GU System

Question 1

Label this pelvis, and describe the function

Answer 1

The pelvis protects some major organs in the pelvic cavity​
The bony false pelvis protects abdominal organs and guides the head of foetus to the true pelvis during labour .
The inguinal canal runs superiorly to the inguinal ligament on each side
We have a much deeper posterior than an anterior pelvic cavity because of the orientation of the pelvis

Question 2

Label this. What is it?

Answer 2

The pelvic outlet.

Question 3

Describe the location and notches of the pelvic outlet

Answer 3

Bounded posteriorly by the coccyx, laterally by the ischial tuberosities and anteriorly by the pubic arch​
​
​Unlike the inlet, the pelvic outlet doesn’t have a smooth line but instead has 3 wide notches:​
Anteriorly the pubic arch and laterally by the sciatic notches. ​
The sciatic notches are divided by ligaments to produce greater(yellow) and lesser sciatic foramina.​

Question 4

Label the urinary tract

Answer 4

Question 5

Describe the position of the kidneys and ureter

Answer 5

Lie behind peritoneum on posterior abdominal wall (retroperitoneal) either side of the vertebral column ​
Right Kidney lies lower due to the liver ​
As diaphragm contracts in breathing kidneys move down​
Left kidney under ribs XI and XII​. Right Kidney rib XII​
Ureter= transverse processes of lumbar vertebrae

Question 6

Label this to show the posterior relations of the kidney

Answer 6

Question 7

What is the function of the coverings of the kidneys?

Answer 7

•Supports the kidney. Holds the kidney in position against the posterior abdominal wall

Question 8

Label these coverings of the kidneys

Answer 8

Question 9

Describe congenital abnormalities of the kidney​

Answer 9

Kidney development starts at the pelvis and then moves up. If this doesn’t occur u can get pelvic kidney which doesn’t ascend to the abdominal wall.​
Horseshoe kidney: when the inferior poles of the 2 kidneys fuse, so can’t ascend to the posterior abdominal wall

Question 10

Label the anatomy of the kidney

Answer 10

Question 11

Describe kidney vasculature

Answer 11

Question 12

What do the highlighted areas show?

Answer 12

Question 13

Describe innervation of the kidneys

Answer 13

• Function: Vasomotor regulates blood flow and renin secretion.
• This innervation comes from the renal plexus, which follows renal arteries.
• Post-ganglionic sympathetic from (T10 – L1)

Question 14

Describe kidney stones and what they’re caused by

Answer 14

Diet​, Chronic infection​, Family history​, Dehydration, Hypercalcaemia​.

Kidney stones can get lodged in:​ the ureteropelvic junction, (2) the crossing over the iliac vessels, and (3) the ureterovesical junction​
​
Also see the Staghorn calculus, a massive kidney stone

Question 15

Label and describe the urinary barrier

Answer 15

Question 16

Label and describe internal features of the urinary bladder

Answer 16

Question 17

Describe the female urethra

Answer 17

Originates from the neck of the bladder. ​
Supported by a pubovesical ligament and pelvic floor muscles ​
Passes inferiorly through urogenital diaphragm and through the perineal membrane.​
Opens at the vestibule between the labia minora

Question 18

Label the male urethra

Answer 18

Question 19

Describe the development of male reproductive organs

Answer 19

Superficial male genital organs= scrotum and the penis​
In a MALE fetus, labioscrotal swellings fuse across the midline, resulting in a single scrotum.
Before descent, a cord of tissue (gubernaculum) passes through the anterior abd wall. This connects the gonad with the labioscrotal swellings (i.e. connect testis w scrotum)​
Testes descend into the scrotum from the posterior abdominal wall along the gubernaculum path.

Question 20

Describe the scrotum and testes

Answer 20

Ellipsoid shaped, enclosed in a musculofascial pouch, continuous with the ant. abdo wall​.
Spermatic cord= tube-shaped connection between the pouch and the anterior abdo. wall ​
Each testis has seminiferous tubules + interstitial fluid. ​
Spermatozoa are produced in 400-600 highly coiled seminiferous tubules which connect to the rete testis.​
12-20 efferent ductules connect the rete testis with the epididymis​
Sperm is stored in epididymis, then pass via the ductus deferens into the ejaculatory duct

Question 21

What is testicular torsion?

Answer 21

Rotation of testis round the spermatic cord w/in the scrotum​

• Causes​: inadequate fixture of testis to scrotum by scrotal ligament.
• V large peritoneum​.
• Activity- eg horseriding ​

Symptoms/diagnosis: severe scrotum pain up through the inguinal region. Testis higher up than normal position​. Fever. Absence of cremasteric reflex​. Doppler ultrasound if diagnosis is unclear.

Question 22

How is testicular torsion treated?

Answer 22

If not treated quickly, testicular artery may become occluded, leading to ischaemia and eventually necrosis of the testis​
Treatment: Manual rotation.
Surgical rotation – attaching testicle to scrotum​
6 hours – 90% chance saving testis. 24 hours – 0%

Question 23

Describe the male external genitalia

Answer 23

The penis= 2 corpora cavernosa (erectile tissue), 1 corpus spongiosum​, a root and a body:​
The root consists of two crura which are the proximal parts of the corpora cavernosa attached to the pubic arch​
The bulb of the penis is the proximal part of the corpus spongiosum, anchored to the perineal membrane​.

Question 24

What are the suprarenal glands?

Answer 24

• Endocrine glands
• Lie on upper pole of kidney
• Surrounded by renal fascia

Yellow cortex: secretes corticosteroids and androgens

Brown medulla: main source of catecholamines (adrenaline and NA)

Question 25

Label the supradrenal glands’ arterial supply

Answer 25

Question 26

Describe venous drainage of the supradrenal glands

Answer 26

Question 27

Label this

Answer 27

Question 28

Label this to show the vasculature of the ureters

Answer 28

Question 29

Describe the course of the ureter in the abdomen

Answer 29

Question 30

Describe the male urethra

Answer 30

Also originates from neck of bladder but is much longer w 4 parts:​
​
1: Preprostatic: bladder to prostate​
2: Prostatic: passes through prostate​
3: Membranous: passes through deep perineal pouch and perineal membrane​
4: Spongy: surrounded by corpus spongiosum (erectile tissue) and bulbospongiosus muscle​
​
Supported by prostate and puboprostatic ligament

Question 31

Label this, what is it?

Answer 31

Question 32

What is micturition?

Answer 32

1. Urine is made in the kidneys and stored in the bladder
2. The sphincter muscles relax, the detrusor contracts
3. The bladder is emptied through the urethra
4. Need sympathetic nerves to allow bladder to fill and parasympathetic (lumbar and sacral) nerves to void the bladder

Question 33

How is micturition innervated?

Answer 33

Parasymp fibres originate as the pelvic splanchnic nerves from S2-S4. These stimulate detrusor muscle contraction and inhibits the sphincter vesicae

Sympathetic fibres originate in L1-L2, descending via the hypogastric plexuses. These close the sphincter vesicae

Somatic – external sphincter. Innervated by pudendal nerve at S2-S4

Question 34

How do the internal and external sphincter control the bladder?

Answer 34

Internal urethral sphincter is controlled by ANS. Normally closed by symp stimulation via hypogastric nerve

External urethral sphincter is skeletal muscle under voluntary control. Innervated by pudendal nerve. It blocks symp innervation so detrusor can contract and relaxation of internal and external sphincters to release urine.