Urinary System Anatomy

Question 1

kidney has many functions

Answer 1

acid-base balance, maintains homeostasis, plasma volume, and detoxifies blood

Question 2

Acetaminophen + Ibuprofen

Answer 2

Acetaminophen is processed in the liver but Ibuprofen is processed in the kidney —> have to be careful not to take two medications with different ingredients

Question 3

kidney failure + definition of death

Answer 3

-used to be that when someone had kidney failure they died but not as acutely as heart or breath death —> kidney function used to be part of the definition of death
-changed with intro of dialysis

Question 4

urinary system

Answer 4

-consists of two kidneys
-ascending vena cava on the left and aorta tucked behind two vessels going to the kidneys
-each kidney gets a single renal artery that are hidden behind renal veins
-renal veins drain the kidney and go to the inferior vena cava
-underneath the renal veins you have renal arteries that go off the aorta

Question 5

how much cardiac output do the kidneys get at any time?

Answer 5

1/3rd

Question 6

hilum

Answer 6

area where vessels are go in to the kidneys

Question 7

what two structures are not vascular in the kidneys?

Answer 7

ureters and pelvis

Question 8

ureters

Answer 8

-conduits for collected urine
-ureters go behind the peritoneum into the perineum and kidneys are also retroperitoneal
-ureters come behind bladder and turn forward —> intersect with the bladder

Question 9

pelvis

Answer 9

site for urine collection from the kidneys

Question 10

where do the arteries and veins come off of?

Answer 10

thoracic aorta

Question 11

gonadal veins

Answer 11

-left gonadal vein goes to the renal vein
-right gonadal vein goes to the inferior vena cava
-vessels are the same but go in different directions as the fetus grows

Question 12

what do the gonadal veins and arteries of the females supply + drain?

Answer 12

ovaries

Question 13

what do the gonadal veins and arteries of the males supply + drain?

Answer 13

testes

Question 14

what two things happened to change people’s thinking of kidney failure?

Answer 14

1. development of dialysis, which does the filtration job of the kidneys
2. kidney transplants

Question 15

kidney transplants

Answer 15

-first one happened in the 1950s
-usually unilateral and not bilateral
-put kidney in lower abdomen b/c
1. hard to get to the kidneys, so it is much safer to put it in one place with easy access
2. not a lot of space where the kidney is located
-removal and transplantation of kidneys is straightforward since vasculature is limited and easily mapped

Question 16

dialysis

Answer 16

removes blood from the body —> blood goes to machine with finer caliber filtration —> filters waste products —> goes back to the body

Question 17

what do surgeons do to prepare dialysis patients?

Answer 17

create a fistula in the arm and expand the size of the vein to tap into for dialysis and catheter stays in

Question 18

peritoneal dialysis

Answer 18

pump diastylate fluid into the peritoneal cavity —> peritoneum membrane filters the waste products —> waste products get pulled out of blood and into the peritoneal cavity through the peritoneum —> diastylate picks up the waste products and fluid is pumped out

Question 19

anatomy of right kidney

Answer 19

right kidney is always shorter and lower b/c of the right lobe of the liver

Question 20

anatomy of kidneys

Answer 20

-retroperitoneal —> behind peritoneum that will go up around the small intestines
-located between the 12th and 3rd lumbar vertebra
-not rigidly fixed to posterior wall, tethered to the body by vessels —> pretty mobile with fat around them
-not well protected so can be easily damaged
-kidneys are 10 cm long and 5-6 cm wide

Question 21

coverings of the kidney

Answer 21

-kidney proper
-renal capsule- similar to the pia and cannot dissect it off
-perirenal fat- thin, inner layer of visceral fat
-renal fascia- outside of the kidney with the fat between kidney proper and tissue
-perarenal fat- visceral fat that fills in all of the spaces and blends in with what’s around
-if someone is starving, they lose this visceral fat that is protective

Question 22

horseshoe kidney

Answer 22

kidneys are connected with ismus

Question 23

vasculature of kidney

Answer 23

-superior messenteric artery always comes on top of left renal
-left renal vein is longer than right renal vein b/c it has to transverse the aorta
-no collateral circulation- blood goes in then goes out so no chance of secondary circulation
-pelvic tissue is very thin and shaped like a pyramid
-suprarenal glands are almost always preserved in cadavers and produce epinenephrine

