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55 Cards in this Set
- Front
- Back
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1.Identify the parts of the urinary system and state the function of each part. |
-kidneys: filtration of blood & formation of urine, hormone filtration & release
-ureters: connects kidneys to bladder -bladder -urethra |
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2.Locate the kidneys and describe their anatomical relations. |
-retroperitoneal
-in extraperitoneal CT on post. abdomen @ level of T12-L3 Ureters run inferiorly from kidneys *L kidney higher than R |
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3.Name the coverings of the kidney. |
innermost--> outermost)
Fibrous capsule--> PERIrenal/PERInephric Fat--> Renal Fascia (of Gerota)--> PARArenal/PARAnephric Fat |
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4.Identify the parts of the kidney as seen in a sagittal section. |
2 main portions: cortex (outer) & medulla (inner)
Hilum continuous w/ renal sinus---> Renal sinus continuous w/ renal pelvis (into ureter) (cortex/outer--->medulla/inner) renal columns, project to inward creating renal pyramids---> pyramid apex, renal papilla point inward & are surrounded by minor calyx---> multiple minor clayx converge to form major calyx---> several major calyx form renal pelvis--> renal pelvis funnels downward as ureter |
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5.Describe the blood supply, lymph drainage, and nerve supply of the kidneys. |
blood supply: R & L renal arteries & veins (veins anterior)
lymph drainage: paraaortic nodes nerve supply: GVE sympathetic- T10-12, splanchnic nerve & aorticorenal ganglion parasympathetic- vagus nerve GVA splanchnic nerves to spinal sensory ganglia & spinal cord T10-L2 |
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6.Locate the ureters and describe their anatomical relations. |
-run inferiorly from kidneys
-along psoas major, pass over pelvic brim @ bifurcation of common illiac arteries -lower 1/2 in pelvis ant. to internal illiac arteries to ischial spine, then to post bladder -adheres to peritoneum |
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7.Identify the (3) areas of normal constrictions of the ureter and the clinical significance of these. |
1. Ureteropelvic junction- where renal pelvis joins ureter
2. Pelvic brim- ureter crosses brim at bifurcation of common iliac arteries 3. Ureterovesical junction- where ureter pierces wall of urinary bladder *significant sites of urinary tract stone (caliculi) impaction |
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8.Describe the blood supply, lymph drainage, and nerve supply of the ureters. |
blood supply:
longitudional anastomoses (upper-->pelvic) renal a, testicular/ovarian a, abdominal aorta, branches of internal iliac a. venous drainage (upper-->pelvic) renal v, gonadal v, branches of internal iliac lymph drainage: upper- paraaortic nodes middle- common iliac nodes inferior- external or internal nodes nerve supply: GVE sympathetic- T11-12 parasympathetic- vagus & pelvice splanchnic nerves, S2-4 GVA splanchnic nerves to spinal sensory ganglia & spinal cord T10-L2 |
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9.Identify the kidneys and their excretory portions on retrograde pyelograms. |
*numbers indicate ureter constrictions
1. ureteropelvic junction 2. pelvic brin 3. ureterovesicular junction |
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10.Locate the suprarenal glands and describe their anatomical relations. |
-associated w/ the superior pole of each kidney
-separated from each kidney by thin septum -located in the perirenal fat & fascia |
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11.Differentiate the right from the left suprarenal gland. |
Right-
pyramidal behind R lobe of liver & IVC Lert semilunar behind stomach, spleen, & pancreas |
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12.Describe the blood supply, lymph drainage, and nerve supply of the suprarenal glands. |
blood supply-
sup, mid, & inf suprarenal arteries R & L suprarenal veins lymph drainage- nerve supply- lesser & least splanchnic nerves (*primarily sympathetic supply) (T10-T12) |
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13.Name the hormones secreted by the adrenal glands and the action of each hormone. |
(outermost-->innermost)
Cortex: zona glomerulosa- mineralcorticoids, fluid & electrolyte balance zona fasiculata- glucocorticoids, fat, carb, protein metabolism zona reticularis- androgens, sex organ development Medulla: chromaffin cells- catecholamines, flight or fight response |
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14.Describe the effects of hyper- and hyposecretion of the hormones of the adrenal glands. |
hyper-
Cushing's syndrome ( excessive cortisol) Pheochromocytoma (catecholamine, medulla tumor) hypo- Addison's disease (adrenal insufficiency) |
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15.Define the role of the intermediate mesoderm in the development of the urinary system. |
-most of urinary system forms from intermediate mesoderm
-during embryonic folding, intermediate mesoderm forms buldge--> urogenital ridges -nephronic portion of ridge, gives rise to most of urinary system (gonadal ridge--> genital system) |
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16.Discuss the development of the embryonic excretory organs and their role in the formation of the permanent kidneys. |
