Abdomen Pelvic Cavity: Bladder, Prostate and Urethra

Question 1

Structure of external urethral meatus in females

Answer 1

Prepuce
Glans clitoris
Frenulum
Labia minora
External urethral opening
Vestibule
Vaginal opening

Question 2

Structure of external urethral meatus

Answer 2

External urethral opening at the end of the dorsum

Question 3

Sections of urethra in males

Answer 3

Preprostatic urethra
Prostatic urethra (passes through prostate)
Membranous urethra (passes through muscle)
Bulbar urethra (passes through bulbar section)
Spongy urethra (passes through spongy section)

Question 4

Sections of urethra in females

Answer 4

Not named by part, v short

Question 5

What to watch out for when catheterising males

Answer 5

Don’t go into the navicular fossa at the external urethral opening
Don’t puncture the inferior urethral wall, v vascular and thin

Question 6

What to watch out for when catheterising females

Answer 6

V easy to catheterize, also very easy for infections to occur (cystitis)

Question 7

Structures in the pelvic floor

Answer 7

Formed from levator ani, surrounds urethra
Urogenital hiatus allows urethra through
Above deep perineal pouch in perineal membrane
Piriformis and coccygeus posterior to levator ani

Question 8

Muscles in female perineal pouch

Answer 8

Compressor urethrae passes around urethra only
External sphincter surrounds urethra fully
Sphincter urovaginalis wraps around urethra and vagina
Deep transverse perineal muscle posterior to vagina

Question 9

Muscles in male peritoneal pouch

Answer 9

Only has external urethral sphincter and deep transverse perineal muscle,
External urethral sphincter controls urine flow

Question 10

Structure of female urethra

Answer 10

External urethral sphincter, top half of urethra sits in deep perineal pouch, controls urine flow
Paraurethral glands enter at bottom half of urethra at urethral exit, lubricates distal urethra

Question 11

Structure of male urethra

Answer 11

Internal urethral sphincter around preprostatic urethra, prevents back flow of semen into bladder
Prostate is above deep perineal pouch
Bulbourethral glands and external urethral sphincter sit in deep perineal pouch
Penis is below deep perineal pouch

Question 12

Pelvic course of male ureter

Answer 12

Ureter crosses over external iliac artery
Over obliterated umbilical artery (ligament)
Under ductus deferens, behind bladder

Question 13

Pelvic course of female ureter

Answer 13

Ureter crosses over external iliac artery
Over obliterated umbilical artery (ligament)
Under uterine artery, behind bladder

Question 14

Structure of the bladder

Answer 14

Ureters enter obliquely at corners of trigone at back of the bladder
Tetrahedral with apex at front, trigone base at back
Has inferior lateral surface on both sides

Internal detrusor muscle, highly folded
Trigone, smooth muscle
Top of muscle flap can act as a valve, prevents reflux

Question 15

Relations of male bladder

Answer 15

Ductus deferent from seminal vesicle’s ejaculatory duct passes between ureter and bladder
Seminal vesicles and prostate posterior to bladder
Bulbous urethral gland is behind prostate

Question 16

Relations of female bladder

Answer 16

Bladder between uterus and pubic symphysis
Back of bladder in bend of uterus
External sphincter at the bottom of the urethra

Peritoneum covers top of bladder, retroperitoneal
Vesicleuterine pouch between top of bladder, under uterus

Question 17

Supports of female bladder and urethra

Answer 17

Pubovesical and pubourethral ligaments wrap around urethra in deep perineal pouch attaching from the pubic symphysis

Question 18

Supports of male bladder and urethra

Answer 18

Pubovesical and puboprostatic ligaments wrap around urethra and prostate in deep perineal pouch attaching from the pubic symphysis

Question 19

Arterial bladder supply

Answer 19

Superior vesicular, branch of ant branch of int iliac

Inferior vesicular in males
Vaginal in females

Question 20

Venous bladder drainage

Answer 20

Vesicular venous plexus => int iliac

Vesical plexus connected to prostatic venous plexus

Question 21

Lymphatic drainage

Answer 21

Paraaortic (L, R kidney)

Common iliac (lower and middle ureter)

External and internal iliac (pelvic ureter/bladder)(lower ureter)

Sacrum (perineum, pelvic organ)

Superficial and deep inguinal (perineum)

Question 22

Somatic innervations of the bladder
SNS of bladder
PNS of bladder

Answer 22

Somatic

• S2-4
• Pudendal nerves, excitatory to external sphincter

SNS
-T10-L2
-Hypogastric nerves => pelvic ganglia
Bladder relaxation, sphincter contraction

PNS

• S2-4
• Pelvic splanchnic
• excitatory to bladder, relax sphincter