2: Anatomy - lower renal tract Flashcards by Ross Wilson

What are the boundaries of the false pelvis?

Iliac crests to Pelvic inlet

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What are the boundaries of the true pelvis?

Pelvic inlet to Pelvic floor

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Which muscle is involved in the pelvic floor?

Levator ani

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Which nerve supplies levator ani?

Pudendal nerve (S2,3,4)

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What is another name for the pelvic floor?

Pelvic diaphragm

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Which renal organs are found in the

a) pelvic cavity
b) perineum?

a) Distal ureters, bladder, proximal urethra

b) Distal urethra

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Where is the urethra found?

Perineum

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The ureters pass along the (anterior / posterior) aspect of the common iliac arteries.

anterior

site of anatomical constriction

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At which level do the ureters turn medially to enter the bladder?

Ischial spine

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The ureters enter the (anterior / posterior) aspect of the bladder.

posterior

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The fact that the ureters enter the posterior aspect of the bladder in a medial direction helps to prevent ___ of urine.

reflux

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What is more anterior - the common iliac artery or vein?

Artery is anterior

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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

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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)

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Which pouch is the most inferior space in the female peritoneal cavity?

Rectouterine pouch / Pouch of Douglas

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Where are the ureters found in relation to the uterine / fallopian tubes?

Posterior

“water under the bridge”

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Where are the ureters found in relation to the vas deferens in males?

Posterior

same idea as females, posterior to uterine tubes

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Which artery supplies most of the organs of the pelvis?

Internal iliac artery

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The arteries supplying the pelvic organs are mostly branches of the ___ ___ artery.

internal iliac artery

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Which branches of the internal iliac artery supply the bladder?

Vesical arteries

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Which branches of the internal iliac artery supply the

a) uterus in females
b) prostate gland in males?

a) Uterine arteries

b) Prostatic arteries

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Which branch of the internal iliac artery supplies the vagina in females?

Vaginal artery

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Which organ is found in the true pelvic cavity and stores and voids urine?

Bladder

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What is in contact with the superior surface of the bladder?

Peritoneum

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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 \>** **L****eft renal vein \>****IVC** ## Footnote **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**