Ureters and bladder

Question 1

Describe the course of the ureters and the relationships in the pelvis to the iliac vessels and uterine vessels, ovary/vas and the urethra in both males and females Normal course course in males course in females

Answer 1

Arise in the abdomen as a continuation of the renal pelvis Terminate at the pelvic cavity where they drain into the bladder Abdominal part Arise in the abdomen as a continuation of the renal pelvis Ureteropelvic junction- where the renal pelvis narrows to form the ureter Ureter descends down the abdomen along the psoas major Retroperitoneal Sacroiliac joints the ureters pass the pelvic brim so enter the pelvic cavity Cross the bifurcation of the common iliac arteries Pelvic part Run down the lateral pelvic walls As the level of the ischial spines they turn anteromedially, moving in transverse planes towards the bladder Pierce lateral bladder in an oblique manor One way valve as high intramural pressure collapses the ureters preventing back flow Females As they cross the pelvic brim the ureters are close to the ovaries 2cm superior to the ischial spine the ureters run underneath the uterine artery (water under the bridge) Men Vas deferens cross the ureters anteriorly In both men and women need to be careful during surgery not to damage the ureter

Question 2

Identify the musculature of the bladder

Answer 2

That the bladder wall is composed of thick layer of interwoven bundles of smooth muscle running transversely, longitudinally, and obliquely — known as the detrusor muscle

Question 3

State and be able to identify the anatomical position of the kidneys

Where are they?

Where do they sit?

Which is higher?

Answer 3

• Posterior muscle wall of the abdominal cavity
• Left kidney is slightly more superior due to the large liver on the right
• Retroperitoneal

Question 4

Identify the medulla, cortex, renal pyramids and associated structures within a human kidney

Answer 4