Genitourinary System Flashcards
Urinary system is formed of:
- kidney
- ureter
- urinary bladder
- urethra
What are some general features of the kidney?
- left is longer, narrower, higher
- right is lower because of right lobe of liver
- anterior surface is convex and irregular
- posterior surface is flat
Where are kidneys located?
- lie retroperitoneally on posterior abdominal wall (both sides of VC)
- hypochondrium and lumbar regions
- anterior-lateral/posterior-medial???
What are the posterior relations of the upper part of the kidneys
- diaphragm and medial and lateral arcuate ligaments
- costodiaphragmatic recess
-right (12th rib). Left (11th rib)
What are the posterior relations of the lower part of the kidneys?
- psoas, quadratus lamborum, aponeurotic origin of transversus abdomins
- subcostal nerve, artery
- iliohypogastic & ilioinguinal nerves
***paranephric fat separates structures
What are the internal structures of the kidney
- cortex (outer) and medulla (inner)
- medulla made of pyramids, apices open into minor calyces
- minor calyx–>major calyx–>renal pelvis–> ureter
- cortex–>renal column
- cortex+pyramid=renal lobe
Coverings of the kidney
- Renal capsule
- Perinephric fat
- Renal fascia
- Paranephric fat
- Peritoneum
Factors that support the kidneys
- renal fascia
- perinephric fat
- renal vessels
- abdominal viscera
- **weakness of results in nephroptosis (floating kidney)
Blood supply of the kidneys
- supplied 70% by single renal artery (branch from abdominal aorta)
- 30% accessory renal artery
Venous drainage of the kidneys
- right kidney: single renal vein–> IVC
- left kidney: renal vein can be doubled
-(L) renal vein drains: left gonadal vein, left suprarenal vein, sometimes left inferior phrenic vein
General shape of urinary bladder
-3 sided pyramid: apex; base (posterior surface), superior surface, two inferolateral surfaces
General location of the bladder
- inside pelvic cavity, most anterior of pelvic viscera
- lies posteriorly to pubis
- separated from pubis by fascia (retro-pubic space)
Location of urinary bladder (males)
-anterior to rectum, separated by rectovesicle pouch
Location of bladder (female)
-anterior to uterus and vagina, separated from by vesico-uterine pouch
Superior surface of the bladder
- superior to pelvic inlet is abdominal cavity/loops of intestine
- covered by peritoneum
- peritoneum forms two “paravesical fossae” with upper margin of inferolateral walls
Inferolateral surface of bladder
- related to “levator ani” on both sides (tail-wagging)
- related to “obturator internus” further outside (abduction of thigh)
Posterior surface of bladder
-females: vagina; males: seminal vesicles & ampulla of the vas deferens
- ureters open at upper corners, urethra at lower corner
- **area between ureters and urethra is trigone and has smooth mucosal lining
Posterior surface of bladder (men)
-sits on top of prostate and lays back on the seminal vesicle and ampulla of vas deferens
Posterior surface of the bladder (female)
-neck of bladder sits on perineal membrane and lays onto the vagina
What are the male genital organs
- prostate
- seminal vesicle
- ducks deferens
- epididymis
- testis
Prostate
- fibromuscular gland contribute to seminal fluids, inverted cone (base on bladder, neck and apex on perineal membrane)
- 2 lateral lobes, anterior (isthmus), posterior lobe, middle lobe
Anatomical relations of prostate
- anteriorly: posterior surface of pubic symphysis, connected by (puboprostatic ligaments)
- posteriorly: rectal ampullae
- laterally: levator ani
- traversed by “prostatic” urethra, ejaculatory ducts
- **drained by internal iliac lymph nodes
Seminal vesicle
- located between posterior surface of bladder and the rectum
- related laterally to the ureter and ductus deferens
- contribute 70% of seminal fluids
- plays a role in sperm maturation, motility, and immunosupression once in female genital tract
Course of the ductus deferens
-begin: scrotum (lower end of epididymis tail)–> runs in spermatic cord–>passes in inguinal canal to reach pelvic cavity–> runs on lateral wall (pelvic cavity) curves medially and forward to posterior surface on bladder–> unites with seminal vesicle duct–> forms ejaculatory duct which drains seminal fluid into prostatic urethra
Testis
- primary male sex organ
- production of sperm and testosterone
- lies in scrotum hangs from spermatic cord, anchored inferiorly to scrotal skin by scrotal ligament
- covered by “tunica albuginea” (fibrous)
Anatomical relations of testis
- posteriorly: epididymis, both are covered by visceral layer of “tunica vaginalis”
- **drained into Para-aortic lymph nodes
What are the female genital organs
- uterus
- ovary
- vagina
Uterus
- thick-walled, muscular, in between rectum and bladder
- covered completely by peritoneum
Anatomical relations of the uterus
- anterior surface related to bladder, separated by vesico-uterine pouch
- anterior round end (fundus)
- posterior surface related to abdominal cavity, loops of instestine, and rectum
- separated from rectum by recto-uterine pouch (Douglas Pouch)
- posterior end (cervix) opens into vagina, crypts surrounding cervix (fornices)
Fornicies of the vagina
- “gutters” created by protrusion of cervix (uterus) into vaginal vault
- forms anterior, posterior, and two lateral fornices
Normal attitude of the uterus
- anteverted: uterus and vagina
- anteflexed: uterus and cervix
Broad ligament
-peritoneal folds of the uterus connecting the lateral wall of the pelvis to the lateral wall of the pelvis
Parts of the broad ligament
- mesosalpinx: part of the broad ligament in the vicinity of uterine tube
- mesovarium: part of broad ligament connecting anterior border of the ovary to broad ligament
- mesometrium: remaining broad ligament
Blood supply of the uterus
Supplied by the uterine artery (branch of internal iliac artery)
Ovaries
- homologue of testis
- site of oogenesis and sex hormones
- mesovarium attaches to anterior edge, ovaries have free posterior edge
- lie in ovarian fossa on lateral wall of pelvis
Blood supply of ovaries
- ovarian artery (branch of abdominal aorta)
- drains into ovarian vein
- lymphatic of the ovary into aortic lymph node
Male and female urethra
- male is longer
- male devided into 4 parts:
- pre-prostatic
- prostatic
- membranous
- penile
