Anatomy of the Ureters and Kidneys

Common iliac artery

The left ureter passes posterior to the root of the mesentery, jejunum, and the sigmoid mesocolon.

Sacroiliac joint

<p>The left colic artery branches off the inferior mesenteric artery.</p> Signup and view all the answers

<p>The right ureter passes posterior to the mesentery of the terminal ileum.</p> Signup and view all the answers

<p>The three nerves that run deep to the thoracolumbar fascia are the subcostal nerve, the ilio-hypogastric nerve, and the ilio-inguinal nerve.</p> Signup and view all the answers

<p>The structures that pass through the hilum of the kidney are the renal vein, renal artery, and pelvis of the ureter.</p> Signup and view all the answers

<p>The lower end of the kidney is located opposite to the L3 vertebral level and lies above the highest point of the iliac crest.</p> Signup and view all the answers

<p>The renal pelvis is a funnel-shaped structure that collects urine from the calyces and directs it into the ureter for excretion.</p> Signup and view all the answers

<p>Minor calyces receive urine from the renal papillae, which are the tips of the renal pyramids.</p> Signup and view all the answers

<p>The renal medulla is the inner region of the kidney and is characterized by 8-18 striated conical structures called renal pyramids. The base of the pyramids faces the cortex, while the apex faces the renal sinus.</p> Signup and view all the answers

<p>The angle formed by the lower border of the 12th rib and the lateral border of the erector spinae muscle is called the costovertebral angle. The posterior surface of the lower part of the kidney lies within this angle.</p> Signup and view all the answers

<p>The afferent glomerular artery connects the renal artery to the glomerulus.</p> Signup and view all the answers

<p>Loops of muscle surrounding the ureteric orifices tighten the openings when the bladder contracts, preventing reflux of urine.</p> Signup and view all the answers

<p>When the bladder is empty, the mucosa exhibits irregular folds due to its loose attachment to the muscular layer. In contrast, when the bladder is full, the mucosa becomes thin and smooth.</p> Signup and view all the answers

<p>The internal urethral sphincter contracts during ejaculation, preventing ejaculatory reflux of semen into the bladder.</p> Signup and view all the answers

<p>The trigone is a small triangular area at the lower part of the bladder base, situated internally between the ureteric orifices (above and posterolaterally) and the internal urethral sphincter (below and centrally).</p> Signup and view all the answers

<p>In males, the trigone is fixed to the prostate gland by the urethra and overlies the median lobe of the prostate. The trigone may extend upwards above the internal urethral orifice, forming a slight elevation called the uvula.</p> Signup and view all the answers

<p>The uterus sits superior to the bladder and is connected to it via the vesicouterine pouch. This pouch is formed by the peritoneum that covers the bladder's superior surface and folds up over the uterus.</p> Signup and view all the answers

<p>The rectovesical pouch, rectum, seminal vesicles, and the ampulla of the ductus deferens all directly relate to the urinary bladder's base in males.</p> Signup and view all the answers

<p>The detrusor muscle in the wall of the urinary bladder contracts during urination.</p> Signup and view all the answers

<p>As the bladder fills, the uterus is pushed upwards because of the pressure from the bladder. This makes the uterus more accessible and easier to visualize during an abdominal ultrasound.</p> Signup and view all the answers

<p>The detrusor muscle's arrangement in whorls and spirals, with some fibers running radially and encircling the ureteric orifices, helps prevent urine backflow from the bladder into the ureters.</p> Signup and view all the answers

<p>When the bladder is full, its superior part extends beyond the pubic symphysis, bringing its anterior surface into direct contact with the anterior abdominal wall. This allows for surgical access to the bladder through a suprapubic approach.</p> Signup and view all the answers

<p>The urinary bladder wall is mainly composed of the detrusor muscle and the mucous membrane.</p> Signup and view all the answers

<p>The prostate gland sits below the neck of the urinary bladder in males.</p> Signup and view all the answers

<p>The coverings of the kidney, from deep to superficial, are: 1. Fibrous capsule (true capsule) - a dense irregular connective tissue layer that surrounds the kidney directly. 2. Perinephric fat - a layer of adipose tissue that cushions and protects the kidney. 3. Renal fascia of Gerota (false capsule) - a condensation of extraperitoneal connective tissue that provides further support and protection. 4. Paranephric fat - a layer of fat located between the renal fascia and the anterior layer of the thoracolumbar fascia, offering additional protection.</p> Signup and view all the answers

<p>The right kidney is typically positioned slightly lower than the left kidney. This difference is primarily due to the presence of the liver on the right side, which occupies a significant portion of the abdominal space, pushing the right kidney downwards.</p> Signup and view all the answers

<p>From medial to lateral, the three muscles situated on the lower posterior surface of the kidney are the psoas major, quadratus lumborum, and transversus abdominis.</p> Signup and view all the answers

<p>The kidney has two surfaces:</p> <ol> <li>Anterior surface: This surface is convex and faces the antero-lateral abdominal wall.</li> <li>Posterior surface: This surface is relatively flat and is positioned against the posterior abdominal wall, in contact with the diaphragm and muscles.</li> </ol> Signup and view all the answers

<p>The Morris parallelogram is a surface marking that helps identify a specific area on the posterior abdominal wall, approximately 9 cm in width and 2 cm in length. It corresponds to the projection of the kidney onto the back and is used as a guide for clinicians to locate and palpate the kidneys during physical examinations.</p> Signup and view all the answers

<p>The kidney is a subdiaphragmatic organ, meaning it sits below the diaphragm. This location allows for some degree of mobility during respiration. The movement of the diaphragm during breathing helps to facilitate kidney blood flow and drainage, supporting its excretory function.</p> Signup and view all the answers

