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(SALMA) Anatomy Handbook Questions > Genito-Urinary Anatomy > Flashcards

Genito-Urinary Anatomy Flashcards

1
Q

what is the role of the functional valve of bladder

A

prevents reflux into ureter

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2
Q

whats the diff btwn internal and external urethral sphincters

A

internal: smooth muscle from bladder
externa: skeletal muscle from pelvic floor

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3
Q

what are the 3 parts of male urethra

A
  • prostatic urethra
  • membranous urethra
  • penile urethra
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4
Q

what is the inguinal canal

A

an oblique passage through the muscles of the anterior abdominal wall: extends from deep inguinal ring to superficial ring

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5
Q

what does the inguinal canal convey in males

A 
spermatic cord (and ilio-inguinal nerve)
also vas deferens, testicular artery, pampniform plexus of veins and neves/lymphatics of testis
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6
Q

what does the inguinal canal convey in females

A

round ligament
olio-inguinal nerve
genital branch of genitofemoral artery

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7
Q

what happens to structures as they pass through each of the abdominal wall layers

A

they gain a layer of tissue from each layer

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8
Q

what are the testes covered by

A

same 3 layers of spermatic fascia that cover the spermatic cord

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9
Q

what is the epidydmis

A

coiled tube laying along posterior border of each testis

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10
Q

what does the scrotum contain

A

testes
epididymis
lower part of spermatic cord

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11
Q

what is the glans penis

A

common outlet for urine and semen

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12
Q

what is the diff btwn direct/indirect hernia

A

direct: passes through transverse fascia of post wall, directly through internal oblique layer and directly through external ring
indirect: passes through each of 3 layers of abdominal wall in diff position

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13
Q

where do the gonads form in embryo

A

post abdominal wall and migrate from kidney level down to adult position

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14
Q

what is the kidney’s/gonads autonomic nerve supply from

A

t10-l2 nerve root

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15
Q

what is the tunica vaginalis

A

sac of peritoneum that partially surrounds testis

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16
Q

what factors normally prevent herniation of abdominal contents through inguinal canal

A

deep/superficial inguinal ring are in diff positions

- lower fibres of transversalis/internal oblique arch over canal and close it off during abdominal wall contraction

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17
Q

where would the ductus deferent be palpated?

A

it is attached to back of the testis and difficult to feel here. easy to feel in spermatic cord, feels like a hard cord

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18
Q

what is a varicocele

A

high pressure of venous blood in pampniform plexus of veins in the scrotum causes the veins to enlarge

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19
Q

what does the pampiniform plexus help regulate

A

temp

arteries supplying the testes run thro’ plexus where blood is cooled from abdominal arterial temp to testicular temp

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20
Q

where would lymph nodes be palpated to assess spread of testicular cancer

A

cancer of testis will spread to lymph nodes around aorta where testicular arteries arise

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21
Q

where is lymph drainage usually

A

lymph drainage of any organ follows arteries (but flow in opposite direction)

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22
Q

should undescended testis be corrected

A

yes bc spermatogenesis doesn’t occur at body temp: vital to ensure fertility

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23
Q

what anatomical structure in glans penis might impede progress of a catheter

A

navicular fossa

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24
Q

which nerves provide sensory innervation to scrotal skin

A

anterior 1/3 through ilii-inguinal nerve (L1)

posterior 2/3 is pudendal nerve (s2-4)

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25
Q

where does the aorta bifurcate

A

L4

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26
Q

what does the aorta bifurcate into at L4

A

common iliac arteries

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27
Q

where is the IVC formed by the unification of the common iliac veins

A

L5

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28
Q

what is the cremaster muscle

A

muscle of spermatic cord

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29
Q

what are renal calculi

A

small stones pass down ureter intobladder

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30
Q

what is left varicocoel

A

left testicular vein passes into left renal vein

disease of left kidney may block drainage of blood from lest testicle - scrotum veins become varicose

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31
Q

what is psoas spasm

A

appendix may lie on psoas, when it becomes inflamed the muscle goes into spasm: patient will have flexed hip. extending hip will be painful

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32
Q

renal tumours can become v large before they invade adjacent structures. what anatomical features explain this

A

they have thick and resilient capsule, surrounded by perinephric fat which is surrounded by perinephricfascia

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33
Q

what are 2 common variations in anatomy of renal pelvis and ureter

A

can be 2 ureters arising from kidney; sometimes they join and there is a single ureter entering bladder but sometimes they enter separately.

bladder doesn’t have valve mechanism; prone to urine passing back up to kidney when bladder contracts

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34
Q

what veins do r and l gonadal veins drain into

A

r - IVC

l - left renal vein

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35
Q

what is a polar artery?

