Clinically Relevant Anatomy of the Lower Urinary Tract Involving the Male Reproductive Tract Flashcards
The pelvic cavity can be split into which two segments?
True pelvis
False pelvis
Why is the false pelvis “false”?
Contains abdominal viscera versus pelvic viscera
Where is the division between the true and false pelvis found?
Pelvic brim at the pelvic inlet
(Uteric constriction can occur here)
What separates the perineum from the pelvic cavity?
Muscles including the levator ani
When the ureter reaches the ischial spines, which direction do they turn?
Medially
(towards posterior bladder)
Within the abdominal cavity, the ureter is ________ and in the pelvic cavity it is _________
Within the abdominal cavity, the ureter is retroperitoneal and in the pelvic cavity it is subperitoneal
Which two anatomical properties prevent reflux of urine up the ureters as the bladder contracts?
- Medial insertion of ureters into bladder
- Detrusor muscle cotracts uteric orifices
What is the name given to the space ony found in males between the rectum and bladder?
Rectovesicle pouch
What is the most dependent area in males when standing up?
Rectovesicle pouch
What is the space found in females
a) Between the uterus and the bladder
b) Between the rectum and uterus
a) Vesicouterine pouch- Between the uterus and the bladder
b) Rectouterine pouch- Between the rectum and uterus
What is the pouch of Douglas?
Rectouterine pouch
What is the most dependent area in females when standing up?
Rectouterine pouch
The ureter runs posterior to which artery in females?
Uterine artery
(“water under the bridge” water = ureter, bridge = uterine artery)
At which level does the aorta bifurcate?
Level of umbilicus
In males the ureter runs inferior to what?
Vas deferens
Which arteries supply the bladder?
Vesical arteries
From which arteries do the vesical arteries branch from?
Internal iliac arteries
What is the term given to the part of the urethra which passes through the prostate?
Prostatic urethra
What is the “trigon”?
A triangular shape on the internal aspect of the bladder created by 3 points:
The 2 ureteric orifices
The internal urethral orifice
What use does the trigon have?
It is very smooth and funnels urine into the urethra
Which muscle forms the main bulk of the bladder wall?
Detrusor muscle
Why does semen not enter the bladder during ejaculation?
Contraction of the internal urethral sphincter
In females, the uterus normally sits “anteflexed”. What does this mean?
Lies superiorly over the bladder
Normally an empty bladder resides within the _____ pelvis
Normally an empty bladder resides within the true pelvis
How is voluntary control over urination conferred?
External urethral sphincter
What are the two route to catheterising patients?
- Urethral (more common)
- Suprapubic (through anterior abdominal wall and avoiding peritoneal cavity)
How long is the urethra in
a) Females
b) Males
a) 4cm
b) 20cm
How many sphincters associated with urination are found in
a) Males
b) Females
a) 2
b) 1
The portion of the urethra that passes through the penis is called the spongy urethra, why is this?
It passes through the corpus spongiosum
Where is sperm stored?
Epididymis
Which two structures combine to form the prostatic urethra?
- Ejaculatory duct
- Urethra
Where do the testes begin their development?
Posterior abdominal wall
What can be found within the spermatic cord?
- Testicular, deferential artery and cremasteric arteries
- Nerve to cremaster and testicular nerves (sympathetic nerves)
- Vas deferens
- Pampiniform plexus
- Lymphatic vessels
- Tunica vaginalis
What is the name of the sac that the testis sits within?
Tunica vaginalis
What is the term used to describe excess fluid in the tunica vaginalis?
Hydrocele
What is the name given to accessory tissue from the testes and epididymis?
Appendix teste
Where do the gonadal (testicular/ovarian) arteries arise?
Aorta
Which structures form the ejaculatory duct?
Vas deferens
Seminal vesicles
Besides the ejaculatory ducts, which other ducts can be found in the prostatic urethra?
Many prostatic ducts
Which region of the prostate gland is most likely to develop malignancy?
Peripheral zone
(Can be felt on PR exam)
How many erectile tissue cylinders are found in the penis?
3
What are the names of the erectile tissue cylinders in the penis?
Corpus cavernosum (x2 large)
Corpus spongiosum (x1 smaller)
Which artery supplies the penis?
Deep artery of the penis
Where does the deep artery of the penis arise?
Internal pudendal artery (arises from internal iliac)
What is the arterial supply of the scrotum?
Scrotal branches from internal pudendal and external iliac artery
What is the lymphatic drainage of the scrotum and penis?
Superficial inguinal lymph nodes
(found in superficial fascia of groin)
What is the lymphatic drainage of the testes?
Lumbar nodes around the abdominal aorta
