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Renal System > Anatomy of the ureter and the urinary bladder > Flashcards

Anatomy of the ureter and the urinary bladder Flashcards

1
Q

What structures form the upper urinary tract?

A

Two kidneys
Two ureters

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2
Q

What structures form the lower urinary tract?

A

One urinary bladder
One urethra

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3
Q

What is the ureter?

A

A muscular tube that extends from the kidney to the posterior surface of the urinary bladder

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4
Q

What kind of structure is the ureter?

A

Retroperitoneal

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5
Q

What structure is similar to the ureter?

A

The esophagus

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6
Q

What is the length and diameter of the ureter?

A

3 to 4mm diameter
25 to 30cm in legth

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7
Q

What is the function of the ureter?

A

Transport urine produced in the kidneys to be stored in the bladder

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8
Q

What are the mechanisms of action of the ureter?

A

Peristaltic contractions (1 to 5mins)
Hydrostatic pressure & gravity

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9
Q

Why are constrictions important?

A

Important for the location of the obstructions

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10
Q

What are the locations of the the constrictions of the ureter?

A
  1. Where the renal pelvis joins the ureter
  2. Where it crosses the pelvic brim, the pelvic inlet (in front of the common iliac artery)
  3. Where it pierces the bladder wall
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11
Q

Why does the ureter have multiple arterial supplies?

A

It is a long structure; it will not have one singular arterial supply

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12
Q

What is the arterial supply of the upper end of the ureter?

A

Renal artery

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13
Q

What is the arterial supply of the middle portion of the ureter?

A

Gonadal arteries

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14
Q

What is the arterial supply in the pelvis?

A

Superior vesical artery

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15
Q

What other structures can be part of the arterial supply of the ureter?

A

Branches of the aorta can also act as a blood supply to the ureter

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16
Q

What are the gender relations of the ureter?

A

Males: vas deferens
Females: uterine artery

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17
Q

What is the vas deferens?

A

Contains sperm from the testes to the prostatic ureter

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18
Q

What does the uterine artery supply?

A

Supplies the ureter

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19
Q

What is the location of the uterine artery?

A

Below the broad ligament and above the ureter

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20
Q

Why is the location of the uterine artery important?

A

In case of surgery, it needs to located in order to be ligated

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21
Q

What is the lymph drainage of the ureter like?

A

Lateral aortic nodes
Iliac nodes

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22
Q

What is the innervation of the ureter like?

A

Renal plexus
Testicular/ovarian plexus
Hypogastric plexus

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23
Q

What is the lumen of the ureter like?

A

Star-like lumen, in lower magnification, the structure might confused with the esophagus

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24
Q

What are the histological layers of the ureter? (4)

A
  1. Mucosa (&lamina propria)
  2. Submucosa
  3. Muscularis
  4. Adventitia
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25
Q

What is the epithelium of the mucosa like?

A

Transitional epithelium, from the minor calyx all the way to the urethra

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26
Q
A
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27
Q

Which parts of the ureter have muscularis?

A

Upper 2/3 of the ureter

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27
Q

What are the sublayers of the muscularis of the ureter?

A

Inner longitudinal
Middle circular
Outer longitudinal (only in the lower 1/3)

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28
Q

What is the outermost layer of the ureter?

A

Adventitia; it is called that because the ureter is retroperitoneal

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29
Q

What is the difference between the muscularis of the GIT and the urinary tract?

A

Urinary tract: Inner longitudinal, middle circular
GIT: inner circular, outer longitudinal

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30
Q

What is the volume of the bladder normally?

A

500 to 700ml

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31
Q

What is the location of the bladder when empty?

A

In the pelvic cavity, directly behind the pubic bone (pubic symphysis)

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32
Q

What happens to the location of the bladder as it fills up?

A

It bulges into the abdomen

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33
Q

Why is the bladder a pelvic organ in adults but not in children?

A

Because in children the pelvis is still growing and evolving

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34
Q

Which layer of the ureter contains the plexus?

A

Submucosa

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35
Q

What is the location of the bladder like in females, and why is that?

A

It is lower in females than it is in males due to the absence of the prostate, –> rests directly on the urogenital diaphragm

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36
Q

What does the urogenital diaphragm separate?

A

The perineum and the true pelvis

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37
Q

What are the shapes of the bladder?

A

Empty: pyramidal
Filled: ovoid

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38
Q

What are the different surfaces of the bladder?

A

Superior: roof
Inferiolateral Surfaces
Anterior: apex
Posterior: base

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39
Q

What covers the roof of the bladder?

A

Covered by peritoneum –> infraperitoneal or extraperitoneal structure

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40
Q

Which structures are related to the base of the bladder?

