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AP 2 - Book
Lecture 11 - Anatomy of the Urinary System
| Question | Answer |
|---|---|
| Food is utilized through the process of ____, ____, and _____, separating substances which can be digested from those that can not | digestion, absorption, and metabolism |
| What systems transport products of digestion to the tissues where they are utilized for growth and repair? | Blood and Lymph Systems |
| Waste products that are formed after tissues have utilized nutrients and oxygen, are taken away to be excreted from the body by what system? | Excretory System |
| What does the Excretory system eliminate? | Metabolic wastes (otherwise toxic to the body) |
| What are the major Excretory organs of the body? | Kidneys |
| Metabolic waste that is eliminated by the Kidneys? | Urea, Uric Acid, and Creatinine |
| Accessory organs of the Excretory System? | Lungs, Liver, Skin/Integumentary System |
| What does the Lungs give off that allows them to serve as an accessory organ as well as a Respiratory organ? | Carbon Dioxide during Expiration |
| Other than detoxifying nutrients from the digestive system, what does the Liver excrete to allow it to serve as accessory excretory organ? | Bile as a waste product |
| What does the skin as part of the Integumentary System do to allow it to serve as an accessory organ of the Excretory System? | Excretion of dissolved wastes through perspiration (contains mostly salts) |
| Functions of the Urinary System? | Remove Nitrogenous waste products and Regulate water, Sodium, Potassium, Calcium and Hydrogen (electrolytes) to maintain homeostasis |
| Components of the Urinary System? | Kidneys, Ureters, Urinary Bladder, and Urethra |
| Location of the Kidneys in the body? | Retroperitoneal - Upper Left and Right Quadrants |
| A mass of peri-renal fat which permits radiographic visualization of the Kidneys? | Adipose Capsule |
| Envelopes the Kidneys and is attached to the diaphragm, peritoneum and surrounding structures? | Sheath of Fascia |
| What are the superior and inferior borders of the Kidneys called? | Poles |
| Upper Pole of the Kidney that lies posterior and medial, closer to the Spine? | Superior Border |
| Lower Poles of the Kidneys that are projected anterior and Lateral? | Inferior Border |
| The Lateral Border of the Kidney is _____? | Convex |
| The Medial Border of the Kidney is _____? | Concave |
| Longitudinal slit or indentation along the medial border of the Kidney? | Hilum |
| Major vessels entering the Kidneys at the Hilum? | Renal Arteries and Nerves |
| Major vessels exiting out of the Kidneys at the Hilum? | Renal Veins, Lymphatic Vessels, and Ureters |
| What angle do the Kidneys form with the Midsagittal Plane due to the Kidneys lying on the Psoas Muscles? | 20-30 degrees |
| The Psoas muscle grows gradually larger as it descends, how does this affect the Kidneys poles? | The upper poles lie posterior and medial (closer to the spine) and the lower poles lying on the psoas muscles are projected more anterior and Lateral |
| Kidney that is lower in position due to its location on the same side as the Liver? | Right Kidney |
| The left Kidney is _____ and ______ than the right? | longer and narrower |
| Kidney location? | Halfway between the Xiphoid Process and the Iliac Crest |
| Due to their attachment to the Diaphragm, the kidneys move slightly with respiration: ____ inch inferior on inspiration, and drop ____ inches from the supine to the upright position | 1; 2 |
| Outer layer of fibrous tissue that covers the Kidneys? | Renal Capsule |
| The two layers beneath the outer Renal Capsule of the Kidneys form what? | The Parenchyma |
| Outer layer of tissue forming the periphery of the Kidney? | Cortex |
| The functional units of the Kidneys | Nephrons |
| Inner layer of the Kidneys? | Medulla |
| The Medulla of the Kidneys, consist of _____ ______, which empty into striated cones called ______ ______? | collecting tubules; renal pyramids |
| Triangular shaped structures, with their bases facing the cortex and their apices within the Medulla? | Renal Pyramids |
