Ureter, Urinary Bladder, Urethra Flashcards
Where is the ureter located?
Retroperitoneal from renal pelvis down to bladder and attached to the posterior abdominal wall
Anatomical Course of UreterDescends along anterior surface of ____| First step
Descends along anterior surface of psoas major| L2-L5
Anatomical Course of UreterCrosses the ____ at level of ____ to enter pelvic cavity| Second step
Crosses the pelvic brim at level of sacroiliac joints to enter pelvic cavity
Anatomical Course of UreterDescend along ____| Third step
Descend along lateral pelvic walls
Anatomical Course of UreterTurn anteromedially at the level of ____ to travel transversely towards bladder| Fourth step
Turn anteromedially at the level of ischial spines to travel transversely towards bladder
Anatomical Course of UreterPierces lateral aspect of bladder walls in ____ manner| Fifth step
Pierces lateral aspect of bladder walls in oblique manner| Creates a one-way valve preventing backflow of urine
Name the 3 constrictions of the ureter
- Ureteropelvic junction2. Pelvic inlet (where ureters cross the iliac vessels)3. Vesico-ureteric junction (narrowest - entrance to bladder)
Clinical significance of constrictions
Common sites of obstruction by calculi
Ureteral PainWhat does ureteral pain result from?
Strong peristaltic waves of contraction pass down ureter in attempt to pass stone onward -> Smooth muscle spasms causes colicky pain
Ureteral PainHow does ureteral pain come about?
Afferent nerve fibers of renal pelvis and ureter enter spinal cord at segments T11, T12, L1 and L2 -> Pain referred to corresponding** dermatomal distribution** along** flank, loin and groin**
Ureteral PainUreter lies in close proximity to the ____ nerve and pain is referred along ____ branch of the nerve -> Pain over tip of penis (male) and labia major (female)
Ureter lies in close proximity to the genitofemoral nerve and pain is referred to genital branch of the nerve -> Pain over tip of penis (male) and labia major (female)
Ureteral PainUreter lies in close proximity to the ____ nerve and pain is referred along ____ branch of the nerve -> Pain over front of thighs
Ureter lies in close proximity to thegenitofemoralnerve and pain is referred along femoral branch of the nerve -> Pain over front of thighs
Urinary bladder is a ____ and ____ organ
Urinary bladder is a hollow and distensible organ
Where is the urinary bladder located?
On floor of pelvic cavity, inferior to peritoneum and posterior to pubic bones
Urinary bladder expands ____ into abdomen when full
Urinary bladder expands superiorly into abdomen when full
Male Urinary BladderUpper part of posterior surface is covered by ____
Upper part of posterior surface is covered by peritoneum
Male Urinary BladderLower part of posterior surface separated from the ____ by ____ , seminal vesciles and the rectovesical fascia
Lower part of posterior surface separated from the rectum by vasa deferens, seminal vesciles and the rectovesical fascia
Male Urinary BladderNeck of bladder rests upper surface of ____
Neck of bladder rests upper surface of prostate
Female Urinary BladderPosterior surface separated from ____ by ____
Posterior surface separated from rectum by vagina
Female Urinary BladderSuperior surface related to ____
Superior surface related to uterovesical pouch
Female Urinary BladderNeck of bladder rests directly on upper surface of ____
Neck of bladder rests directly on upper surface of urogenital diaphragm## Footnoteno prostate
Internal features of bladderWhat is the muscle in the urinary bladder?
Detrusor (smooth muscles)
Function of detrusor muscle
Contracting in response to signals from nervous system and empty bladder when necessary
What is the neck of the bladder formed by?
Convergence of the fundus and 2 inferolateral surfaces
Internal features of bladderWhen bladder is empty, the walls of it have a series of ridges, thick mucosal folds known as ____ that allow for ____ of bladder
When bladder is empty, the walls of it have a series of ridges, thick mucosal folds known as rugae **that allow for expansion of bladder## FootnoteOnly seen when bladder is empty
Internal features of bladderWhat is the trigone of the bladder?
Smooth triangular region on base of internal urinary bladder and is seen in between 2 ureteric orifices/openings and internal urethral orifice## FootnoteNo rugae even when urinary bladder is empty (always smooth)
What are the layers of the bladder wall?
- Mucosal - transitional epithelium- Lamina propria- Submucosa- Detrusor muscle - Peritoneum