Urinary System

Question 1

Function of kidneys

Answer 1

6
fluid balance
acid-base balance
maintenance of elecrolytes (K)
excreting waste
Production of EPO and Renin
Activation of vitamin D

Question 2

Position of kidneys

Answer 2

retroperitoneal

lower border of 12th ribe to L3

Hilum at L1

right kidney sits slightly lower than left

Question 3

Gerota’s fascia

Answer 3

conains kidney, fibrous capsule and perinephric fat

Question 4

Hilum of kidney

Answer 4

transpyloric plane

VAP AP

anterior to posterior

Vein
Artery
Pelvis (ureter)

Question 5

vessel for kidney transplant

Answer 5

external iliac

Question 6

Relations to the right kidney

Answer 6

superior to inferioir

• anterior:
  adrenal, liver, duodenum, colon, small bowel
• posterior:
  diaphragm, 12th rib, psos major, 3 muscles: quadratus lumborum, transversus abdominus, 3nerves: subcostal, iliohypogastric, ilioinguinal

Question 7

Relations to left kidney

Answer 7

superior to inferior

• anterior: adrenal, stomach, spleen, pancreas, colon, small bowel
• posterior: diaphragm, 12th rib, 3 muscles: psoas major, quadratus lumborum, trasversus abdominus, 3 nerces: subcostal, iliohypogastric, ilioinguinal

Question 8

renal vessels orientation with IVC/aorta

Answer 8

aorta sits on the left side of the IVC
right renal artery is longer than the left and passes posterior to the IVC
left renal vein is longer and passes anterior to the aorta

Question 9

blood supply and lymphatics of the kidneys

Answer 9

renal arteries - L2

accessory renal arteries are common

5 segmental arteries at the hilum

renal vein to IVC

para-aortic nodes

Question 10

epithelium ureter

Answer 10

transitional

Question 11

ureter course

Answer 11

retroperitoneal
closely adherent to parietal peritoneum

from renal pelivis, medial border of psoas major, anterior to the tranverse processes of L2 to L5. cross common iliac bifuraction anterior to SIJ and pass down lateral pelvic side wall. at the level of the ischial spine turn forward and medial enetring the posterior lateral bladder.

Entering obliquely prevents reflux

in males the ureter passes anterior to the vas

in females rhe ureter is posterior to the uterine vessels

Question 12

three narrowings of the ureter

Answer 12

ureteropelvic junction
as the ureter crossed pelvic brim
vesicoureteric junction

Question 13

blood supply ureter

Answer 13

upper 1/3: renal aretrues
middle 1/3: branches of aorta and gonadal arteries
lower 1/3: internal ilaic branches and inferior vesical artery

Question 14

movements of the ureter

Answer 14

vermicular when touched

Question 15

Position adrenal gland

Answer 15

superomedial aspect of each kidney

surrounded by perinephric fat

within gerota’s fascia

Question 16

what is the adrenal medualla made up of?

Answer 16

nervous tissue derived from neural crest cells

chromaffin cells act as postganglionic neurons, secreting noradrenaline and adrenaline in response to preganglionic stimulation

Question 17

phaeochromocytoma

Answer 17

catecholamine-secreting tumour of chromaffin cells

** alpha and beta blockade is needed prior to surgery

Question 18

layers of the adrenal cortex

Answer 18

zona glomerulosa - mineralocorticoids (aldosterone)

zona fasciculata - glucocorticoids (cortisol)

Zona reticularis -
(innermost) androgen secreting (dhea)

Question 19

Blood supply adrenal

Answer 19

superior adrenal artery - branch of inferior phrenic

middle adrenal - branch from aorta

inferior adrenal - branch of renal artery

venous drainage by a single vein. direct to IVC on right and into renl vein on left