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Uroradiology > Anatomy and embryology > Flashcards

Anatomy and embryology Flashcards

1
Q

What is the appearance of the adrenal gland with an ipsilateral renal agenesis?

A

Linear as opposed to the inverted Y shape

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2
Q

What is the arterial supply of the adrenal gland?

A

3 main feeding arteries
1 - superior adrenal (off of inferior phrenic)
2 - middle adrenal (off of aorta)
3 - Inferior adrenal (off of renal)

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3
Q

What is the venous drainage of the adrenal gland?

A

Single adrenal vein entering the posterior IVC (right) or inferior phrenic (left)

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4
Q

What marks the junction between cortex and medulla?

A

The arcuate artery at the base of each pyramid

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5
Q

What is a column of bertin?

A

Column of cortical tissue that may descend between the pyramids in the kidney

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6
Q

What is the intrarenal collecting system

A

Minor calyces, infundibulum, and renal pelvis

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7
Q

What is Gerotas fascia?

A

The encasing perirenal fascia (ant and post)

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8
Q

What are the boundaries of the anterior pararenal space? What are its contents?

A

Posterior portion of peritoneal cavity to anterior layer of Gerotas fascia

Pancreas, 2nd-4th portions of duodenum, ascending and descending colon, hepatic and splenic arteries

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9
Q

What are the contents of the perirenal space?

A

Kidney, adrenal gland, proximal ureter

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10
Q

What are the boundaries of the posterior pararenal space? What are its contents?

A

posterior layer of perirenal fascia and psoas/lumborus fascia

No contents, just fat

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11
Q

What are the 4 potential spaces of the pelvic extraperitoneal space?

A

1 - space of retzius (btw bladder and symphisis pubis)
2 - retrovesicular space
3 - perirectal space
4 - presacral space

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12
Q

What is the minor/major infundibulum?

A

The drainage from minor to major calyx (minor) and from major calyx to renal pelvis (major)

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13
Q

What is the relationship of the ureter to the common/external iliac artery?

A

It will run anterior to the vessel

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14
Q

How long do the ureters course submucosally and where do they terminate?

A

2 cm

terminate at the lateral margin of the trigone

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15
Q

What is the narrowest part of the ureter?

A

UVJ

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16
Q

What are the 3 layers of the ureter?

A

mucosa
muscular
adventitial

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17
Q

What is the mucosal epithelium made of in the ureter?

A

Transitional epithelium

continuous with renal pelvis proximally and bladder distally

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18
Q

What is the arterial supply of the ureter, specifically the distal portion?

A

Prox - renal arteries (pelvis as well)
Mid - aorta, lumbar, gonadal, iliac
Distal - inferior vesical artery

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19
Q

What are the 4 layers of the bladder

A

Detrusor muscle
Lamina propria
Submucosa
Mucosa

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20
Q

What are the 3 layers of the detrusor muscle

A

Inner longitudinal
Mid circular
Outer longitudinal

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21
Q

What is the trigone?

A

The meeting point of the three bladder muscle layers

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22
Q

What is the main blood supply to the bladder? Where do these arise from?

A

Sup/Mid/Inf vesicular arteries

Arise from hypogastric arteries

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23
Q

The male urethra has an anterior and posterior portion - name the 2 segments in each

A

Post - prostatic, membranous

Ant - bulbous, penile

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24
Q

Where does the prostatic urethra end?

A

Superior aspect of urogenital diaphragm

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25
Q

What is the verumontanum? What is the utricle?

A

Verumontanum - mound of swelling of a longitudinal smooth muscle just proximal to the membranous urethra, near site of seminal vesicle entry

Utricle - small depression in the verumontanum the arises and projects posteriorly

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26
Q

Where do the ejaculatory ducts enter the urethra?

A

Post - prostatic portion just at the distal verumontanum

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27
Q

At what point does the prostatic mucosa change from transitional epithelium to stratified squamous?

