03. Anatomy of the bladder, urethra and internal gonads (HARC) Flashcards
the URINARY BLADDER is a hollow, muscular organ in which area
ANTERIOR PELVIC CANVITY
SURFACES of the BLADDER
SUPERIOR surface
POSTERIOR surface aka BASE
2x INFEROLATERAL surfaces (come together)
APEX (connected to umbilicus)
SUPERIOR SURFACE of BLADDER is covered in..
PERITONEUM (thin sheet of tissue)
BLADDER tubes
2x URETERS (from kidney)
URETHRA (out)
Majority of INTERNAL BLADDER is LINED by..
DETRUSOR MUSCLE
DETRUSOR MUSCLE that lines internal walls of BLADDER is controlled by which NERVOUS SYSTEM activity
PARASYMPATHETIC nervous system
- AUTONOMIC nervous system
what type of muscle is DETRUSOR MUSCLE that lines internal BLADDER
INVOLUNTARY SMOOTH MUSCLE
what is the only part of the BLADDER that is NOT lined by Detrusor muscle
TRIGONE - the space between the 3 openings (ureters and urethra)
does the TRIGONE of the bladder (space between 3 openings) expand/shrink when the bladder fills/empties
NO
does NOT EXPAND/SHRINK when BLADDER
CAPACITY of BLADDER
approx 400ml
the NECK of the BLADDER (INFERIOR) NARROWS to form the..
URETHRA
what are the 2 URETHRAL SPHINCTERS
INTERAL URETHRAL SPHINCTER (more superior, closer to bladder)
EXTERNAL URETHRAL SPHINCTER (inferior, last point that stops urine leaving the body)
part of the URETHRA where URINE leaves the body from
EXTERNAL URETHRAL ORIFICE
DIFFERENCE between INTERNAL and EXTERNAL URETHRAL SPHINCTERS
INTERNAL:
type of muscle?
nervous system?
difference in CONTROL
- SMOOTH MUSCLE (INVOLUNTARY)
- controlled by AUTONOMIC NERVOUS SYSTEM - SYMPATHETIC stimulation through HYPOGASTRIC NERVES keep it closed
- NO CONTROL OVER IT
DIFFERENCE between INTERNAL and EXTERNAL URETHRAL SPHINCTERS
EXTERNAL:
type of muscle?
nervous system?
CONTROL OVER IT
- SKELETAL MUSCLE (VOLUNTARY)
- SOMATIC NERVOUS SYSTEM control by PUDENAL NERVE
INTERNAL URETHRAL SPHINCTER uses which NERVES to keep it closed
sends SYMPATHETIC stimulation through HYPOGASTRIC NERVES
EXTERNAL URETHRAL SPHINCTERS have SOMATIC CONTROL using which NERVES
PUDENAL NERVES
STEPS of MICTURITION (urine being expelled)
- BLADDER SLOWLY FILLS with URINE
NO change in pressure due to elastic walls and inhibition of parasympathetic activity until THRESHOLD - URETHRAL SPHINCTERS RELAX (so urine can pass)
Internal relax by Parasympathetic NS
External relax by Somatic - DETRUSOR CONTRACTS (squeezes bladder)
Parasympathetic ANS fibres originate from PELVIC SPLANCHNIC NERVES (S2-S4) - BLADDER IS VOIDED INTO URETHRA
in MICTURITION the URETHRAL SPHINCTERS RELAX by which nervous systems
INTERNAL: PARASYMPATHETIC
EXTERNAL: SOMATIC
when DETRUSOR CONTRACTS in MICTURITION the PARASYMPATHETIC ANS fibres ORIGINATE from which NERVES and which area
PELVIS SPLANCHNIC NERVES (S2-S4)
(splanchnic = ‘organ’)
mechanism of MICTURITION is by… controlled by …
SPINAL REFLEX controlled by HIGHER BRAIN CENTRES
in MICTURITION :
PARASYMPATHETIC NERVES come from which spinal nerves
S2, S3, S4
S2-S4
in MICTURITION:
how are the GANGLIA of PARASYMPATHETIC NERVES
GANGLIA CLOSE to the TARGET muscle - DETRUSOR muscle
(long fibre, ganglia, short fibre)
in MICTURITION:
SYMPATHETIC NERVES come from which spinal nerves
L1 L2 L3
L1-L3
in MICTURITION:
SYMPATHETIC NERVES (L1-L3) TRAVEL via … plexus
HYPOGASTRIC PLEXUS
in MICTURITION:
SOMATIC NERVES come from which spinal nerves
S2, S3, S4
S2-S4
in MICTURITION:
SOMATIC NERVES used are
PUDENAL NERVES
4 PARTS of the MALE URETHRA
- INTRAMURAL aka PRE-PROSTATIC
‘within the walls of the organ’
where bladder narrows at neck, surrounded by Internal Urethral Sphincter - PROSTATIC
within prostate (below bladder) - MEMBRANOUS
within DEEP PERINEAL SPACE, passing through Perineal Membrane - PENILE aka SPONGY
within corpus spongiosum of penis
role of DUCTUS DEFERENS / VAS DEFERENS (male)
bring SPERMATOZOA FROM TESTIS
role of SEMINAL VESICLE (Accessory Gland)
(male)
PRODUCE 70% SEMINAL FLUID
(male) EJACULATORY DUCT is the UNION of..