A

when kidneys develop, they have a segmental pattern w a separate artery to each part.
- usually these arteries join to form single renal artery. 1 in 4 ppl have 2 renal arteries to 1 kidney; usually large renal artery and a smaller 1 to inferior pole of kidney; polar artery.

polar artery can compress ureter and stop urine flow

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36
Q

where would u palpate an abdominal aortic aneurysm

A

aorta finishes just above umbilicus so can only be felt in upper abdomen

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37
Q

what are the narrow parts of the ureter where a stone may get stuck

A
  1. where renal pelvis becomes ureter
  2. at pelvic brim
  3. where ureter passes through bladder wall
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38
Q

describe the relationship of the ureter to bony landmarks of abdomen/pelvis

A
  • pelvis of L kidney is approximately L2-3 and R kidney is L3
  • ureter commences at lower part of pelvis and runs down tips of transverse processes of lumbar vertebrae
  • runs just medial to sacroiliac joint but usually directly over it inferiorly
  • it runs across tip of spinous process of pelvis and medially into bladder
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39
Q

where does the femoral nerve pass from abdomen into thigh

A

under inguinal ligament

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40
Q

where does the obturator nerve pass from abdomen into the thigh

A

through obturator foramina

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41
Q

where does sciatic nerve pass from abdomen into thigh

A

through the greater sciatic foramen

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42
Q

what is the path of the ureter

A
  1. ureter enters pelvis
  2. crosses anteriorly to iliac vessels
  3. courses out to ischial spines
  4. courses medially to penetrate bladder base
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43
Q

what is the origin of the psoas

A

from the fascia on the sides of lumbar vertebra

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44
Q

what is the insertion of psoas

A

lesser trochanter of femur

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45
Q

which nerve supplies lateral thigh skin

A

lateral cutaneous nerve of the thigh (runs under inguinal ligament)

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46
Q

what is the recto-vesical pouch

A

lies btw rectum and urinary bladder (lowest part of peritoneal cavity)

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47
Q

what is the recto-uterine pouch aka

A

pouch of Douglas

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48
Q

what is most of the bladder’s mucosa like

A

rugose (wrinkled/conjugated)

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49
Q

what is the trigone

A

smooth triangular area of mucosa on inner aspect of bladder base (it’s sensitive to expansion)

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50
Q

what does the uterine artery arise from

A

anterior division of internal iliac artery

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51
Q

what is benign prostatic hypertrophy

A

enlargement of prostatic gland; may lead to blockage of urethra and inability to pass urine (requires emergency catheterisation)

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52
Q

where does venous drainage from the prostate pass

A

into a plexus of veins which lie anterior to the sacrum and communicate with veins which run up to azygous vein in chest

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53
Q

what are the 3 components of micturition control

A
  1. control from brain
  2. control from spinal cord
  3. sensory input from bladder
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54
Q

why is the ureter in danger of damaging during hysterectomy

A

ureter runs immediately under uterine artery

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55
Q

what steps urine passing from bladder back up to the ureter

A

ureter enters bladder at an oblique angle. as pressure in bladder rises, this presses on part of ureter which is in bladder and stops using passing back up to kidney

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56
Q

where does the bladder lie when full

A

against the lower abdominal wall, with no peritoneum between the bladder and the abdominal wall

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57
Q

a 25 yr old woman is in a car crash; suffered complete transection of SC at T6. is she able to tell when bladder is full?

A

no, signals cannot reach brain

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58
Q

what happens during micturition if there is loss of brain control

A
  • bladder fills, SC knows bladder is full but this doesn’t reach brain
  • SC asks brain to empty, brain doesn’t reply, SC completes normal emptying
  • patient suddenly and unexpectantly passes urine with no control
    (low pressure in bladder so no risk of renal failure)
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59
Q

what happens during micturition is there is loss of sensation

A
  • SC and brain cannot know that bladder is full so don’t tell it to empty
  • bladders fills and patient continually dribbles w high pressure in bladder/kidney can lead to kidney damage
    (patient has no awareness of full bladder)
60
Q

what happens during micturition if there is loss of spinal cord motor

A
  • patient knows bladder is full but cannot empty

- high pressure in the bladder and renal failure

61
Q

how is the body of the uterus usually placed

A

typically bent forwards and lies on superior surface of bladder

62
Q

how does the cervix communicate with uterine cavity

A

via internal os (orifice)

