepsis, fistula, cyst rupture
- excision laparoscopically
find a diagram of the urinary bladder and label the structures
what are stretch receptors
signal the length and changes in length of muscle
where are stretch receptors found in the bladder and what is this area
trigone
- located along the posterior surface of the bladder and marks the point of opening for the two ureters.
what do you call the structure in which the ureter enters in bladder found within the trigone
ureteric orifice
what are the 3 layers of the bladder
- mucosa (inner most layer with longitudinal folds)
- detrusor muscle
- adventitia (outer most layer)
what is the uvula of the bladder
?
what do you call the mucous glands found in the urethra
glands of littre
what percentage of the population have an accessory renal artery
25%
learn/understand what structures articulate with the surface of the kidneys, check images in album