Question 24

inside the kidney

Answer 24

-cortex- outer area
-medulla- deeper tissue in the shapes of pyramids
-glomeruli- dotting in the kidney that are packed in the cortex

Question 25

medulla

Answer 25

-collecting tubules and loops of henle
-as the filtrate is pulled into collecting tubules, everything is heading down to the apices of the pyramids

Question 26

pathway of filtrate in the kidney

Answer 26

rounded hill into collecting areas —> atrium of pelvis —> pelvis proper —> ureter

Question 27

profusion and filtration of blood

Answer 27

-blood comes out of the arteries —> kidney
-interlobar vessels- between lobes of kidney and they are the first branches for the blood
-arcuate arteries- arch around the top of the pyramids into the cortex —> making arches between interlobars
-interlobular arteries- little branches that are irregular- in arteries going up to the filtration units and end up in Bowman’s capsules

Question 28

max bradel’s discovery of the vasculature of the kidney

Answer 28

-avascular plane through mid frontal/coronal section of the kidney
-do not want to slice through the vessels and cause bleeding

Question 29

apices of pyramids

Answer 29

-papillae- tips of the pyramids- perforations that are collecting tubules for urine to drain through
-lesser calyx- atrium- first area where urine collects
-greater calyx- hallway- collecting area then funnels down

Question 30

pathway of blood in kidney

Answer 30

vessels go into the interlobar —> coming into the arcuate —> branches going into the capillaries of Bowman’s capsules —> vessels then go down to medulla —> further filtration in the loops of Henle

Question 31

kidney stones

Answer 31

-staghorn- stone can form in multidirectional form- formations of phosphate and calcium
-some have changes in their core with coagulated blood or broken up
-treated with lithoplaxy
-used to be that they would break up the stones and have people eliminate them themselves

Question 32

lithoplaxy

Answer 32

catheters go up the urethra —> ureters —> kidneys with different devices to break up the stones

Question 33

modern day treatment of kidney stones

Answer 33

we use sound waves and lasers to break up the stones —> put in catheter with laser to blast stones and evacuate them

Question 34

cysts

Answer 34

asymptomatic sometimes but they may hinder kidney functions if so much of the kidney is taken up by them

Question 35

ureters

Answer 35

-25 cm tubes that run posterior to the peritoneum
-sit on the psoas muscles, which help people lift with their knees
-surgeons will typically flag them in surgeries with vessel loops to ensure they are not messed with
-little bit of milking urine to bladder but mostly it is due to gravity

Question 36

what happens if the ureters are clipped?

Answer 36

urine can go into the peritoneal cavity and peritonitis

Question 37

urinary bladder

Answer 37

-tucked under and difficult to distinguish
-with females, the uterus sits on top of it
-rectouterine pouch- space between the uterus and rectum- infectious material can settle here
-vesicouterine pouch- space between the bladder and uterus- infectious material can also settle here
-difficult to get to these areas with antibiotics
-in females, the urethra beyond the bladder and conduit between the bladder and outside world
-in males, urethra is longer since it runs the length of the penis and prostate is located under the bladder
-shouldn’t have air in the bladder
-covered with rugi, which increases the surface area and can hold 500-600 cc of fluid

Question 38

trigone on posterior wall of bladder

Answer 38

perforations that are ureters that turn back into the bladder

Question 39

prostate cancer

Answer 39

-any type of enlargement in prostate can cause backup of fluid
-this is why as men get older they have to pee more often since they are unable to get enough out each time they go

Question 40

pat walsh’s lab + rini’s discovery

Answer 40

-asked rini to depict bladder infections that were common after putting in a catheter with a balloon to hold it there for urine to be collected
-there was a cuff that formed when the catheter gets pulled out and it messes with the mucosa
-discovered that they needed to put 0.5-1.0 cc of saline to round out cuff before pulling catheter out

Question 41

what are the three parts to the male urethra?

Answer 41

1. prostatic
2. membranous
3. cavernous

Question 42

what does damage to the muscular floor of the peritoneum of the bladder in males do?

Answer 42

can cause incontinence