| What is the opening within the renal pyramid that consists of collecting tubules and drains into the calyces? | Renal Papilla |
| The Renal Papilla drains urine into hollow, flattened tubes called the what? | Minor and Major Calyces |
| ____-____ Minor Calyces unite to form ____-____ Major Calyces? | 4-13; 2-5 |
| Expanded funnel-like structure that becomes continuous with the Ureter? | Renal Pelvis |
| The central region of the Medulla - consists of the Renal Pelvis, Calyces, and the major renal blood vessels | Renal Sinus |
| Vessels that comprise the renal blood supply? | Right and Left Renal Arteries; Right and Left Renal Veins |
| Supplies arterial blood to the Kidneys, branches off the abdominal aorta, enters at the Hilum, and rebranches to a vast capillary network is formed within each Kidney? | Right and Left Renal Artery |
| Filtered blood leaves via the Hilum and then Both of these join the Inferior Vena Cava which then brings deoxygenated blood back to the Heart? | Right and Left Renal Vein |
| The three functions of the Nephron? | Filtration, Reabsorption, and Secretion |
| Small vessel that brings unfiltered blood from the Renal Artery to the Nephron? | Afferent Arteriole |
| Small vessel that brings blood, once filtered, from the Nephron to the Renal Vein? | Efferent Arteriole |
| The Renal Corpuscle of the Nephron consists of? | The Glomerulus and Bowman's Capsule |
| A tuft of capillaries formed by small branches of the Renal Artery which filters the blood from the Afferent Arteriole? | Glomerulus |
| A double-walled membranous sac surrounding the Glomerulus which allows protein free plasma, called a Glomerular Filtrate, to pass through its membrane into the Efferent Arteriole? | Bowman's Capsule |
| The Efferent Arteriole wraps around the Collecting Tubule to reabsorbing water and what else from Glomerular Filtrate that are required by the body? | Electrolytes, Glucose, and Amino Acids |
| Substances which cannot pass through the membranous layer of the Bowman's Capsule? | Urea, Uric Acid, and Mineral Salts |
| Waste products which are unable to pass through the membranous layer of the Bowman's Capsule form what to be excreted from the body? | Urine |
| Musculo membranous tubes which transport urine from the Kidneys to the Urinary Bladder | Ureters |
| Where the ureters leave the Kidneys through the Hilum at their junction with the Renal Pelvis | Ureteropelvic Junction (UPJ) |
| The junction of the Ureters and Urinary Bladder | Ureterovesical Junction (UVJ) |
| Constrictions along the Ureters | 1. UPJ (Renal Pelvis constricts to become ureters) 2. Pelvic Brim (ureters cross over arteries at brim) 3. UVJ (ureters enter bladder) |
| Hollow muscular organ whose function is to serve as a reservoir of urine | Urinary Bladder |
| Location of the Urinary Bladder | Infraperitoneal just above Symphysis Pubis |
| When the bladder empties, the lining is thrown into temporary folds called? | Rugae |
| Bladder consists of three layers: | a. Mucosa b. Submucosa c. Muscularis |
| Female Urinary Bladder location? | posterior and just superior to the upper margin of Symphysis Pubis; in front of (anterior) the Uterus and Rectum |
| Male Urinary Bladder location? | Anterior to Rectum, above the prostate |
| Small triangular-shaped area near the floor of the bladder | Trigone |
| Where the two Ureters enter the posterolateral aspect of the bladder at the ureterovesical junctions | Base |
| Point of the Trigone is where the Urethra exits the bladder | Apex |
| Smooth muscular wall, forming the principle portion of the Bladder | Detrusor Muscle |
| The narrow inferior portion of the Bladder at the junction with the Urethra | Neck |
| Parts of the Bladder | a. Trigone b. Base c. Apex d. Detrusor Muscle e. Neck |
| Distal portion of the Urinary System, a narrow musculo-membranous tube lying at the floor of the body for elimination from the Urinary Bladder to the exterior of the body | Urethra |
| Two Sphincter muscles that surround the Urethra: | 1. Internal Sphincter 2. External Sphincter |
| Formed by smooth muscle from the bladder wall, under involuntary control of the Central Nervous System | Internal Sphincter |
