Urinary System Flashcards
Are the kidneys, suprarenal glands and most of the ureters primarily retroperitoneal, secondarily retroperitoneal, or mesenteric?
primarily retroperitoneal
Are the lower parts of the ureters and urinary bladder, and urethra primarily retroperitoneal, subperitoneal, or mesenteric?
subperitoneal
Is the kidney primarily retroperitoneal or subperitoneal?
primarily retroperitoneal
Kidney contains 2 systems:
Vasculature (blood filtration) and collection ducts (waste excret)
What attaches the kidney in place?
the ureter and vessels (other than that it floats in fat)
Name the superior, inferior, lateral, and medial borders of the kidney
Suprarenal Gland, iliac creat, ….., reneal hilum (M)
What is the Renal Hilum and what is inside it Anterior to Posterior?
Conduit Space for vein, art, renal pelvis as becomes ureter
What does the Left kidney span? What rib is it protected by?
T11-L2 (protected by ribs 11 and 12)
What does the right kidney span? What rib is it protected by?
T12-L3 (protected by rib 12)
–limited by LIVER
Each kidney is found within the ____ space surrounded by ____ and filled with _____
Perinephric Space, renal fascia, and perinephric fat (found in paravertebral gutter)
External to the renal fascia is ___ within the paranephric space
paranephric/pararenal fat
Excretory (collection pathway)
Collecting ducts –> minor calices –> major calices –> renal pelvis –> ureter
Kidney supplied by _____ arteries that arise from ____ between L1 and L2 vertebrae
Left and right renal arteries that rise from aorta
Longer right renal artery passes ___ to IVC
posterior
Longer left renal vein passes ____ to abdominal aorta and ___ to SMA
anterior; deep
Both renal veins lie ___ to renal arteries and both renal veins drain into the ___
anterior; IVC
Which renal artery is longer?
Left is 3x right. runs between abdominal aorta and SMA
–often taken for kidney donation
Left renal vein receives the left suprarenal vein and left ____ vein
gonadal
T/F: Right renal vein drains directly into IVC
True
Which renal vein is more likely to be compressed during an aneurysm of an artery? Why?
Left–it sits in the narrow space between SMA and ab aorta
Pregang Sympathetis nerve fibers to the kidneys arise from the _____ and synapse at aorticorenal ganglia
lesser (T10-11) and least (12) spanchnic nerves
Pregang Sympathetis nerve fibers to the kidneys arise from the lesser (T10-11) and least (12) spanchnic nerves and synapse at ____
aorticorenal ganglia
Vagus nerve carrying ___- reaches the kidney but does not have apparent function
parasympathetics
Post ganglionic Sympathetic fibers and vagal fibers reach the kidney via the ____
renal nerve plexus
Nerves to the kidneys arise from the _____ and consist of sympathetic and parasympathetic fibers
renal nerves plexus
Nerves to the kidneys arise from the renal nerves plexus and consist of____fibers
sympathetic and parasympathetic
Urine production (Sympathetics)
Decrease in production through vasoconstriction of renal vessels
Urine Production (Parasympathetics)
No apparent function… seem to carry some visceral afferent information
The hilum of the right kidney is behind what organ?
2nd segment of duodenum
Visceral pain to kidney conveyed via ____ fibers
sympathetic
Visceral non-pain fibers (chemorec, mechanorec) conveyed to kidney via:
lower thoracic and upper lumbar sensory nerves (following sympathetics) and via sensory nerves o nodose ganglion (following parasympathetics)
Suprarenal glands located between ______ of the kidney and diaphragm
superomedial aspects
_____ produce hormones that help regulate several body functions including metabolism, blood pressure, and body’s response to stress
Suprarenal (adrenal galnds)
What is the right suprarenal gland in contact with? the left?
R: right crus, IVC, Liver
L: left cruc, spleen, stomach, pancreas
Suprarenal Glands are enclosed by _____ and attached to the ___ of the diaphragm
renal fascia; crura
Suprarenal glands are separated from the kidneys by ___
a thin septum
Blood supply to the suprarenal glands:
Superior, middle, and inferior suprarenal arteries
What supplies the superior pole of the suprarenal gland? what is it a branch of?
Superior Suprarenal Artery (from inferior phrenic artery)
What supplies the middle of the suprarenal gland? what is it a branch of?
Middle suprarenal artery (from abdominal aorta–near celiac trunk)
What supplies the inferior pole of the suprarenal gland? what is it a branch of?
Inferior suprarenal artery (branch from renal artery)
Left suprarenal vein often joined by the ____ to empty into ____
inferior phrenic vein; left renal vein
Right Suprarenal vein drains into ___
directly into IVC (short vessel)
___ connects the kidney to the urinary bladder
ureter
Ureter transmits urine via ___
peristalsis and gravity
What part of ureter remain retroperitoneal throughout their course?
Abdominal portion of ureter
What is nephrolithiasis?
renal stones formed in kidney
What is urolithiasis?
stone exits renal pelvis and enters ureter
Sites where constrictions in ureters normally appear: (calculi)
1) Ureteropelvic junction (ureters with renal pelvis) 2) crossing the external iliac artery and/or pelvic brim 3) as ureters traverse the bladder wall
4 types of stones:
calcium, uric acid, struvite, cystine
Where are calculi formed in the kidney?
calyces of kidney or in the ureter
The oblique passage of the ureters through the muscular bladder forms a _______ (the internal pressure of the filling bladder causing the intramural passage to collapse and PREVENT backflow of urine
one-way “flip valve”
contractions of ___ act as a sphincter and prevent reluc of urine upn contractions
bladder musulator (Detrusor muscle is smooth muscle)
when empty, the adult bladder is in the _____
lesser pelvis
Label Urinary bladder/regions?
