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anatomy GU > LEC 2 > Flashcards

LEC 2 Flashcards

1
Q

there are three constrictions along the course of the ureter, where stones may be arrested, namely

A

a. At pelviureteral junction
b. Where it crosses pelvic brim
c. Where it passes through muscular wall of bladder

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2
Q

Anterior Relations of Right Ureter

A
  1. 2nd part and beginning of 3rd part of duodenum
  2. Near superior aperture of lesser pelvis, it is related to lower part of root of mesentery of small intestine and terminal part of ileum
  3. crossed by right colic, ileocolic, and right gonadal vessels
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3
Q

Anterior Relations of Left Ureter

A
  1. It is crossed by left colic and gonadal vessels

2. Near the SUPERIOR aperture of lesser pelvis, it is related to sigmoid colon and mesocolon

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4
Q

Posterior Relations of ureters

A
  1. Psoas major muscle separates the ureter from the transverse processes of LUMBAR vertebrae
  2. common iliac artery
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5
Q

Arterial Supply of ureters

A
  • Upper part Renal artery.
  • Middle part Gonadal artery.
  • Lower part Superior vesical artery.
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6
Q

Lymph Drainage or ureters

A

To lateral aortic and iliac lymph nodes

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7
Q

Nerve Supply of the ureter

A

Abdominal part: Renal & gonadal plexuses
Pelvic part: Sup. & inf. Hypogastric plexuses.
Visceral afferent fibers: Enter the spinal cord
at segment T 11 & 12 and L 1 & 2

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8
Q

When a stone enters lower part of ureter colicky pain is felt at ————- and is referred to ———

A

lower level and is often referred to testis and/or tip of penis or labium majus in female

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9
Q

Renal colic due to stone in renal pelvis or upper part of ureter Colicky pain referred to

A

skin areas that are supplied by these segments of spinal cord ( loin, groin, flank)

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10
Q

Sometime pain caused by stones is referred along———— nerve, which will be felt in the ————-

A

femoral branch of genitofemoral (L 1 and 2)

upper part of the front of the thigh

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11
Q

The pain is often sever that afferent pain impulse spread within CNS, giving rise to ———-

A

nausea

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12
Q

Colicky pain is due to

A

spasm of smooth muscle

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13
Q

The wall of the ureter consists of three

coats

A
  1. Outer fibrous coat Is continuous with the fibrous capsule of the kidney in the renal sinus.
  2. Middle muscular coat
  3. Inner mucous coat Continuous with the mucous membrane of bladder
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14
Q

Middle muscular coat :
In the upper two thirds of ureter this coat is made
up of ———-
In the lower third ————-

A
  • outer circularly smooth muscle + inner longitudinal

- the ureter acquires an additional outer longitudinal layer of smooth muscle

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15
Q

Inner mucous coat of ureter Present———————folds

A

5-6 longitudinal

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16
Q

Inner mucous coat of ureter Consists of ———–lined by———

A

lamina propria–> has many elastic fibers

transitional epithelium–>4-5 cells thick

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17
Q

apex is connected to umbilicus by ————Which is the fibrous remains of the ———–

A

median umbilical ligament

embryonic urachus

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18
Q

Empty bladder is located within ————-

A

pelvic cavity, immediately behind pubic bones

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19
Q

The superior wall of a distended bladder may rises up into

A

hypogastric region

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20
Q

Maximum capacity of the bladder is about

A

500 ml

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21
Q

the neck lies behind

A

lower part of symphysis pubis.

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22
Q

the neck rest on
male ——
female ——

A

male–> rests on superior surface of prostate

female –> rests on pelvic fascia

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23
Q

does the peritoneum cover the bladder

A

only the superior surface

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24
Q

the relation btw ureter and peritoneum

A

retroperitoneal

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25
Q

the bladder is related superiorly to
male ———–
female ———-

A

male-> to terminal coils of ileum and to sigmoid colon

female –> The posterior part of superior surface is related to uterus

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26
Q

The space between the superior surface of bladder and uterus is known as the ———

A

uterovesical pouch

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27
Q

Posterior surface of bladder Is related in male to—– but separated from it

  • above–>
  • below –>
A
  • rectum
  • rectovesical pouch of peritoneum
  • two vas deferens, two seminal vesicles, and rectovesical fascia
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28
Q

posterior surface of bladder In female, is separated from rectum by

A

vagina

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29
Q

inferolateral surface Anterior part is separated from pubic bones by

A

retropubic pad of fat

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30
Q

inferolateral surface of bladder posterior part lies in contact above with——- and bellow with ——-

A

obturator internus muscle and below with levator ani muscle with their covering fascia

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31
Q

Lateral and medial puboprostatic ligaments (male)

or pubovesical ligaments (female) Connect bladder to

A

pubic bone

32
Q

Vesical Ligaments

A 
1- Lateral and medial puboprostatic ligaments
or pubovesical ligaments
2- Median umblical ligament
3- Lateral true ligaments
4- Posterior ligaments
33
Q

Median umblical ligament

Connects bladder to

A

umbilicus

34
Q

Lateral true ligaments Connects side of bladder to the

A

tindinous arch of the pelvic fascia

35
Q

Posterior ligaments Envelops on each side ———— that extends to ————–

A

vesical venous plexus and extends from posterior wall of bladder to internal iliac vein

36
Q

Intraperitoneal rupture of bladder Usually involves

A

superior surface when the bladder is extended and full

37
Q

Intraperitoneal rupture results in

A

urine escapes freely into peritoneal cavity

38
Q

Extraperitoneal rupture Involves

A

anterior wall

39
Q

Extraperitoneal rupture could be a result of

A

fractures of pelvis

40
Q

In extraperitoneal rupture there is in most patients a

A

lower abdominal pain and hematuria

41
Q

The area of mucous membrane covering internal surface of posterior wall of bladder is known as

A

trigone of bladder

42
Q

does the trigon has rugae ?

