APE 9: Anatomy of the Genito-Urinary System Flashcards
1
Q
What is the female genital tract originally?
A
Mesodermal
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
3
Q
What are the 3 components of the upper female genital tract?
A
Ovaries, uterine tube and uterus
4
Q
What are the 3 components of the lower female genital tract?
A
Vuvla, cervix and vagina
5
Q
What is the size and shape of a pear?
A
The uterus
6
Q
What is the function of the uterus?
A
Gestation
7
Q
What are the two main divisions of the uterus?
A
Fundus and body
8
Q
What are the 3 tissue layers of the uterus?
A
Endometrium, myometrium and perimetrium
Inner to outer
9
Q
Which part of the tissue layers if muscular?
A
Myometrium
10
Q
What dilates the cervix?
A
The contractions of the myometrium
11
Q
Where is the internal and external os?
A
Internal os= between the uterus and cervix
External os= between the cervix and vagina
12
Q
What is the internal and external os?
A
A way for the cervix to communicate with the uterus and vagina, respectively
13
Q
What begins at the internal os?
A
The uterine cavity
14
Q
Why would clinicians be very familiar with the external os?
A
Swabs for cervical cancer and contraception
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
16
Q
What are the two pouches anterior and posterior to the uterus?
A
Anterior= uterocervical pouch Posterior= rectouterine pouch
17
Q
Which ligaments support the uterus?
A
Broad, round, ovarian, cardinal and uterosacral ligaments
18
Q
What is the broad ligament?
A
Double layer of peritoneum attaching sides of uterus to pelvis
19
Q
Why may the ovaries be very small in a cadaver?
A
Dehydration and menopause
20
Q
What are the 2 ligaments of the ovary?
A
Ovarian and suspensory
21
Q
What is the ovarian ligament?
A
Ligament that extends from the medial part of the ovaries to the fundus of the uterus
22
Q
What is the suspensory ligament?
A
Fold of peritoneum extending from the mesovarium to the pelvic wall
23
Q
What is the mesovarium?
A
The portion of the broad ligament of the uterus that suspends the ovaries
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
25
What is the blood supply of the uterus?
The uterine artery
26
From which artery does the uterine artery arise?
The internal iliac artery
27
Surgically, which important structure is related to the uterine artery?
Ureter
28
What are the 4 parts of the uterine tube?
Isthmus, ampulla, infundibulum and fimbreae
29
Where does fertilisation occur?
Ampulla of uterine tubes
30
What is the life-threatening condition associated with the uterine tube?
Ectopic pregnancy
31
What is the blood supply of the uterine tube?
Lateral half= ovarian arteries
| Medial half= uterine arteries
32
Developmentally, how do the ovaries arise?
Retro-peritoneally on the posterior abdominal wall and then descends
33
Where does the ovarian blood supply come from and at which vertebral level?
Abdominal aorta, at L1/2
34
Where do the ovarian arteries drain to?
```
Right= inferior vena cava
Left= left renal vein
```
35
Where do the lymphatics drain to and what is the significance of this?
Para-aortic lymph nodes
36
What is the vagina?
A fibro-muscular tube capable of expansion for the passage of the foetus
37
What are the vaginal fornices?
The anterior (front) and posterior (back) recesses into which the upper vagina is divided
38
What is anterior to the vagina?
Bladder and urethra
39
What is posterior to the vagina?
Rectum and anus
40
What is lateral to the vagina?
Ureters and uterine arteries
41
What is the practical significance of the posterior fornix?
Posterior fornix palpation exam
42
What does the vagina traverse?
A muscular diaphragm (pelvic floor)
43
What is the pelvic floor composed of?
The levator ani muscles
44
When are the levator ani muscles commonly damaged?
During childbirth
45
What is the external genitalia called?
The vulva
46
What arteries supply the vulva?
Pudendal arteries
47
Which never supplies the vulva?
Superficial inguinal lymph nodes
48
What does the male reproductive tract develop from?
The mesonephric ducts
49
What are the structures found in the internal male genitalia?
Testes, epididymis, urethra, prostate and ejaculatory duct
50
What are the structures found in the external male genitalia?
Scrotum and penis
51
What is the function of the testes?
Production of sperm and testosterone
52
Where do the testes descend from?
From the posterior abdominal wall to the scrotum
53
What radiates from the mediastinum?
Septa
54
What do the septa do?
Divides the testes into lobules
55
What do the lobules contain?
4-5 seminiferous tubules
56
What do the seminiferous tubules do?
Produce sperm
57
Why are the testes situated externally?
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
Which artery supplies the testes?
Testicular artery
59
What is the clinical significance of the descent of the testes being arrested?
Causes cryptorchidism or undescended testicles
60
What does the testes descend down?
The inguinal canal
61
What is the epididymis?
It is a duct posterior to the testes, along which sperm passes to the vas deferens
62
What is the relationship between the testes and epididymis?
The head of the epididymis is attached to the seminiferous tubules of the testes
63
Which structure arises from the epididymis?
Vas deferens and ejaculatory duct
64
What is the vas deferens?
It is where sperm is stored prior to ejaculation
65
What is the course of the vas deferens?
