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LR Renal > Anatomy: Lower Urinary & Male Reproductive Tracts > Flashcards

Anatomy: Lower Urinary & Male Reproductive Tracts Flashcards

1
Q

The bladder is found in the…

a) Abdominal cavity
b) False pelvic
c) Pelvic cavity
d) Perineum

A

c) Pelvic cavity (aka true pelvis)

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2
Q

The false pelvis is part of the…
a) Abdominal cavity
b) Pelvic cavity
?

A

a) Abdominal cavity

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3
Q

What structures form the borders of the false pelvis?

A

Iliac crests to the pelvic inlet/pelvic rim

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4
Q

What structures form the boundaries of the true pelvis/pelvic cavity?

A

Pelvic inlet/pelvic rim to the pelvic floor

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5
Q

What is the main pelvic floor muscle?

A

Levator ani

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6
Q

The pelvic floor has openings which allow structures (e.g., the urethra) to pass into the…?

A

Perineum

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7
Q

What is the perineum?

A

The shallow compartment below the pelvic floor, between the pelvic floor and the skin

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8
Q

Describe the route of the pelvic/distal ureters

aka the pelvic pathway of the ureters

A
  • Pass anterior to the common iliac vessels and pelvic rim to enter the pelvis
  • Run anteriorly along the lateral walls of the pelvis
  • Turn medially at the level of the ischial spine to enter the posterior aspect of the bladder in an inferomedial direction
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9
Q

Why do the ureters enter the bladder in an inferomedial direction?

A

To prevent reflux of urine back into the ureters when the bladder contracts

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10
Q

Where are peritoneal pouches found?

A

Between visceral structures in the true pelvis in the peritoneal cavity

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11
Q

Name the male peritoneal pouch and explain why it is clinically important

A

The rectovesicle pouch (between the rectum and bladder)

It is the most inferior and dependent part of the male peritoneal cavity (in the anatomical position)

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12
Q

Name the 2 female peritoneal pouches

Which is the most inferior/dependent part of the peritoneal cavity?

A

Vesico-uterine pouch (between bladder and uterus)

Rectouterine pouch of Douglas (between uterus and rectum)

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13
Q

How does the term ‘water under the bridge’ help us remember the anatomical relationship between the ureters and the reproductive tracts?

A

The ureter runs inferior to the…

  • Uterine tubes and uterine artery
  • Vas deferens

(this is important as we don’t want to accidentally ligate the ureters instead of the uterine artery in a hysterectomy)

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14
Q

The arteries entering the pelvis are mainly branches of the…?

A

Internal iliac artery

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15
Q

Name some branches of the internal iliac artery that are found in the pelvis
(they are named according to what they supply!)

A
  • Vesical arteries
  • Middle rectal artery
  • Uterine artery
  • Vaginal artery
  • Prostatic arteries
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16
Q

Veins draining from the pelvis mainly drain to the…?

A

Internal iliac vein

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17
Q

What is the trigone of the bladder?

A

A smooth, non-contractile, upside down triangular area on the internal aspect of the bladder

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18
Q

The trigone is formed by what structure in embryological development?

A

The migrating Mesonephric Ducts

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19
Q

The 3 corners of the trigone are formed by..?

A
  • The 2 ureteric orifices (in the base/posterior aspect of the bladder)
  • The internal urethral orifice (on the floor/inferior aspect of the bladder)
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20
Q

What muscle forms the main bulk of the bladder wall?

A

The detrusor muscle

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21
Q

Detrusor muscle fibres encircle the ureteric orifices. Why is this useful?

A

The fibres will tighten when the bladder contracts

This prevents reflux of urine back up into the ureter

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22
Q

Which muscle forms the internal urethral sphincter in males?

A

The detrusor muscle

23
Q

Which muscle forms the internal urethral sphincter around the neck of the bladder in males?

A

The detrusor muscle

24
Q

Why do males, and not females, have an internal urethral sphincter around the neck of the bladder?

A

The internal urethral sphincter contracts during ejaculation to prevent retrograde ejaculation of semen into the bladder

25
Q

The bladder is the most anterior organ in the pelvis.
Describe the relationship of the bladder to the…
-Pubic bone
-Uterus
-Prostate gland

A
  • Pubic bone: anterior to the bladder
  • Uterus: superior to the bladder (the bladder bears most of the weight of the uterus)
  • Prostate gland: inferior to the bladder
26
Q

Describe the relationship of the empty vs the full bladder to the…

  • Pelvis
  • Perineum
A
  • Pelvis: an empty bladder lies within the true pelvis i.e., below the pelvic rim, a full bladder can extend into the false pelvis (part of the abdominal cavity)
  • Peritoneum: regardless of whether it is empty or full, only the superior surface of the bladder is ever covered by peritoneum
27
Q

What are the 2 routes of catheterising a patient?

Which is more common?

A
  • Urethral (most common)

- Suprapubic

28
Q

How is suprapubic catheterisation carried out?

