Anatomy of the Lower Urinary Tract

Question 1

what is the false pelvis?

Answer 1

the area of pelvis between the iliac crests and the pelvic inlet

Question 2

what is the true pelvis?

Answer 2

the area of pelvis from the pelvic inlet to the pelvic floor

Question 3

what part of the pelvis contains the pelvic viscera?

Answer 3

true pelvis

Question 4

what separates the pelvis from the perineum?

Answer 4

pelvic floor muscles eg levator ani

Question 5

name a pelvic floor muscle

Answer 5

levator ani

Question 6

what structures pass through pelvic floor?

Answer 6

rectum
urethra
vagina

Question 7

describe the route the ureters take after they cross the aorta bifurcation

Answer 7

run anteriorly along lateral pelvis
turn medially at the level of the ischial spine
enter the bladder posteriorly

Question 8

what does subperitoneal mean?

Answer 8

below peritoneal cavity

Question 9

why do the ureters enter the bladder inferomedially?

Answer 9

to prevent backup of urine into the ureters when the bladder contracts

Question 10

the ureter runs behind the uterine tubes and artery: T or F

Answer 10

T, described as “water under the bridge”

Question 11

the ureter runs anterior to the vas deferens T or F

Answer 11

F

Question 12

the arteries entering the pelvis are mainly branches of ___

Answer 12

the internal iliac artery

Question 13

most dependent part of the male in standing position?

Answer 13

rectovesicle pouch

Question 14

most dependent part of the female in standing position

Answer 14

rectouterine pouch/pouch of douglas

Question 15

what structures form the 3 corners of the trigone of the bladder?

Answer 15

an inverted triangle:
2 ureteric orifices (base of triangle)
internal urethral orifice (tip of triangle)

Question 16

what does the inner surface of the bladder look like?

Answer 16

very rough except for the trigone which is smooth

Question 17

the prostate is ___ to the bladder

Answer 17

inferior

Question 18

what muscle forms the main bulk of the bladder wall?

Answer 18

detrusor

Question 19

how is backflow of urine back up the ureter from the bladder prevented?

Answer 19

detrusor muscle fibres form sphincters around the ureteric orifices

Question 20

how is backflow of semen from the urethra to the bladder prevented?

Answer 20

the internal urethral sphincter srrounds the internal urethral orifice

Question 21

most anterior organ in the pelvis?

Answer 21

bladder

Question 22

where does the uterus lie in relation to the baldder?

Answer 22

superiorly

Question 23

what part(s) of the bladder are covered by peritoneum?

Answer 23

superior surface only

Question 24

a full bladder can extend out of the pelvis T or F

Answer 24

T

Question 25

the prostatic urethra is a separate structure to the proximal urethra T or F

Answer 25

F, the prostatic urethra is another name for the proximal urethra in men

Question 26

the internal urethral sphincter is present in both men and women T or F

Answer 26

F, women don’t have one

Question 27

where does urine go when it leaves the bladder in men (include sphincters)?

Answer 27

through the internal urethral sphincter
via the prostatic urethra
through the external urethral sphincter
via the spongy urethra
through the external urethral orifice

Question 28

where are sperm made?

Answer 28

seminiferous tubules in testes

Question 29

where is sperm stored?

Answer 29

epididymis

Question 30

outline the movement of sperm from the epididymis to its excretion

Answer 30

epididymis
vas deferens
joins seminal gland to make ejaculatory duct
joins prostatic urethra to make spongy urethra
excreted via external urethral orifice

Question 31

contents of the spermatic cord?

Answer 31

3 arteries: testicular, cremasteric, artery to vas
3 veins: pampiniform plexus, cremasteric, vein of vas
3 nerves: genital branch of genitofemoral, sympathetics, ilioinguinal
3 fascias: external/internal spermatic, cremasteric
3 others: vas deferens, lymphatics, tunica vaginalis

Question 32

in the scrotum, the testis sits within a sac called the ____

Answer 32

tunica vaginalis

Question 33

excess fluid in the tunica vaginalis is called?

Answer 33

a hydrocele

Question 34

what vessel is responsible for draining deoxygenated blood from the testis?

Answer 34

pampiniform plexus

Question 35

pampiniform plexus drains into what?

Answer 35

testicular vein

Question 36

where does the vas deferens begin?

Answer 36

inferior pole of the testis

Question 37

what route does the vas deferens take?

Answer 37

passes superiorly within the spermatic cord to the deep inguinal ring
turns medially into the pelvis
follows the bladder superiorly all the way round

Question 38

how do glandular secretions from the prostate get into the prostatic urethra?

Answer 38

via prostatic ducts

Question 39

the right testicular vein drains into the __

Answer 39

IVC

Question 40

the left testicular vein drains into the __

Answer 40

left renal vein

Question 41

why is a PR exam good for checking for prostate cancer?

Answer 41

the peripheral zone is the most likely area for cancer and this is what is palpated in PR

Question 42

what part of the penis transmits its deep arteries

Answer 42

the right and left corpus cavernosum

Question 43

what part of the penis transmits the urethra and eventually forms the glans?

Answer 43

corpus spongiosum

Question 44

arterial supply to the penis?

Answer 44

deep arteries of the penis

branches of the internal pudental artery

Question 45

arterial supply to the scrotum?

Answer 45

the internal pudental

branches from the external iliac

Question 46

lymph from the scrotum and most of the penis drains to what nodes?

Answer 46

superficial inguinal nodes

Question 47

lymph from the testis drains to?

Answer 47

lumbar nodes