Urinary tract anatomy

Question 1

What vertebral level do the kidneys typically sit at?

Answer 1

T12-L3

Question 2

Which kidney is typically lower?

Answer 2

Right (due to liver)

Question 3

Where do the adrenal glands sit?

Answer 3

Superiorly to the kidneys within the renal fascia

Question 4

What layers surround the kidneys?

Answer 4

Renal capsule - tough fibrous capsule immediately covering kidney
Perirenal (perinephric) fat - outside of renal capsule
Renal fascia - encloses kidneys and adrenal glands
Pararenal fat (paranephric) - mainly located on posterolateral aspect of kidney

Question 5

What is the blood supply to the kidneys?

Answer 5

Renal arteries (arise directly from abdominal aorta)

Question 6

How does the renal artery branch as it enters the kidney?

Answer 6

Renal artery - Segmental - Interlobar - Arcuate - Interlobular - Afferent arterioles

Question 7

What is the venous drainage of the kidneys?

Answer 7

Follow pathway of arteries back to renal veins which drain directly into the inferior vena cava

Question 8

What is the lymph drainage of the kidneys?

Answer 8

Drain into the para-aortic lymph nodes

Question 9

What is the basic structure of an adrenal gland?

Answer 9

Outer connective tissue capsule
Cortex
Medulla
Hilum (where veins and lymphatics leave the gland)

Question 10

Embryologically, where did the cortex and medulla of the adrenal glands derive from?

Answer 10

Cortex - embryonic mesoderm

Medulla - ectodermal neural crest cells

Question 11

What is the function of the adrenal cortex?

Answer 11

Secretes corticosteroids and androgens

Question 12

What is the function of the adrenal medulla?

Answer 12

Chromaffin cells secrete catecholamines (e.g. adrenaline) into the bloodstream in response to stress

Question 13

What is the blood supply to the adrenal glands?

Answer 13

Superior adrenal artery (arises from inferior phrenic)
Middle adrenal artery (arises from abdominal aorta)
Inferior adrenal artery (arises from renal arteries)

Question 14

What is the nerve innervation to the adrenal glands?

Answer 14

Coeliac plexus

Abdominopelvic splanchnic nerves

Question 15

What is the clinical relevance of the positioning of the left renal vein?

Answer 15

Runs anterior to aorta and posterior to SMA meaning that aneurysm of either could compress the left renal vein leading to venous congestion, affecting renal function

Question 16

At what level do the renal arteries arise from the aorta?

Answer 16

L1 (transpyloric)

Question 17

What are the borders of the renal angle?

Answer 17

Bottom of rib 12 and lateral aspect of the erector spinae muscles

Question 18

What are the thinnest areas of the ureter, where stones can cause obstruction?

Answer 18

Renal pelvics/ ureteric junction
Pelvic brim
Entrance to bladder