Urinary System Anatomy Flashcards
kidney has many functions
acid-base balance, maintains homeostasis, plasma volume, and detoxifies blood
Acetaminophen + Ibuprofen
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
kidney failure + definition of death
-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
urinary system
-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
how much cardiac output do the kidneys get at any time?
1/3rd
hilum
area where vessels are go in to the kidneys
what two structures are not vascular in the kidneys?
ureters and pelvis
ureters
-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
pelvis
site for urine collection from the kidneys
where do the arteries and veins come off of?
thoracic aorta
gonadal veins
-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
what do the gonadal veins and arteries of the females supply + drain?
ovaries
what do the gonadal veins and arteries of the males supply + drain?
testes
what two things happened to change people’s thinking of kidney failure?
- development of dialysis, which does the filtration job of the kidneys
- kidney transplants
kidney transplants
-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
dialysis
removes blood from the body —> blood goes to machine with finer caliber filtration —> filters waste products —> goes back to the body
what do surgeons do to prepare dialysis patients?
create a fistula in the arm and expand the size of the vein to tap into for dialysis and catheter stays in
peritoneal dialysis
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
anatomy of right kidney
right kidney is always shorter and lower b/c of the right lobe of the liver
anatomy of kidneys
-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
coverings of the kidney
-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
horseshoe kidney
kidneys are connected with ismus
vasculature of kidney
-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
inside the kidney
-cortex- outer area
-medulla- deeper tissue in the shapes of pyramids
-glomeruli- dotting in the kidney that are packed in the cortex
medulla
-collecting tubules and loops of henle
-as the filtrate is pulled into collecting tubules, everything is heading down to the apices of the pyramids
pathway of filtrate in the kidney
rounded hill into collecting areas —> atrium of pelvis —> pelvis proper —> ureter
profusion and filtration of blood
-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
max bradel’s discovery of the vasculature of the kidney
-avascular plane through mid frontal/coronal section of the kidney
-do not want to slice through the vessels and cause bleeding
apices of pyramids
-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
pathway of blood in kidney
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
kidney stones
-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
lithoplaxy
catheters go up the urethra —> ureters —> kidneys with different devices to break up the stones
modern day treatment of kidney stones
we use sound waves and lasers to break up the stones —> put in catheter with laser to blast stones and evacuate them
cysts
asymptomatic sometimes but they may hinder kidney functions if so much of the kidney is taken up by them
ureters
-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
what happens if the ureters are clipped?
urine can go into the peritoneal cavity and peritonitis
urinary bladder
-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
trigone on posterior wall of bladder
perforations that are ureters that turn back into the bladder
prostate cancer
-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
pat walsh’s lab + rini’s discovery
-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
what are the three parts to the male urethra?
- prostatic
- membranous
- cavernous
what does damage to the muscular floor of the peritoneum of the bladder in males do?
can cause incontinence
