Anatomy Flashcards
__+__ = upper urinary tract
kidneys
ureter
__+__ = lower urinary tract
bladder
urethra
kidneys and proximal ureters lie in __
retroperitoneum in abdomen
part of urinary tract in pelvis
distal ureters
bladder
prox urethra
part urinary tract in perineum
distal urethra
anterior to posterior in front of kidney = visceral peritoneum > __>__>__>renal capsule
paranephric fat
renal/deep fascia
perinephric fat
muscle lying medial to kidneys
psoas
muscle lying posterior to kidneys
quadratus lumborum
muscles of the anterolateral abdo wall that lie lateral to kidney
external and internal obliqe
transversus abdominis
right kidney lies lateral to __ vertebrae
L1-3
left kidney lies lateral to ___ vertebrae
T12-L2
on inspiration the kidneys ascend/descend
descend
normal length and width of a kidney
length = 12cm wide = 6cm
anatomical relations of the right kidney
posterior to liver (+hepatorenal recess)
2nd part of duodenum
ascending colon
R colic flexure
Left kidney lies posterior to ++__+_
stomach
pancreas tail
spleen hilum
splenic vessels
anterior to posterior in renal hilum
renal vein
renal artery
ureter
common iliac arteries lie ant/post to common iliac veins
ant
abdo aorta bifurcates at the level of the
umbilicus
ureteric blood supply is from branches of (5)
AA internal iliac common iliac vesical renal
kidneys drain to __ nodes
lumbar
ureters drain to + nodes
lumbar
iliac
if renal stenosis is combined with a infrarenal AAA the cause of both is likely to be __
atherosclerosis
renal stenosis can be caused by ___ AAA because it __
suprarenal
occludes the proximal renal artery
nephrons run axially towards the __ of renal pyramid
apex
3 ureteric constrictions
pelviureteric junction
when crosses anterior aspect of common iliac artery
ureteric orifice at bladder
urine backpressure causes nephrons to be compressed => renal failure and capsule stretches painfully
kidney becomes palpable and enlarged =
hydronephrosis
false pelvis =
iliac crests to pelvic inlet - part of abdo cavity
true pelvis
pelvic inlet to pelvic floor
ureters pass __ to common iliac vessels to enter ___ > run __ along lateral wall of __ > at level of ___ turn medially to enter ___
entire route is ___
in ___ direction
anterior pelvis anteriorly pelvis ischial spine posterior bladder sub-peritoneal inferomedial
pelvic ureters lie where in relation to uterine tubes and uterine artery?
inferior
pelvic ureters lie where in relation to vas deferens
inferior
arteries that supply the pelvic organs in Females
internal iliac -> vesical arteries, middle rectal, vaginal and uterine
arteries that supply pelvic organs in males
middle rectal
vesical
prostatic
corners of the trigone in the bladder =
2 ureteric orifices (posterior wall)
internal urethral orifice (floor)
makes up most of bladder wall and surround ureteric orifices
forms internal urethral sphincter in males
detrusor muscle
uterus lies __ to bladder usually in a ___ position
superior
anteflexed
2 possible points of catheterisation
urethral
suprapubic
peritoneum covers which surfaces of the bladder
superior
__ splits pelvis and perineum
levator ani
spongy urethra lies in
corpus spongiosum
spermatic cord contents
testicular artery and vein
vas
lymphatic
nerves (auto => SM of vas ; somatic =>cremaster muscle)
testes lie in a sac called ___ has a __+__ layer
if filled with fluid =
tunica vaginalis
visceral and parietal
hydrocele
embryological remnant that is attached to testes
appendix testis
___ drains the blood from the testes to the __
pampiniform venous plexus
testicular vein
left testicular vein drains to __
right to __
left to left renal vein
IVC for right
inferior surface of prostate is in contact with
levator ani
__ zone of prostate is felt on PR and this is where most __ arise
peripheral
