Anatomy Flashcards
compare the length of urethras in males and females?
male urethra is much longer than female urethra
explain how male urethras have a dual function?
both urine and semen pass through
what makes up the upper urinary tract?
kidneys
ureters
what makes up the lower urinary tract?
bladder
urethra
what bony structures mare the transition from abdomen to pelvis?
iliac crests
L4
at what vertebra level does the abdominal aorta bifurcate?
L4
what surface of the kidneys touches the peritoneum?
anterior surface
what groups of skeletal muscles protect the kidneys?
muscles of the anterolateral abdominal wall
muscles of the posterior abdominal wall
muscles of the back
what are the 3 muscles of the anterolateral abdominal wall?
external oblique
internal oblique
transversus abdominis
what are the 3 important structures of the renal hilum?
renal artery
renal vein
ureter
what are the 2 muscles of the posterior abdominal wall?
psoas major
quadratus lumborum
which is more anterior- psoas major or quadratus lumboru,?
psoas major
what surrounds the kidney?
the renal capsule
where does the perinephric fat lie?
surrounds renal capsule, deep to renal fascia
what type of fascia is renal fascia?
deep fascia
where doe the paranephric fat lie?
between the visceral peritoneum and the renal fascia
compare the position of the kidneys to the quadratus lumborum muscles?
kidneys lie anterior to quadratus lumborum muscles
compare the position of the kidneys to the psoas major muscles?
kidneys lie lateral to psoas major
which vertebral bodies does the right kidney lie lateral to?
L1, L2, L3
which vertebral bodies does the left kidney lie lateral to?
T12, L1, L2
why is the right kidney more inferior than the right?
due to size of liver
what ribs protect the kidney?
floating ribs 11 and 12
what regions/quadrants are the kidneys within?
R kidney: RUQ, right lumbar region
L kidney: LUQ, left lumbar region
which sac is the hepatorenal recess part of?
the greater sac
compare the location of the renal veins and renal arteries?
renal veins are anterior to renal arteries
compare the location of the common iliac veins and the common iliac arteries?
common iliac arteries are anterior to common iliac veins
where does lymph from the kidneys drain to?
lumbar lymph nodes
where are lumbar lymph nodes found?
located around abdominal aorta and IVC
where does lymph from the ureters drain to?
lumbar lymph nodes + iliac lymph nodes
where are iliac lymph nodes found?
around common, internal and external iliac vessels
the utereric arterial blood supply is from branches of which arteries?
renal artery abdominal aorta common iliac artery internal iliac artery vesical artery
compare an infrarenal and suprarenal AAA?
infrarenal aneurysm starts below level of renal arteries
suprarenal aneurysm starts above the level of renal arteries
what is the management of an AAA?
EVAR
endovascular aneurysm repair using a stent inserted through the femoral artery
when associated with an infrarenal AAA, what is renal artery stenosis caused by?
atherosclerosis
when associated with a suprarenal AAA, what is the renal artery stenosis?
proximity to aneurysm
what is a bifid renal pelvis?
anatomical variation when there is 2 pelvises extending from the major calyces instead of 1 pelvis
what is a bifid ureter?
anatomical variation in where there are 2 ureters at one side, these join before reaching the bladder
what is a unilateral duplicated ureter?
anatomical variation in where ther are 2 ureters at one side, these do not join
what is a retrocaval ureter?
anatomical variation where the ureter wraps behind the IVC instead of remaining lateral to it
what is a horseshoe kidney?
anatomical variation where the kidneys are connected
what is an ectopic pelvic kidney?
anatomical variation where a kidney is in the pelvis instead of the abdomen
what are the 3 reasons for a solitary kidney?
agenesis
patholoical nephrectomy
nephrectomy for donation
how many pyramids does a human kidney medulla contain?
27 pyramids
what gives the pyramids in the medulla the striped appearance/.
nephrons arranged axially
where does the collecting duct pass it’s filtrate?
minor calyx
are nephrons within the cortex or medulla of a kidney?
medulla
the glomerulus filters blood arriving from water vessel?
branches of renal artery
what do the minor calyces join to form?
a major calyx
what do the major calyces join to form?
renal pelvis
the diameter of urine drainage tubes increases until what junction?
pelviureteric junction
where are the 3 anatomical sites of ureteric constriction?
