2: Anatomy - lower renal tract Flashcards
What are the boundaries of the false pelvis?
Iliac crests to Pelvic inlet
What are the boundaries of the true pelvis?
Pelvic inlet to Pelvic floor
Which muscle is involved in the pelvic floor?
Levator ani
Which nerve supplies levator ani?
Pudendal nerve (S2,3,4)
What is another name for the pelvic floor?
Pelvic diaphragm
Which renal organs are found in the
a) pelvic cavity
b) perineum?
a) Distal ureters, bladder, proximal urethra
b) Distal urethra
Where is the urethra found?
Perineum
The ureters pass along the (anterior / posterior) aspect of the common iliac arteries.
anterior
site of anatomical constriction
At which level do the ureters turn medially to enter the bladder?
Ischial spine
The ureters enter the (anterior / posterior) aspect of the bladder.
posterior
The fact that the ureters enter the posterior aspect of the bladder in a medial direction helps to prevent ___ of urine.
reflux
What is more anterior - the common iliac artery or vein?
Artery is anterior
What space is found between the rectum and bladder?
Is it found in males or females?
Rectovesical pouch
Most inferior part of MALE peritoneal cavity
What are the two spaces found between the pelvic organs in females?
Vesico-uterine pouch (between bladder and uterus)
Rectouterine pouch / Pouch of Douglas (between rectum and uterus)
Which pouch is the most inferior space in the female peritoneal cavity?
Rectouterine pouch / Pouch of Douglas
Where are the ureters found in relation to the uterine / fallopian tubes?
Posterior
“water under the bridge”
Where are the ureters found in relation to the vas deferens in males?
Posterior
same idea as females, posterior to uterine tubes
Which artery supplies most of the organs of the pelvis?
Internal iliac artery
The arteries supplying the pelvic organs are mostly branches of the ___ ___ artery.
internal iliac artery
Which branches of the internal iliac artery supply the bladder?
Vesical arteries
Which branches of the internal iliac artery supply the
a) uterus in females
b) prostate gland in males?
a) Uterine arteries
b) Prostatic arteries
Which branch of the internal iliac artery supplies the vagina in females?
Vaginal artery
Which organ is found in the true pelvic cavity and stores and voids urine?
Bladder
What is in contact with the superior surface of the bladder?
Peritoneum
What holes are found on the posterior aspect of the bladder and act as insertions for the left and right ureters?
Ureteric orifices
What is the other word for the posterior aspect of the bladder?
Base of the bladder
What tube emerges from the inferior aspect of the bladder?
Urethra
What is found at the inferior aspect of the bladder in males and can hypertrophy, causing urinary tract problems?
Prostate gland
What hole is found between the inferior aspect of the bladder and the prostate gland in males?
Internal urethral orifice + SPHINCTER
Internal urethral sphincter only found in males
What structure is formed by the boundaries beween the right and left ureteric orifices and the internal urethral sphincter?
Trigone
Which muscle forms the bulk of the wall of the bladder?
Detrusor muscle
Which holes are closed by the detrusor muscle of the bladder?
Left and right ureteric orifices
Internal urethral orifice
Why does the detrusor muscle close the
a) ureteric orifices
b) internal urethral sphincter?
a) Prevents reflux of urine into ureters
b) Prevents retrograde ejaculation into bladder in males
Which bone of the pelvis does the bladder lie posterior to?
Pubic bone
What organ is the most anterior in the pelvic cavity?
Bladder
Which organ sits on top of the bladder in females?
Uterus
Which organ lies inferior to the bladder in males?
Prostate gland
Which pouch is the most inferior in
a) males
b) females?
a) Rectovesical pouch
b) Rectouterine pouch (of Douglas)
Where is the apex of the bladder?
Anterior surface
How can the bladder be catheterised?
Urethral (more common)
Suprapubic (through the anterior abdominal wall directly into bladder)
In females, does the internal urethral orifice have a sphincter?
No
Not required
The internal urethral sphincter (in males) is made up of ___ muscle.
The external urethral sphincter is made up of ___ muscle.
internal - smooth muscle - involuntary
external - skeletal muscle - voluntary
similar to anal sphincters
How many nuclei do
a) skeletal muscle
b) smooth muscle
c) cardiac muscle
cells have?
Where are their nuclei found?
a) Skeletal - multiple nuclei, peripheral, striated
b) Smooth - one nucleus, central
c) Cardiac - one nucleus, central, striated
What are the three sections of urethra found in males?
Prostatic urethra
Membranous urethra
Spongy urethra
Where are the testes held in males?
Scrotum
What is the path that sperm takes from the testes to the external urethral orifice?
Seminiferous tubules
Epididymis
Vas deferens
Ejaculatory duct
Prostatic urethra
Spongy urethra
External urethral orifice
Which gland secretes into the ejaculatory duct?
Seminal gland
The testes develop in the abdomen and descend into the scrotum through which structures?
Inguinal canals
Which tube contains the structures which support the testes?
What are these structures?
Spermatic cord
Testicular artery, pampiniform plexus > testicular vein, vas deferens, lymphatics and nerves
Within the scrotum, which sac do the testes sit in?
Tunica vaginalis
What are the two layers of the tunica vaginalis?
Parietal layer
Visceral layer
What does the testicular vein come from?
Pampiniform plexus
What is excess fluid in the testes called?
Hydrocele
What is twisting of the spermatic cord called?
Testicular torsion
Which part of the inguinal canal does the spermatic cord pass out of?
Deep inguinal ring
The testicular arteries emerge from the (anterior / lateral) surface of the abdominal aorta.
lateral branches
Once they have passed through the deep inguinal ring, where do the right and left testicular veins drain to?
Left testicular vein > Left renal vein >IVC
Right testicular vein > IVC
After the deep inguinal ring, where does the vas deferens go?
Turns medially and enters the pelvis
The vas deferens pass along the (anterior / posterior) aspect of the bladder.
posterior aspect
Which glands are found on the posterior aspect of the bladder and secrete semen into the ejaculatory ducts?
Seminal glands
The ejaculatory ducts drains into the urethra within which gland?
Prostate gland
How does the prostate gland drain its contents into the prostatic urethra?
Prostatic ducts
Which muscle is the inferior aspect of the prostatic gland in contact with?
Levator ani muscle
The prostate gland can be divided into which three areas?
Left and right peripheral zones
Central zone
Where do most prostate cancers arise?
Peripheral zones
How can the peripheral zones of the prostate gland be palpated?
PR exam
Which pelvic bone is the root of the penis attached to?
Ischium
What is the head of the penis called?
Glans
Where is the external urethral orifice found in males?
Glans
What are the three cyclinders of erectile tissue found in the penis?
Right and left CORPUS CAVERNOSUM (posterior, contain arteries for erection)
CORPUS SPONGIOSUM (anterior, contains spongy urethra)
Which arteries supply the penis?
Internal iliac artery >
Internal pudendal artery >
Deep arteries of the penis
What is the blood supply to the scrotum?
Internal pudendal artery
AND
External iliac artery
What is the blood supply to the
a) penis
b) scrotum?
a) Internal iliac arteries -> Internal pudendal arteries -> Deep arteries
b) Internal pudendal arteries AND External iliac arteries
What lymph nodes drain the
a) scrotum and penis
b) testes?
a) Superficial inguinal nodes
b) Lumbar nodes (as they descend from abdomen during development)
Come up in exams - learn them
Which parts of the male gonads are drained by
a) lumbar nodes
b) superficial inguinal nodes?
a) Testes
b) Penis and scrotum