DUCTUS DEFERENS and SEMINAL VESICLE
passes through Prostate, directly INTO URETHRA
(male) role of PROSTATE GLAND (accessory gland)
PRODUCES 25% of SEMINAL FLUID
where is the PROSTATE (single accessory gland) and what MUSCLE does it sit on
SURROUNDS NECK / underside of BLADDER
(inferior)
SITS ON LEVATOR ANI of the PELVIC FLOOR
characteristics of the SPECIALISED SEMINAL FLUID PRODUCED by the PROSTATE (3)
- ZINC-RICH to STABILISE DNA
- NUTRITIVE to spermatozoa
- ALKALINE to neutralise Vaginal pH
why is the SEMINAL FLUID of the PROSTATE ZINC-RICH
to STABILISE DNA
5 LOBES of the PROSTATE:
ANTERIOR
POSTERIOR
2X LATERAL
MEDIAN (centre) (behind urethra and ejaculatory ducts)
where does the FEMALE URETHRA BEGIN and END
begin: INTERNAL URETHRAL ORIFICE (where neck of bladder narrows)
end: EXTERNAL URETHRAL ORIFICE
approx LENGTH of FEMALE URETHRA
4cm
what do URETHRA in male and female pass through
pass through DEEP PERINEAL SPACE / POUCH and pierces PERINEAL MEMBRANE
what does URETHRA CONSIST of (outer and inner)
OUTER MUSCULAR COAT
and INTERNAL MUCOSA
URETHRA has an ABUNDANCE of … to accomodate PASSAGE of URINE
ELASTIC FIBRES
POSITION of FEMALE URETHRA in relation to VAGINA
ANTERIOR to VAGINA
(posterior to pubis)
VAGINA and female URETHRA have a COMMON MUSCLE to SUPPORT both called
SPHINCTER URETHROVAGINALIS
female URETHRA and vagina are held in place by..
PELVIC FASCIAL LIGAMENTS
and MUSCLES
FEMALE REPRODUCTIVE TRACT is INTERNAL and consists of
OVARIES
UTERUS
VAGINA
(& external genitalia)
GONADS are ORIGINALLY at level of..
L1
(ovarian artery/ gonadal artery arises from aorta at L1)
GONADS are connected to LABIOSCROTAL SWELLING (differentiate into labia or scrota) by
GUBERNACULUM
as the GUBERNACULUM REGRESSES what happens to the GONAD in FEMALES
pulled INFERIORLY
and SETTLES in PELVIS
OVARIES CHANGE APPEARANCE throughout life
Before Puberty:
Post-Puberty:
Post-Menopause:
Before Puberty: SMOOTH
Post-Puberty: progressively SCARRED with menstruation
Post-Menopause: SMALLER and PITTED
where do OVARIES lie
in OVARIAN FOSSA on the LATERAL WALL of PELVIS
(mobile during pregnancy)
how can you get Ectopic Pregnancies
due to the space between the ovary and the fimbrae of the uterine tube
what does the UTERUS consist of
- UTERINE TUBE
- FUNDUS (opposite the opening, top of uterus)
- UTERINE CAVITY (hollow centre)
- BODY (main wall)
- CERVIX
2 OPENINGS of the CERVIX
INTERNAL OS: opens into Uterus
EXTERNAL OS: opens into Vagina
CANAL between the 2 OS
VAGINA lies between the..
Urethra (anterior)
Rectum (posterior)
what is the VAGINA
MUSCULAR TUBE connects Vulva to Uterus
approx LENGTH of VAGINAL CANAL
8cm
HALF ABOVE PELVIC FLOOR
HALF BELOW PELVIC FLOOR
there are 4 FORNICES (space) around the CERVIX (surrounding the external os)
ANTERIOR
POSTERIOR
2 LATERAL
how is the NORMAL ORIENTATION (position) of the UTERUS (2 terms)
ANTEVERSION
Uterus tilted POSTERIORLY at the CERVIS (cervix is tilted anteriorly against the axis of the vagina)
ANTEFLEXION
Uterine body FOLDED ANTERIORLY over the superior surface of the BLADDER
what is the BROAD LIGAMENT
SHEET of PERITONEUM draped over the TOP of the UTERUS, UTERINE TUBES, OVARIES
Continues over the BLADDER ANTERIORLY and RECTUM POSTERIOR (then goes up and covers all abdominal organs)
the BROAD LIGAMENT (draping of the sheet of peritoneum over organs) CREATES 2 RECESSES:
- RECTOUTERINE POUCH (between rectum & uterus)
- VESICOUTERINE POUCH (between bladder & uterus)
FLUID COLLECTS in them and can cause infection spread (MOST DEPENDENT part of cavity)
