Anatomy - Retroperitoneum (bladder and pelvis)

Question 1

What is the function of the bladder?

Answer 1

Collection, temporary storage and expulsion of urine.

Question 2

Give 3 ways in which the bladder is specialised for storage.

Answer 2

1. Rugae give the bladder a great capacity to expand. 2. Detrusor muscle relaxes in storage, increasing bladder volume. 3. Urethral sphincters contract.

Question 3

What is the interureteric bar?

Answer 3

A ridge of muscle between the two ureteric orficies.

Question 4

What is the significance of the trigone?

Answer 4

It marks the two ureteric orifices and the urethral orifice. It is located in the fundus and it has a smooth wall in contrast to the rest of the bladder.

Question 5

Which urethral sphincter is composed of skeletal muscle?

Answer 5

The external urethral sphincter.

Question 6

Which urethral sphincter is under voluntary control?

Answer 6

The external urethral sphincter.

Question 7

Which urethral sphincter is composed of smooth muscle?

Answer 7

The internal urethral sphincter.

Question 8

Which urethral sphincter is under autonomic control?

Answer 8

The internal urethral sphincter.

Question 9

What is the specialised smooth muscle of the bladder wall called?

Answer 9

The detrusor muscle.

Question 10

What is the blood supply to the bladder?

Answer 10

The internal iliac arteries.

Question 11

What nerve provides sympathetic innervation to the bladder?

Answer 11

The hypogastric nerve (T12-L2).

Question 12

What is the affect of sympathetic innervation on the bladder?

Answer 12

Relaxation of the detrusor muscle and constriction of the internal urethral sphincters - this promotes urine retention.

Question 13

What is the affect of parasympathetic innervation on the bladder?

Answer 13

Contraction of the detrusor muscle and relaxation of the internal urethral sphincters - this promotes micturition.

Question 14

What is the role of the sensory nerves in the bladder wall?

Answer 14

They signal the need to urinate to the brain when the bladder becomes full.

Question 15

Name 3 locations where the ureter narrows and renal stones may be present.

Answer 15

1. Ureteropelvic junction. 2. As the ureter passes the pelvic brim. 2. Where the ureters enter the bladder.

Question 16

Why is the ureter at danger of being damaged in a hysterectomy?

Answer 16

The uterine artery is ligated in a hysterectomy. The ureter passes immediately posteriorly to the uterine artery and so may be damaged.

Question 17

What two lumbar plexus nerves have the same nerve roots?

Answer 17

Femoral and Obtruator - L2,3,4.

Question 18

What 3 bones make up the hip bone?

Answer 18

1. Ilium. 2. Pubis. 3. Ischium.

Question 19

What is the socket called formed from the fusion of the ilium, pubis and ischium?

Answer 19

The acetabulum.

Question 20

What bone articulates with the acetabulum?

Answer 20

The head of the femur.

Question 21

Name 2 important ligaments that attach from the sacrum to the ischium.

Answer 21

1. sacrospinous ligament. 2. sacrotuberous ligament.

Question 22

Where does the sacrospinous ligament run between?

Answer 22

The sacrum to the ischial spine.

Question 23

Where does the sacrotuberous ligament run between?

Answer 23

The sacrum to the ischial tuberosity.

Question 24

Why are female pelvis’ different to males?

Answer 24

Female pelvis’ have special adaptations for childbirth.

Question 25

What are the 3 main differences between male and female pelvis’?

Answer 25

1. The female has a larger angled sub-pubic arch. 2. The pelvic outlet is rounder in females. 3. The ischial spine projects further into the male pelvic cavity.

Question 26

What do the left gonadal veins (ovarian and testicular) drain into?

Answer 26

The left renal vein!

Question 27

Give 3 functions of the pelvis.

Answer 27

1. Transfers weight. 2. Provides attachment for muscles and ligaments. 3. Contains and protects pelvic viscera.

Question 28

What are the two hiatuses of the pelvic floor?

Answer 28

1. Urogenital hiatus. 2. Rectal hiatus.

Question 29

What passes through the urogenital hiatus of the pelvic floor?

Answer 29

The urethra and the vagina.

Question 30

What passes through the rectal hiatus of the pelvic floor?

Answer 30

The anal canal.

Question 31

Give 3 functions of the pelvic floor muscles.

Answer 31

1. They support abdomino-pelvic viscera. 2. They resist increases in intra pelvic pressures. 3. They maintain urinary and faecal continence.

Question 32

What are the 2 main muscles of the pelvic floor?

Answer 32

1. Levator ani muscles. 2. Coccygeus muscle.

Question 33

What is the innervation to the levator ani muscles?

Answer 33

Branches of the pudendal nerve, S2, 3, 4 roots.

Question 34

What is the function of levator ani?

Answer 34

Maintains faecal continence, during defecation this muscle relaxes.

Question 35

Which muscles of levator ani are prone to injury in childbirth?

Answer 35

Pubococcygeus and puborectalis due to their medial position.

Question 36

What is the innervation of coccygeus?

Answer 36

Ventral rami of S4 and 5.

Question 37

What can happen if you damage the pelvic floor?

Answer 37

You may get prolapse of pelvic viscera.

Question 38

What risk factors can increase the chance of prolapse?

Answer 38

1. Increasing age. 2. Number of vaginal deliveries. 3. Family history. 4. Being overweight. 5. Chronic coughing e.g. a lung disorder.

Question 39

How long is the female urethra?

Answer 39

4cm.

Question 40

What is the prostatic part of the male urethra?

Answer 40

Where the urethra descends through the prostate (3cm).

Question 41

What is the membranous part of the male urethra?

Answer 41

Where the urethra transverses the urogenital diaphragm (1cm).

Question 42

What is the penile part of the male urethra?

Answer 42

Where the urethra travels through the bulb, corpus spongiosum and glans of the penis (15cm).

Question 43

What dilation in the glans my impede a urethral catheter?

Answer 43

The navicular fossa.

Question 44

Answer 44

Question 45

How long is the male urethra?

Answer 45

15-20cm.