Pelvic Viscera Flashcards
The ureter is a 25-30 cm muscular tube spanning from the _________ to __________
from kidney to urinary bladder
what is the function of the ureter?
to convey urine from kidney to urinary bladder for temporary storage prior to voiding
how is urine moved every 15 seconds in the ureter?
peristalsis
is the urerter retroperitoneal?
yes, along entire course
Where is the ureter located in the cavity?
superiorly in the abdomen, inferiorly in the pelvis
The pelvic part of the ureter begins when it crosses what?
external iliac a
How does the ureter enter the urinary bladder?
pass along lateral pelvic wall to enter inferior aspect of urinary bladder, enter urinary bladder by passing obliquely thru inferomedial wall
What part of the ureter is compressed shut as urinary bladder fills?
intramural section
What happens when the urinary bladder contracts in regards to the ureter?
utere opening is constricted and prevents urine reflux
What is the aterial supply to pelvic part of ureter in female?
uterine a, branch from internal iliac a
what is the aterial supply to pelvic part of ureter in male?
inferior vesicle a which branches from internal iliac a
What is the innervation of pelvic part of ureter?
sympathetic T11-L2 via renal, aortic, hypogastric plexuses
Afferent pain fibers from the ureter go where?
follow sympathetics retrogradely to coresponding spinal ganglia and spinal cord segments
Where can referred pain of the ureter go?
T11-L2 dermatomes, pain usually refers to ipsilateral lower quadrant of abdomen and groin
What is a strong, muscular vesicle with remarkable capacity for distensibility?
urinary bladder
what is the function of the urinary bladder?
temporary reservoir for urine prior to voiding
an empty urinary bladder in adults is located where?
in lesser pelvis posterosuperior to pubic bones
is the urinary bladder retroperitoneal?
nope, extraperitoneal
The urinary bladder is separated from pubic bones by what?
retropubic space
What forms the bladder bed?
pubic bones, obturator internus m, levator ani m, rectum or vagina
Is the bladder freely moveable or held in place by multiple fibrous ligaments?
its relatively free within extraperiotoneal fat except at its neck, aka nothing to hold it in place
Where is the bladder at in tiny humans (infants and children)
located in abdomen even when empty
where is the bladder at in lil pip sqeaks (age 6)
located in greater pelvis
Where is the bladder at in teenagers?
lesser pelvis
Where the bladder be at in us?
empty- entirely in lesser pelvis
full- expands into greater pelvis as it fills- may expand to level of umbilicus
Where is the apex of the urinary bladder?
anterior end pointing towards superior edge of pubic symphysis
Where is the body of the urinary bladder?
central region of urinary bladder
Where is the fundus of the urinary bladder?
posterior convex wall of bladder
the fundus of bladder in males is related to what part?>
rectum
the fundus of bladder in females is related to what part in females?
vagina
Where is the neck of the bladder?
narrowed inferior outflow region
Where do you find the detrusor muscle?
irregular smooth muscle comprising most of urinary bladder wall
Where does the detrusor muscle thicken?
at neck to form the involuntary internal urethral sphincter
What muscles makes up the internal urethral sphincter?
detrusor muscle of the urinary bladder
What is the function of the internal urethral sphincter?
prevents urine from entering urethra, prevents retrograde ejaculate from entering urinary bladder
What is the trigone of bladder?
2 ureter openings passing inferomedially thru urinary bladder wall and 1 internal urethral opening exiting inferiorly from urinary bladder lumen
what is the uvula of urinary bladder?
rounded eminence in middle of trigone, most prominent in men
hypertrophy here may lead to urinary obstructive problems
What pouch is located in between urinary bladder and rectum in males?
rectovesical pouch
What pouch is located in between the urinary bladder and uterus in females?
vesicouterine pouch
What pouch is located between uterus and rectum in females?
rectouterine pouch
The superior vesical a supplies?
anterosuperior region of urinary bladder
What is the superior vesical a. a branch of?
from umbilical a via anterior division of internal iliac a
What does inferior vesical a supply?
fundus and neck of urinary bladder in males only
What does vaginal A supply?
fundus and neck of urinary bladder in females only
What is the parasympathetic innervation to the urinary bladder?
S2-S4 pelvic splanchnic n
What is the parasymp function to the urinary bladder?
motor to detrusor muscle and inhibitory for internal urethral sphincter?
What stimulates parasym to allow exit?
distension
Urine flow is aided by contraction of what muscles?
diaphragm and abdominal
What does toilet training do?
trains kids to override this reflexive action by controlling pelvic diaphragm muscles like pubococcygeus
What is the is the sympathetic innervation to bladder?
T11-L2 splanchnic nerves
What does sympathetic to bladder help with?
contraction of internal urethral sphincter in concert with ejaculation
Visceral afferents of urinary bladder from superior surface follow?
follow symp. retrograde to T11-L2
Visceral afferents from inferior surface of urinary bladder follow?
parasym retrograde to S2-S4
What “organ” is approx 4cm long and 6mm in diameter?
female urethra
the female urethra conveys urine from ____________ of urinary bladder to ________ in vestibule of vagine
internal urethral orifice ; external urethral orifice
where is the female urethra located relative to the vagina?
anterior and parallel
What supplies the female urethra?
internal pudendal and vaginal AV
what is the innervation of the female urethra?
autonomics carried in pudendal n
what is the 18-20cm muscular tube?
male urethra
The male urethra conveys urine from ___________________ of urinary bladder to _______________ at tip of glans penis
internal urethral orifice; external urethral orifice
Does the male urethra only convey urine?
no also conveys semen during ejaculation
Where is the intramural urethra?
in neck or urinary bladder
What surrounds the intramural urethra?
internal urethral sphincter
Size of intramural urethra?
0.5 - 1.5 cm
Where is the prostatic urethra?
anterior prostate
What is the widest and most dilatable section of the male urethra?
prostatic urethra
what is the size of the prostatic urethra?
3-4 cm
What is the median longitudinal ridge on inside of posterior wall of the prostatic urethra?
urethral crest
what is the urethral crest continuous with?
with uvula at trigone of bladder
what are the bilateral grooves on either side of urethral crest called?
prostatic sinuses
What opens into the prostatic sinus?
prostatic ductules
what is the rounded prominence in middle of urethral crest?
seminal colliculus
What is the vestigial remnants of what become uterus and vagina in female?
prostatic utricle
What is the small cul-de-sac entered via slit opening on seminal colliculus?
prostatic utricle
Where do ejaculatory ducts open?
in or near opening in prostatic utricle
What part of the urethra is the 1 cm section passing thru deep perineal pouch and perineal membrane?
membranous urethra
the membranous urethra passes thru _____________ and __________
deep perineal pouch; perineal membrane
What surrounds the membranous urethra?
external urethral sphincter
What is the narrowest and least distensible part of urethra?
membranous urethra
where is the membranous urethra relative to the bulbourethral glands?
anterior
What is the 15-16cm section of urethra passing thru bulb and corpus spongiosum of penis?
spongy urethra
Where does the spongy urethra extend from?
perineal membrane to external urethral orifice on glands penis
What is the typical diameter of the spongy urethra?
5 mm
What are the 2 expanded areas of the spongy urethra?
- intrabulbar fossa - in bulb of penis
2. navicular fossa - in glans penis
What does the proximal portion of the spongy urethra receive?
ducts from bulbourethral glands
What supplies the proximal 2 parts of the male urethra?
inferior vesical AV
What supplies the distal 2 parts of the male urethra?
internal pudendal AV
What is the innervation of the male urethra?
autonomics derive from inferior hypogastric plexus via prostatic plexus
