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Endo Test 2 > Pelvic urinary tract and rectum anatomy > Flashcards

Pelvic urinary tract and rectum anatomy Flashcards

1
Q

where does bladder lie?

A

behind pubic symphysis

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2
Q

apex of bladder? what arises here?

A

lies directly superior to pubic symphysis, most anterior portion of bladder
- median umbilical ligament (urachus) arises here

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3
Q

where does ureter enter bladder?

A

superior-lateral edges

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4
Q

where is bladder related to in males posteriorly?

A
  • rectum, ductus deferens, seminal vesicles
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5
Q

where is bladder related to in females posteriorly?

A

cervix and upper vagina

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6
Q

trigone

A

prevents retrograde urine glow and helps compress ureter within bladder wall

  • area between the orifices of the ureters superiorly and internal urethral orifice inferiorly
  • sympathetically innervated
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7
Q

arterial supply of bladder?

A
  1. superior vesical aa. from umbilical a. (major supplier)
  2. middle vesical aa.
  3. inferior vesical aa.
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8
Q

venous drainage of bladder?

A
  • drains into dense venous plexus around base/neck
  • prostatic venous plexus in males
  • vesico-vaginal plexus in females
  • these drain to deep dorsal v. of penis and internal iliac v.
  • ** important with prostatic cancer***
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9
Q

vascular supply of pelvic ureter?

A

common iliac a.
internal iliac a.
vasiculodeferential a. (male)
uterine/inferior viscal aa. (female)

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10
Q

where does pelvic ureter cross?

A

crosses iliac vessels anteriorly

- however, in females, the uterine a. also crosses the ureter anteriorly

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11
Q

uretal orifices

A
  • where ureter opens into bladder at superior-lateral angles
  • there are no valves
  • pressure on bladder wall closes intramural ureters during distension and empyting of the bladder
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12
Q

what are the four parts of the male urethra?

A
  1. intramural portion: from bladder to upper portion of prostate
  2. prostatic: portion passing through prostate
  3. membranous: portion passing through UG diaphragm
  4. penile: portion from inferior surface of UG diaphragm
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13
Q

where are two luminal dilations of male penile urethra?

A
  • bulb of penis

- glans of penis

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14
Q

external urethral orifice

A

“meatus”

- opening thu glans penis

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15
Q

what are 2 glans that open into penil urethra?

A
  1. bulbourethral (Cowper’s gland): opens into bulbar portion

2. urethral glands: small glands located throughout spongy body

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16
Q

what are two portions of female urethra?

A
  1. superior: similar to male prostatic urethra

2. membranous: pierces UG diaphragm

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17
Q

what vertebral level does rectum originate at?

A

3rd sacral vertebra at the rectosigmoid junction
- can be distinguished from sigmoid colon because it lacks mesocolon, teniae coli are spread out and surround the entire rectum.

18
Q

two curvatures of the rectum?

A
  1. rectum proper: from origination to perineal flexure

2. anal canal: from perineal flexure to anus

19
Q

anatomical vs. clinical anal canal

A

anatomical: from level of upper surface of pelvic diaphragm to anus
clinical: from pectinate line to anal verge

20
Q

what portion of rectum contains peritoneum

A

ventral rectum

21
Q

layers of rectum?

A
  1. muscular layer:
    - outer longitudinal mm. - blend with fibers of levator ani at anal region
    - inner circular mm: thickened to form internal anal sphincter
  2. submucosal layer
  3. mucosal layer
22
Q

Plica transversales

A

transverse rectal folds

3 folds: two left, one right

23
Q

rectal columns:

A

mucous membrane overlying submucosal aa. and vv.

24
Q

anal valves

A

archlike folds of mucous membrane connecting caudal ends of rectal columns

25
Q

pectinate line

A

line formed by anal valves and rectal columns
dividing line for :

  1. venous drainage:
    - superior drains to middle and superior rectal vv.
    - inferior drains to inferior rectal vv.
  2. lymphatic drainage:
    - superior to pelvic nodes
    - inferior to inguinal nodes
  3. nerve supply:
    - superior to autonomic nn.
    - inferior to somatic nn.
  4. eptithelial lining
26
Q

pecten

A

stritified squamous non-keritonized

- area immediately below pectinate line

27
Q

anal verge

A

stratified sqamous keritonzsed

- caudal-most portion of anal canal

28
Q

superior rectal a.

A
  • branch from IMA
29
Q

middle rectal a.

A
  • usually branches from internal iliac anterior division
30
Q

inferior rectal aa.

A

from internal pudendal a.

31
Q

what comes off posterior trunk of internal iliac?

A
  1. ilolumbar: supplies psoas/quadratus/iliacus m.
  2. lateral sacral aa.
  3. superior gluteal a.
32
Q

what comes off anterior trunk of internal iliac a. ?

A 
umbilical a. 
middle rectal 
inferior rectal
obturator 
internal pudendal a. 
inferior gluteal a. 
uterine and vaginal a. 
vesiculodeferential a.
33
Q

what are two pelvic vessels that don’t arise from internal iliac a?

A
  1. middle sacral a: arises from aorta along anterior surface of sacrum
  2. superior rectal a: branch from IMA
34
Q

what makes up the lumbosacral plexus?

A
  1. lumbar plexus: ventral rami L1-4

2. sacral plexus: ventral rami L4-S3

35
Q

what are five major nerves forming from lumbosacral plexus?

A

Anterior divisions: (supply flexors)

  • obturator n.
  • tibial n.(medial and lateral plantar n)

Posterior divisions:(supply extensors)

  • common fibular n.
  • femoral n.
36
Q

general path of lymphatic drainage?

A 
internal iliac nodes →
			external iliac nodes →
				common iliac nodes →
					lumbar nodes →
						cisternachyli →
							thoracic duct
37
Q

lymphatics of urinary bladder?

A

drain to external iliac nodes laterally
internal iliac nodes
sacral and common iliac nodes

38
Q

where do lymphatics of rectum drain?

A

below pectinate line - drain to superficial inguinal
above pectinate line - parallel course of major arteries:

  • from rectal ampulla and sup. anal canal
    along inf. rectal artery to internal iliac nodes
  • from most of rectum via pararectal nodes along middle rectal artery to internal iliac nodes
  • from area of rectosigmoid junction along sup. rectal artery to inf. mesenteric nodes
39
Q

male genitalia lymphatic drainage?

A

external iliac nodes
both int. & ext. iliac nodes
sacral & common iliac nodes

40
Q

prostate lyphatics?

A

sacral nodes posteriorly and internal iliac nodes laterally

41
Q

female genitalia lymph drainage?

A
  • drain along ovarian vessle to lumbar nodes
42
Q

where does parietal vs. visceral lymphatic drainage occur?

A 
parietal – drain body wall 
		lumbar nodes
visceral – drain GI organs
		inf. mesenteric nodes
		sup. mesenteric nodes
		celiac nodes

Endo Test 2 (10 decks)

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