01: Anatomy Flashcards
T/F: Entire urinary system is retroperitoneal.
False - not urethra
Both kidneys lie deep to which ribs?
11 and 12
Kidney and surrounding fat are held in place by (X) tissue.
X = renal fascia
Outermost fascia layer surrounding kidney.
Anterior: peritoneum
Posterior: transversalis fascia
Fascia layer surrounding kidney, just interior to peritoneum and transversalis fascia.
Paranephric (extraperitoneal) fat
Renal fascia is composed of which parts?
- Gerota’s fascia (anterior)
2. Zuckerkandl fascia (posterior)
The part of renal fascia that extends inferiorly along (X) is referred to as (Y).
X = ureter Y = periureteric
List layers of fascia layers surrounding kidney, from outermost to medulla.
- Peritoneum/transversalis fascia
- Paranephric fat
- Renal fascia
- Perinephric fat
- Renal capsule
- Renal cortex
- Renal medulla
T/F: The entire path of ureter is retroperitoneal.
True
List the places where the ureter is normally constricted to some degree.
- Junction with renal pelvis
- Its crossing at brim of pelvic inlet
- Entering wall of bladder
Ureter passes over pelvic brim at which other landmark?
Bifurcation of common iliac arteries
Pain associated with kidney/ureters can be caused by:
- Stretching
- Direct injury
- Irritation of surrounding tissue
Pain fibers of kidneys are primarily:
Preganglionic sympathetic nerves (T11-L2)
Pain fibers of ureters are primarily:
Preganglionic sympathetic nerves (T11-L2)
Irritation of renal capsule or kidney’s surrounding tissue irritates (X) nerves.
X = T11-L1 body wall nerves
CVAT stands for (X), a clinical sign of:
X = Costovertebral angle tenderness
Irritation of renal capsule or inflammation of tissue around kidney
Ureter passes (anterior/posterior/superior/inferior) to psoas major.
Anterior
Ureter is crossed (anteriorly/posteriorly) by gonadal vessels.
Anteriorly
In females, ureter passes immediately (anterior/posterior/superior/inferior) to uterine vessels.
Inferior
In males, ureter passes (anterior/posterior/superior/inferior) to ductus deferens.
Posterior and inferior
In males, ureter passes (anterior/posterior/superior/inferior) to seminal vesicle.
Anterior
T/F: Ureter enters apex of bladder obliquely.
False - enters base of bladder obliquely
Which structure prevents reflux of urine from bladder to ureter?
- Valve: Slit-like orifice as ureter enters bladder
2. Sphincter: Circular fibers in wall of bladder
(X) activates (Y) which initiates peristaltic contractions of ureter.
X = parasympathetics (vagus nerve) Y = pacemaker cells in collecting system
List blood vessels that supply abdominal ureter.
Gonadal and renal
List blood vessels that supply middle portion of ureter.
Common iliac and gonadal
List blood vessels that supply pelvic/distal ureter.
Common and internal iliacs
T/F: Sympathetics have no role in motor innervation of collecting system.
False - regulate vascular tone
Stretching of ureter causes (parietal/visceral) pain that’s accompanied by reflex-like activation of (X). This pain radiates in which areas?
Visceral;
X = subcostal, ilioinguinal, genitofem nerves
Flanks, groin, genitals
Trigone at (apex/base) of bladder is formed by which structures?
Base;
Ureters and urethra
Female urethra length. And male?
F: 4 cm
M: 20 cm
UTIs more common in (M/F) because:
F; shorter urethra, so shorter distance for bac to travel
Prostatic benign hyperplasia (PBH) causes (widening/narrowing) of urethra and which symptoms?
Narrowing;
- Frequent/urgent need to urinate (esp at night)
- Difficulty starting urination
- Weak urine stream
T/F: Both males and females have two urethral sphincters.
True
Internal urethral sphincter is composed of (X) muscle type. It’s controlled by (autonomics/somatics).
X = detursor (bladder) smooth and striated muscle
Autonomics
External urethral sphincter is composed of (X) muscle type. It’s controlled by (autonomics/somatics).
X = skeletal
Somatics (pudendal nerve)
At rest, bladder emptying is (stimulated/inhibited) via (symp/parasymp) signals that (relax/contract) (X).
Inhibited; symp
- Relax bladder wall
- Contract/constrict internal urethral sphincter
Which fibers sense activation of stretch receptors when bladder fills?
GVA fibers of pelvic splanchnic nerves
Bladder fills and stretches. (X) fibers induce reflex (contraction/relaxation) of:
X = GVE fibers of pelvic splanchnic nerves
- Contraction of detrusor muscle
- Relaxation of internal sphincter
Difference in location between kidney and ureter pain.
Kidney: flank pain
Ureter: radiates down to groin