- pelviureteric junction
- where ureter crosses common iliac artery
- ureteric orfice
what does the ureteric orfic open into?
the bladder
the ureter crosses the common iliac artery at what bony landmark?
pelvic brim
what does the pelvic brim divide?
the upper false pelvis and the lower true pelvis
what is the medical name for kidney stones?
renal calculi
what is the name for renal calculi with connections between them?
staghorn calculi
what type of muscle lines the wall of the ureter?
smooth muscle
what does the ureter do in order to dislodge an obstruction?
waves of peristalsis
what type of pain does a patient feel when there is something lodged within one of the ureters and why?
colicky paindue to peristalsis waves
what is renal failure?
failure to adequately filter blood to produce urine
do obstructions within calyces or ureter cause unilateral or bilateral kidney problems?
unilateral
do obstructions within the bladder cause unilateral or bilateral kidney problems?
unilateral or bilateral
do obstructions within the urethra cause unilateral or bilateral kidney problems?
bilateral
what is hydronephrosis?
back pressure into the kidney causing enlargment
why does hydronephrosis cause pain?
because it stretches the renal capsule
embryologically, what becomes the permanent kidney?
metanephros
what does the metanephros form from?
ureteric bud
metanephric blastema
is the kidney endoderm, ectoderm or mesoderm?
mesoderm
is the bladder endoderm, ectoderm or mesoderm?
endoderm
why does kidney agenesis occur?
because the ureteric bud doesn’t come into contact with the metanephric blastema
which becomes the nephron- ureteric bud or the metanephric blastoma?
metanephric blastoma
embryologically, where do the kidneys develop?
in the pelvis
why does ectopic pelvis kidney occur?
failure of kidney to ascend
what are the rounded apexes of the renal pyramids called?
papilla
when the ureter crosses the pelvic brim (pelvic inlet), what part of the pelvis does it pass into?
the true pelvis
describe the location of the false pelvis?
from iliac crests to pelvic inlet (or brim)
describe the location of the true pelvis?
pelvic inlet to pelvic floor
in which cavity is the false pelvis in?
abdominal cavity
in which cavity is bladder in?
the pelvic cavity (true pelvis)
there are openings in the pelvic diaphragm to allow which 3 tracts to pas into the perineum?
alimentary tract
reproductive tract
renal tract
what does the pelvic diaphragm extend between?
sacrum to the pubis
which is the only part of the urinary system to be in the perineum?
urethra
when the ureters cross the common iliac arteries do they pass anteriorly or posteriorly?
anteriorly to the arteries
the ureters enter the posterior bladder wall in which direction?
inferomedial
in the anatomical position, what is the most inferior part of the peritoneal cavity in a male?
rectovesicle pouch
what is the function of the round ligament of the uterus?
attaches uterus to the perineum
what canal is the round ligament of the uterus found in?
inguinal canal
what are 2 pouches of peritoneum in the female?
recto-uterine pouch (of douglas)
vesico-uterine pouch
in the anatomical position, what is the most inferior part of the peritoneal cavity in a female?
recto-uterine pouch of douglas
compare the location of the ureter to the suspensory ligament of the ovary?
suspensory ligament of the ovary is lateral to the ureter
compare the location of the ureter to the uterine tubes and uterine artery?
the ureter runs inferiorly to both the uterine tubes and uterine artery
‘water under the bridge’
compare the location of the ureter to the vas deferens?
ureter runs inferiorly to the vas deferens
are the arteries entering the pelvis mainly from the internal or external iliac arteries?
internal iliac arteries
are the veins draining the pelvis mainly the internal or external iliac veins?
internal iliac veins
which arteries do the prostatic arteries often branch from?
the vesical arteries
what form the three points of the trigone of the bladder?
ureteric orfices x2
internal urethral orfice
where is the prostate in relation to the bladder?
prostate is directly inferior
when empty, in which pelvis is the bladder contained in?