A

Seminal vesicles
Vas deferens
Ampulla of vas deferens

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41
Q

What are the relations of the roof of the bladder in males?

A

Coils of ileum
Sigmoid colon

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42
Q

What are the relations of the roof of the bladder in females?

A

Body of uterus
Utero-visceral pouch

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43
Q

What are the structures related to the inferolateral surfaces? (3)

A
  1. Retropubic pad of fat (behind the pubic bone)
  2. Obturator internus muscle (covers the obturator foramen)
  3. Levator ani muscle
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44
Q

What is the relation between the obturator internus muscle and the levator ani muscle?

A

The obturator internus muscle gives rise to the levator ani muscle

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45
Q

What are the pouches found in women and what are their importnace ?

A

The ureterovesical pouch and rectouterine pouch (pouch of Douglas) fill up with blood and fluid and usually require draining

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46
Q

How many ligaments does the apex have?

A

3; median umbilical ligament and medial umbilical ligaments

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47
Q

What is the urachus?

A

The communication between the yolk sac and urinary bladder –> it is an embryological structure which gets obliterated and becomes the median umbilical ligament

48
Q

What gives rise to the medial umbilical ligaments?

A

Obliterated umbilical arteries

49
Q

What gives rise to the lateral umbilical ligaments?

A

The inferior epigastric artery and veins

50
Q

What is the shape of the base of the bladder like?

A

Triangular; formed by the ureters (superiorly) and the origin of the urethra (inferiorly)

51
Q

What are the relations of the base of the bladder?

A

The vasa deferens (male)
Seminal vesicles (male)
Vagina (female)
Rectum

52
Q

What are the internal structures of the urinary bladder?

A

Rugae
Trigone

53
Q

What is the trigone of the bladder like?

A

Always smooth because it is derived from the embryological structure; mesonephric duct

54
Q

What happens if the median lube of the prostatic gland enlarges?

A

Enlargement and elevation of sphincter/uvula vesicae, which causes accumulation of urine in the pouch of stagnant urine

55
Q

Where is the trigone of the bladder found?

A

The base of the bladder

56
Q

What is the arterial blood supply of the urinary bladder? What are they branches of?

A

Superior vesical artery
Inferior vesical artery
–> Both branches of internal iliac artery

57
Q

What is the venous drainage of the urinary bladder?

A

Prostatic plexus

58
Q

What are the histological layers of the urinary bladder?

A

Mucosa (& lamina propria)
Muscularis
Adventitia/serosa

59
Q

What are the sublayers of the muscularis layer of the urinary bladder?

A

Inner longitudinal
Middle circular
Outer longitudinal
The detrusor muscle is usually found there; very thick muscle

60
Q

What are the points of innervation of the urinary bladder?

A

Autonomic innervation
Voluntary control –> requires sensation

61
Q

What is the pathway that the nerves of the urinary bladder follow? (Parasympathetic)

A

Afferent nerves –> stretch receptors –> visceral sensory –> pelvic splanchnic nerves –> S2, 3, 4

62
Q

What is the effect of the parasympathetic innervation on the urinary bladder?

A

Activate pelvic splanchnic nerves –> stimulate detrusor muscle and inhibit internal urethral sphincter (relaxes it) –> urination

63
Q

Is the internal urethral sphincter voluntary or involuntary?

A

Involuntary –> innervated by pelvic splanchnic nerves

64
Q

Where do the somatic control fibres arise from?

A

S2, 3 and 4

65
Q

Which nerve acts on the external urethral sphincter?

A

The pudendal nerve

66
Q

What is the sympathetic innervation of the urinary bladder like?

A

L1 and L2

67
Q

What is the sympathetic innervation of the urinary bladder like?

A

Efferent neurons —> sympathetic nervous system —> inferior hypogastric plexuses

68
Q

Where do the inferior hypogatsric plexuses act?

A

It inhibits the detrusor muscle and stimulates the internal urethral sphincter —> prevents urination

69
Q

What are the effects of the different innervations on micturition?

A

Sympathetic —> inhibits
Parasympathetic —> stimulates
Somatic motor —> inhibits

70
Q

What is the effect of different innervation on retention?

A

Sympathetic —> stimulates
Parasymapthetic —> inhibits
Somatic motor —> stimulates

71
Q

What is the shape of the prostate?

A

Walnut shape

72
Q

What is the shape of the prostate?

A

Walnut shape

73
Q

What are the surfaces of the prostate?

A

Base; bladder neck
Apex; urogenital diaphgarm

74
Q

What are the relations of the prostate?

A

Anterior; fat in retropubic space —> pubic symphisis
Posterior; retro visceral septum —> rectal ampulla

75
Q

What are the coverings of the prostate?

