SDR 1/2 - Urogenital System Flashcards
Pronephros/Mesonephros
Fake kidney
1) Adrenal Medulla (Neuro - Ecto)
2) Genital Swelling/UG Sinus (Endo)
The mesoderm gives rise to all of the genitourinary organs except
Mesonephric (Wolffian) Duct
This develops into the male parts + trigone
Paramesonephric (Mullerian) Duct
This develops into the female parts
Metanephros
Real kidney
Ureteric Duct
This develops into the ureter and collecting system
Mesonephric duct
The ureteric duct arises from the
Cloaca
This early structure is a common chamber into which urinary, genital and gastrointestinal tracts converge
Urogenital Sinus
This structurs is the site of genitourinary development from the bladder down (excluding gonads and their tubing). It is the ventral part of the cloaca, formed after it separates the anal/urogenital canal during the 4th to 7th weeks of development
Oligohydramnios
Decreased amount of amniotic fluid. Often a sign that the fetus is not producing urine
IMA
A horseshoe kidney is most commonly caught on this artery while ascending
Mesonephron
This structure acts as a premature kidney for the 1st trimester. Then it disappears to give rise to something else (next card)
1) Trigone
2) Efferent ducts of testis
3) Epididymus
4) Vas Deferens
The mesonephron gives rise to the mesonephric duct after ~1st trimester. What 4 structures does the mesonephric duct differentiate into
T
(T/F) All kidneys develop from the intermediate mesoderm
4
Pronephros = gone after week ~____
8
The Metanephros becomes the functional kidney after ~____ weeks
1) Ejaculatory Duct/Prostatic Urethra
2) Lower 1/3 of Vagina/Urethra
In males the UG Sinus/Cloaca develop into the (1), and in females they develop into the (2)
1) Ureteric Bud
2) Nephros
The (1) and (2) are best friends. The induce each other to create the kidney and collecting system
DCT
The metanephros makes up the nephron from the glomerulus to the
1) Collecting Ducts
2) Calyces
3) Pelvis
4) Ureter
The Ureteric Bud gives rise to these 4 aspects of the collecting system
1) Cloaca
2) Metanephros
Two insertions of the ureteric bud
MCDK (Multicystic dysplastic kidney)
Most common cause of abdominal mass in a child
Sacrum
The kidney begins in the (1) and rises up to the chest
F (gains/loses blood supply as it rises)
(T/F) As the kidney ascends, it typically brings along its blood supply
T
(T/F) As the kidney ascends the ureteric bud bifurcates into calyces, infundibula, collecting ducts
1) Complete duplication
2) Partial duplication
3) Bifid duplication
A duplicated ureter that inserts into the bladder at an ectopic location is known as a (1).
A duplicated ureter that joins close to the bladder is called a (2).
A duplicated ureter that joins near the kidney is called a (3) .
In the normal spot (Kidney rises to meet the adrenal)
In a person with a right pelvic kidney, where is the right adrenal located?
F (~15% of kidneys have 2+ arteries)
(T/F) It is uncommon for kidneys to have multiple renal arteries
Urorectal Septum
The cloaca is divided into two separate tubes by the
1) Urogenital sinus
2) Anorectal canal
At 30 days, the urorectal septum splits the cloaca into the (1) and (2)
Trigone
During development the urogenital sinus grows and absorbs a part of the Wollfian Duct distal to ureteric bud (remember—UB is derived from WD). This portion becomes the (1)
Ureteral Orifice
The connection between the WD and the UB moves laterally and becomes the
Ejaculatory Duct
An Insertion of Wolffian Duct into Urogenital Sinus moves medially and becomes
Vesicoureteral Reflux
An abnormal backflow (reflux) of urine from the bladder to the ureter
UPJ (Ureteropelvic Junction Obstruction)
Most common site for fetal and pediatric obstruction is where?
UVJ (Ureterovesicular Junction Obstruction)
Narrowest part of urinary tract and common place for pediatric obstruction
Superior (Weigert-Meyer Rule; Usually obstructed medially)
When a ureter is completely duplicated the (superior/inferior) pole is typically the ectopic ureter
Distal to bladder neck
7 year old girl presents with incontinence. Never potty trained. History reveals she is continuously wet. If this is due to an ectopic ureter, where is it located?
