APE 9: Anatomy of the Genito-Urinary System Flashcards

1
Q

What is the female genital tract originally?

A

Mesodermal

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2
Q

What fuses together to develop the female genital tract and what does it create?

A

The para-mesonephric ducts which creates a genital septum across the pelvic cavity

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3
Q

What are the 3 components of the upper female genital tract?

A

Ovaries, uterine tube and uterus

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4
Q

What are the 3 components of the lower female genital tract?

A

Vuvla, cervix and vagina

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5
Q

What is the size and shape of a pear?

A

The uterus

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6
Q

What is the function of the uterus?

A

Gestation

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7
Q

What are the two main divisions of the uterus?

A

Fundus and body

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8
Q

What are the 3 tissue layers of the uterus?

A

Endometrium, myometrium and perimetrium

Inner to outer

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9
Q

Which part of the tissue layers if muscular?

A

Myometrium

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10
Q

What dilates the cervix?

A

The contractions of the myometrium

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11
Q

Where is the internal and external os?

A

Internal os= between the uterus and cervix

External os= between the cervix and vagina

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12
Q

What is the internal and external os?

A

A way for the cervix to communicate with the uterus and vagina, respectively

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13
Q

What begins at the internal os?

A

The uterine cavity

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14
Q

Why would clinicians be very familiar with the external os?

A

Swabs for cervical cancer and contraception

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15
Q

What is the difference between version and flexion?

A
Version= uterus lies more horizontally than usual, external os projects in one direction and fundus in the opposite direction
Flexion= bend takes place at a level corresponding with the internal os, cervix is in one plane and body of uterus is in another
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16
Q

What are the two pouches anterior and posterior to the uterus?

A
Anterior= uterocervical pouch
Posterior= rectouterine pouch
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17
Q

Which ligaments support the uterus?

A

Broad, round, ovarian, cardinal and uterosacral ligaments

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18
Q

What is the broad ligament?

A

Double layer of peritoneum attaching sides of uterus to pelvis

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19
Q

Why may the ovaries be very small in a cadaver?

A

Dehydration and menopause

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20
Q

What are the 2 ligaments of the ovary?

A

Ovarian and suspensory

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21
Q

What is the ovarian ligament?

A

Ligament that extends from the medial part of the ovaries to the fundus of the uterus

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22
Q

What is the suspensory ligament?

A

Fold of peritoneum extending from the mesovarium to the pelvic wall

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23
Q

What is the mesovarium?

A

The portion of the broad ligament of the uterus that suspends the ovaries

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24
Q

What is the mesosalpinx?

A

The portion of the broad ligament that stretches from the ovary to the level of the uterine tube

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25
Q

What is the blood supply of the uterus?

A

The uterine artery

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26
Q

From which artery does the uterine artery arise?

A

The internal iliac artery

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27
Q

Surgically, which important structure is related to the uterine artery?

A

Ureter

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28
Q

What are the 4 parts of the uterine tube?

A

Isthmus, ampulla, infundibulum and fimbreae

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29
Q

Where does fertilisation occur?

A

Ampulla of uterine tubes

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30
Q

What is the life-threatening condition associated with the uterine tube?

A

Ectopic pregnancy

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31
Q

What is the blood supply of the uterine tube?

A

Lateral half= ovarian arteries

Medial half= uterine arteries

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32
Q

Developmentally, how do the ovaries arise?

A

Retro-peritoneally on the posterior abdominal wall and then descends

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33
Q

Where does the ovarian blood supply come from and at which vertebral level?

A

Abdominal aorta, at L1/2

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34
Q

Where do the ovarian arteries drain to?

A
Right= inferior vena cava
Left= left renal vein
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35
Q

Where do the lymphatics drain to and what is the significance of this?

A

Para-aortic lymph nodes

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36
Q

What is the vagina?

A

A fibro-muscular tube capable of expansion for the passage of the foetus

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37
Q

What are the vaginal fornices?

A

The anterior (front) and posterior (back) recesses into which the upper vagina is divided

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38
Q

What is anterior to the vagina?

A

Bladder and urethra

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39
Q

What is posterior to the vagina?

A

Rectum and anus

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40
Q

What is lateral to the vagina?

A

Ureters and uterine arteries

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41
Q

What is the practical significance of the posterior fornix?

