Ureter, Prostate and Bladder

Question 1

What are the different parts of the male urethra?

Answer 1

Preprostatic urethra - between bladder and prostate.
Membranous urethra - Passes through the perineal membrane.
Spongy urethra - from below urogenital diaphragm to the tip of the penis. (through spongey tissue of the penis)

Question 2

Where could a foley catheter get caught on insertion?

Answer 2

At the valve of the navicular fossa at the head of the penis.

Question 3

What is the Deep Perineal Pouch?

Answer 3

Anatomical space partly enclosed by the perineum. Located superior to the peritoneal membrane.

Question 4

Compare the urethral sphincters in males and females.

Answer 4

Females: only one external sphincter.
Males: 2 urethral sphincters.
- one in deep perineal pouch.
- one at neck of the bladder (internal sphincter) to prevent back flow of semen into the bladder during ejaculation.

Question 5

Outline the pelvic course of the ureters in males and females.

Answer 5

Males: Over the external iliac artery, Over the umbilical artery, Under the seminal vesicle and Vas Deferens.
Females: Over the external iliac artery, Over the obliterated uterine artery, Under the Uterine artery

Question 6

Where do the ureters connect to the bladder?

Answer 6

Vesico-uteral junction - on the posterior wall of the bladder.
Forms the trigone base of the bladder with the urethra.

Question 7

What is the name of the muscle lining the bladder? What is its function?

Answer 7

Detrusor muscle - lines bladder but not over base.

• Folded wall to enable expansion of the bladder.
• Contracts during micturition

Question 8

What is hydronephrosis?

Answer 8

When fluid backtracks up the ureters to the kidney.
Causes swelling of the kidney.
Occurs due to a defective valvular system.

Question 9

What are the relations of the male bladder?

Answer 9

Prostate gland sits below it
Seminal vesical sits behind it
Ductus deferens passes round the side of the bladder.

Question 10

What are the relations of the female bladder?

Answer 10

Uterus lies above the bladder.
Vagina is behind the bladder
Peritoneum covers the superior surface of the bladder.

Question 11

What ligments support the bladder and ureter in males and females?

Answer 11

Males: pubovesical and puboprostatic ligaments.
Female: pubovesical and pubourethral ligaments.

Question 12

What is the arterial supply of the bladder?

Answer 12

Two arteries:

• Superior vesical artery - branches off the internal iliac.
• Inferior vesicle artery (vaginal artery in females) - branches off the anterior division of the internal iliac.

Question 13

What is the venous drainage of the bladder?

Answer 13

Via the vesical venous plexus - drains into the internal iliac veins.

Question 14

What is the lymphatic drainage of the kidney?

Answer 14

Into left and right lumbar lymph nodes

Question 15

What is the lymphatic drainage of the ureter (upper, middle, lower)?

Answer 15

Upper: - to kidney lymphatics (lumbr lymph nodes)
Middle: - to common iliac lymph nodes
Lower: - to common, external and internal iliac nodes.

Question 16

What is the lymphatic drainage of the bladder?

Answer 16

To the internal iliac lymph nodes.

Question 17

Outline the parasympathetic innervation of the bladder.

Answer 17

Parasympathetic pelvic nerves arise from S2,3,4.
Excitatory to the bladder (contracts detrusor muscle)
Relaxes the sphincter

Question 18

Outline the sympathetic innervation of the bladder.

Answer 18

Via the hypogastric nerves to pelvic ganglia. Arise from T10-L2.
Tonic contraction of the spincter and relaxation of detrusor muscle.

Question 19

Outline the somatic innervation of the bladder.

Answer 19

Somatic nerves S2-4 - pudendal nerve.
Excitatory to the external sphincter.
Voluntary contraction of external sphincter to control micturition.

Question 20

What innervation occurs during micturition?

Answer 20

Switch off sympathetics and somatics.

Switch on parasympathetics via pelvic nerves.