Megaureter
An enlarged ureter, congenital or acquired; the common presentation of ureterovesical junction obstruction; may appear as tortuous cystic intra-abdominal mass
Hydronephrosis
the dilation (swelling) of one or both kidneys
Genital ridges
Around 5 weeks, (1) form next to developing mesonephros and create the primitive sex cord
Paramesonephric (Mullerian) ducts
Around 6 weeks, (1) form lateral to the nephric ducts
SRY
The sex determining region of the Y chromosome
Male
With SRY, fetus will develop into a (male/female)
*Assuming everything else goes according to plan
Mullerian
Appendix testis is a (mullarian/wolffian) duct remnant
Wolffian
Appendix epidydimus is a (mullarian/wolffian) duct remnant
1) Testis cord (helped by sertoli cells)
2) Ovarian Follicles
In males (With SRY) the primitive sex cord develops into (1), while in females the primitive sex cord develops into the (2)
MIS (Mullerian Inhibiting Substance)
Sertoli Cells secrete (1), which causes the Mullerian and Paramesonephric Duct Involutes
Leydig
(Sertoli/Leydig) cells secrete testosterone
1) Fallopian Tubes
2) Uterus
3) Upper 2/3 of vagina
Mullerian ducts develop into these 3 things
7
Male and female genitalia are morphologically indistinguishable until week ____
1) Clitoris
2) Penis
The Genital Tubercle develops into (1) in females and (2) in males
1) Labia Majora
2) Scrotum
* Also called labioscrotal folds b/c this
The Genital Swellings develop into (1) in females and (2) in males
1) Labia Minora
2) Penile Urethra
The Urethral Folds develop into (1) in females and (2) in males
1) Vestibule
2) Urethral Lumen
The Urogenital Groove develops into (1) in females and (2) in males
A) Urogenital Groove
The development of which of the following is not driven by DHT? A) Urogenital Groove B) Genital Swellings C) Genital Tubercle D) Urethral Folds
Trigone
In females, a remnant of the wolffian duct forms the
Nothing. Degenerates in the presence of MIF
In males, a remnant of the mullerian duct forms the
1) Round/Ovarian Ligament
2) Gubernaculum
In females the (1) is formed by the Caudal Genital Ligament, while in males it forms the (2)
Skene’s Glands
The female equivalent to the prostate is
Bartholin’s
Cowper’s glands in males are equivalent to (1) glands in females
Cowper’s
(1) glands in males are equivalent to Bartholin’s glands in females
Cryptorchidism
undescended testicles
Orchidoplexy
Process to move undescended testicles down
C) Testis may regain fertility; not certain
Which of the following is not a reason to perform orchidoplexy? A) Decreases chance of malignancy B) Allows surveillance for malignancy C) Testis regains fertility D) It less prone to trauma E) Can fix associated hernia
1) Indirect hernia
2) Hydrocele
Patent processus vaginalis often leads to
T
(T/F) Descends through retroperitoneum to inguinal canal before passing through patent processus vaginalis
Gonadotropins
Cryptorchidism is linked to a deficiency in
1) 21Hydroxylase (95%)
2) 11β Hydroxylase (5%)
Most common enzymatic deficiencies leading to CAHypoplasia
Aldosteron lvls (salt wasting if too low) *Or Progesterone/Deoxycorticosterone bc they are precursors in pathway
The most important thing to check in children with possible CAH
F (occurs in 75%)
(T/F) Salt wasting occurs in all cases of 21OH deficient CAH
T (Deoxycorticosterone helps retain Na; HTN common)
(T/F) Those with 11β OH are usually not salt wasters
MIS secretion by sertoli cells
Those born with Androgen insensitivity (46XY) will present with bilateral absence of Mullerian derivatives due to
B) Incr risk of adenocarcinoma
Which of the following is true of patients with Klinefelter’s Syndrome?
A) They have at least 1 X and 2 Y chromosomes
B) They are at incr risk of developing adenocarcinoma of the breast
C) They undergo replacement of leydig cells with hyaline
D) They are characteristically fertile
E) They bear little resemblance to XX males
1) MCDK
2) Hydrocephalus
These two conditions both look like a bear claw under ultrasound
MCDK (ureteral atresia also common)
This condition is common when the ureteral bud and metanephros do not join
1) FSH
2) LH
Sertoli cells are stimulated by (1). Leydig cells are stimulated by (2)
1) Testosterone
2) DHT
Development of internal male structures is dependent on (1), while development of external male structures is dependent on (2)
High Testosterone:DHT ratio
Fairly definitive diagnosis for 5-alpha reductase deficiency
12
We typically wait at least ____ months (considering a ~normal number of tries) before suggesting a fertility problem may be the underlying issue
Hydronephrosis
It is common for this syndrome to suddenly manifest after pt drinks significant amounts of ADH blocker (coffee, alcohol, H2O)
