Podcast
Questions and Answers
The kidneys are retroperitoneal structures located at the level between __________.
The kidneys are retroperitoneal structures located at the level between __________.
the 11th rib and the transverse process of the 3rd lumbar vertebral body
Each kidney is approximately how many cm in length?
Each kidney is approximately how many cm in length?
11 to 12 cm
At the renal hilus are the following structures, which ones are included? (Select all that apply)
At the renal hilus are the following structures, which ones are included? (Select all that apply)
The organs adjacent to the right kidney include which of the following? (Select all that apply)
The organs adjacent to the right kidney include which of the following? (Select all that apply)
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On the left, the kidney abuts which of the following organs? (Select all that apply)
On the left, the kidney abuts which of the following organs? (Select all that apply)
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Each papilla opens in the minor calices, which unite in the major calices and drain into the renal pelvis.
Each papilla opens in the minor calices, which unite in the major calices and drain into the renal pelvis.
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The __________ is variable in position but serves as the LANDMARK to separate the renal pelvis and the ureter.
The __________ is variable in position but serves as the LANDMARK to separate the renal pelvis and the ureter.
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The ureters course POSTERIORLY and INFERIORLY, paralleling the lateral border of the __________.
The ureters course POSTERIORLY and INFERIORLY, paralleling the lateral border of the __________.
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The mucosal surfaces of these organs all have the same embryologic origin. Which of the following are included? (Select all that apply)
The mucosal surfaces of these organs all have the same embryologic origin. Which of the following are included? (Select all that apply)
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The renal pelvis and ureter have the following layers. Which ones are included? (Select all that apply)
The renal pelvis and ureter have the following layers. Which ones are included? (Select all that apply)
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The right kidney drains predominantly into the __________ lymph nodes.
The right kidney drains predominantly into the __________ lymph nodes.
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The left kidney drains exclusively to the __________ lymph nodes.
The left kidney drains exclusively to the __________ lymph nodes.
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The lymphatic drainage of the ureter is described as which of the following? (Select all that apply)
The lymphatic drainage of the ureter is described as which of the following? (Select all that apply)
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Approximately what percentage of solid renal masses are malignant?
Approximately what percentage of solid renal masses are malignant?
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What is the median age of RCC diagnosis?
What is the median age of RCC diagnosis?
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Men are TWICE as likely as women to be diagnosed with kidney cancer.
Men are TWICE as likely as women to be diagnosed with kidney cancer.
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Danish workers exposed to __________ had an 8-fold higher incidence of kidney cancer.
Danish workers exposed to __________ had an 8-fold higher incidence of kidney cancer.
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Occupations associated with a higher risk of RCC include which of the following? (Select all that apply)
Occupations associated with a higher risk of RCC include which of the following? (Select all that apply)
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Factors associated with the development of RCC include which of the following? (Select all that apply)
Factors associated with the development of RCC include which of the following? (Select all that apply)
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What is associated with an increased risk of developing RCC?
What is associated with an increased risk of developing RCC?
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Which childhood cancer survivors may predispose to translocation RCC? (Select all that apply)
Which childhood cancer survivors may predispose to translocation RCC? (Select all that apply)
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Acquired cystic kidney disease (ACKD) is associated with which percentage increase in the risk of developing RCC?
Acquired cystic kidney disease (ACKD) is associated with which percentage increase in the risk of developing RCC?
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Inherited cancer syndromes affecting the kidney include which of the following? (Select all that apply)
Inherited cancer syndromes affecting the kidney include which of the following? (Select all that apply)
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Study Notes
Kidney Anatomy and Position
- Kidneys are retroperitoneal, located between the 11th rib and the 3rd lumbar vertebrae.
- Each kidney measures approximately 11 to 12 cm in length.
- Encased in a fibrous capsule and surrounded by perinephric fat, wrapped in Gerota fascia.
Renal Hilus
- Contains important structures: renal pelvis, ureter, renal artery, and renal vein.
Adjacent Organs
- Right kidney is adjacent to the liver (superiorly), duodenum, vertebral bodies (medially), and transverse colon/small bowel (anteriorly).
- Left kidney is adjacent to the spleen (laterally), stomach, pancreas, and vertebral bodies (medially), and small bowel/colon (anteriorly).
Kidney Function and Structure
- Each renal papilla opens into minor calices, which combine into major calices draining into the renal pelvis.
- Ureteropelvic junction serves as a landmark separating renal pelvis from the ureter.
Ureter Course
- Ureters travel posteriorly and inferiorly, parallel to the lateral border of the psoas muscle, curving anteriorly to join the bladder.
Embryologic Origin
- Mucosal surfaces of renal collecting tubules, calyces, renal pelvis, ureter, bladder, and urethra share the same embryologic origin.
Renal and Ureteral Layers
- Renal pelvis and ureter consist of epithelium, subepithelial connective tissue, muscularis, and a connective tissue adventitial layer.
Lymphatic Drainage
- Kidney lymphatics drain along renal vessels; right kidney drains mainly into paracaval and interaortocaval lymph nodes, while left kidney drains into para-aortic lymph nodes.
Ureter Lymphatic Drainage
- Lymphatic drainage of the ureter is segmented and diffuse, potentially involving various lymph node groups including renal hilar, abdominal para-aortic, and iliac nodes.
Renal Cell Carcinoma (RCC) Statistics
- About 88% of solid renal masses are malignant; RCC accounts for 80-85% of primary kidney tumors.
- Urothelial carcinomas of the renal pelvis account for approximately 7% of kidney tumors.
Demographics
- Men are twice as likely to be diagnosed with kidney cancer compared to women.
- The median age for RCC diagnosis is 65 years.
Occupational Risks
- Exposure to trichloroethylene, particularly in Danish workers, results in an 8-fold higher incidence of kidney cancer.
- Higher RCC risk associated with occupations in blast-furnace, coke-oven, iron, and steel industries, as well as exposure to asbestos, cadmium, dry-cleaning solvents, gasoline, and petroleum products.
Other Risk Factors
- Environmental factors (thorium dioxide) and hormonal influences (diethylstilbestrol) contribute to RCC development.
- High energy intake and fried foods increase risk; vegetables and fruits have a protective effect.
- Cytotoxic chemotherapy may lead childhood cancer survivors to translocation RCC with TFE3 or TFEB gene fusions.
- Acquired cystic kidney disease (ACKD), affecting up to 50% of long-term dialysis patients, notably increases RCC risk.
Genetic Considerations
- Several inherited cancer syndromes are associated with RCC, including:
- von Hippel-Lindau (VHL) disease
- hereditary papillary renal cancer (HPRC)
- hereditary leiomyomatosis renal cell carcinoma (HLRCC)
- Birt-Hogg-Dubé (BHD) syndrome
- constitutional chromosome 3 translocation.
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Description
This quiz focuses on the anatomy and characteristics of the kidneys, renal pelvis, and ureter as it relates to kidney cancer. Use these flashcards to test your knowledge on the important structures and measurements associated with the kidneys.
