119 Questions
What is the approximate length of the kidneys in adults?
10-12 cm
At which level of the vertebral column are the kidneys located?
Th11-L3
Which structure protects the superior poles of both kidneys?
Thoracic cage
What is the relationship between the upper pole of the kidney and the midline?
The upper pole is nearer to the midline
Why is the right kidney located at a slightly lower level than the left kidney?
Due to the presence of the liver on the right side
Which rib does the left kidney's upper pole extend above?
The eleventh rib
What is the medial margin of the kidney?
Concave
What muscle is the kidney located on the ventral surface of?
Quadratus lumborum muscle
What is the primary function of the interlobular arteries?
To supply the afferent glomerular arterioles
Which vein is longer and crosses anteriorly the abdominal aorta?
Left renal vein
What is the primary destination of lymphatic drainage from the kidneys?
Renal lymphatic nodes
Which nerve provides parasympathetic fibres to the renal plexus?
Cranial nerve X
How long are the ureters, approximately?
25-30 cm
At which vertebral level do the ureters descend from the renal pelvis?
L2
What type of waves occur in the ureters during urine passage?
Peristaltic waves
Which of the following veins communicates with the accessory azygos vein?
Left renal vein
Where are the bulbourethral glands located in the male?
On either side of the urethra as it passes between the muscular fasciculi of the sphincter urethrae muscle
What is the approximate length of the female urethra?
4 cm
What is the superior part of the female urethra corresponding to?
The prostatic part of the male urethra
Where does the female urethra end?
As the external urethral orifice in the vestibule of the vagina
What muscle surrounds the female urethra at the external urethral orifice?
Musculus sphincter urethrae
How many parts can the female urethra be divided into?
Four
What is the diaphragmatic portion of the female urethra surrounded by?
The musculus sphincter urethrae
What is the infradiaphragmatic portion of the female urethra located between?
The paraurethral glands and the vaginal wall
What forms the internal sphincter of the bladder?
Fibres from all layers of the bladder
What covers the superior surface of the bladder in the male?
Peritoneum
What do the inferolateral surfaces of the bladder meet at?
Pelvic diaphragms
What does the posterior surface of the bladder relate to in the male pelvis?
Seminal vesicles
Which arteries supply the urinary bladder?
Superior and inferior vesical arteries from the internal iliac artery
In females, what overlaps the superior surface of the bladder with an empty bladder?
Uterus
What is the relationship of the neck of the bladder in males?
Prostate
In females, what does the base of the bladder relate to?
Supravaginal part of uterine cervix
Which structure does the ureter cross over to enter the cavity of the true pelvis in its abdominal course?
External iliac artery
What is the landmark near the sacral promontory where the ureter crosses over the pelvic brim?
Promontorium
What major structure does the right ureter descend close to in the abdominal region?
Inferior vena cava
Where does the pelvic portion of the ureter run along in the true pelvis before turning medially to enter the urinary bladder?
Lateral wall
In males, what structure loops over the ureter near the bladder to reach the seminal vesicles and prostate?
Ductus deferens
Where does the ureter pass deeply to the uterine vessels in females?
Ischial spine
Why is the ischial spine considered a place of great danger during hysterectomy procedures regarding the ureter in females?
Risk of ureteral injury
What is the primary source of arterial supply to the suprarenal glands?
Inferior phrenic arteries
Which of the following vessels is involved in the venous drainage of the suprarenal glands?
Adrenal veins
What is the primary source of arterial supply to the urinary bladder?
Vesical arteries
Which of the following structures is involved in the lymphatic drainage of the urinary bladder?
Internal iliac nodes
What is the primary source of venous drainage of the urinary bladder?
Vesical veins
What is the relationship between the ureter and the external iliac artery in its abdominal course?
The ureter courses anteriorly to the external iliac artery
What is the relationship between the gonadal vessels and the ureter in the abdomen?