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
What is the vans deferens a component of?
The spermatic cord
67
Where is the spermatic cord formed?
At the opening of the inguinal canal
68
What is found in the spermatic cord?
Testicular artery, vein and nerve
69
What is the prostate gland?
A fibro-glandular structure in the shape of an inverted cone
70
Where is the prostate gland situated?
At the base of the bladder
71
What is the function of the prostate gland?
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
Which structure passes through the gland, from base to apex?
Urethra
73
What are the main zones of the prostate gland?
Central, transitional and peripheral
74
In which zone of the prostate gland does benign prostate hyperplasia (BPH) arise?
Transitional
75
In which zone pof the prostate gland does carcinoma arise?
Peripheral
76
What symptoms does BPH cause?
- Urgent/frequent need to urinate
- Difficulty starting urination
- Dribbling at end of urination
- Inability to completely empty the bladder
77
What are the seminal vesicles?
Male glands that produce 70% of semen
78
What is the position of the seminal vesicles with respect to the prostate gland?
Posterior to prostate
79
What is the relation of the ducts of the seminal vesicles with the ductus deferens?
The single excretory duct of each seminal vesicle is dorsal to the ductus deferens and it empties into the ampullae
80
What are the ejaculatory ducts?
A duct through which semen is ejaculated
81
Where do the ejaculatory ducts open?
They open into the urethra at the seminal colliculus
82
Where do they bulbo-urethral glands open?
Just below the prostate
83
What are the 3 components of the penis?
Root, body and glans
84
What are the 3 cylindrical structures that form the penis?
Paired corpus cavernosa and single corpus spongiosum
85
Which strcuture expands distally to form the glans penis?
Corpus spongiosum
86
Which of the 4 parts of the urethra pass through the penis?
Pre-prostatic, prostatic, membranous and spongy
87
Name the 3 pairs of arteries supplying the penis
Bulbourethral, deep penil and dorsal penile arteries
88
Which is the erectile tissue and what is the neurological control of this?
Corpus carvernosa, innervated by cavernous nerves in the peri-prostatic nerve plexus
89
What are the components of the urinary tract?
Kidneys, urinary bladder, urethra, and ureters
90
What is the position of the kidneys with respect to the abdominal cavity, thoracic cavity and vertebral column?
Lie retroperitoneally in the abdomen (behind the peritoneum), either side of the vertebral column
91
At which vertebral levels are the kidneys and what is the clinical significance of this?
T12-L3, can be used to observe any changes in size when interpreting radiographs
92
Which kidney is lower and why?
Right is lower than left due to liver sitting on right hand side, pushing it down
93
What is the space around the kidneys called and what is its clinical importance?
Peri-nephric space, if removed it feels like a floating kidney
94
What are the main features of a kidney?
Cortex, medulla and pyramids
95
What is the hilum of the kidney and which structures are found here?
It is where vessels pass
| Contains renal vein, renal artery and renal pelvis (anterior to posterior)
96
What is the blood supply to the kidneys?
Renal artery
97
What is the function of ureters?
Transportation of urine from the kidney to the bladder
98
What is the position of the ureters with respect to the peritoneum?
It's retro-peritoneal
99
Which arteries supply the ureters?
Upper third= renal
Middle= abdominal aorta
Lower= internal iliac
100
How do ureters enter the bladder?
In an oblique way
101
What is ureteric reflux?
When the valve between the ureters and bladder isn't working properly so urine flows backwards into the ureters
102
At which point do the ureters narrow?
At the utero-pelvic joint
103
What does a blockage/narrowing of the ureters cause?
Hydronephrosis
104
From the end of the bed, how would you distinguish a patient with ureteric colic from a patient with appendicitis?
Patient with appendicitis would stay really still, ureteric colic patients would have flank pain
105
Where does ureteric pain radiate to?
Flank
106
Where would you look for a ureteric calculus (stones) on a plain radiograph?
L1- renal hilum, pelvic brim and ischial spines
107
What characteristic feature identifies the ureter, surgically?
It's not pulsatile
108
Where is the ureter likely to be injured, surgically?
At the uterine artery
109
What is the difference between the bladder from when it's empty to when it's full?
Extra peritoneal when full but intra peritoneal when empty
110
What is the function of the bladder?
Collection, temporary storage and expulsion of urine
111
What is the sympathetic and parasympathetic innervation of the bladder and what does this cause?
```
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
What are the components of the bladder?
Apex, body, fundus and neck
113
Where does the apex point towards?
The pubic symphysis
114
Which structure arises from the apex band and what is its developmental significance?
Apex connects to the umbilicus by the medial umbilical ligament (a remnant of the urachus)
115
What does the neck do?
Joins the bladder and urethra
116
What is meant by the bladder trigone?
A triangular area located within the fundus of the bladder formed by the two ureteric orifices and the internal urethral orifice
117
Which structures enter and leave the trigone?
Opening from urethra and opening into ureters
118
What is the function of the internal and external sphincters?
Maintains continence (outflow of urine)
119
Which type of epithelium lines the bladder and why?
Transitional epithelium- as it can expand and contract
