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1st Year Med > Genitourinary System > Flashcards

Genitourinary System Flashcards

1
Q

describe the peritoneum characteristics

A

serous membrane lining abdominal cavity
2 layers of mesothelium
peritoneal space inbetween 2 layers

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2
Q

where does the parietal peritoneum line and what is it derived from?

A

lines internal surface of the abdominal-pelvic cavity
derived from somatic mesoderm

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3
Q

what does the visceral peritoneum line?

A

invaginates and lines abdominal organs

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4
Q

what is the difference between pain in the visceral and parietal peritoneum?

A

visceral - poorly localised
parietal - well localised

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5
Q

what are the 3 intraperitoneal organs?

A

stomach, liver, spleen

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6
Q

what are the 3 main retroperitoneal organs and how are they covered by the peritoneum?

A

oesophagus, rectum, kidneys
peritoneum only covers anteriorly

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7
Q

what are the functions of the kidney?

A

filter waste (urine production)
regulates blood (BP/ions/pH/osmolarity/volume/glucose levels)
hormone production such as calcitrol (active vitamin D) or erythropoetin

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8
Q

what are the 3 structures found in the hilum?

A

renal artery, renal vein, ureter (forms at renal pelvis)

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9
Q

what does the cortex of the kidney contain and what is its function?

A

provides supporting tissue
contains glomeruli, bowman’s capsule and convoluted tubules

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10
Q

what is the function of the kidney’s medulla and how is it organised?

A

function - main site of filtration
organised into renal/medullary pyramids

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11
Q

what are the functioning units of the kidneys?

A

nephrons and collecting tubules

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12
Q

what 2 structures make up the renal corpuscle?

A

glomerulus and bowmans capsule

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13
Q

what are nephron collecting tubules comprised of?

A

renal corpuscle and renal tubules

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14
Q

what are the 4 basic steps of the nephron collecting tubules function?

A

filtration, reabsorption, secretion, excretion

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15
Q

what are renal tubules comprised of?

A

PCT, LoH, DCT, diuretics (Na linked)

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16
Q

what 3 blood vessels are located in the kidney and where do they supply?

A

interlobal - lobes
cortical - cortex
arcuate - between cortex/medulla

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17
Q

explain the calyx system

A

papillas link medulla pyramids to the minor calyx which drains the pyramid into a major calyx, which all connects to the renal pelvis which transports the urine to the bladder

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18
Q

what muscle near the kidneys is important for hip flexion?

A

psoas major

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19
Q

name the arteries that supply the area around the kidneys with blood

A

R/L suprarenal arteries
R/L inferior phrenic arteries
R/L renal arteries
R/L testicular/ovarian arteries
inf/sup mesenteric arteries

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20
Q

name the veins around the renal system responsible for blood drainage

A

R/L renal veins
L inferior phrenic vein
R/L testicular/ovarian veins

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21
Q

what is the function of the ureters?

A

transports urine to urinary bladder

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22
Q

what is a common problem of the ureters?

A

highly sensetive and can be blocked by kidney stones

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23
Q

what are the 3 main areas where kidney stones can block the ureter?

A

pelvoureteric junction
pelvic brim
trigone

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24
Q

name the layers of the urinary bladder from superficial to deep

A

detrusor muscle
submucosa
lamina propria
transitional epithelium

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25
Q

where do the ureters enter the bladder?

A

the ureteric meatus’

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26
Q

what is the trigone?

A

a triangular area from the orifices of the ureter openings and the urethra

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27
Q

what does the vas deferens connect?

A

testes to urethra

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28
Q

name the layers of the testes from superficial to deep

A

scrotum skin
superficial fascia
external spermatic fascia
crewmaster muscle (+ fascia)
internal spermatic fascia
parietal tunica vaginalis
visceral tunica vaginalis
tunica albuginea of testis

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29
Q

what are the exocrine and endocrine functions of the testes?

A

exocrine - sperm cells
endocrine - testosterone

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30
Q

what structures in the testes does the tunica albuginea form?

A

200-300 lobules

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31
Q

what does each singular lobule contain?

A

1-4 seminiferous tubules

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32
Q

what 5 structures (in order) does sperm travel through?

