lower urinary tract and male reproductive organs - learn Flashcards
Describe the route taken by the ureters to the bladder
Retroperitoneum –> False pelvis –> True pelvis
State the boundaries of the false pelvis
Iliac crests - pelvic inlet
State the boundaries of the true pelvis
Pelvic inlet - pelvic floor
State the name of the main pelvic floor muscle
Levator ani
The pelvic floor is the boundary between which two structures?
Urethra (part of pelvic cavity)
Perineum (pelvic floor to skin)
Outline the route taken by the ureters to the bladder
Pass anterior to common iliac vessels
- -> Pelvis
- -> At ischial spine turn medially
- -> Posterior bladder and turn INFEROMEDIALLY
Why do the ureters turn inferomedially before entering the bladder?
Prevent reflux of urine to the ureters when bladder contracts
List the pouch(es) present in the male peritoneal cavity
Rectovesical pouch
List the pouch(es) present in the female peritoneal cavity
Pouch of douglas (rectouterine)
Vesicouterine pouch
What is the function of the round ligament in females?
Attaches uterus to perineum via inguinal canal
Which anatomical arrangement is important in hysterectomy?
The ureters are present inferior to the uterine tubes and artery so the uterine artery can be ligated
Arteries entering the pelvis drain into…
Internal iliac artery
Veins draining the pelvis drain into…
Internal iliac vein
List vessels entering the pelvis in females
Vesicular arteries Uterine arteries Middle rectal artery Vaginal artery Uterine tube
List vessels entering the pelvis in males
Vas deferens
Vesicular arteries
Middle rectal artery
Describe the structure of the trigone in the bladder
Triangle in internal bladder
2 ureteric orifices at base (superior)
Internal urethral orifice in floor (inferior)
Which muscle forms most of the bladder wall and encircles ureteric orifices?
Detrusor muscle
Which structure is located inferior to the bladder in males?
Prostate
What is the function of the detrusor muscle in urinary flow?
Tightens when bladder contracts to prevent reflux of urine superiorly into the ureter
What is the function of the detrusor muscle in males specifically?
Forms the internal urethral sphincter - contracts during ejaculation to prevent retrograde ejaculation of semen into the bladder
Which structure is located anterior to the bladder?
Pubic bone
Which structure is located superior to the bladder in females?
Uterus
Which structure is located posterior to the bladder?
Rectum
All of the bladder is covered by peritoneum. True/ False?
False
Only the superior surface is covered
When the bladder is full it extends…
Superior to the pubic bone
State the main catheterisation routes
Urethral (most common)
Suprapubic (through anterior abdominal wall and avoiding peritoneal cavity)
What is the approximate length of the urethra in females?
4cm
What is the approximate length of the urethra in males?
20cm
Outline the lower urinary tract in females from pelvis to perineum
PELVIS: bladder - internal urethral orifice - urethra
(LEVATOR ANI)
PERINEUM: urethra - external urethral sphincter - external urethral orifice
What is the external urethral sphincter?
Voluntary skeletal muscle encircling the urethra
Outline the lower urinary tract in males from pelvis to perineum
PELVIS: bladder - internal urethral orifice - internal urethral sphincter - prostate
(LEVATOR ANI)
PERINEUM: prostatic urethra - external urethral sphincter - spongy urethra - penile urethra - external urethral orifice
What is the internal urethral sphincter?
Involuntary skeletal muscle in bladder neck of males
The testis develop in the _____ and migrate to the ____
Abdomen
Scrotum
List the structures of the spermatic cord and give their function
Testicular artery (oxy. blood to testes) Testicular vein (pampniform plexus) (deoxy. blood from testes) Vas deferens (transport sperm) Lymphatic vessels (drain testes) Autonomic nerves (SM of vas) Somatic nerves (control cremaster muscle)
The testis are contained within…
Tunica vaginalis in scrotal sac
Name the two layers covering the testis
Visceral layer
Parietal layer
The testis are a continuation of the…
Spermatic cord
What is testicular torsion?
Twist of spermatic cord which disrupts blood supply to testis causing severe pain and testicular necrosis
What is a hydrocele?
Fluid in excess in tunica vaginalis
Outline the blood supply to the testis
Abdominal aorta –> Right and left testicular artery
Outline the venous drainage from the testis
Left testicular vein –> Left renal vein –> IVC
Right testicular vein –> IVC
What structure within the testis is involved in the production of sperm?
Seminiferous tubules
Outline the route taken by sperm from testis to urethra
Testis --> Epididymis for storage --> Vas deferens --> Deep inguinal ring --> Inguinal canal Posterior to bladder --> Seminal vesicles --> Ejaculatory ducts (vas deferens and seminal glands) --> Prostatic urethra
Outline the structure of the prostate. Which part is a common site for malignancy?
Peripheral zone (common site for malignancy) Central zone
List the surface anatomy of the penis
Root
Body
Glans
External urethral orifice
Outline the contents of the penis in terms of erectile tissue
3 CYLINDERS OF ERECTILE TISSUE that engorge with blood at onset of erection
(Inferior) Corpus spongiosum
(Superior) Right and left corpus cavernosum
What is the function of the corpus spongiosum tissue?
Transmits spongy urethra and expands distally into the glans
What is the function of the corpus cavernosum tissue?
Transmits deep arteries of penis
Outline the blood supply to the penis
Internal iliac artery –> Internal pudenal artery –> Deep arteries
State the lymphatic drainage for the penis
Superficial inguinal nodes (not glans)
State the lymphatic drainage for the testis
Lumbar nodes
Outline the blood supply to the scrotum
Internal pudenal artery
Branches of external iliac artery
State the lymphatic drainage for the penis
Superficial inguinal nodes
