Ureters, urinary bladder and micturition Flashcards

1
Q

What are three basic renal processes?

A

Glomerular filtration
Tubular secretion
Tubular reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where are the major and minor calyces found?

A

major - pelvis of ureters
minor - medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the role of the major and minor calyces?

A

Collect ultra-filtrate from the collecting ducts and empty it into renal pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the four layers of the ureter?

A

Adventitia, muscular region, lamina propia and urothelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What two types of muscle are present in the muscular region?

A

Outer circular layer
Inner longitudinal layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What 3 features are lined by the urothelium?

A

Renal pelvis
Ureters
Urinary bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How are the inner longitudinal muscle fibres arranged?

A

Bundles parallel with long axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How are the outer circular muscle fibres arranged?

A

Circular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the function of the urothelium?

A

Permeability barrier
coated with uroplakin molecules - tight barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What types of cells are found in the urothelium?

A

Intermediate between stratified cuboidal and stratified squamous epithelia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the three layers of the bladder urothelium?

A

Basal layers (cuboidal) - 1 layer
Intermediate layers (columnar) - 7 layers
Surface cells (umbrella cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are umbrella cells interconnected by?

A

Tight junctions and apical membrane contains uroplakin proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When do peristaltic contractions occur?

A

Renal calyxes and upper regions of the ureters become distended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where do the peristaltic waves originate from?

A

Electrical pacemakers in proximal portion of renal pelves
myogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 3 features of the ureterovesical junction?

A

Fundus comprised of detrusor muscle
Internal urethral sphincter
External urethral muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What maintains the structural integrity of the bladder?

A

3 muscles: inner circular, inner and outer longitudinal
Urine enters at an oblique angle
Urine runs submucosally

17
Q

What prevents the backflow of urine?

A

As the bladder fills it exerts high pressure on the ureters

18
Q

What is micturition coordinated by?

A

Combination of smooth and skeletal muscle relaxation and contraction

19
Q

What does autonomic nervous system control?

A

Controls smooth muscles - detrusor muscle and internal urethral sphincter

20
Q

What does somatic nervous system control?

A

Skeletal muscles - external urethral sphincter

21
Q

Where do sympathetic fibres originate from?

A

T11
L2

22
Q

What nerve innervates the detrusor and internal urethral sphincter?

A

Hypogastric nerve

23
Q

What neurotransmitter is released by sympathetic postganglionic nerves?

A

Noradrenaline

24
Q

What do beta adrenergic receptors do in the detrusor muscle?

A

Inhibitory receptors relax the bladder

25
Q

What do alpha adrenergic receptors do to the IUS?

A

Excitatory receptors cause IUS contraction

26
Q

Where do parasympathetic fibres arise from?

A

S2-S4 sacral spine segments

27
Q

What nerve innervates the bladder wall?

A

Pelvic nerve to ganglia in pelvic plexus

28
Q

What do parasympathetic nerve fibres release?

A

Acetylcholine (ACh), ATP and NO

29
Q

ACh and ATP activates?

A

M3 muscarinic (ACh)
P2X purinergic (ATP)
in detrusor muscle

30
Q

What does NO activate?

A

NO-cGMP dependent inhibitory receptors on IU smooth muscle

31
Q

What does the somatic nervous system allow?

A

Conscious control over micturition

32
Q

Where do somatic nerve fibres arise from?

A

S1-S5 sacral regions of Onuf’s nucleus

33
Q

What type of nerves supply EUS?

A

Cholinergic motor nerves

34
Q

How does the somatic stimulus reach the periphery?

A

Through pudenal nerves

35
Q

What do somatic motor nerves release?

A

ACh

36
Q

What do somatic motor nerves release?

A

Nicotinic receptors in EUS causing contraction

37
Q

What is micturition inhibited by?

A

Hypogastric (sympathetic) nerves
Pudenal nerves
(spinal cord)

38
Q

What is micturition stimulated by?

A

Pelvic (parasympathetic) nerves
(brain)