| Made of skeletal muscles, under voluntary control | External Sphincter |
| Location of female Urethra? | Passes behind Symphysis Pubis; ends at the external urethral meatus between the clitoris and vaginal opening |
| The Male Urethra is common to both what two systems? | Urinary and Male Reproductive System (Passageway for semen and eliminates urine) |
| Length of the Male Urethra? | 7-8 inches |
| Lenth of the Female Urethra? | 1 1/2 inches |
| Four parts of the Male Urethra: | 1. Prostatic Urethra 2. Prostate Gland 3. Membranous Urethra 4. Cavernous Urethra |
| Longest portion of the Male Urethra? | Cavernous Urethra |
| Shortest portion of the Male Urethra? | Membranous Urethra |
| Secretes alkaline fluid that contributes to semen? | Prostate Gland |
| Passes through the Prostate Gland, receiving Ejaculatory Ducts on its posterior wall | Prostate Urethra |
| Urination or Voiding | Micturation |
| Stages of Micturation: 1. 2. 3. 4. 5. | 1. Abdominal and Thoracic Muscles contract 2. Neck of bladder moves downwards 3. Urethra shortens and widens 4. Detrusor Muscle contracts 5. External Urethral Sphincter relaxes and you pee out the yuck yuck |
| Caused by loss of support of the Urethra usually a consequence of damage to pelvic support structures as a result of childbirth | Stress incontinence |
| Caused by uninhibited contractions of the Detrusor Muscle, an enlarged prostate is the most common cause in men over 40; characterized by leaking large amounts of urine with insufficient warning to get to the bathroom in time. | Urge Incontinence |
| Adrenal glands are part of what system? | Endocrine |
| The Adrenal Gland activity is controlled by what in the brain? | Pituitary Gland |
| Two parts of the Adrenal Glands: | Cortex and Medulla |
| Where are corticoids produced within the Adrenal Gland? | In the Cortex |
| Acts as anti-inflammatory agents in the body, speeding up reabsorption of sodium and water during the filtration of the blood in the Kidneys | Corticoids |
| Where is Epinephrine produced within the Adrenal Glands? | In the Medulla |
| Serves to release more Glucose from stored Glycogen in the Liver for muscle activity, increases the force and rate of the heartbeat. | Epinephrine |
| Male Sex Hormones, in conjunction with hormones produced in the Testes, bringing about male sex characteristics | Androgens |
| Typically caused by bacterial or fungal infections, diagnosis made by urinalysis, treatment is prescribed antiobiotic medication | Kidney and Bladder infections |
| An infection of the Calyces and Renal Pelvis of the Kidneys - the most common infectious agent is E-Coli Bacteria normally found in the lower GI Tract | Pyelnephritis |
| An inflammation of the wall of the Urinary Bladder | Cystitis |
| An inflammatory process affecting the capillary loops of the glomeruli of the Kidneys | Glomerulonephritis |
| The modality of choice in the evaluation of patients with acute bacterial pyelonephritis? | CT |
| The modality of choice for evaluation of chronic bladder cystitis and glomerulonephritis? | Ultrasound |
| A condition in which urine from the bladder flows back up into the Ureter and Kidney; another cause of Kidney infections | Vesicoureteral Reflux disorder |
| What is Vesicoreteral Reflux disorder caused by? | A problem with the valve mechanism at the UVJ |
| Performed to demonstrate reflux in children diagnosed with chronic urinary tract infections (UTI) | Voiding Cystourethrogram (VCUG) |
| A dilation of the Renal Pelvis and Calyces caused by an obstruction within the Ureters or Renal Pelvis; common causes are calculi, tumors or congenital anomalies | Hydronephrosis |
| What forms when stagnation of urine occurs? | Renal Calculi or Kidney Stones |
| Clinical indications for Renal Calculi or Kidney stones? | Sharp excruciating pain in the back, side or lower abdomen (flank pain) |
| Microscopic crystals of Calcium Phosphate that clump together form a what? | Stone |
| Kidney Stone formation is unknown, however it is thought to be the result of: a b c d e | a. Recurrent Kidney infections b. Acidic Urine c. High concentrations of calcium in the urine d. Vitamin A deficiency e. Hyperparathyroidism |
