REB 29. Bladder, Prostate, Seminal Vesicles Flashcards
What separates the real and the false pelvis?
Above the Pelvic Brim - False Pelvis
Below the Pelvic Brim - Real Pelvic
Is the bladder an intraperitoneal, retroperitoneal and extraperitoneal organ?
extraperitoneal organ
What are the different surfaces of the bladder?
[1] Base
[2] Apex
[3] Infero-lateral Surface
What structure do you have at the apex of the bladder?
Median Umbilical Ligament
What type of muscle increases the surface area in the bladder?
Rugae
What is the function of rugae in the bladder?
to increase the surface area so more urine may be held
- bladder holds around 300 to 400 mL
What is the muscle of the bladder that helps hold urine and push it out?
Detrusor Muscle
What is the function of Detrusor Muscle?
- helps the bladder hold urine when it relaxes
- when it contracts, it pushes the urine out
What is the pubovesical ligament?
- it wraps around the neck of the bladder, and attaches to the pubic bones
- they are an extension of the detrusor muscle
- present in FEMALES
What is the puboprostatic ligament?
- it wraps around the prostate and attaches to the pubic bones
- present in MALES
What is the arterial blood supply of the bladder?
[1] Superior Vesical Artery (of Internal Iliac Artery)
- supplies anterior parts
[2] Inferior Vesical Artery (of internal Iliac Artery)
- supplies posterior and lateral parts
What is the nerve supply of the bladder?
[1] Sympathetic
- via the splanchnic nerves it allows contraction)
[2] Parasympathetic
- it allows relaxaton of the detrusor muscle
[3] Somatic Nerve Supply
- via the pudendal nerve (both motor and sensory )
- it opens up the external urethral sphincter
What are the 2 types of catheters?
[1] Ureter Catheter
[2] Suprapubic Catheter
- goes through the abdominal wall
What is a cytoscope?
- you put a camera up the urethra and into the bladder
Describe the length of the urethra in females
very short
Where is the external urethral sphincter located in females?
located in the deep perineal pouch
Describe the length of the urethra in males
pretty long
- around 15 to 20 cm in length
Where is the external urethral sphincter located in males?
located in deep perineal pouch
Where is the internal urethral sphincter located in males?
in the neck of the bladder
What are the 4 parts of the urethra in males?
[1] Preprostatic Part of Urethra
[2] Prostatic Part of Urethra
[3] Membranous Part of Urethra
[4] Spongy Part of Urethra
What are the 2 bends of the penis?
[1] infrapubic bend
[2] prepubic bend
What is the narrowest region of the urethra in males?
Membranous part of urethra
Which part of the urethra may undergo dilation in males?
Prostatic part of urethra
What is another name for the ductus deferens?
vas deferens
What is another name for the vas deferens
ductus deferens
Explain the process by which semen is transported out of epididymis.
[1] semen transported out of epididymis through ductus (vas) deferens
[2] behind the bladder, the vas deferens widens - this is the Ampulla of Ductus Deferens
[3] the vas deferens and seminal vesicle join to form the Ejaculatory Duct
[4] they pass through the prostate and opens into the urethra
- the prostate ensures that the semen doesn’t clot by adding something to it
What is the Ampulla of Ductus Deferens?
behind the bladder, the vas deferens widens - this is the Ampulla of Ductus Deferens
What are the 3 holes in the prostate?
[1] openings of ducts of glandular elements of prostate
[2] openings of ejaculatory ducts (2 of them)
How many lobes of the prostate are there?
[1] Anterior Lobe
- anterior to the urethra
[2] Median Lobe
- posterior to urethra
- bounded inferiorly by the ejaculatory ducts (enlarges in base of bladder)
[3] Posterior Lobe
- posterior to urethra
- bounded superiorly by ejaculatory ducts
[4] Lateral Lobe
- right + left
What is the blood supply of the prostate gland?
PROSTATIC ARTERIES arise from the internal iliac artery
What is the venous drainage of the prostate gland?
PROSTATIC PLEXUS OF VEINS
they drain to the Internal Iliac Veins
- + they connect with vertebral venous plexuses
Where does lymph drain to in the prostate gland?
- lymph vessels drain to the internal iliac nodes
Who does a benign prostatic enlargement (BPH) normally affect? Which lobe does it normally affect? What may it lead to and what are some exams/treatments?
- usually occurs in 50% of men at the age of 50
- normally affects central region of the median lobe
- it causes a bladder obstruction
- you can use a Digital Rectal Examination (DRE)
- you can also do a Transurethral Resection of Prostate (TURP)
What areas of the prostate does prostate cancer affect? How common is it? Where does it normally metastasize to?
- it normally affects peripheral regions
- very common – around 80% of men at 80 have microscopic foci of cancer
- but less than 5% of people die from it
- metastases normally go to the vertebral bones
Where does prostatic cancer normally metastasize to?
vertebral bones
What is a digital rectal exam?
put a finger into the rectum and feel around
- if there is a hard lump that is usually indicative of prostatic cancer
What is Transrectal Ultrasonography (TRUS)?
you put a camera up the rectum
How does transurethral resection of the prostate (TURP) work?
- you put the instrument (resectoscope) into the urethra of the penis
- this then goes to to the prostate and parts may be resected
What is the function of the prostatic fascia? Where does the fascia thicken and thin?
- membranous partition at the lowest part of the rectovesical pouch
- separates the prostate + urinary bladder from the rectum
- the fascia thickens around the non-distensible organs
- the fascia is thinner around the distensible organs such as the bladder
What is the pouch between the rectum and bladder in males?
rectovesical pouch
What is the venous drainage of the bladder?
drains into the VESICAL PLEXUS
What does the motor aspect of the pudendal nerve control?
- external anal sphincter
- internal anal sphincter
What does the sensory aspect of the pudendal nerve control?
- proves sensory to genitalia, peritoneum and around the anal canal
What are the 2 types of nerves that have an effect on the detrusor muscle?
[1] Pelvic Splanchnic Nerves (Parasympathetics from S2 to S4)
- leads to contraction of detrusor muscle
[2] Inferior Hypogastric Plexus
- involves relaxation of detrusor muscle
What effect do the pelvic splanchnic nerves (parasympathetics from S2 to S4) on the detrusor muscle?
it leads to contraction of the detrusor muscle
What effect do the inferior hypogastric plexus have on the detrusor muscle?
it involves in the relaxation of detrusor muscle
