Male Pathophys 3 Flashcards
Cell types from the bottom up in a urinary bladder?
Basal cells, intermediate cells, umbrella cells
Three layers of the wall of the ureter are?
Mucosa, muscularis, adventitia
Remember that the ureter is not a passive structure. Peristaltic contraction of its muscle layer propels the urine
ok
The two most common primary tumors of the ureter are?
fibroepithelial polyps and leiomyomas
Really there are two sorts of ways that the ureter may stop operating properly
1) Physically blocked
2) Some sort of neurogenic cause that prevents peristalsis from occuring
Sclerosing retroperitoneal fibrosis
Fibrous proliferative inflammatory process, encasing the retroperitoneal structures including the URETER and causing COMPRESION OF THE URETER. Rare disease, middle to late age. Can be related to drugs like ergot derivatives, beta blockers, and diseases like Crohns
Endometriosis
Presence of endometrial tissue outside of the uterus. Most commonly found on organs adjacent to the uterus (fallopian tubes, ovaries, etc..) The interesting thing about endometriosis is that it is responsive to hormones and therefore is characterized by cyclic bleeding and menstrual related pain
Regarding the ureters, you can get cyclical hydronephrosis if the endometriosis is compressing the ureters somehow
Ureteritis cystica
Only develops with longstanding ureteritis.
The accumulation of lymphocytes in the subepithelial layer may produce a fine granularity of the mucosa- ureteritis follicularis
Ureter can develop cysts filled with clear yellow fluid- ureteritis cystica
Chronic obstruction of the bladder results in hypertrophy of its muscle. Trabeculation of the bladder wall develops.
Diverticulum may form and why is this problematic?
May lead to infection
Eventually this process affects kidneys
Exstrophy?
Developmental defect of closure of the anterior wall of the abdomen and bladder so that the bladder communicates with the exterior of the body as a large defect or as an open sac.
Its often related with other GU abnormalities and may lead to increased incidence of malignancy
Urachus
danger of adenocarcinoma
Cystocele
Protrusion of the bladder into the vagina creating a pouch. It’s caused by uterine prolapse which pushes the bladder down.
Ureter enters the bladder normally at an acute angle. This is great design, because when the bladder fills up it shuts of the ureters so that urine can’t flow back up into the kidney.
ok
Malakoplakia
KNOW IT…Inflammatory disorder
Malakoplakia
Soft yellow 3-4 cm mucosal plaques composed of closely packed, large, foamy macrophages with occasional giant cells and interspersed lymphocytes.
Macrophages contain PAS + granules filled with bacterial debris.
Michaelis-Gutmann bodies: laminated mineralized concretions within and between macrophages.
Most likely represents a defective host response to bacterial infection, usually from gram-negative bacilli (E. coli, Proteus, etc.)
Strictures of the ureter can be acquired or congenital. Examples of acquired strictures are:
chronic inflammations and/or sclerosing retroperitoneal fibrosis
What is salpingitis
inflammation of the fallopian tube
Diverticulitis
inflammation of the intestinal diverticulum and surrounding tissues
What is peritonitis
inflammation of the peritoneum
Ureteropelvic junction obstruction
Usually in boys, usually on the left, abnormal organization or excess stromal collagen between smooth muscle bundles. Leads to hydronephrosis