PBL questions Flashcards
male urinary system
shares common pathway with reproductive system
urethra passes through penis and is 10-15cm long
what does the male urethra pass through?
prostate
internal and external sphincters
urogenital diaphragm
cowper’s gland
female urinary system
doesn’t share common pathway with reproductive system - only close proximity
urethra only functions to excrete urine and is 3-4cm long
higher risk of UTIs due to proximity to vagina and anus
female urethra
extends from neck of bladder, internal and external sphincters and urogenital diaphragm
shape of the bladder
when full oval-shaped
when empty it is flattened by the bowel
parts of the bladder
apex body fundus neck trigone
what is the trigone?
smooth walled area that marks the entry of ureters and exit of urethra
origin of trigone
mesonephric ducts
muscle of the bladder
detrusor muscle - specialised smooth muscle
fibres run in multiple directions
innervations of the bladder
sympathetic and parasympathetic
muscular sphincters
2 - internal and external urethral sphincters
internal urethral sphincter
differs in males and females
male internal urethral sphincter
consists of circular smooth fibres under autonomic control
female urethral sphincter
formed by the anatomy of the bladder neck and proximal urethra
no sphincteric muscle present
external urethral sphincter
same structure in both sexes
skeletal muscle under voluntary control
however, more complex in males
arterial blood supply to bladder
derived from internal iliac vessels
superior vesical branch
obturator and inferior gluteal arteries may contribute small branches
arterial supply to female bladder
superior vesical branch is supplemented by vaginal arteries
arterial supply to male bladder
superior vesical branch is supplemented by inferior vesical artery
venous drainage of bladder
vesical venous plexus
drains into internal iliac veins
nervous supply of bladder
autonomic and somatic
autonomic supply to bladder
sympathetic and parasympathetic
sympathetic innervation of bladder
hypogastric nerve
hypogastric nerve root
T12-L2
what does the hypogastric nerve do?
relax the detrusor muscle
promotes urine retention
parasympathetic innervation of bladder
pelvic nerve
pelvic nerve root
S2-4
what does the pelvic nerve do?
causes contraction of detrusor muscle and stimulates micturition
somatic innervation to bladder
pudendal nerve
pudendal nerve root
S2-4
sensory nerves to bladder
report to brain from bladder wall to signal when the bladder is full
bladder stretch reflex
micturition is stimulated in response to stretch of the bladder wall
how does the bladder stretch reflex work?
bladder fills with urine
walls stretch
sensory nerves detect stretch and transmit to spinal cord
interneurons relay signal to parasympathetic efferent nerves - pelvic nerve
contracts the detrusor muscle
stimulates micturition
when does the bladder reflex occur?
only functional in childhood
what are the normal parameters for urine output?
1L/ day
ranges from 800-2000ml/ day with 2L fluid intake / day
what happens in a routine health check?
helps to tell you if you are at a higher risk of getting certain serious health problems
what health problems does the routine health check focus on?
heart disease diabetes kidney disease stroke dementia (if over 65)
when is the routine health check carried out?
every 5 years for those between 40 and 74
what is involved in the routine health check?
full medical history questions about lifestyle family history measure height and weight BP blood test receive personalised advice medications for BP and cholesterol prescribed if necessary lifestyle advice
common renal system diseases
acute and chronic kidney failure/ disease congenital malformations - PKD UTIs urinary retention bladder incontinence
