CPR Module (SGU) - Anatomy of the Urinary System 1

Question 1

Which embryological rudiments develop into the urinary system?

Answer 1

intermediate mesoderm and urogenital sinus

Question 2

Where can you find the intermediate mesoderm?

Answer 2

Between paraxial and lateral mesoderm

Question 3

What is the urogenital sinus part of?

Answer 3

cloaca

Question 4

What are the two parts of the urogenital ridge? What arises from each of these components?

Answer 4

1) nephrogenic cord which gives rise to urinary system

2) gonadal ridge which gives rise to genital system

Question 5

What are the three sequential components of the embryological kidney?

Answer 5

1) Pronephros
2) Mesonephros
3) Metanephros

Question 6

Which primitive kidney will form the permanent kidney?

Answer 6

Metanephros

Question 7

When does the pronephros form? When does it regress? Where is it located?

Answer 7

1) fourth week
2) regresses by end of fourth week
3) cervical region

Question 8

When does the mesonephros form? When does it regress mostly? Where is it located?

Answer 8

1) end of week 4
2) end of second month
3) caudal to the regressing pronephros to the cloaca

Question 9

In the male embryo, some parts of the mesonephros persist, what are they?

Answer 9

some tubules and mesonephros duct will form ductus deferens, duct of epididymis and efferent ductules

Question 10

What do the excretory tubules of the mesonephros form?

Answer 10

Primitive Bowman’s capsules and renal tubules

Question 11

Where do the mesonephric tubules appear and what do they connect with?

Answer 11

appear laterally, grow into an S shaped loop and meet with tufts of primitive glomeruli

Question 12

When does the metanephros appear?

Answer 12

5th week

Question 13

What structure do the excretory ducts of the metanephros come from?

Answer 13

metanephric mesoderm

Question 14

The ureteric bud is an outgrowth from what? What is it initially close to?

Answer 14

mesonephric duct, close to the cloaca

Question 15

The bud is “capped” by tissue which it eventually penetrates, what is this cap?

Answer 15

metanephric blastema

Question 16

The ureteric bud forms what structures?

Answer 16

Primitive renal pelvis and major calyces

Question 17

The renal tubules are formed from what structure and through which process?

Answer 17

formed from clusters of mesenchymal cells from the metanephric blastema. induced by collecting tubules

Question 18

What causes a lobulated kidney? When is it not pathological?

Answer 18

1) failure of the growth of connective tissue, vascularity, and nephron growth
2) kidney is normally lobulated in fetus

Question 19

What forms the excretory part of the nephron? What forms the conducting part of the nephron?

Answer 19

1) excretory –> mesenchyme of the metanephric blastema

2) conducting –> ureteric bud

Question 20

How do glomeruli form?

Answer 20

Through invaginations of the metanephric tubules

Question 21

Where are the kidneys initially located? Which direction does the hilum face initially?

Answer 21

1) in the pelvis

2) ventrally

Question 22

Where does the kidney initially receive its arterial supply? What about when it ascends?

Answer 22

1) common iliac

2) aorta

Question 23

When do the kidneys reach the adrenal glands?

Answer 23

9th week

Question 24

During a kidney’s ascent, what happens if an artery is not obliterated before it receives the next segmental arterial supply?

Answer 24

accessory renal arteries

Question 25

What is the cause of renal agenesis?

Answer 25

early degeneration or failure of formation of the ureteric bud

Question 26

What does bilateral renal agenesis cause?

Answer 26

1) olilgohydramnios 2) pulmonary hypoplasia 3) fetal demise

Question 27

What is the cause of a supernumerary kidney?

Answer 27

development of two separate ureteric buds on a side

Question 28

What causes a bifid ureter?

Answer 28

early, incomplete division of the ureteric bud

Question 29

What causes a horseshoe kidney?

Answer 29

fusion of lower poles of the kidneys while still in the pelvis

Question 30

What structure interrupts the ascent of a horseshoe kidney?

Answer 30

inferior mesenteric artery

Question 31

from deep to superficial, what are the coverings of the kidney?

Answer 31

1) renal capsule 2) perirenal fat 3) renal fascia 4) pararenal fat 5) transversalis fascia

Question 32

Where is the hepatorenal recess?

Answer 32

superior to the right kidney

Question 33

What is another name for the hepatorenal recess? Which body position causes fluid to collect there?

Answer 33

1) Pouch of Morrison | 2) body is supine

Question 34

sensory nerves from the kidneys travel back to the CNS with which nerves?

Answer 34

thoracic splanchnic

Question 35

What nerves form the renal plexus?

Answer 35

1) celiac ganglion/plexus 2) aorticorenal ganglion 3) least thoracic splanchnic nerves 4) first lumbar splanchnic nerve 5) aortic plexus 6) sympathetics from T11-L2

Question 36

Most renal nerves are which type?

Answer 36

vasomotor

Question 37

What does water under the bridge mean with respect to the ureters?

Answer 37

Ureters pass UNDER the uterine vessels or ductus deferens

Question 38

Where does the bladder reside when it is empty? When it is full?

Answer 38

1) true pelvis | 2) protrudes into the abdominal cavity

Question 39

What supplies the blood of the urinary bladder?

Answer 39

superior and inferior vesicle arteries

Question 40

Where does lymph from the urinary bladder drain into?

Answer 40

external iliac nodes

Question 41

How is the urinary bladder attached to the umbilicus?

Answer 41

median umbilical fold

Question 42

What are the ligaments which hold up the bladder?

Answer 42

1) pubovesical and cardinal in women | 2) puboprostatic and cardinal in men

Question 43

When does the bladder develop?

Answer 43

4-7 weeks

Question 44

What divides the cloaca into the rectal and urogenital canals?

Answer 44

urorectal septum

Question 45

What are the portions of the urogenital sinus?

Answer 45

1) vesical (upper) - forms bladder 2) pelvic (middle) - most of male urethra and all of female urethra 3) phallic (males)

Question 46

What developmental structures form the trigone of the bladder?

Answer 46

caudal portion of the mesonephric ducts

Question 47

What are the two pelvic pouches in females? Males?

Answer 47

Females: rectouterine and vesico-uterine pouch Males: rectovesical pouch

Question 48

What three muscles control micturition? How are each of these controlled?

Answer 48

1) detrusor muscle - tonically relax by SNS, PSNS causes contraction in micturition 2) internal urethral sphincter - SNS keeps contracted, PSNS relaxes it 3) external urethral sphincter - PUDENDAL NERVE (somatic)

Question 49

What are the parasympathetic and sympathetic innervations of the bladder?

Answer 49

SNS - T10-12 (lesser and least splanchnics), L1-2 (lumbar splanchnics PSNS - S2-4 (pelvic splanchnics)

Question 50

How do visceral afferents for pain travel to the bladder?

Answer 50

Majority of bladder travel with parasympathetics | Peritoneal portion travels with sympathetics

Question 51

Where does pain from the bladder refer to?

Answer 51

perineum

Question 52

Stretch and pain in urinary bladder is carried by what?

Answer 52

Visceral afferents accompanying parasympathetics or sympathetics depending on location

Question 53

What are the three portions of the male urethra?

Answer 53

1) prostatic urethra 2) membranous urethra 3) penile urethra

Question 54

Why is ascending UTI in females more common?

Answer 54

- short urethra - proximity to vagina and anus - intercourse