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Renal > Anatomy of the lower urinary tract and male reproductive tract: > Flashcards

Anatomy of the lower urinary tract and male reproductive tract: Flashcards

1
Q

where do the ureters pass through?

A

retroperitoneum, through the false pelvis and into the true pelvis

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2
Q

where is the false pelvis?

A

Superior part
from iliac crests to pelvic inlet
part of the abdominal cavity

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3
Q

where is the true pelvis?

A

the true pelvis (pelvic cavity)

pelvic inlet to pelvic floor

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4
Q

where is the bladder found?

A

pelvic cavity

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5
Q

what are the pelvic floor muscles?

A

levator ani (pelvic diaphragm)

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6
Q

where does the urethra pass through?

A

urethra passes through pelvic floor

into perineum

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7
Q

the pelvic floor is formed by?

A

the bowl shaped :
pelvic diaphragm
made up of muscles including levator ani

openings in the pelvic floor
distal parts of alimentary, renal and reproductive tracts to pass through
from pelvic cavity into the perineum

perineum is shallow compartment
between pelvic floor and skin

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8
Q

what separates the false and the true pelvis?

A

the pelvic ridge

it is important because the false pelvis contains the abdominal viscera whereas the true pelvis is the area that contains the pelvic viscera

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9
Q

what is the perineum?

A

the part between the pelvis floor and the external genetalia

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10
Q

course of the ureters?

A

The ureters pass anterior to the common iliac vessels to enter the pelvis

They run anteriorly (along the lateral walls of the pelvis),

At the level of the ischial spine, they turn medially to enter the posterior aspect of the bladder

This route is completely “sub”peritoneal

The ureters (at the ischial wall) enter the posterior bladder wall in an inferomedial direction. 
helps prevent reflux of urine back into the ureters when the bladder contracts
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11
Q

what does sub-peritoneal mean?

A

below the peritoneum

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12
Q

a space within the peritoneum cavity in the male?

A

is the rectovesicle pouch - in the anatomical position, it is the most inferior part of the male peritoneal cavity

abnormal fluid in a standing man will collect in the rectovesicle pouch

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13
Q

once peritoneum is removed

A

you find the ureter

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14
Q

what are the two pouches in the peritoneum in women?

A

the vesicle-uterine pouch - between the bladder (vescical) and uterus

the rectouterine pouch (of Douglas) - in the anatomical position this is the most inferior part of the female peritoneal cavity. abnormal fluid builds up over here in females

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15
Q

what are the anatomical relations of the pelvic ureters?

A

the ureter runs inferiorly to the uterine tubes and the uterine artery
‘water under the bridge’ - females

the ureter runs inferiorly to the vas deferens (transports sperm) - males

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16
Q

what is the importance of the anatomical relations of the ureter in females?

A

gynaecological surgery, e.g hysterectomy (surgical removal of the uterus) which requires ligation of the uterine artery

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17
Q

the key arteries are coming from (females)?

A

the common iliac artery
will branch into the internal and external (becomes femoral)

internal iliac artery become vesicle arteries - to bladder
uterine artery - supplies the uterus
middle rectal artery - towards the rectum

vaginal artery - towards the vagina

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18
Q

key arteries (males)

A

vescical arteries
middle rectal
prostatic arteries - often branches from the vesical arteries

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19
Q

the bladder is?

A

sub -peritoneum

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20
Q

inside the bladder there are a number of openings?

A

the 2 ureteric orifices (the point where the ureter enters the bladder) and the internal urethral orifice form the 3 corners of a triangle shape on the internal aspect of the bladder called the “trigone”

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21
Q

the internal surface of the bladder has?

A

trigone of the bladder - smooth triangular area

rest of the bladder full of folds?

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22
Q

the detrusor muscle?

A

the muscle which forms the main bulk of the bladder wall is called the detrusor muscle

detrusor muscle fibres encircle the ureteric orifices, these fibres tighten when the bladder contracts: another mechanism to prevent reflux of urine superiorly into the ureter

around the neck of the male bladder, the detrusor muscle forms the internal urethral sphincter muscle which contracts during ejaculation to prevent retrograde ejaculation of semen back into the bladder

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23
Q

where does the empty bladder lie?

A

The bladder is the most anterior organ in the pelvis lying posterior to the pubic bone (when empty)

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24
Q

int he female body, the uterus usually lies?

A

superior to the bladder (in an “anteflexed” position), it is separated from the bladder by the uterovesical pouch. As a result, most of the weight of the uterus is borne by the bladder

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25
Q

in males the prostate gland lies?

A

inferior to the bladder and the rectum posterior

26
Q

an empty bladder lies?

A

within the pelvis and the peritoneum covers its superior surface only

27
Q

a full bladder?

A

can extend out of the pelvis: its superior part lies superior to the pubic bone (into the false pelvis)
peritoneum still only covers its superior surface

28
Q

what are the two routes of catheterizing a patients bladder?

