1 The Kidneys and Urinary Tract Flashcards Preview

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Flashcards in 1 The Kidneys and Urinary Tract Deck (23)
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1
Q

Q: Describe the location of the kidneys. What surrounds them? outside of that? What is posterior to them? superior to them?

A

A: Retroperitoneal in upper abdomen
-right usually slightly lower than left

dense fibrous capsule

enclosed within retroperitoneal space via renal fascia containing peri-renal adipose tissue

Posteriorly overlapped by diaphragm and pleural cavity superiorly

2
Q

Q: To which level does the superior pole of the right kidney lie? left?

Hilum?

A

A: 11th ICS

11th rib

L1

3
Q

Q: What is anterior to the right kidney? (2) Hilus?

A

A: liver, hepatic flexure

lies behind 2nd part of duodenum

4
Q

Q: What is anterior to the left kidney? (3)

A

A: stomach, pancreas, spleen, splenic flexure

5
Q

Q: Describe the renal blood supply. (4)

A

A: renal arteries

BP drives ultrafiltration by glomerular capillaries

renal veins

drain into IVC

6
Q

Q: What does the kidney cortex look like? due to? medulla? due to?

A

A: Cortex: granular-looking due to random organisation

Medulla: striated due to radial arrangement of tubules and micro-vessels

7
Q

Q: How many lobes does each kidney have? meaning? (2) What lies above each kidney?

A

A: Multilobar

each lobe drains through its own papilla and calyx

suprarenal glands

8
Q

Q: Apart from venous blood, what leaves the kidneys? how? (2)

A

A: urine

via renal pelvis (in hilum)
and ureter

9
Q

Q: Where do the ureters run? (2) What 2 structures do they cross?

A

A: vertically down

  • posterior abdominal wall
  • in plane of tips of transverse processes of lumbar vertebrae

Cross pelvic brim anterior to sacro-iliac joint and bifurcation of common iliac arteries

10
Q

Q: In what direction do the ureters enter the bladder? at what level?

A

A: Descend anteromedially to enter bladder at level of ischial spine

11
Q

Q: How is urine transported down the ureters? entry into bladder?

A

A: Urine transported by peristalsis in smooth muscle walls

-> open obliquely through bladder wall

12
Q

Q: What occurs 3 times along the length of each ureter? Name the locations. What are these sites of?

A

A: 3 sites of ureteric constriction

  • pelviureteric junction (just after leaves)
  • crossing of pelvic brim (at location of bifurcation of common iliac As)
  • traversing of bladder wall (where is enters bladder wall)

sites of renal colic from kidney stones attempting to pass

13
Q

Q: What kind of organ is the bladder? Shape? specify (2). When looking from within, what shape is the posterior? name?

A

A: pelvic organ

Triangular pyramid: apex anteriorly; base/fundus posteriorly

triangle, trigone

14
Q

Q: What lines the bladder? What is their cell turnover speed? What cells make it up? Describe. Benefit of this property?

A

A: Lined by urothelium = 3-layered epithelium

v. slow cell turnover

large luminal cells have highly specialised low-permeability luminal membrane -> prevents dissipation of urine-plasma gradients

15
Q

Q: Name the 4 surfaces of the bladder. Apart from the 2 ureters, name 2 other attachments.

A

A: posterior (= triangular base/fundus)

superior surface (= triangle)

2 inferolateral surfaces

  • urethra going down
  • median umbilical ligament at apex- anterior (opp fundus/base)
16
Q

Q: What is the trigone of the bladder? Formed by? (3) Role?

A

A: smooth triangular region of the internal urinary bladder

formed by the two ureteric orifices and the internal urethral orifice

area is very sensitive to expansion and once stretched to a certain degree, the urinary bladder signals the brain of its need to empty

17
Q

Q: How many urinary sphincters do we have? How do they differ in males and females? Name and describe (sphincter type, muscle type, location, role/tone, controlled by)

A

A: 2, closer together in females

sphincter vesicae -> internal sphincter (smooth muscle); at neck of bladder; reflex opening in response to bladder wall tension; controlled by PNS

sphincter urethrae -> external sphincter (striated muscle); in perineum; tone maintained by somatic nerves in pudendal nerve (S2,3,4); opened by voluntary inhibition of nerves

18
Q

Q: Do males and females have the same urethra? Female? (2)

A

A: no

just goes from internal urethral orifice to external (aka urethral meatus)

19
Q

Q: Describe the male urethra. (7)

A

A: internal urethral orifice (bladder neck, bladder outlet)

prostatic urethra (going through prostrate)

membranous urethra (where you have periurethral striated muscle

bulbar urethra (where bulbourethral glands are)

         FIRST BEND (now going horizontal)

penile urethra = spongy part (SECOND BEND is during this- now going down)

navicular fossa (just before end)

external urethral meatus

20
Q

Q: Posterior relations to kidneys. 3 muscles- inc which part of kidney). Ribs. Diaphragm location.

A

A: outer- transverus abdominis, quadratus lumboram muscle, psoas major muscle (nearest hilum)

L- rib 11 and 12
R- rib 12

D= upper third

21
Q

Q: Name of top of kidney? bottom? side opposite hilum?

A

A: superior pole

inferior pole

lateral margin

22
Q

Q: Kidney cross section (8).

A

A: -renal papilla

  • renal pyramid
  • minor calix
  • major calix
  • renal pelvis
  • renal columns
  • renal cortex
  • ureter
23
Q

Q: Reflex and voluntary control of bladder.

A

A: REFER
reflex control……………………………….voluntary control

bladder fills………………………………….cerebral cortex
\/ +
stretch receptors——————–……………………..\/+
\/ +………………………………………………..\ (-)
parasympathetic nerves…………….motor neurons
\/ + ……………………………………………………….1…………2
bladder
\/
bladder contracts
\/
internal urethral sphincter mechanically opens when bladder contracts

from motor neuron:

  1. external urethral sphincters opens when motor neuron is inhibited (as done when stretch receptors are activated when bladder fills)
  2. external urethral sphincter remains closed when motor neuron is stimulated (as done under voluntary control from cerebral cortex)