3 overlapping kidneys develop in a cranial-caudal sequence (as the next one develops, the previous one disappears)
1. Pronephros 4th week, nephrotomes form 2. Mesonephros 4th week- middle 2nd month, mesonephric ducts 3. Metanephros 5th week-birth, ureteric bud, permanent kidney |
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17.List the derivatives of the ureteric bud and the metanephric mesoderm. |
Ureteric bud-
ureter, renal pelvis, major & minor calyces, renal pyramids, collecting tubules (collecting system) metanephric mesoderm- glomeruli, nephrons, bowmans capsule, proximal & distal convoluted tubules, loop of henle (excretory portion) |
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18.Describe the positional changes of the kidney during development and associated position of the renal vessels. |
-initially, kidneys (metanephros) in pelvis, supplied by pelvic branches of aorta
-ascent into abdomen, becomes vascularized by arteries at higher levels -by week 9, retroperitoneal on post. abdomen wall -lower vessels degenerate, may persist as accessory renal arteries |
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19.List and describe most common congenital anomalies of the kidneys |
Renal agenesis-
metanephric diverticulum fails to develop or degenerates early-->unilateral of bilateral absence bilateral-> oligohydramnios, Potter sequence (flat face, hypoplastic lungs, deformed limbs) Renal ectopia failure of one or both to ascend--> abnormal position or fusion (discoid, pancake) crossed--> both kidneys on one side horseshoe kidney--> fusion of poles (normal ascent prevented by inf. mesenteric artery) Malrotated kidney- no rotation, or incorrectly rotated Cystic Kidney disease- polycystic--> multiple cysts (renal insufficiency) autosomal recessive (childhood)- collecting duct cysts autosomal dominant (adult)- nephron cysts multicystic--> fewer cysts, nephrons |
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What structures enter the kidneys at the medially located hilums?
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renal vein
renal artery ureter (ant. V-->A-->U post.) *lymphatics & nerve plexuses also transmitted through hilum |
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What structures run posteriorly to BOTH kidneys? (same)
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-diaphram (superior-most)
-psoas major-->quadratus lumborum-->transversus abdominis (medial-->lateral) *pleural sacs & costodiaphragmatic recesses also posterior to both |
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What structures run anteriorly to EACH kidney? (differs)
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(listed superior-->inferior)
Right: liver, descending duodenum, R colic flexure, small intestine (intraperitoneal part) Left: stomach, spleen, pancreas, L colic flexure, descending colon, jejunum |
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The _______________ lie superior-most and anterior to each kidney
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suprarenal glands
(R & L respectively) |
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The (Right/Left) kidney is anterior to ribs 11 & 12.
The (Right/Left) kidney is anterior to 12 only. |
Left
Right |
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What nerves run posterior to both kidneys?
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subcostal nerves (& vessels)
iliohypogastric nerve ilioinguinal nerve |
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The renal fascia encloses both the ________ & _________, which are separated by a thin septum
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kidneys & suprarenal glands
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The renal fascia encloses the ureter inferiorly & directs perinephric infections where?
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inferiorly into the pelvis
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What is the renal fascia continuous w/ laterally?
medially? posteriorly? |
laterally- fascia transversalis
medially- sheath of renal vessels, aorta & inferior vena cava posteriorly- fascia of psoas major |
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The (cortex/medulla) contains the following:
-renal corpuscles (glomerulus & Bowman's capsule) -PROXIMAL parts of proximal & distal convoluted tubules & distal collecting ducts |
cortex
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The (cortex/medulla) contains the following:
-thick & thin limbs of loops of Henle -DISTAL parts of proximal & distal convoluted tubules & distal collecting ducts |
medulla
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Describe the functional subdivisions of the kidneys (largest-->smallest divsions)
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Segments (5), each supplied by own segmental artery-->
Lobe, cortical tissue around each pyramid, includes renal column--> Lobule, cortical tissue w/ medullay ray in middle--> Uriniferous tubule, nephron + collecting duct (functional unit of kidney**^) |
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What are the 5 segments of the kidney
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Superior
Inferior Posterior Anterosuperior Anteroinferior |
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The renal artery arises from the abdominal aorta at what spinal level?
