Urinary system Flashcards
Enumerate the components of the urinary system and their respective function
Kidneys- process a filtrate of the blood to form urine
Ureters - conduct urine from the kidney to bladder
Urinary bladder - temporary storage for urine
Urethra - passage thru which urine is voided
What are the functions of the urinary system?
Excretory - waste products of metabolism is excreted thru production of urine
Maintenance of body homeostasis - kidneys maintain the acid base balance of the body and maintain the normal body fluid by eliminating excess waster
Endocrine - releases of hormones like erythropoietin and renin ( control blood pressure)
Reproductive - exclusive to male urethra as passageways for semen. ( in females, urethra is for urinary function only)
Explain the gross structure of the kidney
Bean shaped, reddish brown organ
Retroperitoneal on the posterior abdominal wall
Extend from T12 - L3
120-170g avg 150g
10-12cm L x 5-6cm W x 3-4cm a-p thickness
Explain the position of the kidney
Left kidney is 1-2cm higher than the right kidney because of the presence of the liver in the right
In a Supine position - Left kidney superior pole - T12 Inferior pole - L3 Right kidney - IVC Left kidney - aorta
What structures can bee seen. Between the kidneys?
Celiac plexus and ANS ganglia
Explain the anterior anatomical relations of the kidney
Right kidney :
Transpyloric plane passes thru right pole
Hepatic flexure of the colon and duodenum
Right kidney is separated from the liver by the Hepatorenal recess
Left kidney: Tail of the pancreas Splenic flexure Stomach Jejunum Descending colon
Explain the posterior anatomical relations of the kidney
2/3 of the posterior kidney lie on the quadrants limbo rum ms ( part of the posterior abdominal wall)
Medially - psoas ms
Laterally - transversus abdominis
Upper 1/3 of posterior kidney lies on the abdominal surface and arcuate ligament of the diaphragm
What are the structures to take note of during surgery of the kidney via the posterior abdominal wall?
Sub costal or 12th intercostal nerve
Iliohypoogastric nerve
Ilioinguinal nerve
What is the main function of the renal fascia?
It provides or serves as a barrier against spread of infection
Note: renal fascia
- represents the TRUE capsule
- can be stripped off from normal parenchyma
- thin, fibrous glistening membrane which encloses the renal parenchyma
What is the adipose capsule found immediately outside the true capsule?
Perirenal/ perinephric fat
The renal capsules are compose of what structures?
Perirenal/perinephric fat
Gerota’s fascia/ fibrous renal fascia
Pararenal/ para nephron fat
What is the Pararenal or para euphoric fat?
Extra peritoneal fat of the lumbar region
What is the gerota’s fascia or fibrous renal fascia?
Fascia enclosing the Perirenal fat. Referred to as renal fascia
What is the Perirenal or perinephric fat?
Adipose capsule found immediately outside the true capsule
Explain the border curvature relationship of the kidney
Convex lateral border
Concave medial border
Explain the structure of the kidney
Convex lateral border
Concave medial border
Rounded poles , superior and inferior
Medial surface is concave indented by the hills which leads to the renal sinus
Differentiate renal sinus vs renal pelvis
Renal sinus is the area surrounding the calyces
Renal pelvis is the expanded upper end of the ureter.
It transmits renal vessels
Hilus
State the renal vessels from anterior to posterior
Renal vein
2 renal arteries
Ureter
Differentiate the shape of kidney and renal pelvis
Kidney is bean shape or ovoid shape
Renal pelvis is flattens, funnel shape
It is the expansion of the superior end of the ureter
Renal pelvis
Note: apex of the renal pelvis is continuous with the ureter
Receive 2-3 major calyces
The minor calyces of the renal pelvis is indented by what structure?
Renal papilla, the apex of the renal pyramid, from which the urine is excreted
Explain the internal appearance of the kidney
The renal pyramid contain the collecting tumbles and from the medulla of the kidney. The renal cortex contain the renal corpuscles.
The renal papilla, project into the minor calyces,into which they discharge urine, which then passes into the major calyces and renal pelvis
Enumerate the structures of the renal parenchyma
Cortex ( outer ) - dark brown and grainy
Medulla ( inner ) - light brown and striated
List and explain the parts of the outer renal parenchyma.
Cortical arches
Renal columns of bertin - in between pyramids
Medullary rays - long delicate processes separating tubules
Contains Nephron - only in cortex
Note: outer renal parenchyma is also known as cortex
Perforated tips located in the medulla or the inner renal parenchyma where the urine passes through.
Area cribosa
Note:
Medulla have 6-10 medullary pyramids
Apex - renal papilla and area cribosa
Base - medulAry rays made up of collecting tables and LH
Each medullary pyramids plus the cortical tissue at its base and along it’s side constitutes what structure?
Renal lobe.
Laterality and shaped of the suprarenal (adrenal ) glands
L suprarenal gland - crescent shape - superomedial
R - suprarenal gland - pyramid in shaped - more apical location
It is located between superomedial aspects of kidney and diaphragm
Suprarenal gland
Suprarenal gland is separated from the kidney via a what? Which is a part of what?
