L11 - RENAL SYSTEM

The posterior abdominal wall:

contains the diaphram (D), psoas minor, psoas major (P), iliacus (I), iliopsoas, quadratus lumborum (Q), and transverus abdominits (T)

psoas minor: T12-L1 to pubic bone

psoas major: T12-L5

iliacus: iliac fossa

quadratus lumborum: rib 12 and TPs of lumbar vertebrae to iliac crest

the diaphram:

contains the —> esophageal hiatus (hole), right crus below EH, lateral arcuate ligament is on both sides, medial arculate ligament is also on both sides and closer to the aortic hiatus (bigger hole but under EH hole), there is left crus

the renal system:

organs of the Renal sys includes:

  • right and left kidneys, filter blood to produce urine

  • right and left ureters, transport urine to bladder

  • the bladder, storage organ for urine until eliminate

  • the urethra, responsible for expelling urine to exterior

the organs of this system ensure for a stable internal environment to maintain survivial cells and tissues in the body (homeostasis)

the kidneys:

contains the renal capsule “fibrous”, then is filled with perienal fat “adipose tissue” which is held by peririneal fascia “renal fascia” and then contain by paraneal fat, and outer layer is pariteal peritoneum

  • retroperitoneal

  • left kidney, T11 to L3

  • right kidney, T12 to L4

  • right kid sits lower than left

contains the hilum of kidney which is renal A and V, has the ureter bellow the renal V, has the adrenal gland on top.

pos view: renal pyramid, renal papilla, cortex, medulla, renal pelvis, minor calyx, major malyx, ureter

functions of the kidney:

  • regus electrolytes

  • maintain blood ph by reg H and HCO3

  • reg blood vol thru urine produce and bp via renin

  • excrete of waste products

the kidneys:

horseshoe kidney —> cogential abnormal

donor kidney vasculature is re-anastomosed to the iliac vessels, ureter attached to bladder. degenerating kidney not removed

branches of abdominal aorta: from top to bottom

—> celiac trunk, renal A, superior mesenteric A, gonadal A, inferior mesenic A, common illiac A (L4/5)

venous drainage of the kidneys:

to right of aorta

LIV/LV

common iliac VV

contains: r gonadal v, l renal v, l gonadal v, r renal v, hepatic vv at T8

vascular supply of the kidneys:

r renal a longer than left, travels pos to the IVC

ureter to bladder

inferior mesentic A is below aorta

common iliac a branches off

l renal v longer than r, travels ant to aorta and inferior to SMA

nutcracxker syndrome:

a result of compression of the l renal v, one cause can be due to dilation of the SMA, leads to tortuous l renal and gonadal vv and varicoceles

vascular supply of the kidneys:

segmental a - arteries that go to the 5 seg of a kidney

interlobar a - extend along renal columns, supply lobes of kidney

arcuate a - arch along base of medulla

interlobular a - rediate from acurate a, extend into cortex

the ureters

  • 25-30cm

  • 5mm in diameter

    • has 3 layers: transitional epithelia mucosa “inner”, smooth muscle layer “middle”, fibrous connective tissue “outer”

  • constriciton sites of the urteres

    • 1. at the hilum

    • 2. upon entry into pelvis- pelvic brim

    • 3. during passage thru the wall of bladder

urinary bladder: ureter, body of bladder, apex, urethra, fundus of bladder, median umbilical ligament

urachus to the median umbilical ligament - begin to see develop bladder and diff kidneys, urine produce by kidneys releases vis urachus

before birth, open urachus

after birth, closed off

the urinary bladder: pins in ureteric and urethral orifices demonstating area of trigone

born male urethra, transport urine and semine, 20cm in length, divide into 4 main parts

born female urethra, 4cm, bound to ant vaginal wall, external opening to ant to vaginal