63
Q

how does cervix communicate with vagina

A

via external os (orifice)

64
Q

how is the position of the cervix stabilised

A

levator ani muscle and cervical ligaments

65
Q

how are ovaries attached to posterior of broad ligament

A

by a short mesentery (mesovarium)

66
Q

what does the uterine artery anastomose with

A

ovarian artery

67
Q

where does the vagina lie

A
  • upper 2/3 in pelvic cavity

- bottom 1/3 in the perineum

68
Q

what is the perineum

A

area btwn anus and scrotum/vulva (diamond-shaped)

69
Q

what is the mons pubis

A

a rounded, hair bearing skin elevation located in front of pubic symphysis

70
Q

where does the ductus deferent terminate

A

by joining duct of seminal vesicle to form the ejaculatory duct

71
Q

do the seminal vesicles store sperm

A

no, they secrete thick alkaline fluid which forms the bulk of seminal fluid

72
Q

where does the prostate gland lie

A

against neck of bladder

73
Q

what is the prostate gland pierced by

A

urethra and ejaculatory ducts

74
Q

what does the shaft of the penis consist of

A

3 erectile cylinders:

  1. corpus spongiousum
  2. paid corpora cavernosa
75
Q

where on the thigh, may inflammation of the ovary result in pain? and why

A

medial aspect of thigh

  • ovary lies in space btwn internal/external iliac arteries on lateral wall of pelvis
  • immediately deep to peritoneum is obturator nerve; relays sensory info from medial thigh
  • ovary mar irritate nerve and cause pain
76
Q

what is a retroverted uterus

A

body of uterus is at an angle to the cervix with the body position more posteriorly
(if it is more anterior, it is ante-versed)

77
Q

what maintains the normal position of the uterus

A

cardinal and broad ligaments

78
Q

to which lymph nodes would cervical cancer spread?

A

internal iliac group

79
Q

what structures may be palpable during examination through the vagina

A
  • cervix
  • spinous process ofpelvis
  • contains of recto-uterine pouch
  • ovaries
  • bladder
  • urethra
  • rectum
  • anal canal
80
Q

what is the superficial perineal pouch

A

space btwn perineal membrane and fascia which encloses external genitalia

81
Q

what is the perineal membrane

A

fibrous membrane lying btwn inferior pubic rami as far as back as ischial tuberosities; triangular with holes in midline for vagina, urethra and anteriorly for venous drainage from external genitalia

82
Q

what is the urogenital diaphragm

A

most superior layer of deep perineal pouch

83
Q

what is anterior to the vagina

A

bladder and urethra

84
Q

what is posterior to the vagina

A

rectum and anus

85
Q

what is lateral to the vagina

A

ureters and uterine arteries

86
Q

what are the 2 main holes in the pelvic floor

A
  • urogenital hiatus: anteriorly situated, allows passage of urethra (and vagina in females)
  • rectal hiatus: centrally positioned, allows passage of anal canal
87
Q

what kind of muscle are the ureters

A

smooth muscle

88
Q

what is the abdominal supply of ureters

A

renal artery

testicular/ovarian artery

89
Q

what is the pelvic supply of ureters

A

superior and inferior vesicle arteries

90
Q

what is the bladder derived from

A

hindgut

91
Q

how are the detrusor muscles fibres orientated

A

in 3 directions to retain structural integrity when stretched

92
Q

what are the roots of the hypogastric nerve

A

t12-l2

93
Q

what are the roots of the pelvic nerve

A

s2-4

94
Q

what are the roots of the pudendal nerve

A

s2-4

95
Q

what are the 3 parts of the penis

A

root, body, glans

96
Q

what are the erectile tissues and what do they do

A

left/right crura and bulb of penis

these fill with blood during sexual arousal

97
Q

what do the left and right crura form

A

the 2 corpora cavernosa

98
Q

what are the leading cells responsible for

A

testosterone production

99
Q

what are seminiferous tubules lined by

A

Sertoli cells

100
Q

why is the scrotums skin wrinkled

A

helps to regulate temperature; decreases SA, heat loss is reduced

101
Q

what does the scrotum receive arterial supply from

A

anterior and posterior scrotal arteries

102
Q

what is the spermatic cord

A

a collection of vessels, nerves and ducts that run to and from the testes. surrounded by a fascia

103
Q

what is the pampiniform plexus

A

a network of veins, responsible for the venous drainage of testes.

has a unique configuration; wraps itself around testicular artery

104
Q

what is the prostate innervated by

A

inferior hypogastric plexus

105
Q

what is the lumbar plexus formed from

A

anterior rami of l1/2/3/4

106
Q

what is the Point and Shoot mnemonic for?

