Urinary System Flashcards

1
Q

What are the 4 overall steps of the urinary system?

A
  1. a pair of kidneys produce urine
  2. a pair of ureters transport urine to the urinary bladder
  3. urinary bladder temporarily stores the urine
  4. urethra conducts urine to the exterior
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2
Q

What are functions of the kidney?

A
  • produces urine
  • eliminate nitrogenous waste (protein metabolism)
  • maintains electrolytes and water balance
  • releases renin for regulation of blood pressure
  • releases erythropoietin for stimulation of RBC production
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3
Q

Where are the kidneys?

A

in the posterior abdominal wall behind the peritoneum on each side of the vertebral column (T12-L3)

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4
Q

What 4 parts of the abdomen do the kidneys occupy?

A

epigastric, hypochondriac, lumbar and umbilical regions

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5
Q

Why is the right kidney slightly lower than the left?

A

due to the presence of the liver

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6
Q

What is the left kidney closer to?

A

the median plate

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7
Q

What does the transpyloric plane pass through?

A
  • upper part of the hilum of the right kidney
  • lower part of the hilum of the left kidney
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8
Q

What are the 4 external features of the kidney?

A
  • 2 poles (superior and inferior)
  • 2 surfaces (anterior and posterior)
  • 2 borders (medial and lateral)
  • hilum
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9
Q

From the deepest to most superficial, what are the 4 capsules/coverings of the kidney?

A
  • fibrous (true) capsule
  • perirenal fat
  • renal fascia (false capsule)
  • pararenal fat
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10
Q

What passes through the kidney hilum from anterior to posterior?

A
  • renal vein
  • renal artery
  • renal pelvis
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11
Q

Why is the true capsule of the kidney fibrous?

A

due to condensation of the organ stroma

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12
Q

What does the perirenal fat of the kidney do?

A

give support to the kidney

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13
Q

What are the 5 anterior relations of the right kidney?

A
  • suprarenal area
  • hepatic area
  • duodenal area
  • colic area
  • jejunal area
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14
Q

What are the 6 anterior relations of the left kidney?

A
  • suprarenal area
  • gastric area
  • splenic area
  • pancreatic area
  • colic area
  • jejunal area
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15
Q

What are the 4 posterior muscle relations of both kidneys?

A
  • diaphragm
  • psoas major
  • quadratus lumborum
  • transversus abdominus
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16
Q

What are the posterior nerve relations of both kidneys?

A

subcostal, iliohypogastric and ilioinguinal nerves

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17
Q

What is the only difference between the posterior relations of both kidneys?

A

right kidney is related to 1 rib and the left is related to 2

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18
Q

What is the kidney proper composed of?

A

outer cortex and inner medulla

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19
Q

Where is the outer cortex of the kidney proper?

A

just below the renal capsule and extends between the renal pyramids and renal columns

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20
Q

What is the inner medulla of the kidney proper composed of?

A

5-11 dark conical masses called renal pyramids

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21
Q

What do the apices of renal pyramids form?

A

renal papillae that invaginate the minor calyces

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22
Q

What does a minor calyx do?

A

surround the renal papillae of each pyramid and collect urine from that pyramid

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23
Q

Where does the renal sinus open?

A

at the medial border of the kidney as hilus

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24
Q

What does the renal sinus contain?

A
  • greater part of the renal pelvis, major and minor calyces
  • renal vessels
  • lymphatics and nerves
  • fat
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25
Q

What is a nephron?

A

the structural and functional unit of the kidney

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26
Q

What does each nephron consist of?

A

a glomerulus and a tubule system

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27
Q

What is a glomerulus?

A

a tuft of capillaries surrounded by Bowman’s capsule

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28
Q

What does a renal tubular system consist of?

A
  • PCT
  • loop of Henle
  • DCT
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29
Q

Where do collecting tubules begin?

A

from the DCT

30
Q

Where do collecting ducts open?

A

on the apex of the renal papilla

31
Q

What are the 3 main functions of nephrons?

A
  • filtration of metabolic end products from the blood
  • selective reabsorption of useful substances back into the blood
  • secretion of some materials into renal tubules
32
Q

What are the 2 types of nephron?

A
  • cortical involved in sodium reabsorption
  • juxtamedullary involved in water reabsorption
33
Q

Where are renal corpuscles mainly found and what do they consist of?

A

found in the cortical arches and consist of capillaries and Bowman’s capsule

34
Q

What is Bowman’s capsule made up of?

A

visceral and parietal layers and Bowman’s space

35
Q

What is the vascular pole?

A

where the afferent and efferent arterioles enter and leave the glomerulus in the Bowman’s capsule

36
Q

What structures are between the glomerular capillaries and Bowman’s space?

A
  • flattened endothelium of the capillary
  • continuous basement membrane
  • foot plate of podocyte cells
37
Q

How much filtrate is collected in Bowman’s space?

