Surgical Specialties: Urology

Question 1

Narrowest calibre point of the ureters?

Answer 1

Vesicoureteric junction.

Question 2

Define pelvi-ureteric junction obstruction.

Answer 2

Obstructed flow of urine from renal pelvis to proximal ureter.

Question 3

Describe how ureters enter the bladder.

Answer 3

Obliquely for 1-2cm before reaching their orifices at the upper lateral angles of the trigone.

Question 4

A congenitally deficient flap valve where the ureters enter the bladder causes what?

Answer 4

Vesicoureteric reflux.

Question 5

What lines the ureters?

Answer 5

Transitional epithelium.

Question 6

What are ureters composed of?

Answer 6

25cm of smooth (involuntary muscle) lined by transitional epithelium (urothelium).

Question 7

What lines the whole urinary tract?

Answer 7

Transitional epithelium.

- With the exception of the terminal urethra lined by stratified squamous epithelium.

Question 8

Arterial supply to upper third of ureters is by?

Answer 8

Renal arteries.

Question 9

Arterial supply to middle third of ureters is by?

Answer 9

Branches of descending abdominal aorta.

Question 10

Arterial supply to lower third of ureters is by?

Answer 10

Superior and inferior vesical arteries.

Question 11

Which segment of the ureters is most vulnerable to post-operative ischaemia and stricture formation?

Answer 11

Middle third - supplied by branches of the descending abdominal aorta.

• If its blood supply is endangered by stripping ureter clean of surrounding tissue.

Question 12

How to differentiate ureter from surrounding vessels?

Answer 12

White, non-pulsatile cord showing peristaltic activity when gently pinched (i.e. it vermiculates).

Question 13

Describe the anatomical relation of the ureters and uterine arteries.

Answer 13

Ureters are passed superiorly by the uterine arteries - i.e. “water passes under the bridge”.

Question 14

Outer parenchymal covering of the kidneys is called?

Answer 14

Cortex.

Question 15

Middle of the kidney is called?

Answer 15

Medulla.

Question 16

Where do the kidneys lie?

Answer 16

Between T12 and L3.

The right kidney is 1.5cm lower than the left.

Question 17

How far do the kidney move with respiration?

Answer 17

3cm.

Question 18

Functional unit of the kidney?

Answer 18

Nephron.

Question 19

Nephron consists of?

Answer 19

Glomerulus.
Proximal tubule.
Loop of Henle.
Distal tubule.
Collecting tube.

Question 20

Each kidney contains approximately how many nephrons?

Answer 20

100,000.

Question 21

Normal urine output calculcation?

Answer 21

0.5ml/kg/hour.

Question 22

What is the minimal urine output of an average, 60kg adult?

Answer 22

30ml/hour.