| An unusual type of Kidney stone resembling a deer's antlers; large stone that grows and fills the Renal Pelvis, completely blockng the flow of urine? | Staghorn Calculus |
| Kidney/Bladder stones may be demonstrated during what procedures? | IVU, Ultrasound, Retrograde Cystography, or CT |
| What modality can detect calculi, renal enlargement, hemorrhage, parenchymal calcification, obstruction, and inflammatory masses? | Unenhanced CT (without contrast media) |
| Modality that demonstrates function of the Kidneys and has been increasingly used in place of IVU (Intravenous Urogram) | CT Urology (with contrast media) |
| An enlargement of the Prostate Gland surrounding the Prostatic Urethra; common in older males due to a decrease in male hormones | Benign Prostatic Hypertrophy (BPH) |
| Radiographic findings of Benign Prostatic Hypertrophy (BPH) include: | Poor emptying of bladder, varying degrees of thickening and trabeculation of the bladder wall and indentation of the bladder base |
| An enlarged Prostate produces a characteristic ____-shape or "______" of the distal Ureters | J; hooking |
| Congenital Anomalies of the Urinary System: a. b. c. d. | a. Horseshoe Kidney b. Double Collecting System c. Ectopic Kidney d. Agenesis |
| Occurs when the Kidneys are joined at their lower poles across the midline of the Abdomen | Horseshoe Kidney |
| Two Renal Pelvis's and Ureters demonstrated on an IVU, Ultrasound or CT Imaging | Double Collecting System |
| The Kidney lies out of it's normal location - usually in the pelvic area | Ectopic Kidney |
| The absence of a Kidney | Agenesis |
| The reduction in arterial blood flow to the Kidneys caused by a blockage or narrowing of the Renal Artery, which can lead to Secondary or Renal Hypertension | Renal Arterial Stenosis |
| Secondary or Renal Hypertension (High Blood Pressure) occurs when: a b c d | a. The Kidneys release a hormone called Renin into bloodstream b. Renin acts on Adrenal Gland to produce hormone Aldosterone c. Aldosterone increases = reabsorption of Sodium in bloodstream d. Causing blood vessels to constrict = High Blood Pressure |
| Imaging procedures (Renal Arterial Stenosis): a b c d | a. Renal Arteriogram b. Duplex Color-flow Ultrasonography c. CT Angiography (CTA) d. Magnetic Resonance Angiography (MRA) |
| A genetic disorder characterized by the growth of numerous cysts within the Kidneys | Polycystic Kidney Disease (PKD) |
| Polycystic Kidney Disease (PKD) is the most common inherited disorder of the Kidneys and commonly diagnosed with what modality? | Ultrasound or CT Imaging |
| Formerly known as Hypernephroma, is a kidney cancer that originates in the lining of the proximal convoluted tubule; the most common type of kidney cancer in adults (80%) | Renal Cell Carcinoma (RCC) |
| The most common form of childhood kidney cancer, may also be referred to as Nephroblastoma | Wilm's Tumor |
| A birth defect that is sometimes associated with this type of childhood cancer, a missing iris of the eye, as well as certain urinary tract problems and swelling of one side of the body | Wilm's Tumor |
| A missing iris of the eye? | Aniridia |
| Swelling of one side of the body | Hemi-hypertrophy |
| The most frequently occurring malignancy of the Urinary Tract, most are transitional cell carcinomas | Bladder Cancer |
| One of the most common types of cancer in men, occurs when cells in the gland grow and multiply uncontrollably, damaging surrounding tissue and interfering with the normal function | Prostate Cancer |
| Caused by a number of diseases of the Urinary and Circulatory Systems - may be a result of shock, injury, trauma, bleeding, heart failure, or poisoning; common symptom is Anuria | Acute Renal Failure |
| Absence of urine formation | Anuria |
| Calculated to determine kidney function and stage of kidney disease | Glomerular Filtration Rate (GFR) |
| The most appropriate method for imaging renal failure | Renal Ultrasound (US) |
| Diabetes and high blood pressure are the two most common causes; may require Dialysis or a Kidney Transplant | Chronic Kidney Disease (CKD) |
Created by:
teresachristensen
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