A

~170L (10% of total filtrate over 24h)

38
Q

How much urine is formed in 24 hours?

A

1.5L

39
Q

What is the main function of the PCT?

A

active reabsorption of:
- glucose and amino acids
- sodium, chloride and bicarbonate
- majority of water

40
Q

What does the loop of Henle consist of?

A

a descending limb (thin segment) and ascending limb (thick segment)

41
Q

What is the main function of the loop of Henle?

A

reabsorption of water, sodium and chloride

42
Q

Where does the DCT begin?

A

from the vascular pole of the nephron

43
Q

What is the main function of the DCT?

A

reabsorption of water, sodium and chloride

44
Q

What is the blood supply of the kidney?

A

the renal artery, which is a direct branch of the abdominal aorta

45
Q

What is the venous drainage of the kidney?

A

the renal vein into the inferior vena cava

46
Q

What is the order of branching of the renal artery?

A

aorta → renal artery → segmental artery → interlobar artery → arcuate artery → cortical radiate artery → afferent arterioles

47
Q

What is the juxtaglomerular apparatus involved in?

A

regulation of blood pressure

48
Q

What are the 3 components of the juxtaglomerular apparatus?

A
  • juxtaglomerular (JG) cells
  • macula densa
  • Lacis/Polkissen cells
49
Q

What are JG cells?

A

modified smooth muscle cells present in the tunica media of the afferent arteriole at the point of contact with the DTC

50
Q

What do JG cells secrete?

A

renin

51
Q

What are JG cells sensitive to?

A

changes in blood pressure in the afferent arterioles

52
Q

What is the macula densa?

A

a specialised region in the wall of the DCT that comes into contact with the JG cells

53
Q

What is the macula densa sensitive to?

A

the concentration of sodium ions in the fluid present in the DCT

54
Q

What are Lacis/Polkissen cells?

A

extraglomerular mesangial cells found at the vascular pole in close relationship with the macula densa

55
Q

What are the 7 steps of the RAAS?

A
  1. kidneys sense a drop in blood pressure or low sodium levels
  2. renin is released into the bloodstream
  3. renin converts angiotensinogen (from the liver) into angiotensin I
  4. angiotensin-converting enzyme (ACE), mainly from the lungs, converts angiotensin I into angiotensin II, a powerful vasoconstrictor
  5. angiotensin II narrows blood vessels, raising blood pressure
  6. angiotensin II stimulates the adrenal glands to release aldosterone, a hormone that increases sodium and water reabsorption in the kidneys
  7. sodium and water retention raises blood volume, which helps restore blood pressure to normal
56
Q

What is the ureter?

A

a narrow, thick-walled, expansile muscular tube that is 25cm in length and 3-4mm in diameter made up of an abdominal and pelvic part

57
Q

What are the sites of anatomical constrictions in the ureter?

A
  • pelviureteric junction
  • pelvic brim where it crosses the common iliac artery
  • utero-vesical junction i.e. where the ureter enters the bladder
58
Q

What is the blood supply of the ureter?

A

the branches of all the arteries related to it (renal, testicular/ovarian, internal iliac, vesical, middle rectal, uterine)

59
Q

Where is the urinary bladder?

A

in the anterior part of the lesser pelvis immediately behind the pubic symphysis

60
Q

What are the posterior relations of the urinary bladder in males and females respectively?

A
  • males - rectum
  • females - anterior wall of vagina
61
Q

What are the anterior relations of the urinary bladder?

A

muscles of the pelvic diaphragm and pelvic bone

62
Q

What are the 3 external surfaces of the urinary bladder?

A
  • superior
  • posterior
  • inferolateral
63
Q

When are the rugae of the urianry bladder visible?

A

when the bladder is empty

64
Q

What is the bladder trigone?

A

a triangular area at the base of the bladder bounded by the internal urethral meatus and the two ureteric orifices that has no rugae

65
Q

What are the 3 components of the male urethra?

A
  • prostatic urethra
  • membranous urethra
  • spongy urethra
66
Q

What muscles are the internal and external urethral sphincters derived from respectively?

A
  • internal - bladder musculature of trigonal region
  • external - sphincter urethrae muscle
67
Q

What are the internal and external urethral sphincters innervated by respectively?

A
  • internal - sympathetic fibres (T11-L2)
  • external - somatic fibres (S2-S4)
68
Q

Describe the epithelium of the 5 parts of the nephron

A
  • Bowman’s capsule - simple squamous epithelium
  • PCT – simple cuboidal epithelium with a microvilli brush border
  • loop of Henle – simple squamous epithelium (thin) and simple cuboidal epithelium (thick)
  • DCT – simple cuboidal epithelium without microvilli
  • collecting ducts – simple cuboidal to columnar epithelium
69
Q

Describe the epithelium of the ureter and urinary bladder

A

transitional epithelium

70
Q

What cells are in the epithelial layers of the ureter and bladder?

A

basal cells, intermediate cells and umbrella cells