GA 14 Suprarenal and Urinary System

Suprarenal gland is also called

adrenal gland

What kinda gland is Suprarenal

endocrine and retroperitoneal

Shape of right gland

Pyramidal

Shape of left gland

crescentic

Parts of suprarenal gland

Cortex and medulla

Cortex is derived from

mesoderm

Medulla is derived from

neural crest cells associated with sympathetic nervous system

Medulla is a mass of

nervous tissue

Zona Glomerulosa secretes

mineralocortidcoids or aldosterone

Aldosterone causes

sodium retention

Which layer of adrenal has multiple layers

cortex

Zona fasciculata secretes

glucocorticoids or cortisol

Cortison does what

long term stress causation

Zona reticularis secretes

sex hormones (androgens and estrogens)

Medulla secretes

norephniphrine and epinephrine

Addisons disease is due to

low aldosterone

Cushings disease is due to

excessive cortisol

Blood supply of suprarenal gland

middle, superior and inferior suprarenal arteries

superior suprerenal artery is branch of

inferior phrenic

Middle suprarenal artery is a branch

aorta

inferior suprarenal artery is branch of

renal artery

right suprarenal veins drains into

IVC directly

left suprarenal vein drains into

left renal vein

Nerve supply of suprarenal gland

Abdominopelvic lesser and least splanchnic

(T10-L1)

Nerve supply of suprarenal gland terminates at

medulla

Vasomotor nerve supply of suprarenal gland is only for

cortex

Adrenal medulla is a modified

sympathetic ganglion

Pheochromocytoma is a

tumor of adrenal medulla

Pheochromocytoma causes

tachycardia, anxiety, HBP, papillary dilation, constipation

The Kindeys are retroperitoneal

true

Kidney location

posterior abdominal wall at T12-L3

Kidney function

Excretion

Fluid volume regulation

BP

Electrolyte regulation

Erythropoieton (RBC production)

Activation of vitamin D

Kidney contacts

spleen, cuadate lobe, root of trans. mesocolon, jejenum and ileum, ascending colon

Kidney renal artery goes into

segmental arteries

Kidney segmental arteries goes into

lobar arteries

Kidney lobar arteries goes into

arcuate arteries

Kidney arcuate arteries gives into

interlobular arteries

Innervation of kidneys

renal sympathetic plexus

Renal Plexus

Pregg PS

Postgg SP

GVA

Referred pain of kidney is mostly in

T12 dermatome (loin to groin)

GVA fibers of renal plexus are going to end where

T10-L1

Ureter extends from

kidney to urinary bladder

ureter is retroperitoneal

true

Ureter is posterior to ____ and anterior to_____

parietal peritoneum, psoas major

Normal constrictions of ureter

1. where renal pelvis joins ureter

2. as it crosses pelvic brim

3. where it pierces bladder wall

Blood supply of upper portion of ureter

renal arteries

Blood supply of middle portion of ureter

Testicular/ovarian

Blood supply of lower portion of ureter

super vesical(pelvic)

Nerve supply of upper portion of ureter

renal plexus

Nerve supply of middle portion of ureter

testicular/ovarian plexus

Nerve supply of lower portion of ureter

hypogastric plexus

GVA fibers for hypo plexus enter at

T11-L2

Referred pain for upper ureter

Along T12

Referred pain for lower ureter

Ipsilateral groin region

(extends to testis or tip of penis or labium majus)

urinary bladder in children is located

higher than adults, empty portion projects above upper border of pubic symphysis

urinary bladder in adults is located

within pelvis, posterior to pubic bone

urinary bladder in adults does what as it fills

rises above hypogastric region

Empty bladder has what shape

pyramidal

Apex of bladder lies posterior to upper margin of

pubic symphysis

Apex of bladder is connected to umbilicus by

median umbilical ligament (urachus)

In males apex of urinary bladder superior surface is related to

colis of ileum or sigmoid colon

In females apex of urinary bladder superior surface is related to

uterus (uterovesical pouch)

Base of urinary bladder is what shape

triangular

Base of urinary bladder is related to what in males?

ampulla of ductus deferens, seminal vessicles and rectum

Covered in peritoneum

Base of urinary bladder is related to what in females?

vagina

not covered in peritoneum

Neck of urinary bladder is

most fixed part of bladder

where urethra begins

Neck of urinary bladder in males rests on

superior surface of prostate

Neck of urinary bladder in females rests on

urogenital diaphragm

Urinary Bladder mucosa when empty is

thrown into folds and dissapear when full

Mucosa lining is base is always

smooth

trigone superior angles is

opening of ureters

trigone inferior angle is opening

internal urethral orifice

ureter pierce bladder obliquely

valve like action that prevents backflow of urine

Urinary bladder blood supply

branches of internal iliac

1. superior vesical

2. inferior vesical

Urinary bladder nerve supply

Inferior hypo plexus

GVA fibers enter mostly S2, S3, S4

Some GVA enter L1 and L2

Urinary bladder muscles

detrusor muscle (smooth)

internal urethral spincter (spinchter vesicae

Sympathetic (T11-L2) stimulation effect

increases tension on spincter

decreases tension on detrusor

nerve of retention

Parasympathetic (S2-S4) stimulation effect

increases tension on detrusor

decreases tension on sphincter

nerve of evacuation

Male urethra

18-20cm

extends from internal orifice in urinary bladder to external orifice (meatus) on glans penis

Parts of male urethra

prostatic

membranous

penile (spongy)

External urethral sphinter (skeletal muscle) is acted on by

S2-S4 (pudendal nerve- spinal nerve)

Pudendal nerve is

GSA GSE

somatic

Prostatic urethra extends

from base to apex of prostate

Prostatic urethra feature

widest and most dilateable part

receives openings of prostatic glands and ejaculatory glands

Membranous urethra feature

least dilatable part

passes through urogenital diaphragm

surrounded by sphincter urethrae muscle (external urethral spincter)

Penile urethra contained within

corpus spongiosum of penis

penile urethra receives

ducts of bulbourethral glands inferior to urogenital

Narrowest part of entire urethra

external meatus

female urethra size

4cm

Female urethra extends from

internal orifice in urinary bladder to external orifice, in the vestibule (space between labia minora)

External meatus of female located between

clitoris and opening vagina

Female urethra passes through

urogenital diaphragm and is surround by sphincter urethrae

Female urethra lies

anterior to vagina and posterior to pubic symphysis