Lower Urinary System Flashcards
Where does most pathology occur in the urinary bladder?
Inner mucous membrane
How long are the ureters?
Typically 30cm
What’s the average diameter of the ureters?
6mm
Where does constriction typically occur?
A) UPJ (ureteropelvic junction)
B) UVJ (uterovesical junction)
C) Both
Both
How long is the male urethra? How long is the female urethra?
Male: 20cm
Female: 3-4cm
The voiding of urine is called:
Micturition
Stress Incontinence (most common, etiology)
THE most common pissing abnormality and happens in a large percent of postmenopausal women.
Etiology: genuine stress incontinence, detrusor instability, voiding difficulty (so piss build up, overflow)
What is the average bladder wall thickness?
Less than 3mm when fully distended, up to 5mm when almost empty
Where do the ureter jets appear?
At the UVJ
What are the 3 types of duplication bladder?
- Peritoneal fold
- Septum dividing bladder sag/coronally
- Transverse band of muscle diving bladder into two uneven cavities
Duplication: Ureter (list two types, most common in, unilateral or bilateral?)
Incomplete: bif. of ureter at or near renal pelvic and unites between kidney/bladder to enter bladder as ONE ureter
Complete: two separate renal collecting systems (think Emma), two separate ureters
Most common in: women
Can be either unilateral or bilateral!
Duplication of the urethra
Uncommon and almost exclusively in males, associated with duplication of bladder and genitalia
What is Diverticula: Bladder?
Outpouching of bladder wall. Either congenital or aquired.
Hutch’s diverticulum: ureteral insertion at a weak point in the bladder wall
Complications: intradiverticular tumours and stones, random rupture
Name the SA for the diverticula bladder.
Anechoic outpouching with thin wall/acoustic enhancement.
Connected to bladder via a narrow neck.
CD shows flow in both directions between bladder and pouch
Diverticula may not empty and may increase in size.
Diverticula: Urethra
Well seen in women.
Complications: stone formation, cancer
SA: simple or complex collection of fluids intimately related to urethra
What is the most common bladder outlet obstruction?
Posterior Urethral Valves (PUV)
What is the most common cause of urinary obstruction in baby boys?
Posterior Urethral Valves
Describe Bladder Exstrophy
A defect causes a separation of the pubic symphysis. Mucosal edges of the bladder and distal ends of the ureters fuse with skin protruding through the lower central abdo wall.
Ectopic Ureter (etiology, most common location)
Etiology: embryologic error in development
Most commonly arises from the sup. pelvic of a duplex kidney and so it inserts lower and more towards the middle of the base of the bladder
The ureter arise/insert in a weird location so it can cause hydroureter
Describe a Ureterocele (etiology, complication, SA)
Cyst like enlargement of the lower end of the ureter.
Etiology: congenital or acquired stenosis of the distal ureter
Complications: hydroureter, hydronephrosis, and infection proximally), may obstruct a thing
SA: round oval thin walled cystic structure on the POSTERIOR wall of where we expect the distal ureteral orifice, can change shape/size depending on UVJ pressure
What are the 4 types of Urachal Variants? (And which is the most common?)
- Patent urachus or fistula (most common) (hypoechoic tract superior to the bladder extending to umbilicus, may have fluid on either end)
- Urachal cyst (both ends close trapping urine in canal)
- Urachal sinus (closes at bladder but not umbilicus)
- Urachal diverticulum (closes at umbilicus but not bladder)
What is an ‘embryonic tract that forms as the bladder begins its descent from the umbilicus into the pelvis in the fetus’?
Urachus
What is the closed urachus referred to in adults as?
Median umbilical ligament
What is Cystitis?
Bladder infection!!! Occurs most commonly in women due to the shorter urethra and proximity of pee hole opening near vagina and anus)