The gonadal vessels cross anteriorly to the middle 1/3 of the ureter
What is the path of the ureter in the true pelvis?
The ureter runs along the lateral wall of the true pelvis
In males, what structure loops over the ureter near the bladder?
Ductus deferens
What is the primary destination of the veins from the bladder?
Internal iliac vein
In females, what is the relationship between the ureter and the uterine vessels?
The ureter passes deeply to the uterine vessels
From which part of the bladder does lymph drain into the external iliac lymphatic nodes?
Superior part
What is the function of the urethra in males during ejaculation?
To allow the passage of sperm between the prostate and the tip of the penis
What is the relationship between the vesical venous plexus and the prostatic plexus in males?
They communicate freely
What is the normal transverse width of the urethra?
5-6 mm
What is the structural arrangement of the muscular wall of the urinary bladder?
Three layers with fibres penetrating each other
What is the location of the ureteric orifices in the urinary bladder?
In the two upper angles of the trigone of the bladder
What is the name of the muscle formed by the smooth muscles of the urinary bladder wall?
Musculus detrusor urinae
What is the relationship between the mucous membrane and the muscular layer in the urinary bladder wall?
The mucous membrane is loosely connected to the muscular layer, except in the fundus
What is the origin of the median umbilical ligament?
From the apex of the urinary bladder
Through which vein does the left suprarenal vein usually drain?
Left renal vein
What is the origin of the inferior suprarenal arteries?
Renal artery
What is the main function of the urinary bladder?
Urine storage
What covers the superior surface of the urinary bladder?
Peritoneum
Where does the urinary bladder rest on?
Lining of the inner aspect of the pubis and floor of the pelvis
Where do the ureters cross over the pelvic brim to enter the true pelvic cavity?
at the level of S1
Which arteries supply the suprarenal glands?
inferior phrenic, abdominal aorta, and posterior abdominal wall arteries
What is the route of the arterial supply to the ureters?
renal arteries, abdominal aorta, posterior abdominal wall arteries, gonadal arteries, and common iliac arteries
Where are the suprarenal glands located?
on the upper poles of the kidneys, in front of the crus of the diaphragm
What is the significance of the ureteric constrictions?
they become problematic when renal calculi are passed to the bladder
What is the primary route of venous drainage from the kidneys?
Renal veins → inferior vena cava
Which artery provides the primary arterial supply to the ureters?
Abdominal aorta
What is the relationship between the ureter and the external iliac artery in the true pelvis?
The ureter crosses anterior to the external iliac artery
Which vein forms the primary venous drainage of the urinary bladder?
Vesical venous plexus
What is the primary source of arterial supply to the urinary bladder?
Internal iliac artery
Which structure is involved in the lymphatic drainage of the kidneys?
Renal hilar nodes
What is the relationship between the ureter and the gonadal vessels in the abdomen?
The ureter crosses anterior to the gonadal vessels
What is the primary function of the interlobular arteries in the kidney?
To supply blood to the renal cortex
Which nerve provides parasympathetic fibers to the renal plexus?
Pelvic nerve
What is the approximate length of the ureters in adults?
25-30 cm
Which of the following arteries is NOT a source of the arterial supply of the suprarenal glands?
Superior mesenteric artery
What is the shape of the right suprarenal gland?
Pyramidal
Which of the following structures lies behind the right suprarenal gland?
All of the above
What is the location of the lower end of the left suprarenal gland?
At the hilum of the kidney
How many sources of arterial supply do the suprarenal glands receive from?
3
What is the usual drainage point of the left suprarenal vein?
Left renal vein
What is the origin of the inferior suprarenal arteries?
Renal artery
What is the relationship between the right suprarenal vein and the inferior vena cava?
The right suprarenal vein drains into the inferior vena cava
What is the usual route of venous drainage of the suprarenal glands?
Into the left renal vein and then the inferior vena cava
What is the location of the suprarenal glands in relation to the kidneys?
