What are the two types of dialysis?
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Peritoneal dialysis and haemodialysis.
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What are the two types of dialysis?
Peritoneal dialysis and haemodialysis.
From which part does the excretory part of the kidney develop?
From the metanephros.
Where does the ureter begin?
Within the renal sinus as a funnel-shaped dilatation called the renal pelvis.
How does the left kidney compare to the right kidney in terms of size?
The left kidney is a little longer and narrower than the right kidney.
What do the apices of the renal pyramids form?
They form the renal papillae, which indent the minor calyces.
What are the ureters?
A pair of narrow, thick-walled muscular tubes that convey urine from the kidneys to the urinary bladder.
What is a common congenital condition of the kidney?
Polycystic kidney.
What are the supports of the kidney?
Perirenal fat, renal fascia, and surrounding organs.
How far apart are the ureteric openings in a distended bladder?
About 5 cm apart.
What regions do the kidneys occupy?
Epigastric, hypochondriac, lumbar, and umbilical regions.
What are the two parts of the uriniferous tubule?
The excretory part (nephron) and the collecting part.
What initiates the formation of the collecting system in the permanent kidney?
Ureteric buds.
What type of stones are likely to form in the kidneys?
Staghorn stones, as urine gets concentrated there.
What are the kidneys also known as?
Renes and nephros.
What are the two layers of fascia associated with the kidneys?
The posterior layer is called the fascia of Zuckerkandl and the anterior layer is called the fascia of Gerota.
What are the sites of normal constrictions of the ureter?
Ureteropelvic junction, pelvic brim, and ureterovesical junction.
What is the average weight of the kidneys in males and females?
150 g in males and 135 g in females.
What is the role of the renal corpuscle?
For filtration of substances from the plasma.
What structures are anterior to the left kidney?
Renal vessels, pancreas, peritoneum, and jejunum.
Which muscles do not form the posterior relation of the kidney?
Transversus abdominis.
What structures are formed from the ureteric bud?
The ureter, renal pelvis, major and minor calyces, and collecting tubules.
What anomaly results from non-union of the excretory and collecting parts of the kidney?
Congenital polycystic kidney.
What surgical procedure can be done to fix the kidney in position?
Suturing the posterior layer of renal fascia with the diaphragm.
What does raised blood urea indicate?
Suppressed kidney function and renal failure.
What happens to blood from a ruptured kidney?
It distends the renal fascia and then forces its way downwards into the pelvis.
Where do gallstones typically lie in relation to the vertebra?
Anterior to the body of the vertebra.
What is the current understanding of the lateral conal fascia?
It is now understood to be a single multi-laminated structure rather than fused fasciae.
Why are renal stones radio-opaque?
Because they contain calcium, which absorbs X-rays.
What is the shape of each kidney?
Bean-shaped.
What type of epithelium lines the ureter?
Transitional epithelium.
What is the anterior relation of the left kidney?
Left suprarenal gland, spleen, stomach, pancreas, splenic vessels, splenic flexure, and descending colon.
What is the length of each ureter?
About 25 cm (10 inches).
What structures are found medially to the right ureter?
Inferior vena cava.
What is the significance of the mesonephric duct in kidney development?
It persists and gives rise to the ureteric bud.
What is the relationship of the ureter to the uterine artery in females?
The uterine artery lies first above and in front of the ureter and then crosses it superiorly from lateral to medial side.
What structures are related to the anterior surface of both kidneys?
Muscles, vessels, and nerves.
Where do kidney stones typically lie in relation to the vertebra?
On the body of the vertebra.
How can kidneys be injured?
Due to penetrating injuries to the lower thoracic cage or kicks in the renal angle.
How many major calyces does the renal pelvis divide into?
2 to 3 major calyces.
What arteries supply the middle part of the ureter?
Branches from the aorta, and possibly from gonadal or iliac vessels.
What are the three layers of the ureter?
What structures cover the hepatic and intestinal surfaces of the right kidney?
Peritoneum.
What muscle is located posterior to the kidneys?
Psoas major muscle.
What is the blood supply to the upper and middle parts of the ureter?
Branches from the medial side.
What lies laterally to the pelvic part of the ureter?
Fascia covering the obturator internus, superior vesical artery, obturator nerve, obturator artery, obturator vein, inferior vesical vein, and middle rectal artery.
What does Fig. 24.4 illustrate?
Posterior relations of the right kidney.
Which veins should be traced to the left renal vein during dissection?
Left suprarenal vein and left testicular or ovarian vein.
What supplies the pelvic part of the ureter?
Branches from the vesical, middle rectal, or uterine vessels.
What treatment is needed in cases of chronic renal failure?