true pelvis
when full in which pelvis is the bladder contained in?
can expend into false pelvis
which border of the bladder is in contact with the peritoneum?
superior
what is the name of the part of the urethra which passes through the prostate?
prostatic urethra
around the internal urethral orfice, what muscle is present in males?
internal urethral sphincter
which muscle forms the bladder wall?
detrusor muscle
why does the detrusor muscle encircle the ureteric orfices?
contracts during bladder contraction to prevent reflux of urine into the ureters
which muscle makes the internal urethral sphincter muscle?
the detrusor
what is the function of the internal urethral sphincter muscle?
contracts during ejaculation to prevent retrograde ejaculation of semen into the bladder
which is the most anterior organ in the pelvis?
the bladder
what separates the uterus and the bladder?
vesicouterine pouch
what position is the uterus in?
anteflexed position
compare the relation of the bladder to the peritoneum when full and empty?
no change
what are the 2 routes of catherisation?
urethral suprapubic (ie through abdominal wall)
why may a suprapubic method of catheterisation be used over uretheral catheterisation?
if there is a urethral obstruction
how long is the female urethra?
4cm
is the external urethral sphincter voluntary or involuntary?
voluntary
how long is the male urethral?
20cm
is the internal urethral sphincter voluntary or involuntary?
involuntary
what part of the urethra is within the penis? (also known as the penile urethra)
spongy urethra
which cylinder of erectile tissue of the penis is the spongy urethra within?
corpus spongiosum
where is sperm produced?
seminiferous tubules
where is sperm stored?
epididymis
the vas deferens joins with the seminal duct to form what?
the ejaculatory duct
what is produced int he seminal glands?
semen
what part of the urethra does the ejaculatory duct drain into?
the prostatic urethra
what is the embryological origin of the testes?
posterior abdominal wall
what is contained within the spermatic cord?
testicular artery testicular vein vas deferens lymphatic vessels nerves
within the scrotum, what sac do the testis sit within?
tunica vaginalis
what is contained between the visceral and parietal layers of tunica vaginalis?
serous fluid
what is the name for too much fluid within the tunica vaginalis?
hydrocele
what is the function of the appendix testis?
none
what venous plexus drains blood from the testes?
pampiform plexus
what is the name for hwen the spermatic cord twists and disrupts the blood supply to the testis?
torsion
what does the pampiform plexus drain into?
testicular vein
where does the right testicular vein drain?
directly into the IVC
where does the left testicular vein drain?
to the left renal vein then to the IVC
what is in contact with the inferior aspect of the prostate gland?
levator ani muscle
what are the 3 zones of the prostate gland?
2 peripheral zones
1 central zone
which zones are felt on palapation of prostate? (PR)
peripheral zones
which zones within the prostate do cancers most likely arise in?
peripheral zones
what are the 3 cylinders of erectile tissue within the penis? (and describe location)
corpus cavernosum x2 posteriorly
corpus spongiosum x1 anteriorly
what does the corpus spongiosum transmit?
spongy urethra
what does the corpus cavernosum transmit?
deep arteries of the penis
what are the scrotal and penile raphes?
ridges of skin within the midline
which cylinder of erectile tissue is directly posterior to the midline raphe?
corpus spongiosum
what is paraphimosis?
when the prepuce is retracted and the glans swells
what is the management of paraphimosis?
circumsicion
what is the medical name for foreskin?
prepuce
what is the blood supply to the penis?
deep arteries of the penis
what artery are the deep arteries of the penis a branch of?
the internal pudendal artery
what artery is the internal pudendal artery a branch of?
the internal iliac artery
what is the blood supply to the scrotum?
internal pudendal artery from the internal iliac artery and branches of the external iliac artery
where does lymph from the scrotum and post of the penis (not the glans) drain to?
superficial inguinal lymph nodes
where are superficial inguinal lymph nodes found?
in superficial fascia in the groin
where does lymph from the testes drain to?
lumbar lymph nodes
what are the 5 types of nerve fibre modality?
somatic sensory visceral afferent somatic motor parasympathetic sympathetic
what nerve modality controls ureteric peristalsis?
sympathetic or parasympathetic
what nerve modality controls bladder contraction?
sympathetic or parasympathetic
what nerve modality controls the external sphincter?
somatic motor
what nerve modality controls the levator ani?
somatic motor
what nerve modaliry controls the internal sphincter?
sympathetic/parasympathetic
what part of the urinary system is different with regards to pain being carried by somatic sensory instead of visceral afferent nerve fibres?
distal urethra
part of the perineum so somatic sensory
from which spinal cord levels is there sympathetic outflow?