A

urethral (more common) &

suprapubic (through anterior abdominal wall & avoiding peritoneal cavity) - can’t be done on an empty bladder , will pierce peritoneum

29
Q

external urethral sphincter in females?

A

important landmark - because it is in the same place last eh elevator and muscle - hence anything below external/urethral muscle/levator and - true pelvis

if below - perineum

30
Q

within the prostrate gland urethra is?

A

the prostatic urethra

31
Q

the spongy urethra?

A

within the corpus spongiosum

32
Q

how long is the male urethra?

A

~20cm long

33
Q

where are sperms produces?

A

testicles

34
Q

where is sperm stored?

A

epidydimys

35
Q

where does the pserm pass through?

A

the vas deferent, inguinal canal

36
Q

during embryological and fetal development the testes move from?

A

from their original position in the posterior abdomen and descends through the inguinal canal to the scrotum, dragging with them a lot of anatomical organs such as the spermatic cord - a collection of structure which support he functioning of the testis

37
Q

the spermatic cord?

A

a collection of structures which support the functioning of the testis (testicular artery, testicular vein, vas deferens, lymphatic vessels draining testis, nerves (autonomic for smooth muscle of vas) and somatic (for cremaster muscle

38
Q

tunica vaginalis?

A

two layers of the tunica vaginalis
visceral - in contact with the testis

the parietal - around the scrotum

has fluid that lubricates

39
Q

what is an hydrocele?

A

excess fluid within the tunica vaginalis

40
Q

the pampiniform venous plexus?

A

the venous drainage of the testis

41
Q

what is torsion of the spermatic cord?

A

twisting of the spermatic cord (fairly mobile, and free structure) can disrupt the blood supply to the testis:

severe pain

danger of testicular necrosis (cell death)

42
Q

testicular arteries arise from the

A

aorta

43
Q

the testicular veins arise form?

A

the right gonadal vein - right IVC

the left gonadal vein - left renal vein - left IVC

44
Q

what is the deep inguinal ring?

A

passing through (and into/out of the inguinal canal) are testicular artery, testicular vein (pampiniform plexus of veins drains into this), vas deferens, lymphatics and nerves

45
Q

the epididymis is?

A

is palpated at the posterior aspect of the testis: its proximal end (the head) is located at the posterior aspect of the superior pole of the testis

46
Q

the vas deferens is?

A

is palpated within the spermatic cord; within the scrotum, superior to the testis; it feels like a thick piece of string

47
Q

route of the sperm?

A

produced in the testicles
the vas deferent passes superiorly within the spermatic cord to the deep inguinal ring
at the deep inguinal ring, the vas deferent turn medially into the pelvis, posterior to the bladder

ureter passes under the vas deferent - vas deferens meets with the seminal vesicle and along with the vas deferent will form the ejaculatory duct and that will join the prostatic urethra

48
Q

little pin pricks alongside the ejaculatory duct?

A

prostatic ducts:

through which the glandular secretions from the prostate drain into the prostatic urethra)

49
Q

prostate gland?

A

the prostate gland is approximately “walnut sized” and surrounds the prostatic urethra
its inferior aspect is in contact with the levator ani muscle

50
Q

the prostate glands is described as consisting of “zones”:

A

the peripheral zone is the part of the prostate that is felt on digital rectal examination
most prostate cancers (i.e. malignant) arise in the peripheral zone - clinicians can palpate the masses

51
Q

the penis

A

has a root is attached to the ischium of the pelvis

52
Q

the root of the penis?

A

(laterally attached to ischium (bone) of pelvis)

53
Q

what are the top two of the 3 cylinders of the erectile tissue?

A

the right and left corpus cavernous

posteriorly - transmit the deep arteries of the penis

54
Q

erection?

A

the 3 cylinders of erectile tissue become engorged with blood at arterial pressure during erection

internal iliac artery

55
Q

blood supply to the penis?

A

is via the deep arteries of the penis; branches of the internal pudendal artery (from the internal iliac)

56
Q

blood supply to the scrotum?

A

Blood supply to the scrotum is via the internal pudendal and branches from the external iliac artery

dual blood supply

57
Q

what forms the glans?

A

corpus spongiosum (anteriorly – transmits the spongy urethra and expands distally to form the glans)

58
Q

lymph from the scrotum and most of the penis (not the glans)?

A

drains to the superficial inguinal lymph nodes found in the superficial fascia in the groin

59
Q

lymph from the testis?

A

drains to the lumbar nodes around the abdominal aorta due to the embryological location of the testis

60
Q

lymph from the testis?

A

drains to the lumbar nodes around the abdominal aorta due to the embryological location of the testis

61
Q

what forms the ajculatory duct?

A

the vas deferens joins the seminal gland

62
Q

what is the female equivalent of the testicular artery and vein?

A

ovarian artery and vein

can be called gonadal artery and vein

Renal (15 decks)

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