A

seminiferous tubules
straight tubules (tubulus rectus)
rete testes
efferent ductules
epididymus

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33
Q

where are sperm cells produced and matured?

A

produced - seminiferous tubules (as spermatozoa)
matured - epididymus

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34
Q

what are the 3 parts of the urethra?

A

prostatic, membranous, pendulous

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35
Q

what is the urethral crest and what is its function?

A

long fold in posterior urethra wall stopping sperm entering the bladder

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36
Q

what is the function of the sphincter urethrae muscles?

A

controls urine expulsion

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37
Q

what is the function of bulbourethral (cowper’s) glands?

A

glycoprotein secretion in mucous during arousal
lubricates urethra/penis, controls acidity and removes dead cells

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38
Q

what is the function of the prostate?

A

produces enzymes to break down proteins, stop clotting and maintain semen in a fluid state

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39
Q

what are the 4 uterine positions?

A

anteverted and anteflexed
retroflexed
retroverted
retroverted and retroflexed

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40
Q

what ligaments hold the uterus in place?

A

round ligament - maintains forward orientation (anteflexus)
broad ligament - acts as a mesentery

41
Q

what does the ovarian ligament connect?

A

ovary and lateral uterus

42
Q

what does the suspensory ligament do?

A

contains blood supply to the ovarian artery/vein and connects to anterior abdominal wall

43
Q

what is the rectouterine pouch?

A

a double fold of peritoneum between the rectum and the back wall of the uterus

44
Q

what can occur if uterine tubes or the ampulla become blocked?

A

ectopic pregnancy

45
Q

what can happen if water/electrolyte homeostasis isn’t maintained?

A

haemorrhage, dehydration, unusual eating/drinking behaviour

46
Q

what is the typical water intake/output per day?

A

2.5 litres

47
Q

what is the sequence of blood vessels in the kidneys?

A

afferent arteriole -> glomerular capillaries -> efferent arteriole -> tubular capillaries -> venule

48
Q

name the 2 nephron types and state which one has more effective water reabsorption

A

superficial
juxtamedullary (more water reabsorption)

49
Q

what are the 4 sections of the nephron?

A

PCT
LoH
DCT
collecting duct

50
Q

what is nephron reabsorption?

A

the active pumping of filtrate into tubules in substances being retained (water/glucose)

51
Q

what is nephron secretion?

A

the active pumping of filtrate into tubules for substances being eliminated (ammonia/uric acid)

52
Q

what is ultrafiltration driven by?

A

BP in glomerular capillaries

53
Q

what are the components of a glomerulus?

A

afferent/efferent arterioles
glomerular tuft
glomerular capillary

54
Q

what composes the filtration barrier of the glomerular capillary?

A

podocyte foot processes
fenestrated endothelial cells
glomerular BM
slit diaphragm

55
Q

what occurs in glomerulus ultrafiltration?

A

high glomerular capillary pressure (55mmHg)
water and small molecules filter through slits between podocytes at a normal filtration rate of 90-140ml/min

56
Q

explain what occurs in proximal CT active reabsorption

A

in the brush border:
Na, K, AAs and glucose reabsorbed through co-transporters and membrame pumps
substantial water reabsorption and complete glucose/AA reabsorption
filtrate volume reduced by 2/3

57
Q

what differences does the wall of the LoH have at different points?

A

thinner during descent into medulla
thicker during ascent from medulla

58
Q

explain the counter current mechanism of the loop of henle

A

solute is actively pumped up ascending tube
solute diffuses into descending tube
this recycles the solute

59
Q

what is the function and characteristics of the DCT?

A

function - solute absorption and secretion
less intense electrolyte/water reabsorption than PCT
ion pumping controlled by aldosterone (hormone that ‘fine tunes’ Na/K exchange)

60
Q

what does AVP do?

A

decreases water loss by increasing uptake of water reabsorption in collective duct

61
Q

how does ADH work?

A

promotes water reabsorption in DCT and collecting duct

62
Q

what is the collecting duct permeability set by?

A

ADH and AVP

63
Q

what occurs in collecting ducts permeable to water?

A

water moves out of the duct to concentrate filtrate

64
Q

explain the function of aquaporins

A

they are inserted into luminal membrane to allow water movement when ADH or AVP is present

65
Q

what is blood/plasma osmolarity?