Thin septum , renal fascia
What is the major attachment of suprarenal gland?
Diaphragmatic crura.
Suprarenal gland is not attached to the kidney so the movement of the diaphragm may move the gland
Compare the left and right adrenal gland by shape, location and anatomical relations
Shape: L-crescent R-pyramid
Location: L-superomedial R-more apical, located anterolateral to the right crus of diaphragm
Anatomical relations: L-related to spleen , stomach, pancreas and left crus of diaphragm
R-in contact with liver, anterolaterally
In contact with IVC, anteromedially
What are the parts of adrenal glands?
Suprarenal cortex - derived from mesoderm
- secretes androgen and steroids, these hormones cause the kidneys to retain sodium and water in response to stress, increasing blood volume and blood pressure.
Suprarenal medulla - from neuroectoderm
- mass of nervous tissue permeated with capillaries and sinusoids associated with sympathetic nervous system
- chromaffin cells of medulla are related to sympathetic Anglian neurons and both derivation and function
Chromatin cells secretes?
Catecholamines
Where epinephrine and norepinephrine activates the body’s fight or flight response
Why does the suprarenal gland or adrenalin gland has abundant blood supply?
Because of its endocrine function
What are the arterial blood supply of the adrenal gland or suprarenal gland
Superior suprarenal a. Fom inferior phrenic a.
Middle suprarenal a from abdominal aorta
Inferior suprarenal a from the renal a
What are the venous drainage of the suprarenal glands via suprarenal veins
R suprarenal veins -> IVC
L suprarenal veins -> L renal vein
What are the nerve supply of the suprarenal glands
Celiac plexus and abdominopelvic splay chic nerves
Presynaptic sympathetic fibers - derived from the lateral horn of gray matter of spinal cord T10-L1
What is the main arterial blood supply to the kidneys?
Renal Artery
Which renal artery is longer?
Right renal artery
Where does the renal artery arises?
Arises from the IV disc between the L1 and L2
What are the vascular/Renal segments?
Apical Segmental a. Anteroinferior Segmental a. anterosuperior Segmental a. inferior Segmental a. posterior Segmental a.
Where does the venous drainage of the kidneys blood supply
Renal veins -> IVC
Left renal vein receives blood from?
L. suprarenal v
L gonadal v
L ascending lumbar v
what are the microvasculature of the kidney
interlobar a
afferent arteriole
efferent arteriole
peritubular capillaries
a microvasculature of the kidney that is present on each side of the renal lobe
interlobar a
a microvasculature of the kidney that serves as the entrance to the glomerus
afferent arteriole
a microvasculature of the kidney that serves as the exit from the glomerus
efferent arteriole
In the vasa recta, the microvasculature to the kidneys loop back into thecortex to become _____?
interlobular vein
What are the medullary blood supply?
vasa recta
What are the two types of vasa recta?
vasa recta vera - true vasa recta
vasa recta spuriae - false vasa recta
where does the vasa recta vera arise directly from?
arcuateor interlobular vein
participates in countercurrent exchange system
vasa recta vera
vasa recta spuriae extends to __?
cortex and the medulla
What are the parts of the ureter
renal pelvis
abdominal uereter - false ureter
pelvic ureter - true ureter
intravesical ureter
Ureters are muscular tube that is ____ in location and its length is ____. Ureters is continous superiorly with the ______.
retroperitoneal
20-25cm
renal pelvis
right ureter is parallel or lateral to _____ while the left ureter is parallel or lateral with the ______
IVC
abdominal aorta
Ureter runs in the medial part of ____
psoas muscles
ureter is obliquely crossed by ____
gonadal vessels
ureter lies anterior to the ______ from the ____
internal iliac artery
pelvic side wall
ureters enter the bladder _____?
posteriorly
ureters cross ________ to enter ______ near the bifurcation of ________
iliac vessels ; pelvis; internal and external arteries
Uereters courses under the uterine vessels very near the _____ of the uterus
isthmus
state the ureteric constrictions
- junction of tghe ureters and renal pelvis
- where the ureters cros the pelvic brim
- during passage thru the wall of urinary bladder
It is the most common pathalogic condition in the kidneys
kidney stones
What are the arterial blood supply of the ureters
renal a
testicular or ovarian a
abdominal a
common iliac a
These branches of the arterial blood supply of the ureter divide into ascending and descending branches and form ______ on the ureter wall
longitudinal anastomoses
Waht is the venus drainage of the ureter
renal v
gonadal v
Blood vessels of the ureters are easily traumatized during surgery, damage to the small blood vessels may lead to _____
ischemia
histological shape of ureter
stellate shaped lumen
What is the epithelial lining of ureter
transitional epithelium or urothelium - —-single layer of small basal cells
- intermediate layer of one to several layers of columnar cells
- umbrella cells (polyhedral) - binucleated / multinucleated
umbrella (polyhedral) cells expresses _____ whcih protect the lining of the ureter from toxic effects of urine
uroplakin proteins