FERGU anatomy Flashcards
Pain sensation in bladder
due to spasm/distention - mostly parasympathetic (ant. abdominal wall, perineum, genitals)
Cystocele
loss of bladder support due to damage to perineal muscles
herniation of bladder into vaginal wall
can occur due to damage from childbirth
Ectopic vesicae
absence of anterior abdominal wall, pubic bones, and anterior wall of urinary bladder results in trigone & openings of ureters being visible
Prostatic urethra
3-4 cm
widest
midline ridge = urethral crest, bordered by urethral sinuses - ducts of prostate drain into these sinuses
seminal colliculus - ejaculatory duct drains here
Pudendal artery
off of internal iliac
Pronephros
1st 6 cervical somites
a few tubules –> induce formation of pronephric duct
grows down through thorax/abdomen, becomes mesonephric duct
Mesonephros
functional in first trimester
~ 70 tubules/side
grows down on each side to the cloaca = vas deferens
some from mesonephric kidney becomes rete testis
Metanephros
5th week
Uretic bud grows posteriorly from mesonephric duct into surrounding mesoderm
Polycystic kidney disease
failure of tubules to fuse with CDs
paramesonephric ducts
Mullerian ducts, appear as Wolffian ducts disappear
Bladder
develops from urogenital sinus + allantois
Allantois connected with umbilicus - becomes ligament
mesoderm covered by endoderm
Renal agenesis
absent kidney development
can occur due to abnormal Wolffian duct, ureteric bud or metanephric mesenchyme
true agenesis = ipsilateral ureter and hemitrigone also absent
Contralateral kidney undergoes compensatory hypertrophy
common - missing ipsilateral vas deferens, Mullerian duct problems
15% have vesicourethral reflux (VUR)
Duplication anomalies
of ureters due to abnormal ureteric bud
can cause ureterocele = bag-like dilation of ureter, can cause obstruction
UTI, pain, VUR
Horseshoe kidney
fusion anomaly
metanephric mesenchyme not separated during development
can be associated with UPJ
often gets hooked on inferior mesenteric artery
Testicular descent
2nd month
migrates and sits at internal inguinal ring - 4th month
into scrotum - 7th month
cryptorchidism = undescended testicle
Male/female differentiation
week 9
Male developing factor
SRY gene on Y chromosome
testes produce: androgens & Mullerian inhibiting factor
navicular fossa = glans of penis caniculation
UPJ
ureteropelvic junction abnormal vessel development leads to hydronephrosis Tx: surgical repair laproscopic, endo-urological, open urological
Posterior urethral valves
membranous fold in posterior urethra –> obstruction
affects kidney & lungs
only seen in male
VUR
abnormal intravesical ureter that is too short, due to abnormal ureteric bud
pyelonephritis, renal dysplasia and damage
most common lower Urinary tract congenital anomaly
Dx: voiding cystourethrogram
Tx: surgical repair (endoscopic, open surgery)
Cryptorchidism
failure of testes to descend into scrotum through inguinal canal
3rd trimester
may descend spontaneously on their own after birth
abdominal scarring, abnormal SRY gene on Y chromosome
androgen-dependent
Risk factors: mother taking hormone replacements, pesticides
associated with sub-fertility and testicular cancer
Corrected by: orchiopexy - placement of testes in scrotum
surgical/laproscopically
sperm production improves, risk of testicular cancer drops
done by 12 mths of age
Congenital adrenal hyperplasia
enzymatic deficiency cause overproduction of androgens from adrenal gland
no negative feedback from adrenal gland
excessive androgen –> virilization of external genitalia on girls, no effect on internal
Hypospadia
abnormal development of urethral folds and genital tubercle
urethral meatus opens proximal to glans
incomplete foreskin and chordee (ventral penile curve)
can’t urinate standing up, can’t inseminate
Tx: reconstructive surgery
Histology of urethra
Prostatic/membranous: urothelium
penile: stratified columnar
navicular fossa: stratified squamous
