Anatomy Topic 4 Case 8 Flashcards
In which direction does the apex of the bladder face?
- To top of pubic symphysis
- A structure called the median umbilical ligament
In which direction does the base of the bladder face?
- Posterolaterally
- Where the ureters enter the bladder
What is the trigone?
- Smooth triangular area
- Between the openings of the ureters and urethra on either side of the bladder inferiorly
The inferolateral surfaces of the bladder are cradled between which muscles?
- Levator ani
- Obturator internus
Where is the neck of the bladder located?
- Surrounds the origin of the urethra
- At the point where the inferolateral surfaces and base intersect
Why is the neck of the bladder the most fixed part?
- It is anchored by a pair of fibromuscular bands
- Which connect the neck of the bladder and pelvic part of the urethra to the posteroinferior aspect of each pubic bone.
What is the name of these fibromuscular bands in males and females?
- Females: Pubovesical ligaments
- Males: Puboprostatic ligaments
Outline the arterial supply to the bladder
- Superior and inferior vesical arteries
- From internal iliac artery
Outline the venous drainage of the bladder
- Pelvic plexus of veins
Pain from the bladder is carried by which nerves?
- Pelvic splanchnic nerves (S2-S4)
What is the function of parasympathetic fibres to the bladder?
- Stimulates bladder contraction
How long is the female urethra?
- 4cm long
Describe the course of the female urethra
- Beings at base of bladder
- Passes inferiorly through pelvic floor into perineum
- Passes through deep perineal pouch and perineal membrane
- Opens into vestibule between labia minora
Identify and describe the glands associated with the female urethra
- Lesser vestibular glands / Skene’s glands
- Which are small para-urethral mucous glands
- Which drain via a duct that opens onto the lateral margin of the external urethral orifice
How long is the male urethra? How many times does it bend along its course?
- 20 cm
- Twice
Outline the course of the male urethra
- Begins at base of the bladder
- Passes inferiorly through the prostate
- Passes through the deep perineal pouch and perineal membrane
- Enters the root of the penis.
Identify the four parts of the male urethra
- Pre-prostatic
- Prostatic part
- Membranous part
- Spongey part
How long is the pre-prostatic part of the male urethra? Which muscle is it associated with?
- 1 cm long
- Internal urethral sphincter
How long is the prostatic part of the urethra?
- 3 - 4 cm
Describe the structure of the prostatic part of the urethra
- Midline urethral crest
- Depression on either side (prostatic sinus) through which prostate ducts empty through
- Midway along its length the enlarges to form seminal colliculus
- Small blind ended pouch, prostatic utricle, opens into seminal colliculus
- Opening of ejaculatory duct on either side of prostatic utricle
Identify the glands and muscle associated with the membranous part of the urethra
- Bulbo-urethral glands
- Externa urethral sphincter
What is the spongy part of the urethra surrounded by?
- Corpus spongiosum
What is the navicular fossa?
- Spongy urethra forms an enlarged bulb at apex of penis
Identify the anterior, posterior and superior relations of the prostate
- Anterior: Pubic symphysis
- Posterior: Rectum
- Superior: Bladder
Which muscles is the prostate in contact with?
- Levator ani
Identify the arterial supply to the prostate
- Inferior vesical artery and middle rectal artery
- Both of which are branches of the anterior trunk of the internal iliac artery
Identify the venous drainage of the prostate
- Prostatic venous plexus
- Which lies outside capsule of prostate
- And drains into internal iliac veins
Identify the lymphatic drainage of the prostate
- Internal iliac nodes
Identify the nerve supply of the prostate
- Inferior hypogastric plexus
- Sympathetic nerves stimulate smooth muscle during ejaculation
Identify the muscular layers of the bladder
- Inner longitudinal
- Outer circular
- Outermost longitudinal
- Collectively referred to as detrusor muscle
What type of epithelium lines the bladder?
- Transitional epithelium
- Stratified layer
- Consisting of a layer of basal cuboidal cells
- And intermediate columnar cells
- With an underlying lamina propria
What is the function of umbrella / dome cells of transitional epithelia?
- Maintains the impermeability of the epithelium to urine even at full stretch
Identify the three zones of the prostate
- Transition zone surrounding proximal prostatic urethra
- Central zone surrounding the ejaculatory ducts
- Peripheral zone making up the bulk of the gland
What is corpora amylacea?
- Prostatic secretions become thicker and calcified with age
Which cells of the prostate are associate with hyperplasia?
- Basal cells