A

Catheter inserted through the abdominal wall but must avoid the peritoneal cavity

The bladder will be full so we know the peritoneal cavity will have been pushed up

29
Q

How long is the female vs the male urethra?

A

Female: ~4cm
Male: ~20cm

30
Q

The external urethral sphincter is formed from voluntary/involuntary muscle

31
Q

The pelvic floor/levator ani muscle is found superior to the external urethral sphincter. T/F?

A

False

The pelvic floor is around the same level as the external urethral sphincter

32
Q

What are the 2 parts of the male urethra?

A

Prostatic urethra (runs through the prostate)

Spongy urethra (runs from the prostate to the penile tip within the corpus spongiosum of the penis)

33
Q

Describe the path taken by the testes during embryological development

A
  • The testes develop on the posterior abdominal wall
  • They travel through the inguinal canal
  • And reach their final position in the scrotum
  • They pull the spermatic cord along behind them on this journey
34
Q

The spermatic cord is a collection of structures which support the function of the testes. What structures are found in the spermatic cord?

A

Vas deferens
Testicular artery
Pampiniform venous plexus

35
Q

What is testicular torsion?

A

When twisting of the spermatic cord disrupts blood supply to the testes, resulting in severe pain and testicular necrosis

36
Q

What is the tunica vaginalis?

A

A sac which the testes sit within inside the scrotum

The testes develop into the sac during embryological development, much like a fist punching into a balloon

So they never enter the sac, just displace it

37
Q

What are the 2 layers of the tunica vaginalis called and what structures are they in contact with?

A

Parietal layer of TV: in contact with the skin of the scrotum

Visceral layer of TV: in contact with the testes and epididymis

A small amount of fluid is found within the sac i.e., between the layers

38
Q

What is a hydrocoele?

A

Excess fluid found between the visceral and parietal layers of the tunica vaginalis

39
Q

The right and left testicular arteries are both branches of…?

A

The abdominal aorta

40
Q

Which veins do the right and left testicular veins drain into?

A

Right testicular vein: drains directly into the IVC

Left testicular vein: drains into the left renal vein

41
Q

Which structures pass through the deep inguinal ring towards the testes?

A 
Testicular artery
Testicular vein (pampiniform plexus of veins drains into this)
Vas deferens
Lymphatics
Nerves
42
Q

Where would you palpate the…
-Epididymis
-Vas deferens
…?

A
  • Epididymis: the posterior aspect of the testis (its head is at the superior pole of the testes)
  • Vas deferens: within the spermatic cord, within the scrotum, or superior to the testis (it feels like a thick piece of string, begins at the inferior pole of the kidneys)
43
Q

Describe the route of a sperm from the testes

A
  • Sperm produced in the seminiferous tubules in the testes
  • Enters the head of the epididymus where it is stored
  • Travels down to the inferior pole of the testes and into the vas deferens
  • Vas deferens takes the sperm out via the spermatic cord
  • Enters the inguinal canal via the superficial inguinal ring and exits via the deep inguinal ring
  • Now in the abdominal cavity, it travels anterior to the bladder, travels along its superior surface, then travels down its posterior surface
  • It moves medially on the posterior surface of the bladder and empties sperm into the ejaculatory duct
  • Semen produced in the seminal vesicles combine with the sperm in the ejaculatory duct
  • Ejaculatory duct opens into the prostatic ureter in the prostate gland
  • The sperm + semen can now exit the penis through the urethra and external urethral orifice
44
Q

What are the prostatic ducts?

A

Openings in the prostatic urethra through which glandular secretions from the prostate drain

45
Q

What surface of the prostate gland is in contact with the levator ani muscle?

A

The inferior aspect

46
Q

What are the 3 zones of the prostate gland and how do they relate to the position of the prostatic urethra?

A

2 peripheral zones (found on each side of the urethra)

1 central zone (found posterior to the urethra in a standing male)

47
Q

Which zone of the prostate gland is felt during digital rectal examination?

A

The peripheral zone

48
Q

What are the 3 cylinders of erectile tissue?

A

The right and left corpus cavernosum

The corpus spongiosum

49
Q

What structures pass through the…
Right and left corpus cavernosum
Corpus spongiosum
…?

A

Right and left corpus cavernosum: deep arteries of the penis

Corpus spongiosum: the spongy urethra

50
Q

What happens to the 3 cyclinders of erectile tissue during erection?

A

They become engorged with blood

51
Q

The root of the penis is attached to which bone?

A

The ischium of the pelvis

52
Q

Which arteries supply the…
-Penis
-Scrotum
…?

A
  • Penis: deep arteries of the penis and branches of the internal pudendal artery (both from the internal iliac)
  • Scrotum: internal pudendal (internal iliac) and scrotal branches of the external iliac artery
53
Q 
Where does lymph from the...
-Penis (except the glans)
-Scrotum
-Testes
... drain to?
A
  • Penis & scrotum: superficial inguinal lymph nodes

- Testes: lumbar nodes around the abdominal aorta (due to its development in the abdomen)

LR Renal (16 decks)

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