A

mucous membrane is always smooth

even when bladder is empty

43
Q

The two posterolateral angle of the trigon contain the

A

two ureteral opening

44
Q

the anteromedial angle of the trigon contains

A

the opening of the urethra (internal urethral

opening),

45
Q

Blood Supply of Urinary Bladder

A
  • Superior and inferior vesical arteries
  • Veins form a complicated venous plexus on
    the inferolateral surface called vesical
    venous plexus, which drains on each side
    into internal iliac vein
46
Q

nerve supply of bladder

A

From inferior hypogastric plexus :
1- sympathetic -> Preganglionic fibers from L 1 and 2
–> enter 1 st and 2 nd lumbar sympathetic ganglia –> postganglionic descend through the hypogastric nerve plexus to reach bladder

2- Parasympathetic nerve fibers Preganglionic fibers (pelvic splanchnic nerves), which arise from the S 2+3 +4–>descend through inferior hypogastric plexus –>
Postganglionic fibers supplied bladder

3- Visceral afferent fibers enter S 2+3+4 segments of
spinal cord via the pelvic splanchnic nerves

However some of afferent fibers pass
through hypogastric plexus to enter L 1 and 2
segments of spinal cord

47
Q

what is the sympathetic and parasympathetic action on the bladder

A

Sympathetic nerves
Inhibit contraction of detrusor muscle of
bladder wall and stimulate closure of
sphincter vesicae

Parasympathetic
nerves Stimulate contraction of detrusor muscle and inhibit action of the sphincter vesicae

48
Q

Lymph Drainage of Urinary Bladder

A

Drains into the internal and external iliac lymph nodes

49
Q

The wall of bladder is composed of three coats and their components

A

(1 )Outer serous or peritoneal coat Covers only superior surface of bladder

(2) Middle muscular coat (detrusor muscle ) -> outer and inner longitudinal , middle circular

(3)Inner mucous coat –>The mucosa consists of transitional epithelium and a lamina propria of loose to
dense connective tissue

50
Q

which muscle forms the internal urethral sphincter

A

At neck of bladder, circular layer forms internal urethral sphincter, which surrounds internal urethral orifice

51
Q

how much is the thickness of the distended bladder and the empty

A

The transitional epithelium of in the un
distended state is 5 6 cells in thickness

When bladder is full of urine, the epithelium
is only 3 4 cells in thickness

52
Q

how does the shape of cells change from distended to empty bladder

A

empty :
The cells of basal layer are cuboidal in
form, while those of intermediate layers are more columnar.
the surface layer made of dome shaped (umbrella) cells

distended :
the superficial cells become squamous

53
Q

female urethra at Its lower end pierces

A

perineal membrane

54
Q

the external urethral sphincter is located

A

above the perineal membrane encircled by striated muscles

55
Q

the widest part of the male urethra is

A

prostatic urethra

56
Q

On each side of the urethral crest, there is a shallow depression

A

the urethral or prostatic sinus

57
Q

the urethral or prostatic sinus floor is perforated by

A

orifices of prostatic ducts

58
Q

about middle of urethral crest we have ——– on which slit like orifice of ———— is situated

A

the seminal colliculus

prostatic utricle

59
Q

On each side of the orifice of the prostatic

utricle, there is opening of the

A

ejaculatory ducts

60
Q

where does the bulbourethral glands lie

A

above perineal membrane, one on each side posterolateral to the membranous urethra

61
Q

where does the bulbourethral duct lie

A

The duct of each gland pierces perineal membrane to open into proximal part of penile urethra, about 2.5 cm below perineal membrane.

62
Q

The part of the urethra that lies within glans penis is dilated to form

A

the Navicular fossa or fossa terminalis

63
Q

Penile (Spongy) Urethra traversed bulb of
penis——— and opens on
summit of ——— as —————

A

corpus spongiosum
glans penis
external urethral meatus

64
Q

what is the narrowest part of urethra

A

The external urethral orifice or meatus

65
Q

Sphincter Urethrae Muscle (External Urethral Sphincter) Composed of ————— surrounds ————

A

circular striated muscle fibers that surrounds the membranous part of the urethra

66
Q

Sphincter Urethrae Muscle (External Urethral Sphincter) is supplied by

A

pudendal nerve

67
Q

Sphincter Vesicae Muscle (internal Urethral Sphincter) Composed of

A

non striated circulatory muscles surrounds the internal urethral orifice at neck region of bladder

68
Q

Sphincter Vesicae Muscle (internal

Urethral Sphincter) is innervated by

A

sympathetic nervous

system

69
Q

The wall of female urethra consists of

A

mucosa, which Is folded,

surrounded by a muscular coat

70
Q

the mucosa of female urethra is lined by

A

Near neck of bladder the urethra is lined by transitional epithelium

The remaining part of the urethra is lined by non keratinizing stratified squamous epithelium

71
Q

The two paraurethral glands in females correspond to———– in males

A

prostatic gland

72
Q

The mucous membrane of urethra in females is much folded and contains a number of mucous glands called

A

skene’s glands

73
Q

paraurethral glands open by way of long

ducts on

A

either side of external urethral orifice

74
Q

the muscular coat of the female urethra consists of

A

internal longitudinal and external circular fibers

75
Q

The wall of the male urethra consists of which type of cells

A

The prostatic urethra is lined by transitional epithelium

The remaining part of male urethra is lined by stratified or pseudostratified columnar epithelium, but there may be many patches of stratified squamous epithelium

The fossa terminalis is completely lined by stratified squamous epithelium

anatomy GU (11 decks)

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