Retroperitoneum
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| Intraperitoneal | organs that have a visible mesentery
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| Which organs are intraperitoneal? | stomach
liver
spleen
pancreas
1 and 4 portion of duodenum
jejunum
ileum
appendix
transverse colon
sigmoid colon
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| Secondarily retroperitoneal | organs that move back to the body wall during development and their mesenteries "lay down" on the perioneaum
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| Which organs are secondarily retroperitoneal? | 2 and 3rd portions of duodenum
ascending colon
descending colon
rectum
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| Primarily retroperitoneal | organs that never develop a mesentary
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| Which organs are primarily retropertioneal? | kidneys
suprarenal glands
ureters
pelvic viscera
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| Retroperitoneum | region immediately posterior to teh lining of teh abdomen
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| Which ribs are posterior to the kidneys? | T11 and 12
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| Which kidney is inferior? | The right kidney is inferior to the left
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| How is surgical access to the kidneys gained? | By incising the skin, subcutaneous fat and intercostal muscles.
Ribs are then spread to allow room in surgical window
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| Concave side of kidney | Hilum
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| Capsule | surrounds kidney to protect it from environment
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| Renal vascular segments of the kidneys | superior
anterior/superior
anterior/inferior
inferior
posterior
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| Are there anastomaoses between interlobal arteries? Why is this important? | No, therfore blood cannot shunt around an infarct
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| If there is an infarct what happens to the kidney? | focal necrosis results
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| Where is renal papilla located? | apex of each renal pyramid
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| What do renal papilla do? | collects the filtrate from teh collecting ducts and empties it into the lumen of the minor calyx
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| What happens to kidneys as they ascend in terms of blood supply? | They pick up more and more superior arterial blood supply and lose older, more inferior arteries
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| Never reflect a ureter away from its _______. | Blood supply
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| Ureters pass posterior to the | gonadal arteries and inferior to the uterine arteries.
"water under the bridge"
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| Proximal ureter has a thin layer of smooth muscle that is called the | muscularis externa
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| The distal ureter has a thick | muscularis externa
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| What is the difference histologically between the proximal and distal ureter? | proximal ureter has a thing layer of smooth muscle and the distal ureter has a thick layer of smooth muscle in the muscularis externa
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| Polycystic kidneys | Inherited disease following an autosomal dominent inheritance pattern.
Kidneys get large and nonfunctional
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| Renal caliculi | kidneystones
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| What are the common sites where the caliculi get wedged? | renal pelvis
arcuate line of pelvis
entry into the bladder
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| What is the entry point of the kidney? | Hilum
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| How many vascular segments do kidneys have? | 5
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| What is the order of arteries form the segmental artery? | Segmental aretery -> interlobal aa -> arcuate aa. -> interlobular aa.
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| What kind of autonomic innervation is in the kidney? | only sympathetic
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| What is the sympathetic innervation of the kidneys? | T10-11
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| What is the parasympathetic innervation of the kidneys? | There isn't any
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| What is the order of innervation from the sympathetic nerve? | Sympathtetic chain -> lesser splanchnic n. -> aorticorenal ganglion (synapse) -> follow the renal artery to the kidney
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| urine leaves teh collecting ducts at teh apex of each? | renal papilla
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| Each papilla empties into a | minor calyx
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| Order of urine flow from the papilla | papilla -> minor calyx -> major calyx -> renal pelvis -> ureter
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| Where does blood supply to the ureters coem from? | its medial side in the abdomen and from its lateral side in the pelvis
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| As ureters descend, they pass __________ to the gonadal arteries and ___________ andterior to the large common iliac arteries. | posterior;anterior
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| Why does the muscular lining of the ureter become more prominent as you move down? | The ureters must sometiems force urine into a full bladder
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| From the bladder, how does urine drain in the male? | bladder -> prostatic urethra -> membranous urethra -> spongy urethra -> out
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| From the bladder, how does urine drain in the female? | bladder -> membranous urethra -> out
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| Where does the prostate secrete in the male? | into the urethra thru several small ducts
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| Where do the ductus deferens and seminal vesicles release their contents? | prostatic urethra and prostatic utricle
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| What kind of muscle does the membranous urethra pass thru? | skeletal muscle
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| Why is important we have skeletal muscle in the membranous urethra? | It allows for urinary continence
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| Where is kidney transplantion done? | At the more accessible common iliac arteries.
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| Are old kidneys left in place during transplant? | Most often it is left in place.
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