Anatomy book - renal/urology

Question 1

Why does a renal carcinoma tend to present at a late stage rather than an early stage?

Answer 1

a space occupying lesion in the kidney will not cause symptoms in early stages as no closely related structures will be affected by growth
kidney innervation = autonomic, few sensory fibres, small lesion not detected

Question 2

How does the anatomy of the kidney allow for a portion of the kidney to be removed rather than removal of the whole organ?

Answer 2

kidneys develop embryologically as lobular structures and blood supply is dictated by this development

Question 3

Which lymph nodes does a renal cell carcinoma spread to first?

Answer 3

renal and caval lymph nodes

Question 4

If haematogenous metastases occur in RCC< which structure would likely be affected first?

Answer 4

lungs
tumour will invade renal veins and then the IVC and will pass through the heart and to the lungs

Question 5

How does the anatomy of the left and right renal veins differ? How does this affect the likelihood of haematogenous metastatic spread?

Answer 5

right renal vein shorter
less distance to travel for RCC to spread haematogenously

Question 6

Why do the anterolateral and superior walls of the bladder have a folded nature?

Answer 6

to allow for distension of the bladder

Question 7

What is the function of the detrusor muscle?

Answer 7

contract bladder wall during voiding

Question 8

Where is the detrusor muscle located?

Answer 8

anterolateral and superior walls of the bladder

Question 9

What is the functional reason for the angle at which the ureters enter the bladder?

Answer 9

create a pseudovalve
preventing reflux of urine to kidneys

Question 10

What are the 3 most common locations that renal calculi can become lodged in the ureter?

Answer 10

ureteropelvic junction (UPJ)
point where the ureter passes the pelvic brim/external iliac artery
ureterovesical junction

Question 11

Which structures does the ureter pass as it descends to the bladder?

Answer 11

psoas
common iliac
uterine artery/vas deferens

Question 12

What physiological/anatomical mechanisms prevent urine backflow?

Answer 12

angle at which ureter enters bladder
expansion of bladder
ureters are long so would take long time for urine to reach kidney
ureter is peristaltic

Question 13

Which kidney is anatomically higher?

Answer 13

left

Question 14

Why is renal colic a colicky pain?

Answer 14

peristalsis of ureter
causes a crampy sensation

Question 15

What is the innervation of the ureter?

Answer 15

autonomic
T11-L1

Question 16

Where can renal colic pain be referred to?

Answer 16

loin to groin
bottom of ribs (T11)

Question 17

How can you position the penis to help with catheterisation as the urethra enters the prostate?

Answer 17

gently pull the penis inferiorly

Question 18

What autonomically controlled structure is at the base of the bladder?

Answer 18

internal urethral sphincter (involuntary control of urinary continence)

Question 19

What wall of the rectum is the prostate palpated through?

Answer 19

anterior

Question 20

Which anatomical lobe of the prostate is more commonly associated with malignant changed?

Answer 20

median

Question 21

Enlargement of which lobe is associated with benign prostatic hyperplasia?

Answer 21

lateral lobes
makes groove feel more pronounced

Question 22

What substance do seminal vesicles produce?

Answer 22

seminal fluid - fructose-rich, alkaline fluid that provides an ideal environment for spermatozoa

Question 23

What is the function of the vas deferens?

Answer 23

transport sperm from testes to prostate
sperm will also mature on their journey through vas deferens

Question 24

Why are hip and lower spine a common site of metastatic spread in prostate cancer?

Answer 24

venous plexus that drains the prostate connects with the venous drainage of the vertebral column
this allows for haematogenous metastatic spread to the spinal column

Question 25

What is the function of the bulbourethral glands?

Answer 25

to secrete an alkaline mucus substance to lubricate the urethra and contribute to the final volume of semen

Question 26

What structure is the scrotal ligament a remnant of?

Answer 26

gubernaculum