LUT- Intro

Question 1

Despite differing embryonic origins, the various components of the lower urinary tract have
many morphologic similarities.

The renal pelves, ureters, bladder, and urethra (save for its
terminal portion) are lined by a special form of_______________

Answer 1

** transitional epithelium (urothelium).**

Question 2

The surface layer consists of large, ____________with abundant cytoplasm that horizontally cover several underlying cells.

Answer 2

flattened “umbrella cells”

Question 3

The umbrella cells have a trilaminar asymmetric unit membrane and possess apical plaques composed of specific proteins called _____________

Answer 3

uroplakins.

Question 4

The underlying
urothelium is composed of several layers of cells with ____________________-

Answer 4

oval smaller nuclei often with linear
nuclear grooves and less cytoplasm.

Question 5

This epithelium rests on a well-developed basement
membrane, beneath which is a____________-

Answer 5

** lamina propria**.

Question 6

The lamina propria in the urinary bladder
contains wisps of _____________.

Answer 6

smooth muscle that form a discontinuous muscularis mucosae

Question 7

It is important
to differentiate the muscularis mucosae from the deeper well-defined larger muscle bundles of
the detrusor muscle (muscularis propria), because ____________________

The bladder musculature is capable, with obstruction to the flow of urine,
of great thickening.

Answer 7

• *since bladder cancers are staged** on the basis of
• *invasion of the latter. **

Question 8

The ureters lie throughout their course in a _________________position.

Answer 8

retroperitoneal

Question 9

______________may trap the ureters in neoplastic or dense, fibrous tissue, sometimes obstructing them.

Answer 9

Retroperitoneal tumors or
fibrosis

Question 10

As ureters enter the pelvis, they pass anterior to either the ________________

Answer 10

common iliac or the external iliac
artery.

Question 11

In the female pelvis they lie close to the ____________

Answer 11

uterine arteries and are therefore vulnerable to
injury in operations on the female genital tract.

Question 12

There are three points of slight narrowing—__________________________
—all providing loci where renal calculi may become impacted when they pass from the kidney to
the bladder.

Answer 12

• at the ureteropelvic junction,
• where they enter the bladder,
• and where they cross the iliac vessels

Question 13

As the ureters enter the bladder they pursue an oblique course, terminating in a
slitlike orifice.

The __________________ of the ureteral orifice **permits the
enclosing bladdermusculature to act like a sphincteric valve, blocking the upward reflux of urine
even in the presence of marked distention of the urinary bladder.**

As discussed in Chapter 20 ,
a defect in the intravesical portion of the ureter leads to vesicoureteral reflux.

Answer 13

obliquity of this intramural segment

Question 14

The close relationship of the female genital tract to the bladder makes possible the spread of
disease from one tract to the other

. In middle-aged and elderly women, relaxation of pelvic
support leads to prolapse (descent) of the uterus, pulling with it the floor of the bladder.

In this fashion the bladder is protruded into the vagina, creating a pouch (cystocele) that fails to empty
readily with micturition.

In males the seminal vesicles and prostate have similar close
relationships, being situated just posterior and inferior to the neck of the bladder.

Thus,

• *enlargement of the prostate**, so common in middle to later life, constitutes an important cause of
• *urinary tract obstruction**.

In the subsequent sections we discuss the major pathologic lesions in
the ureters, urinary bladder, and urethra separately.