pelvis/ perineum/ kidney/ ureter/ bladder/ urethra

Question 1

pelvic bones

Answer 1

ilium (largest), ischium and pubic bone

Question 2

joints in pelvis

Answer 2

all 3 in acetabulum
sacroiliac posterior
pubic symphysis anterior

Question 3

bony landmarks of pelvis

Answer 3

iliac crest on side of body
anterior superior iliac spine
pubic crest and tubercle
posterior = greater sciatic notch, ischial spine and ischial tuberosity

Question 4

sacroiliac joint features

Answer 4

sacrospinous and sacrotuberous ligaments, between sacrum and ischial spine/tuberosity
creates 2 gaps in greater sciatic notch between the sacrum and ischial bone, greater and lesser foramen

Question 5

angle of pelvis

Answer 5

tilt of 60 degrees forward
ASIS and pubic symphysis in same plane
sacrum forms roof of posterior wall

Question 6

sex differences of pelvic inlet

Answer 6

female = inlet more oval shaped, less acute pubic symphysis 
male = prominent sacrum which indents pelvic inlet, more heart shaped, more prominent ischial spines

Question 7

structure of pelvic floor

Answer 7

sheets of muscle on either side, collectively called the levator ani muscles
span from inner surface of pubis and ischium to the coccyx

Question 8

passes through pelvic floor

Answer 8

urethra, anus and vagina

Question 9

fusion point

Answer 9

anococcygeal raphe, midline from coccyx

Question 10

anterior to gap where rectum and anus are

Answer 10

small connective tissue body called the perineal body

in front of that is the genital hiatus and then pubic symphysis

Question 11

position of perineum

Answer 11

below the pelvic floor and pelvic inlet, below levator ani

Question 12

sections of perineum

Answer 12

anterior = urogenital triangle formed by the perineal membrane, where urethra/vagina passes 
posterior = space called the anal triangle

Question 13

position of perineal body

Answer 13

between anus and vagina
midline at the free edge of the perineal membrane
links the perineal membrane, levator an and supporting ligaments of urethra and vagina

Question 14

male perineum differences

Answer 14

membranous part of urethra passes through the perineal membrane

Question 15

formation of kidney lobules

Answer 15

each lobule from bifurcation of the original uteric bud

each lobule has its own arterial supply

Question 16

position of kidneys

Answer 16

hilum of kidneys lies about 5cm lateral to the midline

Question 17

which kidney is higher

Answer 17

left, upper pole at T11 rather than T12

Question 18

what happens if kidney ascent doesn’t occur properly

Answer 18

pelvic kidney, still fully functioning

Question 19

muscles in contact with kidney

Answer 19

psoas, quadratus lumboram and transversus abdominis

Question 20

left kidney position with other organs

Answer 20

on the floor of lesser sac, behind pancreas and in contact with spleen

Question 21

right kidney position with other organs

Answer 21

kidney is behind the liver with the second part part of the duodenum above the hilum

Question 22

position in peritoneum

Answer 22

retroperitoneal

Question 23

what are the upper parts of the kidneys protected by

Answer 23

11th and 12th ribs

Question 24

structure of the kidney

Answer 24

fibrous outer capsule
cortex with nephrons, medulla with collecting ducts and renal pelvis at the centre
pelvis leads to the ureter

Question 25

blood supply to kidney

Answer 25

left and right renal arteries from aorta (right longer than left)
IVC on the RHS of the aorta, so short right renal vein and longer left renal vein drain into it
suprarenal vein also drains into left renal vein

Question 26

lobular arterial supply

Answer 26

arteries split into anterior and posterior branches either side of the pelvis
arteries then split into interlobar arteries which are end arteries

Question 27

route of the ureter

Answer 27

from hilum of the kidneys
passes over psoas
over common iliac arteries
over vesicular arteries and enter the bladder posteriorly
passes obliquely through the posterior wall of the bladder

Question 28

base of the bladder formed by

Answer 28

trigone
two openings for ureters at the top and urethra at the base
relatively smooth, doesn’t change shape

Question 29

main part of the bladder

Answer 29

detrusor muscle

smooth muscle, capable of huge expansion, lined by transitional epithelium

Question 30

bladder position

Answer 30

beneath the peritoneal cavity

Question 31

bladder blood supply

Answer 31

internal iliac artery via the vesicular arteries

Question 32

structure of female urethra

Answer 32

short and attached to the anterior wall fo the vagina

Question 33

structure of male urethra

Answer 33

3 parts: prostatic (through prostrate gland), membranous (through perineal membrane) and penile

Question 34

bladder sphincters

Answer 34

internal = smooth muskie, autonomic NS
external = striated muscle, somatic NS

Question 35

control of micturition

Answer 35

stretch receptors in bladder wall send signals to the CNS via autonomic nerves
stimulation fo the smooth muscle causes contraction
voluntary relaxation of sphincter muscle via pudendal nerve

Question 36

further divisions of blood supply to kidney

Answer 36

interlobar arteries divide into arcuate arteries

arcuate arteries give rise to interlobular arteries which supply nephrons

Question 37

bladder innervation

Answer 37

inferior hypogastric, sym from L1-2
parasym from S2-4, splanchnic nerves
pelvic splanchnic also carry afferent sensory