cancers
R + L corpus ___ in penis contain
cavernosum
deep arteries of penis
___ extends distally to form glans of penis
corpus spongiosum
deep arteries of the penis are branches of the __ from the __ artery
internal pudendal artery
internal iliac
arteries that supply the scrotum
internal pudendal artery (from internal iliac)
branches of external artery
lymph from scrotum and penis (not glans) drains to __
superior inguinal nodes
lymph from testes drains to ___
lumbar nodes
ureteric peristalsis and bladder contraction are under __+__ nerve control
parasympathetic
sympathetic
levator ani is under ___ nerve control
somatic motor
pain from kidneys, ureter, bladder, urethra in pelvis and testes are carried in ___ fibres
visceral afferent
pain in perineum is carried in ___ nerve fibres
somatic sensory
sympathetic spinal nerves leave at ___ spinal levels
T1-L2 = thoracolumbar outflow
rami communicans is between __+__
anterior spinal rami and sympathetic chain
sympathetics to kidneys, ureters and bladder leave spinal cord at ___ level => ___ nerves > synapse at ___ around AA > postsynaptics on outside of arteries = ___
T10-L2
abdominopelvic splanchnic
abdominal sympathetic ganglion
periarterial plexus
parasympathetics carried in CNs = ___ and ___ spinal nerves
III VII IX X
sacral
cranioscaral outflow
parasympathetics to kidneys, ureters and bladder is from
kidneys and ureters = CNX
bladder = pelvic splanchnic nerve (S2-4)
only part of renal system with somatic motor fibres = those in __ eg ___ = ___nerve
perineum
distal urethra, external urethral sphincter and levator ani
pudendal nerve
visceral afferents from kidney run alongside __ and enter cord at __ level
dermatomal pain = __ pain
is dulla nd achy
sympathetic fibres
T11 and L2
loin
visceral afferents from ureters enter cord at __ level
dermatomal pain distribution =
T11-L2
loin to groin
visceral afferents from bladder part touching peritoneum =
run alongside ___
enter cord at ___ level
sympathetic fibres
T11-L2
visceral afferents from bladder part not touching peritoneum =
run alongside ___
enter cord at ___ level
parasympathetic nerves
S2-S4
visceral afferents from proximal urethra run alongside ___
enter cord at __ level
parasympathetic nerves
S2-4
somatic sensory fibres from distal urethra are contained in ___ nerve and enter cord at ___ level
pudendal
S2-4
testes visceral afferents run alongside __ and enter cord at __ level
sympathetic
T10-11
bladder pain location
suprapubic
pain from testes may present in __ dermatome due to close relation with groin/scrotum
L1
key nerve fibres in urinary continence
S2-4
bladder stretch is sensed by ___ nerve fibres that enter spinal cord at __ level > reflex (that is overriden) to __+__
visceral afferents
S2-4
detrusor
internal urethral sphincter (M)
when inhibition of micturition is lifted detrusor \_\_\_ (\_\_ nerve supply) internal sphincter (\_\_ nerve supply), external sphincter and levator ani \_\_\_ anterolateral abdominal muscles \_\_\_ ( \_\_\_ nerve supply)
contract - parasymp S2-4 pelvic splanchnic nerves
parasymp S2-4 pelvic splanchnic nerves - relax
contract - somatic motor - pudendal S2-4
iliohypogastric nerve = __ spinal level
supplies ++_
L1
lateral gluteal region above pubis
internal oblique
transversalis
ilioinguinal nerve = ___ spinal level
supplies +++
L1
mons and labia majora
root of penis and upper scrotum
lateral cutaneous nerve = __ spinal level
L2+3
genitofemoral nerve = + spinal level
supplies +++
L1+2 upper thigh anterior scrotum mons cremaster
femoral and obturator nerves relation to psoas major
femoral = lies lateral to psoas obturator = lies medial
sural nerve is from + and supplies
common fibular and tibial nerves
lateral foot sensation