A

At the membranous portion

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28
Q

Which portion of the urethra is narrowest? What are the margins?

A

Membranous

Prox - distal verumontanum
Dist - tip of the cone of the bulbous urethra

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29
Q

What are the margins of the bulbous urethra?

A

Inf aspect of urogenital diaphragm

Penoscrotal junction angle

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30
Q

What is the fossa navicularis?

A

The distal 2 cm of the penile urethra that is slightly dilated

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31
Q

What are the glands of littre?

A

Small mucus secreting submucosal glands in the bulbous and superior aspect of the penile urethra

Secrete mucus during sexual stimulation

32
Q

Where do the cowpers ducts enter?

A

Into the proximal or midbulbous urethra

33
Q

Where are cowpers glands in relation to the urethra

A

along the membranous portion

34
Q

What is “Cobbs collar”, or the musculus compressor nuda?

A

A small striated musculotendinous sling of teh bulbocavernosus muscle at the proximal bulbous urethra

35
Q

What are the three sphincters involved in continence of urine?

A

Internal urethral sphincter
Intrinsic sphincter
External sphincter

36
Q

What is the primary muscle of passive urinary continence?

A

Circular internal urethral sphincter

37
Q

Which sphincter is damaged during prostatectomy? Which one takes over?

A

Internal is damaged, intrinsic takes over

38
Q

Where is the internal sphincter? Where is the intrinsic sphincter?

A

Internal - around the bladder neck

Intrinsic - below the verumontanum and surrounding the membranous urethra

39
Q

Where is the external sphincter? What is its function?

A

Lies peripheral to the intrinsic sphincter and functions in active urinary incontinence

40
Q

Dilated rete testes indicate what?

A

Vasectomy, epididymitis history

41
Q

What is the hydatid of morgagni?

A

Vestigial remnant of the mullerian duct - “appendix teste”

tiny oval sessile body at upper ends of testes adjacent to head of epidydimis

42
Q

Is the vas deferens ciliateD?

A

Only near the testicular portion

43
Q

Where do the ejaculatory ducts empty

A

distal verunmontanum

44
Q

What are the two components of the ejaculatory duct?

A

Ampulla of the vas deferens

Excretory duct of the seminal vesicles

45
Q

What are the 4 zones of the prostate?

A

Anterior
Transitional
Central
Peripheral

46
Q

What is the anterior zone of the prostate?

A

anterior to urethra, fibrous tissue

47
Q

Where does BPH occur?

A

Transitional zone

48
Q

Where is the transitional zone of the prostate?

A

Midprostatic urethra

49
Q

Where do most prostatic carcinomas and infections occur?

A

Peripheral zone

50
Q

What are the two anchors of the prostate? What separates it from the rectum?

A

1 - puboprostatic ligaments, extends from the posterior aspect of the pubis to the prostatic capsule

2 - apex is embedded in the muscle fibers of the external sphincter

Denonvilliers fascia

51
Q

What is the normal ovarian volume in a premenopausal woman? Postmenopausal?

A

Pre - 5-20cm3

Post- 2-10 cm3

52
Q

What is the graafian follice?

A

A dominant follicle that develops during the proliferative phase, usually >2cm

53
Q

What is responsible for the “physiologic fluid” in the cul de sac

A

Mid cycle rupture of a dominant follicle

54
Q

What is the life cycle of a dominant follicle?

A

Grows, then ruptures at mid cycle releasing fluid. Will then undergo vascularization and becomes the corpus luteum. This then secretes progesterone to prepare the endothelium for implantation

55
Q

What is the blood supply to the ovary?

A

Ovarian artery off aorta

Adnexal branch off uterine artery

56
Q

Where do the ovarian veins drain?

A

Left - ipsilateral renal vein

Right - IVC

57
Q

What are the 3 segments of the fallopian tube?

A

Isthmus - narrow medial third
Ampulla - intermediate dilated portion
Infundibulum - fimbriated opening adjacent to ovary

58
Q

What is the junctional zone of the uterus?