?
Trigone of urinary bladder
triang space between 2 ureteric orifices (lateral) and the internal urethral orifice (median or apex)
Bladder bed: Inferolateral surface of bladder
pubic bones and fascia covering the lavtor ani and superior obturator internus muscle
Bladder Bed: Posterior Surface
Fascial rectovesical septum (males) and anterior wall of vagina (females)
Arterial Supply to Bladder– are branches of the ___
internal iliac artery
Blood supply to anterosuperior bladder
superior vesical arteries
Blood supply to postero-inferior bladder (fundus and neck)
(males = inferior vesical arteries) (females=vaginal arteries)
Veins draining the bladder are tributaries of the ____
internal iliac viens
What venous network associated with the bladder?
vesical venous plexus
The Vesical Venous Plexus mainly drains through the ____ veins into the ___ veins
inferior vesical veins into the internal iliac veins
In males, the detrusor muscle fibers form the ___
involuntary urethra sphincter
Functional/Physiological urethra sphincter in women is formed by
the anatomy of the bladder neck and proximal urethrae
Male urethra divided into 3 parts:
Prostatic, Membranous (intermediate), and spongy (penile)
The external urethral sphincter is innervated by the _____ and functions to maintain urinary continence
Pudendal Nerve (S2-S4)
(Genitourinary Innervation)
(Genitourinary Innervation) Parasympathetics Role:
producing and releasing waste from the body
(Genitourinary Innervation) Sympathetics role
general role in slowing production of waste while retaining it in the body until proper time to release
(Genitourinary Innervation) Somatic role
assists sympathetic NS in retaining waste
(Innervation of the bladder) Sympathetics from the _____ to pelvic plexus via _____ nerves to hypogastric plexuses and nerves
(T11-L2); lumbar splanchnic nerves (synapse occur in plexus in route to pelvic viscera)
(Innervation of the bladder) Parasympatics from ____ by the _____ and the inferior hypogastric plexus
S2-S4; pelvic splanchnic nerves
(Innervation of the bladder) ________ nerve controls the external urethral sphincter which is skeletal muscle under ____ control
Pudendal nerve (somatic nerve, S2-S4); voluntary control
(Innervation of the bladder) Sensory fibers–superior surface of bladder– follow ____ nerves to T11-L2 spinal ganglia
sympathetic fibers
(Innervation of the bladder) Reflex afferents (non-pain) and pain sensations from inferior part of bladder follow ______ fibers
Parasympathetic (pelvic splanchnic nerves; S2-S4)
Detrusor and internal urethra mnuscle are ___ muscle ; external urethral sphincter is __
smooth muscle; skeletal muscle
Parasymp acting on Detrusor muscle
Activation (contract muscle to push out urine)
Parasym actions on internal urethral sphincter
Inhibition (opening of urethra)
Somatic motor actions on external urethral sphoncter (skeletal m)
Voluntary inhibition (opening of urethra)
Symp action on detrusor muscle
inhibition (allow wall of bladder to expand and fill with urine)
Sympathetic action on internal urethral sphincter
activation (closing of urethra)
Somatic action on external urethral sphincter
voluntary action (closing urethra)
What urinary structure is potentially at risk of injury during an appendectomy?
right ureter
What urinary stucture is at risk of injury during surgery of the sigmoid colon and rectum?
left ureter
The ureters pass _______ to the posas muscle and common iliac vessels?
anterior
What are the common sites for ureteral stones?
ureteropelvic junciton
ureter crosses internal iliac artery
ureterovesical junction
Where is the most common spot for a ureteral stones?
Ureterovesical junction
What type of peritoneum do the uterus and bladder have?
visceral (no pain sensation when stretched)
What neural control has the role of producing and releasing waste from the body?
parasympathetics
What neural control has the role of slowing production of waste while retaining it inside the body?
sympathetics
What neural control has the role of assisting the sympathetics in retaining waste?
somatic motor
Sympathetics to the kidney and the renal vessels ________ urine production
through ____________
Sympathetics to the kidney and the renal vessels decrease urine production
through vasoconstriction
What do the parasympathetics do in the lower ureter?
increase peristalsis
What do the sympathetics do in the lower ureter?
inhibit peristalsis
What do parasympathetics do in the bladder?
eliminate urine
- detrusor muscle contracts
- inhibit the internal (involuntary) urinary sphincter (relax and opens it)
What do sympathetics do in the bladder?
retain urine
- detrusor to relax
- internal sphincter to constrict and close (active unless urinating)
Which urinary sphincter is voluntary?
external urinary sphincter (skeletal muscle)
- used to prevent urination
Where are the aorticorenal ganglion located and what type of signal do they carry?
at the origins of the renal arteries; sympathetics
Which kidney is in contact with liver, duodenum, ascending colon, small intestine/ileum?
right kidney
Which kidney is in contact with stomach, spleen, pancreas, descending colon, small intestine/ileum
left kidney
