Urinary System

Question 1

what makes up the urinary system?

Answer 1

kidneys
ureters
urinary bladder
urethra

Question 2

what are the kidneys associated with?

Answer 2

Perinephric fat (perirenal fat capsule)

Renal fascia

Paranephric fat (pararenal fat body)

Question 3

what makes up the hilum of the kidney?

Answer 3

an indentation on the medial surface; vessels and nerves enter and exit at this location

Question 4

describe the kidneys?

Answer 4

The kidneys are bean-shaped and obliquely placed, lying at an angle to each other.

Question 5

what is the renal sinus?

Answer 5

the space inside the kidney that is reached after passing through the hilum. In reality, the sinus is a “potential” space.

Question 6

since we know that the renal sinus is a potential space, what can we find inside it?

Answer 6

It is filled with all the structures passing into and out of the kidney, and the space not occupied by these structures is filled in with adipose (fat) tissue.

Question 7

what is the kidney comprised of?

Answer 7

cortex and medulla, the medulla is organized into pyramids.

Question 8

what are the renal columns?

Answer 8

consisting of cortical tissue extend centrally between adjacent pyramids.

Question 9

describe the renal pyramid?

Answer 9

Each renal pyramid has a base and an apex

Question 10

since the kidney has an apex, what does we mean by renal papilla?

Answer 10

an opening through which urine produced by the kidney will begin its journey to the urinary bladder.

Question 11

where do the renal arteries come from?what do they become?

Answer 11

paired branches of the aorta; 5 segmental arteries

Question 12

what do the five segmental arteries supply?

Answer 12

. The five segmental arteries supply largely non-over-lapping areas within the kidney. Each of these areas, or segments, are surgically resectable.

Question 13

what is the path of the arteries after the renal arteries divide into the segmental arteries?

Answer 13

renal artery to segmental artery to interlobar arteries. These form arcuate arteries that then give rise to interlobular arteries then the afferent glomerular artery

Question 14

what is the arterial supply of the kidneys?

Answer 14

Proximally, they receive branches from the renal arteries.

More distally they receive branches from the:

1) Aorta
2) External iliac A
3) Internal iliac A (and branches)

Question 15

where is the urinary bladder in relation to the pubic symphysis? what position does it take when filled?

Answer 15

posterior; when filled, extends superior to the pubic symphysis.

Question 16

what is the wall of the urinary bladder known as?

Answer 16

The wall of the urinary bladder is smooth muscle known as “detrusor” muscle.

Question 17

what constitute the internal landmarks of the urinary bladder?

Answer 17

ureteric orifices

internal urethral orifice

Question 18

what is the ureteric orifice?

Answer 18

the openings of the ureters

Question 19

what is the internal urethral orifice?

Answer 19

the opening into the urethra.

Question 20

the three openings of the urinayr bladder delimit a triangular region called?

Answer 20

trigone

Question 21

how is the urethra in males different than females?

Answer 21

The male urethra exits the urinary bladder at the “neck” of the bladder to become the prostatic urethra, which is continuous with the intermediate (membranous) urethra and then the spongy (penile) urethra.

The female urethra is not shared with the genital system as is the male prostatic, intermediate and spongy urethra.

Question 22

during a urethral catheterization, what must be considered?

Answer 22

The intermediate segment of the male urethra is vulnerable to rupture during this procedure.

Question 23

what can the interior of the bladder and its three orifices can be examined with ?

Answer 23

cytoscope, during transurethral resection of a tumor, the instrument is passed into the bladder through the urethra. Using electrical current, the tumor is removed in small fragments that are washed form the bladder with water.

Question 24

what is TURP?

Answer 24

Transurethral Resection of the Prostate (TURP), this condition is common after middle age and will affect every male that lives to old age.

When enlarged, the prostate gland projects into the bladder, distorts the prostatic urethra and obstructs the internal urethral opening. These alterations make urination difficult.

With the resectoscope, the prostatic urethra and surrounding prostatic tissue is removed to create free passage of urine from the urinary bladder to the external urethral opening.

Question 25

this part of the male genitals is a common site of surgical intervention.

Answer 25

the prostate, the complete removal is the radical prostatectomy

Question 26

how does the prostatectomy work?

Answer 26

The prostate gland is accessed through either a retropubic or perineal approach. The prostate, including the prostatic urethra is removed. An catheter connects the distal and proximal ends of the transected urethra. The ends are sutured together to restore the urethra.

Question 27

where does the lymph from the kidneys drain?

Answer 27

to right and left lumbar lymph nodes.

Question 28

where does lymphatic drainage occur in the ureters?

Answer 28

Ureters, depending on the specific ureteric level, drain to:

Lumbar nodes

Common iliac nodes

Internal and external iliac nodes

Question 29

where does all the lymphatic drainage from the lower half of the body go?

Answer 29

converges in the abdomen to enter the beginning of the thoracic duct (cisterna chyli).

Question 30

describe the innervation to the kidneys?

Answer 30

Sympathetic fibers (preganglionic), traveling in abdominopelvic splanchnic nerves, arrive at the aorticorenal ganglion; postganglionic neurons reach the hilum of the kidney by way of the renal plexus; involved in vasoregulation.

Parasympathetic preganglionic fibers extending from the vagal trunk travel along the renal plexus to the kidney.

Question 31

describe the innervation to the ureters?

Answer 31

Abdominal segment is supplied through renal, abdominal and superior hypogastric plexuses.

Visceral afferent fibers conducting pain sensation from kidney and ureters follow sympathetic fibers and travel to spinal nerves T11 – L2. These fibers are especially sensitive to over distension of the ureters.