A

Innermost layer of myometrium

59
Q

What are the MR characteristics of the endometrium? Junctional zone? Myometrium?

A

Endo - T2 hyperintense
JZ - T2 T2 hypointense
Myometrium - T2 hyperintense

60
Q

In the premenopausal woman in the first half of the cycle, what are the 3 layers of endometrium on US?

A

Inner hyperechoic - coated walls of uterine cavity
Hypoechoic - functional layer
Outer basal layer - hyperechoic

61
Q

What are the three phases and there approximate age of gestation in kidney development?

A

Pronephros - 3 weeks
Mesonephros - >3 weeks
Metanephros - 5th week

62
Q

What are the remnants of the mesonephric duct in adults?

A

Male - vas deferens, seminal vesicles, ejaculatory ducts

Female - vestigial

Its also known as the wolffian duct

63
Q

What does the metanephric blastema form into? What does the ureteral bud form into?

A

MB - nephrons

UB - ureter, renal pelvis, calyces, collecting ducts

64
Q

When/how do the kidneys migrate into their adult positions?

A

4-8 weeks

Migrate cephalad and rotate 90 degrees around its longitudinal axis

65
Q

How many renal lobes are present during gestation? When do they assimilate? What does failure of assimilation lead to?

A

14, 7 anterior and 7 posterior separated by a fibrous longitudinal groove

Assimilate at 28 weeks

Failure to join results in grooved cortical contour known as persistent fetal lobulation

66
Q

What is a hypertrophied column of bertin?

A

When the cortex fuses in the embryo, the associated medulla in that lobe will abut the adjacent medulla, with little fusion. There will be columns of cortical tissue between adjacent medullary lobes, and some of them have a bulbous appearance and slight mass effect on the calyces - known as the column of bertin

67
Q

What are the 4 stages of lower urogenital tract formation?

A

1 - formation of the cloaca
2 - separation of the cloaca into ventral and dorsal portions
3 - development into bladder, allantois, urogenital sinus
4 - development of ventral and vesicourethral portions of bladder, division of urogenital sinus into pelvic and phallic portions

68
Q

What are the remnants of the mullerian duct in the male?

A

prostatic utricle in verumontanum, appendix testes

69
Q

What do the mullerian ducts form in the female?

A

fallopian tubes, uterus, cervix, uppervagina, proximal urethra

70
Q

What does the pelvic portion of the urogenital sinus form in the male? female?

A

Male - prostatic urethra, membranous urethra, distal prostate gland, UGD

Female - distal urethra, vestibule

71
Q

What does the phallic portion of the urogenital sinus form in the male? female?

A

Male - bulbous and penile urethra, cowpers glands, glands of littre, corpus cavernosa and spongiosum

Female - clitoris, labia, hymen

72
Q

How is the sex determined? When is it determined embryologically and anatomocally?

A

Undifferentiated gonads contain a cortex and medulla

Males - cortex regresses and sex cords form the rete testes and seminiferous tubules in medulla

Females - cortex develops follicles around vascular stromal core

6th week, by 12 weeks its anatomically

73
Q

What are the embryonic origins of the following:
adrenal glands
kidney
collecting ducts/calyces/renal pelvis/ureter
bladder

A

mesoderm/ectoderm
metanephric blastema
ureteral bud from mesonephric duct
vesicourethral canal

74
Q

What are the embryologic origins of the following:
Proximal posterior urethra
Distal posterior urethra/membranous urethra/anterior urethra
Prostate
Seminal vesicle
Ejaculatory duct/vas deferens/epididymis
Testis

A 
Vesicourethral canal
Urogenital sinus
Urethral buds
Mesonephric duct buds
Mesonephric duct
Genital ridge
75
Q

What are the embryologic origins of the following:
Ovary
Uterus/fallopian tubes, upper vagina

A

Genital ridge

Mullerian duct

Uroradiology (11 decks)

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