A

Posterior fornix palpation exam

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42
Q

What does the vagina traverse?

A

A muscular diaphragm (pelvic floor)

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43
Q

What is the pelvic floor composed of?

A

The levator ani muscles

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44
Q

When are the levator ani muscles commonly damaged?

A

During childbirth

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45
Q

What is the external genitalia called?

A

The vulva

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46
Q

What arteries supply the vulva?

A

Pudendal arteries

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47
Q

Which never supplies the vulva?

A

Superficial inguinal lymph nodes

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48
Q

What does the male reproductive tract develop from?

A

The mesonephric ducts

49
Q

What are the structures found in the internal male genitalia?

A

Testes, epididymis, urethra, prostate and ejaculatory duct

50
Q

What are the structures found in the external male genitalia?

A

Scrotum and penis

51
Q

What is the function of the testes?

A

Production of sperm and testosterone

52
Q

Where do the testes descend from?

A

From the posterior abdominal wall to the scrotum

53
Q

What radiates from the mediastinum?

A

Septa

54
Q

What do the septa do?

A

Divides the testes into lobules

55
Q

What do the lobules contain?

A

4-5 seminiferous tubules

56
Q

What do the seminiferous tubules do?

A

Produce sperm

57
Q

Why are the testes situated externally?

A

As they produce sperm and, to do this, the temperature of the testicles needs to be cooler than the inside of the body. This is why the scrotum is located outside of the body

58
Q

Which artery supplies the testes?

A

Testicular artery

59
Q

What is the clinical significance of the descent of the testes being arrested?

A

Causes cryptorchidism or undescended testicles

60
Q

What does the testes descend down?

A

The inguinal canal

61
Q

What is the epididymis?

A

It is a duct posterior to the testes, along which sperm passes to the vas deferens

62
Q

What is the relationship between the testes and epididymis?

A

The head of the epididymis is attached to the seminiferous tubules of the testes

63
Q

Which structure arises from the epididymis?

A

Vas deferens and ejaculatory duct

64
Q

What is the vas deferens?

A

It is where sperm is stored prior to ejaculation

65
Q

What is the course of the vas deferens?

A

It ascends to the bladder then comes back down to form the ampullae. The ampullae then joins the ducts of the seminal vesicles to form the ejaculatory ducts.

66
Q

What is the vans deferens a component of?

A

The spermatic cord

67
Q

Where is the spermatic cord formed?

A

At the opening of the inguinal canal

68
Q

What is found in the spermatic cord?

A

Testicular artery, vein and nerve

69
Q

What is the prostate gland?

A

A fibro-glandular structure in the shape of an inverted cone

70
Q

Where is the prostate gland situated?

A

At the base of the bladder

71
Q

What is the function of the prostate gland?

A

Secretes proteolytic enzymes into the semen, which break down clotting factors in the ejaculate, allowing the semen to remain in a fluid state, moving throughout the female RT for potential fertilisation

72
Q

Which structure passes through the gland, from base to apex?

A

Urethra

73
Q

What are the main zones of the prostate gland?

A

Central, transitional and peripheral

74
Q

In which zone of the prostate gland does benign prostate hyperplasia (BPH) arise?

A

Transitional

75
Q

In which zone pof the prostate gland does carcinoma arise?

A

Peripheral

76
Q

What symptoms does BPH cause?

A
  • Urgent/frequent need to urinate
  • Difficulty starting urination
  • Dribbling at end of urination
  • Inability to completely empty the bladder
77
Q

What are the seminal vesicles?

A

Male glands that produce 70% of semen

78
Q

What is the position of the seminal vesicles with respect to the prostate gland?

A

Posterior to prostate

79
Q

What is the relation of the ducts of the seminal vesicles with the ductus deferens?

A

The single excretory duct of each seminal vesicle is dorsal to the ductus deferens and it empties into the ampullae

80
Q

What are the ejaculatory ducts?

A

A duct through which semen is ejaculated

81
Q

Where do the ejaculatory ducts open?

A

They open into the urethra at the seminal colliculus

82
Q

Where do they bulbo-urethral glands open?

A

Just below the prostate

83
Q

What are the 3 components of the penis?

A

Root, body and glans

84
Q

What are the 3 cylindrical structures that form the penis?