A

Inside: fibrous capsule
Outside: fascial sheath

76
Q

What is between the two coverings of the prostate?

A

Prostatic venous plexus, the urinary bladder drains in it

77
Q

What forms the prostatic venous plexus?

A

Vesicular venous plexus
Internal vertebral venous plexus

78
Q

What is the importance of the prostatic venous plexus being in communication with the internal vertebral plexus?

A

CA metastasis; in cases of cancer it can lead to metastasis of axial skeleton

79
Q

What is arterial supply of the prostate?

A

Inferior vesicular artery
Middle rectal artery

80
Q

What are the lobes of the prostate?

A

Anterior
Median
Posterior
2 Lateral

81
Q

What is the location of the anterior lobe of the prostate?

A

In front of the urethra

82
Q

What is the location of the median lobe of the prostate?

A

Between urethra & ejaculatory ducts

83
Q

What is the location of the posterior lobe of the prostate?

A

Behind urethra and below ejaculatory ducts

84
Q

What are the positions of the 2lateral lobes of the prostate?

A

On either side of the urethra

85
Q

What is the anterior lobe of the prostate like?

A

Devoid of glands —> fibromuscular

86
Q

What is the median lobe of the prostate like?

A

Bladder trigone —> stagnant urine (in the case of the median lobe enlargement)
Rich in glands

87
Q

What makes up the posterior and the 2 lateral lobes of the prostate?

A

Glandular tissue

88
Q

What are the different zones of the prostate?

A

Muscular zone (isthmus)
Central zone
Peripheral zones

89
Q

Which lobe associates with the muscular zone?

A

Anterior

90
Q

Which zone is associated with the median lobes?

A

Central zone

91
Q

What lobes are associated with the peripheral zones?

A

Posterior and 2 lateral ones

92
Q

What are histological layers of the prostate?

A

Branched tubuloalveolar glands
Dense fibromuscular stroma

93
Q

What kind of glands are found in the lumen of the prostate? What do they secrete?

A

Branched tubuloalveolar glands, which secretes corpora amylacea

94
Q

When is there a physiological increase of secretion of corpora amylacea? Why?

A

Increased secretion with age, because of the physiologic prostatic hyperplasia that occurs with age

95
Q

What are the different zones of the branched tubuloalveolar glands?

A

Transitional zone
Central zone
Peripheral zone

96
Q

What percentage does each each zone of the branched tubuloalveolar glands make up?

A

Transitional zone; 5%
Central zone; 25%
Peripheral zone; 70%

97
Q

What are the gland types in the transitional zone of the prostate?

A

Mucosal glands

98
Q

What are the gland types in the central zone of the prostate?

A

Submucosal glands

99
Q

What are the gland types of the peripheral zone of the prostate?

A

Main glands

100
Q

Which type of glands of the prostate are associated with inflammation and cancer?

A

Main glands

101
Q

What is the lining of the urethra like in females?

A

Close to the bladder;transitional epithelium
The rest of the urethra; stratified squamous nonkeratinised epithelium

102
Q

What are the layers of the female urethra?

A

Lining
Mucous secreting glands
Muscularis

103
Q

What are the layers of the muscularis of the female urethra?

A

Inner longitudinal
Outer circular

104
Q

What are the different parts of the male urethra?

A
  1. Preprostatic part of the urethra (intramural part)
  2. Prostatic part of urethra
  3. Membranous part of the urethra (part of the urogenital diaphragm)
  4. Spongy part of the urethra
105
Q

What is the length of the prostatic urethra?

A

3 to 4cm

106
Q

What is the length of the intermediate part of the urethra?

A

1 to 2cm

107
Q

What is the length of the spongy urethra?

A

15cm

108
Q

What is the epithelium that lines the prostatic urethra?

A

Transitional epithelium

109
Q

What structures does the prostatic urethra receive?

A

Prostatic ducts
Two ejaculatory ducts

110
Q

What is the urethral crest?

A

Elevation in posterior surfaces of prostatic urethra

111
Q

What is the prostatic utricle?

A

Remnant of the uterus and vagina

112
Q

What is the epithelium of the intermediate urethra like?

A

Stratified columnar epithelium

113
Q

What structures does the intermediate urethra pass through?

A

Perineal muscles

114
Q

What structures does the intermediate urethra pass through?

A

Perineal muscles

115
Q

Where is the spongy urethra located?

A

Corpus spongiosum

116
Q

What kind of epithelium lines the spongy urethra?

A

Stratified columnar epithelium and stratified squamous epithelium

117
Q

Which part of the spongy urethra is lined by stratified squamous epithelium?

A

Navicular fossa

Renal System (24 decks)

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