Urinary system

Question 1

What are the 4 components of the urinary system?

Answer 1

Kidneys
Ureters
Bladder
Urethra

Question 2

At what vertebral levels do you find the kidneys?

Answer 2

Found in paravertebral gutters on posterior abdominal wall on either side of vertebral column between vertebrae T12-L3

Question 3

At what vertebral level does the transplyoric plane lie?

Answer 3

L1

Question 4

Which kidney is lower?

Answer 4

Right due to presence of liver

Question 5

What are the 4 layers of the coverings of the kidneys?

Answer 5

Fibrous renal capsule
Fatty renal capsule
Renal fascia - fibro-fatty tissue
Pararenal fatty tissue - mainly on posterior aspects

Question 6

Why is there so much fatty tissue surrounding the kidneys?

Answer 6

Protection from trauma as there is no protection from bone in the abdomen

Question 7

What are the posterior relations of the kidneys?

Answer 7

Diaphragm
Psoas major
Quadratus lumbarum

Question 8

Over which muscle does the ureters lie?

Answer 8

Psoas major

Question 9

List some retroperitoneal organs and structures

Answer 9

S - suprarenal glands
A - abdominal aorta
D - duodenum

P - pancreas (except tail)
U - ureters
C - colon (ascending and descending parts)
K - kidneys
E - oesophagus
R - rectum

Question 10

What happened embryologically to cause duplicated ureters?

Answer 10

Due to duplication of ureteric bud from mesonephric duct

Question 11

What happened embryologically to cause horseshoe kidneys?

Answer 11

Inferior poles of the kidneys have fused

Question 12

What proportion of the population have horseshoe kidneys?

Answer 12

1 in 400

Usually found incidentally

Question 13

Describe the nerve supply of the kidneys

Answer 13

Sympathetic - T12-L1 nerves run through coeliac ganglion and along renal artery

Parasympathetic - from vagus nerve

Question 14

Describe the lymphatic drainage of the kidneys and where they are located

Answer 14

Drains to para-aortic lymph nodes around the origin of the renal arteries (L1)

Question 15

What structures are found in the cortex of the kidney?

Answer 15

Proximal and distal convolutes tubules

Renal corpuscles

Question 16

What structures are found in the medulla of the kidney?

Answer 16

Collecting ducts

Loop of Henle

Question 17

At what vertebral level are the renal arteries given off from the abdominal aorta?

Answer 17

L1/L2

Question 18

What happens to the renal arteries at the hilum of the kidneys?

Answer 18

Divide into 5 segmental arteries

Question 19

On what side is the inferior vena cava of the aorta in the body, and how does its affect the renal arteries?

Answer 19

IVC is found to the right of the aorta

Makes left renal vein longer as it has to travel anteriorly over the aorta to the left kidney

Question 20

How does the positioning of the main vessels of the abdomen affect the right renal artery?

Answer 20

Right renal artery is longer than the left renal artery as it has to travel posteriorly past the inferior vena cava to reach the right kidney

Question 21

What vein from the pelvis travels up to drain into the left renal vein?

Answer 21

Left gonadal vein

Question 22

Where does the right gonadal vein drain into?

Answer 22

Inferior vena cava

Question 23

How are the ureters peritonised?

Answer 23

Retroperitoneal

Question 24

What crosses the ureters superiorly in males?

Answer 24

Ductus/vas deferens

Question 25

What crosses the ureters superiorly in females?

Answer 25

Uterine artery

Question 26

Where are the 3 constrictions of the ureters?

Answer 26

1 - ureteropelvic junction: where pelvis narrows to form the ureters 2 - as the ureter enters the pelvis and crosses over the common iliac artery bifurcation 3 - during passage of ureters into the bladder

Question 27

Which part of the bladder do the ureters enter?

Answer 27

Ureteric orifices are found on the superior angles of the trigone of the bladder (smooth triangular area found in the bladder)

Question 28

From which part of the bladder does the urethra exit?

Answer 28

Neck of the bladder

Question 29

What is the median umbilical ligament a embryological remnant of?

Answer 29

Embryonic urachus

Question 30

What kind of tissue makes up the walls of the bladder?

Answer 30

Smooth muscle detrusor

Question 31

What bony joint is found anterior to the urinary bladder?

Answer 31

Pubic symphysis

Question 32

What symptoms might a patient experience if they are found to have a larger bladder that may extend into the abdominal cavity?

Answer 32

Urine retention

Question 33

Describe the anatomical position of the bladder to the vagina

Answer 33

Bladder is anterior to the vagina

Question 34

Describe the anatomical position of the bladder to the uterus

Answer 34

Bladder is inferior to the uterus

Question 35

What kind of epithelium lines the bladder and ureters?

Answer 35

Transitional epithelium (stratified)

Question 36

What would make a kidney look ill defined on a CT-KUB?

Answer 36

Oedema

Question 37

What is a CT KUB?

Answer 37

CT of kidneys, ureters and bladder