anatomy lecture 2; the lower urinary tract and male reproductive system Flashcards
ureters pass from the
retroperitoneum through the false pelvis and into the true pelvis
false pelvis
from the iliac crests into the pelvic cavity
false pelvis is part of
the abdominal cavity
true pelvis
from pelvic inlet to the pelvic floor
true pelvis forms the
pelvic cavity
what is found within the pelvic cavity?
the bladder
pelvic floor muscle
levator ani muscle forms the pelvic diaphragm
urethra then passes through
the pelvic floor into the perineum
pelvic floor is formed from
the bowl shaped pelvic diaphragm which is made up of muscles including the levator ani muscle
openings in the pelvic floor
- distal part of the alimentary, renal and reproductive tracts pass through the pelvic floor from the pelvic cavity into the perineum
perineum is
between the pelvic floor and the skin
the ureters pass anteriorly to what?
the common iliac vessels to enter the pelvis
at the level of what?
at the level of the ischial spine the ureters turn medially to enter the posterior aspect of the bladder, this route is completely sub-peritoneal
the ureter enters what part of the bladder?
the posterior bladder wall in an infero-medial direction which helps prevent the reflux of urine when the bladder contracts
what is the pouch in males called
rectovesical pouch in the anatomical position this is the most inferior part of the male peritoneal cavity
round ligament of the uterus
attaches the uterus to the perineum via the inguinal canal
what are the pouches called in females
- vesico-uterine pouch= between the bladder and the uterus
- recto-uterine pouch (pouch of douglas)= in the anatomical position this is the most inferior part of the female peritoneal cavity
in females the ureter runs inferiorly to what?
the uterine artery (water under the bridge)
in males the ureter runs inferiorly to what?
the vas deferens
the anatomical relationship of the ureter are particularly important during
gynaecological surgery ie in a hysterectomy where the uterine artery has to be ligated
the arteries entering the pelvis are mainly
branches from the internal iliac artery and the veins drain into the internal iliac vein
arteries in females
- vesical arteries
- uterine artery
- middle rectal artery
- vaginal artery
arteries in males
- middle rectal artery
- vesical artery
- prostate arteries often branches from vesicle arteries
what is at the base of the posterior aspect of the bladder
the ureteric orifices where the 2 ureters enter the bladder
what is at the inferior aspect in the floor of the bladder
the internal urethral orifice
what do the 2 ureteric orifices and the internal urethral orifice form?
the 3 corners of a triangle shape on the internal aspect of the bladder called the trigone
what is the muscle that forms the main bulk of the bladder called
the detrusor muscle
detrusor muscle fibres encircle what?
the internal ureteric orifices and they tighten when the bladder contracts which prevents reflux of urine
what happens around the neck of the male bladder
the detrusor muscle form the internal urethral sphincter which contracts during evacuation to prevent retrograde ejaculation of semen into the bladder
an empty bladder lies within
the pelvis and the peritoneum is the only thing covering it superior surface
a full bladder can
extend out of the pelvis, its superior part lying superior to the pubic bone however, the superior surface of the bladder is still only covered with peritoneum
2 routes of catheterisation
- urethral
2. supra-pubic which is through the anterior abdominal wall and avoiding the peritoneal cavity
the bladder is the most
anterior organ in the pelvis and it lies posterior to the pubic bone (when empty)
in the female the body of the uterus usually
lies superior to the bladder, it is separated from the bladder by the utero-vesical pouch so most of the weight of the uterus is borne by the bladder
in the male the prostate gland
lies inferior to the bladder and anterior to the rectum
female urethra is approximately
4cm long
in females urine passes from the bladder
through the internal urethral orifice then through the external urethral sphincter and then excreted through the external urethral orifice in the perineum
external urethra sphincter
voluntary skeletal muscle circularly arranged around the urethra
male urethra is approximately
20cm long
in males urine passes from bladder through
the internal urethral orifice, then through the internal urethral sphincter (involuntary) and then through the prostatic urethra which travels between the prostate gland, through the external urethral sphincter (voluntary), then through the spongy urethra (within the corpus spongiosum) and then through the external urethral orifice
male reproductive system
sperm is produce in the testes within the scrotum, then travels towards the epididymis and into the vas deferens and then into the seminal gland through the ejaculatory duct and through the prostate gland and then prostatic urethra into the spongy uretrha and then out through the external urethral orifice
during embryological and foetal development the testes move from
their original position in the posterior abdomen through the inguinal canal into the scrotum
the spermatic cord is
a collection of structures which supports the functioning of the testes
speramtic cord consists of
the testicualr artery, testicualr vein, vas deferents, lymphatic drainage, nerves (autonomic smooth muscle of vas deferens and somatic from the cremaster muscle)
inside the scrotum the testis sit within a sac called the
tunica vaginalis
excess fluid within the tunica vaginalis is called
a hydrocele
testicualr torsion
twisting of the spermatic cord which disrupts the testicualr artery causing ischaemia and necrosis of the testes
right and left testicualr arteries comes off
the abdominal aorta
right and left testicualr veins comes of
the inferior vena cava
passing through the deep inguinal ring
are the testicualr artery, testicualr vein (pampiform plexus of veins drain into the testicualr vein), vas deferents, lymphatic and nerve
the epididymis is
palpated at the posterior aspect of the testis, its proximal end (the head) is located at the posterior aspects of the superior pole of the testis
the vas deferents is palpated within
the spermatic cord within the scrotum, superior to the testis, vas deferent begins at the inferior pole of the testis
prostate gland surround the
prostatic urethra
the inferior aspect of the prostate gland is in contact with
the lavator and muscle
prostatic ducts
the ganldular secretion from the prostate drain into the prostatic urethra
the prostate is split into
peripheral and central zones
what zone of the prostate gland is palpated on PR
peripheral zone
which zone of the prostate gland is most likely to undergo malignant transformation
the peripheral zone
the penis is within the
perineum
surface landmarks of the penis
body of penis
glans
root of penis
external urethral orifice
corpus cavernous
posteriorly transmits the deep arteries of the penic
corpus spongiosum
anteriorly transmits the spongy urethra and expands distally to form the glans
the 3 cylinders of erectile tissue
become encouraged with blood at arterial pressure during erection
blood supply to the penis is via
the deep arteries of the penic which are branches of the internal pudendal artery from the internal iliac artery
blood supply to the scrotum
is via the internal pudendal artery ad branches from the external iliac artery
lymph from the scortum and most of the penis (but not the glans)
DRAINS INTO THE SUPERFICIAL INGUINAL NODES FOUNF IN THE SUPERFICIAL FASCIA OF THE GROIN
Lymph from the testis drains into the
lumbar nodes around the abdominal aorta