At the hilus of the kidneys
What is the anterior relation of the left kidney?
Area of the stomach
What layer arises from the prevertebral fascia and covers the kidney?
The perirenal fascia
What is the relation of the right kidney to the suprarenal gland?
Anteromedially
What is the posterior layer of the perirenal fascia also known as?
Fascia retrorenalis
What is the relation of the left kidney to the spleen?
Anteriorly
What is the primary source of arterial supply to the suprarenal glands?
The inferior phrenic artery
Which of the following vessels is involved in the venous drainage of the suprarenal glands?
The adrenal vein
What is the relationship between the suprarenal glands and the kidneys?
The suprarenal glands are located on top of the kidneys
What is the function of the suprarenal glands?
To produce hormones that regulate various bodily functions
What is the anatomical relationship between the suprarenal glands and the diaphragm?
The suprarenal glands are located above the diaphragm
What is the role of the renal fascia with respect to the suprarenal gland?
It surrounds the suprarenal gland and kidney
What is the relationship between the true fibrous renal capsule and the suprarenal gland?
It separates the kidney from the suprarenal gland
What is the function of the renal fat associated with the kidney?
It surrounds the kidney and suprarenal gland
What is the role of the renal fascia with respect to the renal vessels?
It fuses around the renal vessels
What is the anatomical location of the suprarenal gland?
It is located at the superior pole of the kidney
What is the relationship between the left suprarenal vein and the inferior vena cava?
The left suprarenal vein drains into the left renal vein, which then drains into the inferior vena cava
What is the surface of the right kidney that relates to the duodenum?
Duodenal surface
Where is the left suprarenal gland located in relation to the colic surface?
Above the colic surface
What is the relationship between the suprarenal glands and the psoas muscle?
The suprarenal glands are located posterior to the psoas muscle
What is the relationship between the renal hilus and the renal sinus?
The renal sinus opens medially into the renal hilus
What is the origin of the inferior suprarenal arteries?
Outside the kidney
At which vertebral level do the left and right renal arteries usually arise?
Between L1 and L2
What is the course of the right renal artery in relation to the inferior caval vein?
It passes posteriorly to the inferior caval vein
What is the number of segmental arteries that the renal artery divides into within the renal sinus?
5
What is the origin of the interlobar arteries?
From each segmental artery
Which structure do the arcuate arteries run across?
The bases of the pyramids between the cortex and medulla
What is the relationship between the ureter and the gonadal vessels in the abdomen?
The ureter passes anteriorly to the gonadal vessels
What is the course of the left renal artery in relation to the superior mesenteric artery?
It arises below the origin of the superior mesenteric artery
What is the primary destination of the arterial twigs from the renal arteries to the ureter?
The ureter
What is the relationship between the renal arteries and the abdominal aorta?