A

Paired corpus cavernosa and single corpus spongiosum

85
Q

Which strcuture expands distally to form the glans penis?

A

Corpus spongiosum

86
Q

Which of the 4 parts of the urethra pass through the penis?

A

Pre-prostatic, prostatic, membranous and spongy

87
Q

Name the 3 pairs of arteries supplying the penis

A

Bulbourethral, deep penil and dorsal penile arteries

88
Q

Which is the erectile tissue and what is the neurological control of this?

A

Corpus carvernosa, innervated by cavernous nerves in the peri-prostatic nerve plexus

89
Q

What are the components of the urinary tract?

A

Kidneys, urinary bladder, urethra, and ureters

90
Q

What is the position of the kidneys with respect to the abdominal cavity, thoracic cavity and vertebral column?

A

Lie retroperitoneally in the abdomen (behind the peritoneum), either side of the vertebral column

91
Q

At which vertebral levels are the kidneys and what is the clinical significance of this?

A

T12-L3, can be used to observe any changes in size when interpreting radiographs

92
Q

Which kidney is lower and why?

A

Right is lower than left due to liver sitting on right hand side, pushing it down

93
Q

What is the space around the kidneys called and what is its clinical importance?

A

Peri-nephric space, if removed it feels like a floating kidney

94
Q

What are the main features of a kidney?

A

Cortex, medulla and pyramids

95
Q

What is the hilum of the kidney and which structures are found here?

A

It is where vessels pass

Contains renal vein, renal artery and renal pelvis (anterior to posterior)

96
Q

What is the blood supply to the kidneys?

A

Renal artery

97
Q

What is the function of ureters?

A

Transportation of urine from the kidney to the bladder

98
Q

What is the position of the ureters with respect to the peritoneum?

A

It’s retro-peritoneal

99
Q

Which arteries supply the ureters?

A

Upper third= renal
Middle= abdominal aorta
Lower= internal iliac

100
Q

How do ureters enter the bladder?

A

In an oblique way

101
Q

What is ureteric reflux?

A

When the valve between the ureters and bladder isn’t working properly so urine flows backwards into the ureters

102
Q

At which point do the ureters narrow?

A

At the utero-pelvic joint

103
Q

What does a blockage/narrowing of the ureters cause?

A

Hydronephrosis

104
Q

From the end of the bed, how would you distinguish a patient with ureteric colic from a patient with appendicitis?

A

Patient with appendicitis would stay really still, ureteric colic patients would have flank pain

105
Q

Where does ureteric pain radiate to?

A

Flank

106
Q

Where would you look for a ureteric calculus (stones) on a plain radiograph?

A

L1- renal hilum, pelvic brim and ischial spines

107
Q

What characteristic feature identifies the ureter, surgically?

A

It’s not pulsatile

108
Q

Where is the ureter likely to be injured, surgically?

A

At the uterine artery

109
Q

What is the difference between the bladder from when it’s empty to when it’s full?

A

Extra peritoneal when full but intra peritoneal when empty

110
Q

What is the function of the bladder?

A

Collection, temporary storage and expulsion of urine

111
Q

What is the sympathetic and parasympathetic innervation of the bladder and what does this cause?

A
Sympathetic= hypogastric nerve (T12-L2)- causes relaxation of detrusor muscle, promoting urine retention
Parasympathetic= pelvic nerve (S2-S4)- causes contraction of detrusor muscle, stimulating micturition
112
Q

What are the components of the bladder?

A

Apex, body, fundus and neck

113
Q

Where does the apex point towards?

A

The pubic symphysis

114
Q

Which structure arises from the apex band and what is its developmental significance?

A

Apex connects to the umbilicus by the medial umbilical ligament (a remnant of the urachus)

115
Q

What does the neck do?

A

Joins the bladder and urethra

116
Q

What is meant by the bladder trigone?

A

A triangular area located within the fundus of the bladder formed by the two ureteric orifices and the internal urethral orifice

117
Q

Which structures enter and leave the trigone?

A

Opening from urethra and opening into ureters

118
Q

What is the function of the internal and external sphincters?

A

Maintains continence (outflow of urine)

119
Q

Which type of epithelium lines the bladder and why?

A

Transitional epithelium- as it can expand and contract