T1 to L2
do sympathetic fibres reaching the body wall synapse in the sympathetic chain?
yes
do sympathetic fibres reaching the smooth muscles/glands of the body synapse in the sympathetic chain? (ignoring supply of the head)
no
what are the 2 groups of nerves which carry sympathetic supply to the smooth muscles /glands (organs) of the body?
cardiopulmonary splanchnic nerves
abdominpelvic splanchnic nerves
how do sympathetic nerve fibres reach the structures of the head?
synapse in sympathetic chain then ‘hitch a ride’ with arteries which supply the same structures
what is the name of the connections between the anterior rami of the spinal cord and the sympathetic chain?
rami communications
how many cervical sympathetic chain ganglia are there?
3
superior, middle inferior
which splanchnic nerves do the sympathetic nerve fibres which supply the kidneys, ureter and bladder leave with?
abdominopelvic splanchnic nerves
are the sympathetic nerve fibres within the abdominopelvic splanchnic nerves pre or post synaptic neurones?
pre synaptic neurones
do not synapse at the sympathetic chain
where do the sympathetic nerve fibres which carry supply to the kidneys, ureters and bladder (within abdominopelvic splanchnic nerves) synapse?
abdominal sympathetic ganglia
where are abdominal sympathetic ganglia located?
around central branches of the abdominal aorta
eg coeliac’s trunk, SMA, IMA
where do the postsynaptic sympathetic nerve fibres go once synapsing at the abdominal sympathetic ganglion?
take part in the periarterial plexus on the arteries which are heading to the same organ that they innervate
apart from sympathetic nerve fibres, which other nerve modalities are present in periarterial plexuses on the arteries heading to the kidneys, ureters and bladder?
parasympathetic supply
visceral afferent
what are the 7 in total cranial/spinal nerves which contain parasympathetic supply?
CN III, VII, IX, X
S2,3,4
what group of nerves carry parasympathtic supply to the hindgut and pelvic organs?
pelvic splanchnic nerves
compare abdominopelvic splanchnic nerves and pelvic splanchnic nerves?
abdominopelvic splanchnic: sympathetic supply
pelvic splanchnic: parasympathetic supply
what carries parasympathetic fibres to the kidneys?
vagus nerve
what carries parasympathetic fibres to the bladder?
pelvic splanchnic nerves
what carries parasympathetic fibres to the ureters?
vagus nerve
what spinal cord level do pelvic splanchnic nerves come from?
S2,3,4
what 3 main parts of the urinary tract are supplied by somatic motor innervation?
distal urethra
external urethral sphincter
levator ani
what is the main nerve swhich supplies the external urethral sphincter with somatic motor supply?
pudendal nerve
which spinal nerves make up the pudendal nerve?
S2,3,4
which nerve modality stimulates the detrusor muscle to contract and via what nerve(s)?
parasympathetic fibres from pelvic splanchnic nerves
during ejaculation, which nerve modality stimulates the contraction of the internal urethral sphincter?
sympathetic fibres
which nerve modality inhibits the contraction of the internal urethral sphincter to allow urine to follow into the urethra?
parasympathetic fibres
which nerve modality stimulates the external urethral sphincter to contract and via what nerve(s)?
somatic motor pudendal nerve (S2,3,4)
which nerve modality stimulates the levator ani muscle to contract and via what nerves(s)?
somatic motor pudendal nerve (S2,3,4)
why is pain from the distal part of the urethra much more localised than pain from elsewhere in the urinary tract?
perineum has somatic sensory supply
elsewhere has visceral afferent supply
what is the name of the posterior aspect of the flank region?
loin
where is pain from the kidney itself felt?
loin on the affected side
where is the pain from a calculus obstructing the ureter felt?
radiation from loin to groin on affected side
where is the pain from the bladder usually felt?
suprapubic region
where is the pain from the distal urethra felt?
localised in the perineum
visceral afferents from the kidneys run back to the spinal cord alongside which- sympathetic or parasympathetic nerve fibres?
sympathetic nerve fibres
which spinal cord levels do visceral afferents from the kidneys enter?