A

a measure of the chemical components of the blood concentration

66
Q

what is a normal value for blood osmolarity?

A

300 mOsm

67
Q

what happens when water intake is restricted?

A

plasma osmolarity decreases
more ADH/AVP is secreted by the hypothalamus to reabsorb more water and concentrate urine

68
Q

what is the maximum concentration of urine?

A

1200 mOsm

69
Q

what is the minimum and maximum accepted urine output?

A

minimum - 1ml/min
maximum - 20ml/min

70
Q

what is the second stage of filtration pressure and BP control in the kidney?

A

renin splits angiotensinogen into angiotensin 1 which is converted to angiotensin 2 (powerful vasoconstrictor)

71
Q

what controls the salt balance in kidneys when electrolytes fall?

A

aldosterone
promotes reabsorption of Na/Cl ions and promotes K secretion

72
Q

what signals volume in the bladder?

A

stretch receptors

73
Q

what maintains bladder continence? (holding it in)

A

sphincter activity (can be unconcious or concious)

74
Q

what measures bladder behaviour and compliance?

A

cystometrogram

75
Q

what is the detrusor muscle affected by?

A

reflexes
wall stretching triggers contractions which produce additional force and pressure

76
Q

what sphincter is present at the bottom of the urinary tract and how does it differ in M and F?

A

external sphincter
in males it is stronger with more skeletal muscle

77
Q

what is notable about bladder pressure in the beginning of the storage phase?

A

no bladder sensations due to stretchy bladder walls, pressure remains fairly constant

78
Q

what happens to the external sphincter when sensation is felt?

A

contraction

79
Q

what is voiding?

A

the emptying of the bladder

80
Q

what occurs straight after voluntary voiding?

A

bladder wall contracts
internal/external sphincters begin to relax

81
Q

how can voiding be halted voluntarily?

A

contractions of both sphincters causing spike in bladder pressure

82
Q

why does bladder pressure not immediately decrease during voiding?

A

to keep pushing the urine past the sphincters to empty the bladder

83
Q

explain urine flow in terms of bladder and sphincter pressure

A

urine will flow out and void when bladder pressure exceeds sphincter pressure

84
Q

what makes the coordination between the bladder and sphincters complex?

A

the external sphincter is skeletal muscle which changes force faster than the urethra (smooth muscle)

85
Q

what sympathetic innervation does L1/L2 supply?

A

bladder and internal sphincter

86
Q

what parasympathetic inervation does S2/3/4 supply?

A

bladder wall

87
Q

what somatic innervations do S2/3/4 supply?

A

external sphincter

88
Q

describe the afferent bladder control pathways

A

sensory fibres sense bladder wall stretching (through hypogastric nerve entering cord in upper lumar roots)
urethra sensors sense urine flow
skeletal muscle sensors sense external sphincter

89
Q

describe the efferent bladder control pathways

A

parasympathetic to detrusor
sympathetic to internal sphincter

90
Q

what causes contraction and relaxation of the detrusor?

A

contraction - pelvic splanchric nerve fibres
relaxation - hypogastric nerve fibres

91
Q

what effects dominate the storage and voiding phases?

A

storage - sympathetic
voiding - parasympathetic

92
Q

name the sensations accompanied with bladder filling in order

A

first fullness sense -> fullness -> desire to micturate -> discomfort -> pain

93
Q

what nerve fibres provide sensation to the bladder?

A

large myleinated fibres - intense sensation
small unmyleinated fibres - less intense sensation

94
Q

what is the general maximum bladder capacity?

A

400-600ml

95
Q

what is the maximum micturition and detrusor pressure in the bladder?

A

micturition - 75-90cmH2O
detrusor - 55-75cmH2O

96
Q

what are the 3 volume-pressure relationships?

A

normal - fills slowly to 375ml then reflex contractions start, then stop
neurogenic bladder - reflexes overactive and stiff bladder, higher pressures at lower volumes
atonic bladder - reflexes underactive and small

97
Q

what is the problem of prostate hypertrophy?

A

urethra compression, slowing urine flow

98
Q

what is the first stage of controlling filtration pressure and BP in kidneys?

A

hypofiltration initiates renin secretion by the juxtoglomerular apparatus

1st Year Med (52 decks)

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