A 
erection = Parasympathetic innervation
ejaculation = Sympathetic innervation
107
Q

what are the nerve roots of the pudendal nerve

A

s2-4

108
Q

what is the sensory innervation of pudendal nerve

A

external genitalia of both sexes

and skin around anus, anal canal and perineum

109
Q

what is the motor innervation of pudendal nerve

A

various pelvic muscles
external urethral sphincter
external anal sphincter

110
Q

where is the sacral plexus located

A

posterior pelvic wall

111
Q

where does the pudendal nerve leave the pelvis

A

greater sciatic foramen

112
Q

what is the main arterial supply of pelvic cavity

A

internal iliac artery

113
Q

where does the common iliac artery bifurcate

A

l5-s1

114
Q

where does the internal iliac artery divide into anterior and posterior trunks

A

at the superior border of the greater sciatic foramen

115
Q

what does the anterior trunk of int iliac artery supply

A

pelvic organs
perineum
gluteal and adductor regions of lower limb

116
Q

what does the posterior trunk of int iliac artery supply

A

lower posterior abdominal wall
posterior pelvic wall
gluteal region

117
Q

what are the 3 main vessels involved in pelvic venous drainage

A

external iliac
internal iliac
common iliac

118
Q

what is the external iliac vein a continuation of

A

femoral vein (when it crosses under inguinal ligament)

119
Q

what are the external genitalia collectively known as

A

vulva

120
Q

what are 3 functions of the vulva

A
  1. . to act as sensory tissue during sex
  2. to assist in micturition by directing urine flow
  3. to defend internal reproductive tract from infection
121
Q

what is the blood supply to the external genitalia

A

paired pudendal arteries

122
Q

what is the cervix

A

lower portion of the uterus

123
Q

how does the cervix facilitate sperm passage into the uterine cavity

A

via dilation of the external and internal os

124
Q

what are the 3 parts of the uterus

A

fundus
body
cervix

125
Q

where does the broad ligament attach

A

sides of the uterus to the pelvis

- contributes to maintaining it in position

126
Q

where does the round ligament attach

A

extends from uterine horns to labia major via inguinal canal

- maintains anteverted position of uterus

127
Q

what are PS fibres of uterus derived from

A

pelvic splanchnic nerves (s2-4)

128
Q

what is the main function of the uterine tubes

A

to assist in transfer/transport of ovum from ovary to uterus

129
Q

what are the 4 parts of the fallopian tube (lateral to medial)

A
  • fimbriae
  • infundibulum
  • ampulla
  • isthmus
130
Q

where do gonads develop within

A

mesonephric ridge

131
Q

how are ovaries attached to the posterior surface of the broad ligament

A

by the mesovarium

132
Q

what are the 2 coverings of the testicles

A
  • tunica vaginalis

- tunica albuginea

133
Q

what is the path of the sperm from seminiferous tubules to epididymis

A

seminiferous tubules –> rete testes –> efferent tubules –> epididymis

134
Q

how many days does the epididymis store sperm

A

50 days

135
Q

where does the tail of the epididymis connect to

A

vas deferens

136
Q

what branches off the abdominal aorta at t12

A

inferior phrenic arteries

137
Q

what branches off the abdominal aorta at L1

A

coeliac trunk, middle suprarenal arteries

138
Q

what branches off the abdominal aorta at lower L1

A

superior mesenteric artery

139
Q

what branches off the abdominal aorta at L1/2

A

renal arteries

140
Q

what branches off the abdominal aorta at L2

A

gonadal arteries

141
Q

what branches off the abdominal aorta at L3

A

inferior mesenteric artery

142
Q

what is diff btwn labia majora and minora

A

majora - hair bearing fold

minora - non-hair bearing fold

143
Q

what are the 3 layers of the uterus

A

endometrium
myometrium
perimetrium

144
Q

what are the 3 zones of the prostate gland

A

central
peripheral
transitional

145
Q

where is sperm produced

A

seminiferous tubules of testis

(SALMA) Anatomy Handbook Questions (6 decks)

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