T11 to L1
which is the most common differential for loin pain?
muscular
visceral afferents from the ureters run alongside which- sympathetic or parasympathetic nerve fibres?
sympathetic nerve fibres
which spinal cord levels do visceral afferents from the ureters enter?
T11 to L2
visceral afferents from the superior part of the bladder (which touches the peritoneum) run along side which- sympathetic or parasympathetic nerve fibres?
sympathetic nerve fibres
which spinal cord levels do visceral afferents from the superior part of the bladder enter?
T11- L2
visceral afferents from the inferior part of the bladder (ie part that doesn’t touch the peritoneum) run alongside which- sympathetic or parasympathetic nerve fibres?
parasympathetic nerve fibres
which spinal cord levels do visceral afferents from the inferior part of the bladder enter?
S2,3,4
visceral afferents from the superior part of the urethra run alongside which- sympathetic or parasympathetic nerve fibres?
parasympathetic nerve fibres
somatic sensory nerve fibres from the inferior part of the urethra are carried by what nerve back to the spinal cord?
pudendal S2,3,4
visceral afferents from the testis run alongisde which- sympathetic or parasympathetic nerve fibres?
sympathetic nerve fibres
which spinal cord level do visceral afferents from the superior urethra enter?
S2,3,4
which spinal cord level do visceral afferents from the testis enter?
T10-11
what within the bladder do visceral afferent fibres sense?
stretch
distension
what spinal roots is the sciatic nerve made from?
L4,5
S1,2,3
what area does the iliohypogastric nerve supply?
skin of lateral gluteal redion
what spinal roots is the iliohypogastric nerve made from?
L1
what area does the ilioinguinal nerve supply?
skin around perineum area
what spinal roots is the ilioinguinal nerve made from?
L1
what area does the lateral cutaneous nerve of the thigh supply?
skin of the lateral side of the thigh
what spinal roots is the lateral cutaneous nerve of the thigh made from?
L2,3
what does the genitofemoral nerve supply?
skin of the perineum
what spinal roots is the genitofemoral nerve made from?
L1,2
what does the femoral nerve supply?
anterior compartment of the thigh
what spinal roots is the femoral nerve made from?
L2,3,4
what does the obturator nerve supply?
medial compartment of the thigh
what spinal roots is the obturator nerve made from?
L2,3,4
the femoral nerve reaches the anterior compartment of the thigh by passing under what?
the inguinal ligament
the obturator nerve reaches the medial compartment of the thigh by passing through what?
the obturator foramen of the pelvis
which nerve supplies the lateral muscle compartment of the leg?
superficial fibular
which nerve supplies the anterior compartment of the leg?
deep fibular
which nerve supplies the posterior compartment of the leg?
tibial
which nerve supplies the intrinsic muscles of the foot?
tibial
which nerve becomes the saphenous nerve?
the femoral nerve
what nerve supplies the skin of the posterior thigh?
posterior cutaneous nerve of the thigh
which nerve supplies the skin of the anterior thigh?
femoral nerve
which nerve supplies the skin of the lateral leg?
sciatic nerve
which nerve supplies sensation to the plantr aspect of the foot?
tibial nerve
which nerve supplies the sensation to the lateral aspect of the foot?
sural nerve
which nerve supplies the sensation to the medial aspect of the foot?
saphenous nerve
which nerve supplies the sensation to the dorsum of the foot? *except the 1st web space)
superficial fibular
which nerve supplies the sensation to the 1st web space of the dorsum of the foot?
deep fibular
