Renal tract anatomy (excl. kidneys)

Question 1

How long are the ureters?

Answer 1

25-30cm long

Question 2

How wide are the ureters?

Answer 2

3-4mm in diameter

Question 3

Where do the ureters lie?

Answer 3

In the retroperitoneal space

Question 4

Where do the ureters arise from?

Answer 4

Pelvis of kidney

Question 5

Where do the ureters exit the kidney?

Answer 5

Hilum in the transpyloric plane at L1

Question 6

Where do the ureters pass in relation to the posts major?

Answer 6

Pass anteriorly to the posts major

Question 7

Which part of the bladder do the ureters enter at?

Answer 7

Lateral aspect in an oblique fashion

Question 8

Why do the ureters enter the bladder in an oblique direction?

Answer 8

Creates a valve that prevents back flow of urine

Question 9

What are the 3 main points of constriction of the ureters?

Answer 9

Pelvicoureteric junction of renal pelvis and ureter (PUJ)
Bifurcation of the common iliac arteries
Vesicoureteric junction (VUJ)

Question 10

Mass effects of what can cause ureteric obstruction?

Answer 10

Constipation
Pregnancy
Ovarian cysts

Question 11

Nerves to the ureters arise from where?

Answer 11

Renal plexus

Question 12

The renal plexus is supplied by nerves from where?

Answer 12

Thoracic splanchnic nerves

Question 13

Sensory input from the ureters travels to what spinal levels?

Answer 13

T11-L2

Question 14

Referred pain from the ureters can be felt where?

Answer 14

Posterior lumbar/ flank region

OR

hypogastrium

Question 15

How much urine can the bladder hold?

Answer 15

300-600ml

Question 16

At what volume does the bladder need to be at to cause the sensation of needing to void?

Answer 16

400ml

Question 17

What is the bladder enveloped in?

Answer 17

Extraperitoneal fat + connective tissue

Question 18

What is the bladder separated from the pubic symphysis by?

Answer 18

Anterior premedical space (space of retzius)

Question 19

What are the 4 surfaces of the bladder?

Answer 19

Superior surface
Two inferolateral surfaces
Posterior surface

Question 20

What are the 4 areas of the bladder?

Answer 20

Apex
Body
Fundus
Neck

Question 21

What is the trigone of the bladder?

Answer 21

A smooth triangular region situated in the fundus of the bladder

Question 22

What form the trigone?

Answer 22

2 ureteral orifices and urethral orifice

Question 23

What is the name of the muscle in the wall of the bladder?

Answer 23

Detrusor

Question 24

When does the detrusor muscle contract?

Answer 24

During micturition

Question 25

Who is the internal urethral sphincter present in?

Answer 25

Males

Question 26

Who is the external urethral sphincter present in?

Answer 26

Both sexes

Question 27

What is the function of the internal urethral sphincter?

Answer 27

Prevents se final regurgitation during ejaculation

Question 28

What type of control is the internal urethral sphincter under?

Answer 28

Autonomic

Question 29

What type of control is the external urethral sphincter under?

Answer 29

Voluntary

Question 30

What does the external urethral sphincter do during micturition?

Answer 30

Relaxes

Question 31

What is the arterial supply to the bladder?

Answer 31

Superior vesical bronco of the internal iliac artery **also the inferior vesical artery in men/ vaginla artery in women

Question 32

What is the venous drainage of the bladder?

Answer 32

Vesical venous plexus

Question 33

The superior aspect of the bladder drains to which nodes?

Answer 33

External iliac nodes

Question 34

The posteroinferior aspect of the bladder drains to which nodes?

Answer 34

Internal iliac drugs

Question 35

Some vessels from the neck of the bladder drain to which nodes?

Answer 35

Sacral/ common iliac nodes

Question 36

What is the sympathetic innervation of the bladder?

Answer 36

Hypogastric nerve (T12-L2)

Question 37

What does sympathetic stimulation of the bladder cause?

Answer 37

Relaxation of detrusor = retention of urine

Question 38

What is the parasympathetic innervation of the bladder?

Answer 38

Pelvic splanchnic berves

Question 39

Parasympathetic stimulation of the bladder causes what?

Answer 39

Contraction of detrusor = micturition

Question 40

What is the somatic innervation of the bladder?

Answer 40

Pudendal nevre (S2-S4)

Question 41

What does somatic innervation of the bladder act on?

Answer 41

External urethral sphincter

Question 42

Somatic control over the bladder causes what?

Answer 42

Voluntary control of the external urethral sphincter = relaxation/ constriction

Question 43

What do sensory afferents of the bladder detect?

Answer 43

Sense when the bladder is stretched and full

Question 44

Spinal cord transection above T12 causes what to happen to the bladder?

Answer 44

Spastic (reflex) bladder

Question 45

What happens in a spastic bladder?

Answer 45

The bladder automatically empties as it fills as the parasympathetic efferents are intact, but the other nerves are not.

Question 46

Spinal cord transection below T12 causes what to happen to the bladder?

Answer 46

Flaccid bladder

Question 47

What happens in a spastic bladder?

Answer 47

Urinary retention (can sometimes lead to reflux nephropathy)

Question 48

How long is the male urethra?

Answer 48

15-20cm long

Question 49

What are the 3 points of constriction in the male urethra?

Answer 49

Internal urethral sphincter External urethral sphincter External urethral orifice

Question 50

What are the 4 parts of the urehtra?

Answer 50

Pre-prostatic Prostatic Membranous Spongy

Question 51

What is the widest and most dilatable part of the male urethra?

Answer 51

Prostatic part

Question 52

What is the narrowest part of the male urethra?

Answer 52

Membranous

Question 53

Where is the membranous part of the male urethra located in?

Answer 53

Deep perineal pouch

Question 54

The spongy part of the urethra passes through what?

Answer 54

Penis

Question 55

Which part of the male urethra are Cowper's glands located in?

Answer 55

Spongy part

Question 56

How long is the female urethra?

Answer 56

4cm

Question 57

What is the arterial supply to the prostatic urethra?

Answer 57

Inferior vesical artery

Question 58

What is the arterial supply to the membranous urethra?

Question 60

What is the arterial supply to the female urethra?

Answer 60

Pudendal, vaginal and inferior vesical branches of the vaginal arteries

Question 61

What is the lymphatic drainage of the urethra?

Answer 61

Internal iliac nodes Deep inguinal nodes

Question 62

What is the innervation of the male urethra?

Answer 62

Pudendal nerve Prostatic plexus (arises from inferior hypogastric plexus)