<p>The kidneys are supplied by the renal arteries which branch into five independent vascular segments: anterior, posterior, apical, upper anterior, middle anterior, and lower segmental arteries. The anterior division branches into four segmental arteries at the hilum, while the posterior division continues as the posterior segmental artery.</p> Signup and view all the answers

<p>The true capsule, or fibrous capsule, is a thin layer of dense connective tissue that directly surrounds the kidney. It is directly attached to the kidney's surface and helps maintain its shape. The false capsule, or renal fascia of Gerota, is a thicker layer of perirenal fascia that holds the kidney in place along with its surrounding fat and structures. It is distinct from the kidney itself and provides further protection and support.</p> Signup and view all the answers

<p>The kidneys are located on the posterior abdominal wall, within the retroperitoneal space, meaning they are situated behind the peritoneum but not within the peritoneal cavity. They extend from the level of T12 to L3 vertebrae. The right kidney is slightly lower than the left due to the presence of the liver. The kidneys are protected by the 11th and 12th ribs.</p> Signup and view all the answers

<p>In cortical nephrons, the efferent arterioles break up into peritubular capillaries that surround the tubular portions of the nephrons. In juxtamedullary nephrons, the efferent arterioles form long loop-shaped capillaries called vasa recta, which surround the tubular portions of the juxtamedullary nephrons.</p> Signup and view all the answers

<p>Brodel's line is a relatively avascular plane located on the lateral wall of the kidney. This avascular zone acts as a barrier between the upper and lower poles of the kidney, limiting the spread of infection or tumor.</p> Signup and view all the answers

<p>Blood from the kidneys is drained by the right and left renal veins. The left renal vein is longer and drains blood from the left kidney, left gonad, and left suprarenal gland. Both renal veins drain into the inferior vena cava.</p> Signup and view all the answers

<p>The sympathetic nervous system, derived from the renal plexus, plays a role in regulating blood flow to the kidneys and stimulating the production of renin by the juxtaglomerular apparatus.</p> Signup and view all the answers

<p>The ureters are a pair of narrow, but thick-walled muscular tubes, conveying urine from the kidneys to the urinary bladder. They are retroperitoneal organs, with the upper half lying in the abdominal cavity and the lower half in the pelvic cavity.</p> Signup and view all the answers

<p>The ureters are constricted at three sites: the pelvi-ureteric junction, the pelvic brim, and the vesico-ureteric junction. These constrictions are clinically significant because they are prone to obstruction, which can cause hydronephrosis (swelling of the kidney due to urine backup).</p> Signup and view all the answers

<p>As the ureters descend from the abdominal cavity to the pelvic cavity, they cross the bifurcation of the common iliac artery. This crossing point marks the transition of the ureters from the abdomen to the pelvis.</p> Signup and view all the answers

Arteries supplying blood to the colon, including right & left colic arteries.

Pathway of ureters from kidneys to bladder, including abdominal and pelvic parts.

The right ureter passes posterior to the root of the mesentery and jejunum.

Point where the abdominal aorta divides into right and left common iliac arteries near the pelvic brim.

In the lesser pelvis, ureters run along the anterior border of the greater sciatic notch.

1 L of blood circulates through both kidneys per minute.

Nephrons where the efferent arteriole becomes peritubular capillaries surrounding tubules.

Nephrons that have efferent arterioles forming long vasa recta.

A relatively avascular plane on the lateral wall of the kidney.

Left renal vein is longer and drains the left kidney, gonad, and suprarenal gland.

Narrow, thick-walled muscular tubes that convey urine from kidneys to bladder.

Ureters are 25-30 cm long and 3 mm in diameter.

Both renal veins drain into this large vein.

The kidneys are retroperitoneal organs located from T12 to L3 on the posterior abdominal wall.

A muscle that closes off the bladder from the urethra during ejaculation and prevents urine backflow.

Muscle layer that contracts to expel urine from the bladder.

The average kidney is 11-12 cm long, 6 cm wide, and 3 cm thick, weighing about 150 grams.

Triangular area at the bladder base, between ureteric orifices and urethral sphincter, with smooth mucosa.

The kidney has four layers: fibrous capsule, perinephric fat, renal fascia of Gerota, and paranephric fat.

Openings where ureters enter the bladder; prevent urine reflux when the bladder contracts.

A dense irregular connective tissue layer that protects the kidney and can be easily stripped off.

Slight elevation found at the internal urethral orifice in males, related to the prostate.

Fat located around the kidney and renal sinus, providing cushioning and support.

Extra peritoneal connective tissue with anterior (thin) and posterior (thick) layers around the kidneys.

The kidney has two main surfaces (anterior and posterior), two ends (superior and inferior), and two borders (medial and lateral).

The posterior surface of the kidney is flat and non-peritoneal, relates to the diaphragm, ribs, and several muscles.

A muscle located on the inner surface of the pelvis, aiding in hip movement.

A group of muscles forming the pelvic floor, supporting pelvic organs.

The anatomical connections of the bladder to surrounding structures (e.g., uterus, rectum).

The lower part of the uterus connecting it to the vagina.

A procedure where a catheter is inserted above the pubic bone to drain urine.

The peritoneal pouch between the bladder and uterus in females.

Glands that produce seminal fluid, contributing to sperm transport in males.

A nerve that runs below the 12th rib and innervates abdominal muscles.

A nerve providing sensation to the lower abdominal wall and upper thigh region.

Striated conical structures in the renal medulla, crucial for urine formation.

Funnel-shaped structure that collects urine from the calyces and funnels it to the ureter.

The indentation where renal vessels and ureter enter and exit the kidney.

The angle formed by the 12th rib and the spine, relating to kidney position.

Blood vessels branching from the aorta to supply the kidneys.

Concave side of the kidney featuring the hilum.