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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
What is the verumontanum? What is the utricle?
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
26
Where do the ejaculatory ducts enter the urethra?
Post - prostatic portion just at the distal verumontanum
27
At what point does the prostatic mucosa change from transitional epithelium to stratified squamous?
At the membranous portion
28
Which portion of the urethra is narrowest? What are the margins?
Membranous Prox - distal verumontanum Dist - tip of the cone of the bulbous urethra
29
What are the margins of the bulbous urethra?
Inf aspect of urogenital diaphragm Penoscrotal junction angle
30
What is the fossa navicularis?
The distal 2 cm of the penile urethra that is slightly dilated
31
What are the glands of littre?
Small mucus secreting submucosal glands in the bulbous and superior aspect of the penile urethra Secrete mucus during sexual stimulation
32
Where do the cowpers ducts enter?
Into the proximal or midbulbous urethra
33
Where are cowpers glands in relation to the urethra
along the membranous portion
34
What is "Cobbs collar", or the musculus compressor nuda?
A small striated musculotendinous sling of teh bulbocavernosus muscle at the proximal bulbous urethra
35
What are the three sphincters involved in continence of urine?
Internal urethral sphincter Intrinsic sphincter External sphincter
36
What is the primary muscle of passive urinary continence?
Circular internal urethral sphincter
37
Which sphincter is damaged during prostatectomy? Which one takes over?
Internal is damaged, intrinsic takes over
38
Where is the internal sphincter? Where is the intrinsic sphincter?
Internal - around the bladder neck | Intrinsic - below the verumontanum and surrounding the membranous urethra
39
Where is the external sphincter? What is its function?
Lies peripheral to the intrinsic sphincter and functions in active urinary incontinence
40
Dilated rete testes indicate what?
Vasectomy, epididymitis history
41
What is the hydatid of morgagni?
Vestigial remnant of the mullerian duct - "appendix teste" tiny oval sessile body at upper ends of testes adjacent to head of epidydimis
42
Is the vas deferens ciliateD?
Only near the testicular portion
43
Where do the ejaculatory ducts empty
distal verunmontanum
44
What are the two components of the ejaculatory duct?
Ampulla of the vas deferens | Excretory duct of the seminal vesicles
45
What are the 4 zones of the prostate?
Anterior Transitional Central Peripheral
46
What is the anterior zone of the prostate?
anterior to urethra, fibrous tissue
47
Where does BPH occur?
Transitional zone
48
Where is the transitional zone of the prostate?
Midprostatic urethra
49
Where do most prostatic carcinomas and infections occur?
Peripheral zone
50
What are the two anchors of the prostate? What separates it from the rectum?
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
What is the normal ovarian volume in a premenopausal woman? Postmenopausal?
Pre - 5-20cm3 Post- 2-10 cm3
52
What is the graafian follice?
A dominant follicle that develops during the proliferative phase, usually >2cm
53
What is responsible for the "physiologic fluid" in the cul de sac
Mid cycle rupture of a dominant follicle
54
What is the life cycle of a dominant follicle?
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
What is the blood supply to the ovary?
Ovarian artery off aorta | Adnexal branch off uterine artery
56
Where do the ovarian veins drain?
Left - ipsilateral renal vein | Right - IVC
57
What are the 3 segments of the fallopian tube?
Isthmus - narrow medial third Ampulla - intermediate dilated portion Infundibulum - fimbriated opening adjacent to ovary
58
What is the junctional zone of the uterus?
Innermost layer of myometrium
59
What are the MR characteristics of the endometrium? Junctional zone? Myometrium?
Endo - T2 hyperintense JZ - T2 T2 hypointense Myometrium - T2 hyperintense
60
In the premenopausal woman in the first half of the cycle, what are the 3 layers of endometrium on US?
Inner hyperechoic - coated walls of uterine cavity Hypoechoic - functional layer Outer basal layer - hyperechoic
61
What are the three phases and there approximate age of gestation in kidney development?
Pronephros - 3 weeks Mesonephros - >3 weeks Metanephros - 5th week
62
What are the remnants of the mesonephric duct in adults?
Male - vas deferens, seminal vesicles, ejaculatory ducts Female - vestigial Its also known as the wolffian duct
63
What does the metanephric blastema form into? What does the ureteral bud form into?
MB - nephrons UB - ureter, renal pelvis, calyces, collecting ducts
64
When/how do the kidneys migrate into their adult positions?
4-8 weeks Migrate cephalad and rotate 90 degrees around its longitudinal axis
65
How many renal lobes are present during gestation? When do they assimilate? What does failure of assimilation lead to?
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
What is a hypertrophied column of bertin?
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
What are the 4 stages of lower urogenital tract formation?
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
What are the remnants of the mullerian duct in the male?
prostatic utricle in verumontanum, appendix testes
69
What do the mullerian ducts form in the female?
fallopian tubes, uterus, cervix, uppervagina, proximal urethra
70
What does the pelvic portion of the urogenital sinus form in the male? female?
Male - prostatic urethra, membranous urethra, distal prostate gland, UGD Female - distal urethra, vestibule
71
What does the phallic portion of the urogenital sinus form in the male? female?
Male - bulbous and penile urethra, cowpers glands, glands of littre, corpus cavernosa and spongiosum Female - clitoris, labia, hymen
72
How is the sex determined? When is it determined embryologically and anatomocally?
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
What are the embryonic origins of the following: adrenal glands kidney collecting ducts/calyces/renal pelvis/ureter bladder
mesoderm/ectoderm metanephric blastema ureteral bud from mesonephric duct vesicourethral canal
74
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
``` Vesicourethral canal Urogenital sinus Urethral buds Mesonephric duct buds Mesonephric duct Genital ridge ```
75
What are the embryologic origins of the following: Ovary Uterus/fallopian tubes, upper vagina
Genital ridge | Mullerian duct

Uroradiology (11 decks)

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