March 14

Question 1

What is the relationship of the ureters to the peritoneum?

Answer 1

Abdominal parts of ureters adhere closely to the peritoneum and are retroperitoneal throughout their course

Question 2

How does urine move through the ureters?

Answer 2

Via peristalsis

Question 3

Which arteries does the common iliac artery divide into? At which vertebral level does this happen?

Answer 3

L4

Question 4

What is the relationship of the ureters with the common iliac arteries?

Answer 4

They pass over the pelvic brim at the bifurcation of the common iliac arteries

Question 5

What is the relationship of the ureters with the internal iliac arteries?

Answer 5

Ureter lies anterior and parallel to the internal iliac artery

Question 6

At the level of the ischial spine, what direction do the ureters take to enter the bladder?

Answer 6

Anterio-medially

Question 7

What is the direction of the ureters through the muscular wall of the bladder?

Answer 7

Inferior-medially

Question 8

Which blood vessels supply the pelvic part of the ureters? What is the most common variant of blood supply to the female ureter? What is the most common variant of blood supply to the male ureter?

Answer 8

• Common iliac and internal iliac artery
• Female = Uterine artery (most common); vaginal artery (next common)
• Male = Inferior vesical artery

Question 9

List the plexuses which innervate the ureters.

Answer 9

Autonomic = Renal, aortic, superior and inferior hypogastric

Question 10

What is the relationship of the urinary bladder to the pubic bone?

Answer 10

Anterior portion of the bladder is directly superior to the pubic bone

Question 11

What is in between the bladder and pubic bone.

Answer 11

Retro-pubic space

Question 12

Which ligament holds the male bladder in place and what does it attach to?

Answer 12

Held in place by puboprostatic ligament and neck of bladder

Question 13

Which ligament holds the female bladder in place and what does it attach to?

Answer 13

Held in place by pubovesical ligament and neck

Question 14

Which muscle is the wall of the bladder composed of?

Answer 14

Detrusor muscle

Question 15

How high can a full bladder ascend?

Answer 15

Full bladder can ascend all the way up to the level of the umbilicus

Question 16

In the male bladder, what do the muscle fibers form at the neck?

Answer 16

Towards neck of bladder, the detrusor muscle fibers form the involuntary internal urethral sphincter

Question 17

Which ligament attaches to the apex of the bladder?

Answer 17

The median umbilical ligament

Question 18

Which sphincter contracts during ejaculation? What does this prevent?

Answer 18

Internal urethral orifice (sphincter)  contracts during the ejaculation of sperm to prevent retrograde ejaculation of semen into the bladder

Question 19

Describe the trigone of the bladder. Where is the trigone located?

Answer 19

• Where the ureters enter the inferior part of the bladder and the point where the urethra leave the under-side of the bladder, the three points make a triangle shape called the trigone
• Location = base/inferior part of the bladder

Question 20

The arteries that supply the bladder are branches of which artery?

Answer 20

Internal iliac artery

Question 21

Which arteries supply the superior part of the bladder?

Answer 21

Superior vesical artery

Question 22

Which arteries supply the inferior part of the bladder in males?

Answer 22

Inferior vesical artery

Question 23

Which arteries supply the inferior part of the bladder in females?

Answer 23

Vaginal artery

Question 24

List all of the arteries which supply the bladder.

Answer 24

• Obturator artery
• Inferior gluteal arteries
• Superior Portion = Superior vesical artery
• Inferior Portion = Inferior vesical artery (M) and Vaginal artery (F)

Question 25

In the male, which veins drain the bladder and which structures do they drain into?

Answer 25

• Deep dorsal veins of the penis drain into the prostatic venous plexus
• The prostatic venous plexus is continuous with the vesical venous plexus of the bladder which both drain into inferior vesical veinsNext, they drain into the internal iliac veins OR the sacral veins which then drain into the internal vertebral plexus

Overview:

• Deep dorsal vein of penis
• Prostatic venous plexus + Vesical venous plexus
• Inferior vesical veins
• Internal iliac veins OR Sacral veins
• Internal vertebral venous plexus

Question 26

In females, which veins drain the bladder and which structures do they drain into?

Answer 26

• Dorsal vein of clitoris
• Vesical venous plexus
• Vaginal OR uterovaginal venous plexus

Question 27

In females, which blood vessels supply the urethra?

Answer 27

• Internal pudendal

- Vaginal pudendal

Question 28

In males, which blood vessels supply the prostatic urethra? Which blood vessels supply the intermediate and spongy urethrae?

Answer 28

Prostatic urethra
- Prostatic branches of inferior vesical and middle rectal arteries

Intermediate and spongy urethra
- Internal pudendal artery

Question 29

In females, what is the innervation of the urethra?

Answer 29

• Vesical plexus
• Pudendal nerve
• Pelvic splanchnic nerves

Question 30

In males, what is the innervations of the urethra?

Answer 30

Prostatic nerve plexus (extension of the inferior hypogastric plexus)

Question 31

Which spinal segments are involved in composition of the pudendal nerve?

Answer 31

S1-S4

Question 32

Identify similarities and differences in vasculature and innervation between the male and female bladder.

Question 33

Identify similarities and differences in vasculature and innervation between the male and female ureter.

Question 34

Identify similarities and differences in vasculature and innervations between the male and female urethra.