The renal arteries arise from the lateral aspect of the abdominal aorta
Study Notes
Kidney Structure and Location
- The kidneys are paired organs located on the posterior abdominal wall, between Th11-L3
- They are retroperitoneal, meaning they are situated behind the peritoneum, and are in contact with the diaphragm
- Each kidney is obliquely set, with the upper pole being nearer to the midline than the lower pole
- The superior poles of both kidneys are protected by the thoracic cage
Kidney Structure
- The kidney has two poles (upper and lower) and two surfaces (anterior and posterior)
- The kidney has two margins (lateral and medial) with a convex lateral margin and a concave medial margin
Renal Arteries and Veins
- The renal arteries supply the kidneys
- The renal veins drain the kidneys, with the right renal vein entering the inferior vena cava at a lower point than the left renal vein
- The left renal vein receives tributaries from the left gonadal vein, left suprarenal vein, and left inferior phrenic vein
Lymphatic Drainage and Innervation
- Lymph from the kidneys drains to the renal lymph nodes and then to the lumbar lymph nodes
- The kidneys are supplied by the coeliac plexus, which gives sympathetic and parasympathetic fibers to the renal plexus
Ureters
- The ureters are excretory tubes that convey urine from the kidneys to the bladder
- They are 25-30 cm long and have a thick muscular wall
- The ureters descend retroperitoneally from the renal pelvis to the urinary bladder
Bladder Structure and Location
- The urinary bladder is a highly muscular organ that stores urine
- It is located in the true pelvic cavity, resting on the lining of the inner aspect of the pubis and floor of the pelvis
- The superior surface of the empty bladder reaches the pubic crest, and as it fills with urine, it distends superiorly into the abdominal cavity
Bladder Relations
- The superior surface of the bladder is covered with a sheet of peritoneum
- The bladder is related to the uterus in the female, and the rectum in the male
- The bladder shape varies with the amount of urine it contains and is also determined by the organs closely related to it
Urethra
- The urethra conveys urine from the bladder to the external environment
- The male urethra is 15-20 cm long and has a normal transverse width of 5-6 mm
- The female urethra is 4 cm long and 5 mm wide
Suprarenal Glands
-
The suprarenal glands are endocrine glands located on the upper poles of the kidneys
-
They are asymmetrical, with the right gland being pyramidal in shape and the left gland being crescent in shape
-
The suprarenal arteries arise from the inferior phrenic artery, abdominal aorta, and renal artery
-
The suprarenal veins drain to the inferior vena cava and left renal vein### Lower Part of the Urinary System and Internal Iliac Artery
-
The lower part of the urinary system consists of the kidneys, ureters, urinary bladder, and urethra.
The Kidneys
- Paired kidneys are responsible for removing waste products of protein metabolism, excess salts, and water from the blood.
- The kidneys are situated near the sacral promontory (level of S1) where the ureter crosses the pelvic brim to enter the true (lesser) pelvic cavity.
- The three ureteric constrictions become problematic when renal calculi are passed to the bladder.
- The kidneys have similar posterior relations: diaphragm, psoas muscle, quadratus lumborum muscle, and transversus abdominis muscle.
Structure of the Kidneys
- The kidney is divided into two parts: cortex and medulla.
- The cortex consists of renal corpuscles, proximal convoluted tubules, and distal convoluted tubules.
- The medulla is formed by 10-20 renal pyramids, containing proximal straight tubules, Henle's loops, distal straight tubules, and collecting tubules.
- The collecting system of the kidney is composed of three elements: minor calyces, major calyces, and renal pelvis.
Arterial Supply of the Kidneys
- The renal arteries arise from the lateral aspect of the abdominal aorta and divide into branches near the hilum.
- The left and right renal arteries arise usually between L1 and L2, just below the origin of the superior mesenteric artery.
- The renal arteries divide into segmental arteries within the renal sinus, defining five segments: superior, anterior-superior, anterior-inferior, inferior, and posterior segments.
Ureters
- The ureters are serviced by arterial twigs from the renal arteries, abdominal aorta, small arteries of the posterior abdominal wall, gonadal arteries, common and internal iliac arteries, and inferior vesical arteries.
- The three ureteric constrictions become problematic when renal calculi are passed to the bladder.
Suprarenal Glands
- Two suprarenal endocrine glands are situated on the upper poles of the kidneys.
- The right gland is pyramidal in shape and lies in the front of the right crus of the diaphragm behind the inferior vena cava and bare area of the liver.
- The left gland is crescent and its lower end reaches the hilum of the kidney.
Arterial Supply of the Suprarenal Glands
- Suprarenal arteries arise from three sources: superior suprarenal arteries, middle suprarenal arteries, and renal hilus.
Internal Iliac Artery
- The internal iliac artery has two types of branches: parietal and visceral branches.
Learn about the measurements, localization, and anatomical features of the kidneys. Understand their position on the posterior abdominal wall, relationship with the diaphragm, and contact with the adrenal gland.
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