Lecture 5 cont. : Kidneys, Ureter, Bladder and Posterior abdominal wall

Question 1

Female Urethra

Answer 1

Passes through Deep and Superficial Inguinal/Perineal Pouches
Short and vertical –> required more muscles to slow down and control flow

Question 2

Male Urethra

Answer 2

4x Distinct Regions:
1. Pre-prostatic (still in bladder)
2. Prostatic (in prostate. Many ducts draining into it (e.g. ejaculatory) –> therefore is Widest part)
3. Membranous: Through Deep Perineal Pouch –> thinnest
4. Spongy: through Corpus spongiosum
Note: 2x 90 degree turns –> greater innate control of mechanical urination

Question 3

Lymphatics of the Ureter, Urethra and Bladder

Answer 3

1. Ureter: Lumbar, Common/External/Internal Iliacs (as they descend towards the bladder)
2. Urethra: mainly Internal Iliac nodes (some male/female variation)
3. Bladder: mainly Internal Iliac nodes

Question 4

Components of the Lumbar Plexus

Answer 4

Lateral –> Medial

1. Subcostal n.
2. Iliohypogastric n.
3. Ilioinguinal n.
4. Lateral femoral cutaneous n.
5. Femoral n.
6. Genitofemroal nerve (within psoas. 2x branches)
7. Obturator n.
8. Lumbosacral trunk

Question 5

Features of Illiohypogastric and Illioinguinal nerve

Answer 5

Both L1 (MOTOR AND SENSORY)
Both Motor innervation to Transversus abdominus and Internal Oblique
1. Illiohypogastric:
a) Sensory: Lateral Gluteal + Pubic Skin (superior)
b) Motor: Transverse abdominus + Internal Oblique
2. Ilioinguinal:
a) Sensory: Skin of medial thigh, root of penis/scrotum/mons pubis/labia majora
b) Motor: Transverse abdominus + Internal Oblique

Question 6

Course of Illiohypogastric and Illioinguinal nerve

Answer 6

Lateral to Psoas –> obliquely ontop of Quadratus Lumborum –> Pierces Transversus Abdominus –> enter neurovascular plane
Note: Hypogastric is superior to inguinal
Note: Illioinguinal –> pierce Internal oblique –> enter inguinal canal –> accompany spermatic cord and enter superficial inguinal ring