Dialysis, which can be peritoneal or hemodialysis.
What structures are formed after the metanephric cap in kidney development?
Renal vesicles.
What are the main components identified when looking at the interior of the kidney?
Cortex, pyramids, and calyces.
What is the significance of the superior aspect of the perirenal space?
It is 'open' and continuous with the bare area of the liver on the right side and the subphrenic extraperitoneal space on the left side.
What is the anterior relation of the right kidney?
Right suprarenal gland, liver, second part of duodenum, hepatic flexure of colon, and small intestine.
What caps the ureteric bud during kidney development?
Metanephros.
What is the appearance of the kidneys in a fetus?
Lobulated, made up of about 12 lobules.
What is the function of perirenal or perinephric fat?
It is a layer of adipose tissue that fills the extra space in the renal sinus and is thickest at the borders of the kidney.
What are the five constrictions of the ureter?
Pelviureteric junction, brim of pelvis, crossing with ductus deferens or broad ligament, intravesical course, and termination at the trigone of the urinary bladder.
Where do the lymphatics of the kidney drain?
Into the lateral aortic nodes at the level of origin of the renal arteries (L2).
What are common diseases of the kidney?
Nephritis, pyelonephritis, tuberculosis of the kidney, renal stones, and tumors.
What structures are present at the hilum of the kidney in order?
Renal artery, renal vein, and renal pelvis.
What forms a lobe of the kidney?
Each pyramid along with the overlying cortical arch.
What are the vascular segments of the kidney?
Segmental arteries that supply different regions of the kidney.
How does the anterior perirenal fascia relate to the kidney?
It courses around the front of the kidney as a thin layer.
What are the medial and lateral arcuate ligaments associated with?
They are associated with the abdomen and pelvis anatomy.
How many minor calyces are typically found in a kidney?
About 7–14.
What are renal pyramids?
They are about 10 conical masses that make up the renal medulla.
What are the five renal segments?
Apical, upper, middle, lower, and posterior.
How does the ureter relate to the ductus deferens in males?
The ductus deferens crosses the ureter superiorly from lateral to medial side.
What does a section through the pyramid of the medulla show?
Light staining collecting ducts, sections of loop of Henle, thick and thin segments of descending and ascending limbs, capillaries, and connective tissue.
What is the renal angle?
The angle between the lower border of the 12th rib and the outer border of the erector spinae, which overlies the lower part of the kidney.
Where do the ureters lie in the body?
Deep to the peritoneum, closely applied to the posterior abdominal wall in the upper part, and to the lateral pelvic wall in the lower part.
How can tenderness in the kidney be elicited?
By applying pressure over the renal angle with the thumb.
What is the first stage in the development of the permanent kidney?
Metanephric cap.
What does the renal sinus contain?
Branches of the renal artery, tributaries of the renal vein, and the renal pelvis.
What arteries supply the upper part of the ureter?
Branches from the renal artery, and possibly from gonadal or colic vessels.
What parts of the nephron develop from the differentiation and growth process?
Loop of Henle, proximal and distal convoluted tubules.
What structures are anterior to the right kidney?
Renal vessels and the second part of the duodenum.
Where is the perirenal fat thickest?
Along the borders.
What lies posteriorly to the abdominal part of the left ureter?
Psoas major, tips of transverse processes, and genitofemoral nerve.
What is the position of the kidneys in relation to the peritoneum?
The kidneys are retroperitoneal organs and are only partly covered by peritoneum anteriorly.
How does the ureter enter the pelvis?
By crossing in front of the termination of the common iliac artery.
What are the components of the juxtaglomerular apparatus?
Macula densa, juxtaglomerular cells, and agranular cells.
What is a horseshoe kidney?
Fusion of the lower poles of the kidneys, with ureters passing anterior to the isthmus.
What does the shaded area in Fig. 24.3a represent?
Areas covered by peritoneum.
What are common manifestations of kidney disease?
Renal edema and hypertension.
Which kidney is at a lower level and why?
The right kidney is lower due to the position of the liver.
What is the function of the intravesical oblique course of the ureter?
It has a valvular action that prevents regurgitation of urine from the bladder to the ureter.
Where are the kidneys located?
On the posterior abdominal wall, one on each side of the vertebral column, behind the peritoneum.
What is the functional unit of the kidney?
The nephron.
What forms a lobe of the kidney?
A renal pyramid with the cortex overlying it.
What are the main components visible in a coronal section of the kidney?
An outer reddish-brown cortex, an inner pale medulla, and a space called the renal sinus.
What do the ducts of Bellini open into?
The minor calyces through the renal papillae.
What is the fibrous capsule of the kidney?
A thin membrane that closely invests the kidney and lines the renal sinus.