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arises below superior mesenteric btwn L1 & 2
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The (right/left) renal vein is longer
The (right/left) renal artery is longer |
left vein longer
right artery longer |
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T/F
Accessory renal arteries are common & enter the kidney at the hilum |
FALSE
do NOT enter at hilum (extra hilar arteries) |
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Before the R & L renal veins drain into the IVC, the L vein crosses the midline btwn what two structures, where it may become compressed?
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aorta & superior mesenteric
(compressed by aneurysm of either^) |
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Describe the vascular divisions of the R & L renal arteries
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R & L renal arteries-->
Ant & Post branches--> 5 segmental end arteries--> interlobar arteries--> arcuate arteries--> interlobular arteries--> afferent arterioles--> glomerulus--> efferent arteriole--> cortical peritubular capillaries (cortex) or rectae spuriae (medulla) |
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What is the main advantage & disadvantage of the segmental END arteries
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advantage- segments can be surgically resected individually, leaving rest of kidney functional & intact
disadvantage- no collateral circulation, if artery becomes occluded the entire segment infarcts (dies) |
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What causes nutcracker syndrome?
What may male patients develop as a result? |
compressed L renal vein btwn SMA & aorta
may develop varicocele & left testicular pain |
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In females only, the ureters are crossed by _________________
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uterine artery
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Describe symptoms & treatments for caliculi (UT stones)
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symptoms:
-ureteric colic (intermittent pain) -loin to groin pain (T11-L2) -hematuria (bloody urine) treatments: -lithotripsy (laser shock waves, break stones to pass) |
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Why is renal cell carcinomas is especially dangerous when it invades the renal vein?
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Spreads from the renal vein to inferior vena cava, will then be able to travel into right atrium, across tricuspid valve into pulmonary artery
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During renal transplant, where is the new kidney placed and why?
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in the illiac fossa
-doesn't compromise existing structures & extraperitoneal approach provides swift recovery |
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The (cortex/medulla) of the suprarenal gland has a mesoderm origin
The (cortex/medulla) has a neural crest cell origin |
cortex (mesoderm)
medulla (neural crest) |
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What do each of the following arteries branch from?
Superior suprarenal artery Middle suprarenal artery Inferior suprarenal artery |
Superior suprarenal artery- inf. phrenic artery
Middle suprarenal artery- abdominal aorta Inferior suprarenal artery- renal artery |
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The (left/right) suprarenal vein drains into the left renal v, while the other drains directly into the IVC
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left
(drains into L renal, which then drains into IVC) |
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Preganglionic fibers (T10-T12) pass through the paravertebral _______ ganglia & plexus, joining the _________ plexus, & ending on the postganglionic chromafin cells
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celiac ganglia
(joining) periarterial plexus |
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The mesonephros & mesonephric duct are derived from intermediate mesoderm in the __________________ segments
What does the mesonephros form? |
upper thoracic to upper lumbar (L3) segments
forms glomerulus, Bowman's capsule, renal corpuscle, mesonephric/wolffian duct |
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The ridge between the mesonephros & primary gonads, formed in the middle of the 2nd month is the ____________________
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urogenital ridge
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The mesonephric duct persists in (males/females) & contributes to the formation of what?
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males
genital system |
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The definitive kidney becomes functional near the ___ week.
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12th
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Each developing collecting tubule is covered distally be a ________________
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metanephric tissue cap
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Prior to birth, the _____________ is the primary remover of nitrogenous wastes from fetus. After birth, the ______________ takes on this role
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placenta
kidney |
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19.List and describe most common congenital anomalies of the ureters. |
Duplication of Urinary tract-
division of metanephric diverticulum--> incomplete-> divided kidney w/ bifid ureter complete- >double kidney w/ bifid ureter formation of 2 metanephric diverticula-> supernumerary kidney (3rd) w/ own ureter Ectopic Ureteral orifices- ureter is not incorporated into post urinary bladder-->ureters open somewhere besides into urinary bladder--> incontinence |
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What syndrome are horseshoe kidneys associated with?
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Turner's syndrome (45, XO)
women |