What structures are found in the hilum of the kidney?
The renal vein, renal artery, and renal pelvis.
What forms the juxtaglomerular apparatus?
It is formed at the vascular pole of the glomerulus, related to the ascending limb of Henle’s loop near the distal convoluted tubule.
What surrounds the terminal part of the ureter in males?
Vesical veins.
What is the order of structures at the hilum of the kidney?
Renal vein, renal artery, pelvis of ureter (VAU).
What section of the body do the kidneys and ureters belong to?
Abdomen and Pelvis Section.
What should be removed from the anterior surface of the kidneys during dissection?
Fat and fascia.
What is the competency achievement for students regarding the kidney?
Describe and identify the microanatomical features of the kidney.
What are the two parts of the renal cortex?
Cortical arches (or cortical lobules) and renal columns.
How is a kidney palpated?
Bimanually, with one hand in front and the other behind the flank.
What is a floating kidney?
A kidney that can move up and down within the renal fascia, but not side-to-side.
Which structures are formed from the S-shaped tubule?
Bowman's capsule and glomerulus.
What lies in front of the renal pelvis in the renal sinus?
Branches of renal vessels.
What is the orientation of the long axis of the kidney?
Directed downwards and laterally.
What is ureteric colic?
Severe pain due to a ureteric stone causing spasm of the ureter.
What is a duplex ureter?
Two ureters draining the renal pelvis on one side.
From which embryonic structure does the kidney develop?
Metanephros.
What is the diameter of the ureter?
About 3 mm.
How do most renal stones differ from gallstones in terms of radiopacity?
Most renal stones are radio-opaque, while most gallstones are non-radio-opaque.
How many segmental branches does the renal artery give?
Five segmental branches: four from the anterior division and one from the posterior division.
What layers need to be reflected to expose the kidney from behind?
Skin, superficial fascia, posterior layer of thoracolumbar fascia, erector spinae, middle layer of thoracolumbar fascia, quadratus lumborum, and anterior layer of thoracolumbar fascia.
What is depicted in Fig. 24.3b?
Anterior relations of the kidneys.
What structures are visible in the cortex of the kidney?
Cut sections of glomeruli, proximal convoluted tubules, distal convoluted tubules, and collecting ducts.
What is a potential risk when resecting the 12th rib during kidney surgery?
The danger of opening the pleural cavity.
How do the arteries to the ureter divide?
They divide into ascending and descending branches that form a plexus on the surface of the ureter.
What is the primary function of the kidneys?
To remove waste products of metabolism and excess water and salts from the blood, and maintain its pH.
What is the shape of the tubule during kidney development?
S-shaped tubule.
What veins drain directly into the inferior vena cava from the right side?
The right testicular or ovarian and suprarenal veins.
What does the pararenal or paranephric body consist of?
It consists of a variable amount of fat lying outside the renal fascia, more abundant posteriorly and towards the lower pole of the kidney.
What structures make up the renal tubule?
Proximal convoluted tubule, loop of Henle (descending and ascending limbs), and distal convoluted tubule.
What structures are formed from the ureteric bud?
Ureter, renal pelvis, major calyces, minor calyces, and collecting tubules.
What are the normal constriction points of the ureter?
Pelviureteric junction, brim of the lesser pelvis, crossing by ductus deferens or broad ligament, through the bladder wall, and at its opening in the trigone.
What is the significance of the hilum in identifying the kidney?
It allows for the determination of the side to which a kidney belongs by examining the structures present.
What are the segments of the kidney supplied by the renal artery?
Apical, upper, middle, lower segments on the anterior aspect, and posterior segment on the posterior aspect.
What are the posterior relations of the pelvic part of the ureter?
Internal iliac artery, commencement of the anterior trunk of the internal iliac artery, internal iliac vein, lumbosacral trunk, and sacroiliac joint.
What causes the referred pain in ureteric colic?
Pain is referred to areas innervated by segments T11 to L2, which supply the ureter.
Where does the ureter lie in relation to the cervix in females?
About 2 cm lateral to the supravaginal portion of the cervix.
What is the nerve supply of the kidney?
Supplied by the renal plexus, an offshoot of the coeliac plexus, containing sympathetic fibers (T10–L1).
Where is a new kidney placed during a transplant?
In the right or left iliac fossa.
What role does the Wilms’ tumour protein (WT1) play in kidney development?
It enables the metanephric blastema to respond to induction by the epithelium of the ureteric bud.
What is the position of the terminal portion of the ureter in relation to the vagina?
It lies anterior to the vagina.
What is the role of the macula densa?
It is formed by altered cells of the distal convoluted tubule and is part of the juxtaglomerular apparatus.
