Urinary System Flashcards
Zones affected by BPH
Transitional zone
Arterial supply of the ovaries
Ovarian artery (branch of aorta)
Describe the 3 fascial layers of the spermatic cord and their origins
- External spermatic fascia from the external oblique aponeurosis
- Cremasteric fascia and cremaster from internal oblique aponeurosis
- Internal spermatic fascia from the transversalis fascia
What features must substances have to be used to measure GFR
- Inert
- Free filtration from the plasma at the glomerulus
- Not absorbed or secreted in at the tubules
- Plasma concentration constant during urine collection
3 divisions of the male urethra
- Prostatic
- Membranous
- Penile (Bulbous)
Testicular lymphatic drainage
Para-aortic nodes
Lateral relations of the uterus
- Broad ligament
- Ureter lies superolateral to the supravaginal cervix
Arterial supply of the testes
Testicular artery (branch of the aorta)
Describe the course of the ovarian ligament
Runs within the broad ligament to the cornu of the uterus
Describe the course of the left renal vein
- Longer
- Passes in front of the aorta at the level of the SMA (L1)
- Receives the adrenal vein and gonadal vein
Describe the structure of the uterine wall
- Perimetrium - outer serous coat
- Myometrium - middle coat of smooth muscle - vascular layer
- Endometrium - inner mucous coat - active in the menstrual cycle
Where is the timing of micturition controlled
Pontine micturition centre
What is the forward continuation of the bulb of the penis and what does it contain
Corpus spongiosum surrounds the penile urethra
Scrotal exploration - layers of incision
- Skin
- Dartos muscle (superficial fascia)
- External spermatic fascia
- Cremaster muscle
- Internal spermatic fascia
- Parietal layer of tunica vaginalis
(7. Visceral layer of tunica vaginalis)
What converts 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol
1-alpha-hydroxylase
Capillary pressure within the afferent capillaries
50mmHg
Layout of the hilum of the kidney
From anterior to posterior:
- Renal vein
- Renal artery
- Pelvis of the ureter
Venous drainage of kidney
Renal vein into IVC
Where is calcium and phosphate reabsorbed and how is this regulated
- Both actively reabsorbed in PCT and ascending loop of Henle
- Any remaining is reabsorbed in DCT/collecting duct
- Absorption in the DCT/collecting duct is regulated by PTH
- PTH stimulates calcium reabsorption and phosphate excretion
Venous drainage of testes
Pampiniform venous plexus forms right and left testicular veins
Level of the kidneys
T12-L3
What occurs in the descending loop of Henle
- Water is removed
- NaCl is added from medulla
- More concentrated from addition of NaCl and reduction in volume from removal of H2O (1200mosmol/L)
Describe the division and distribution of the renal artery
- Anterior (75% of flow)
- Posterior (25% of flow)
Actions of angiotensin 2
Stimulates:
- Arterial vasoconstriction
- Release of ADH
- Drinking
- Release of aldosterone
Superior relations of left kidney
- Spleen
- Adrenal gland
Describe the posterior relations of the right kidney
- Diaphragm
- 12th rib
- Psoas major, quadratus lumborum, transversus abdominis
- Subcostal, iliohypogastric, ilioinguinal nerves
Where is the prostate plexus of veins and nerves situated
True (fibrous) capsule
Describe the lobes of the prostate
- Posterior lobe - posterior to urethra and inferior to plane defined by ejaculatory ducts
- Median lobe - lies between ejaculatory ducts and is posterior to urethra
- Right and left lobes - separated by a shallow posterior median groove
- Isthmus - narrow, anterior to urethra
Describe ductus deferens
- Thick wall and small lumen
- Begins at tail of epididymis
- Ascends posterior to testes
- Penetrates anterior abdominal wall via inguinal canal
- Crosses over external iliac vessels to enter pelvis
- Ends by joining duct of the seminal gland to form ejaculatory duct
At what BP does autoregulation fail
- <80
- >180
Name of opening of fallopian tube
Ostium
Describe the suspensory ligament
- Prominent fold of peritoneum
- Attached to superior poles of the ovaries
- Passes up over the pelvic brim and external iliac vessels to blend with the peritoneum over psoas major
- Contains ovarian vessels, lymphatics, and nerves
- Becomes continuous with mesovarium
Anterior relations of the uterus
- Uterovesical pouch of peritoneum
- Lies on superior surface of bladder
- Supravaginal cervix directly related to bladder
Ureter narrowings
- Pelviureteric junction
- Cross the pelvic brim
- Passage through wall of the urinary bladder
Course of spermatic cord
- Begins at the deep inguinal ring lateral to the inferior epigastric vessels
- Passes through inguinal canal
- Exits at superficial ring
- Ends in the scrotum
Location of female urethral orifice
Vestibule of vagina directly anterior to the vaginal orifice
What stimulates renin release
- Decrease in afferent arteriole pressure
- Reduction in Na+ (detected by macula densa)
- Renal sympathetic nerve stimulation
What do the juxtaglomerular cells secrete
Renin
Describe dartos fascia
- Fat-free fascial layer
- Includes smooth muscle fibres (dartos muscle)
- Continuous anteriorly with Scarpa’s fascia
- Continuous posteriorly with Colle’s fascia
What forms the juxtaglomerular apparatus
- Juxtaglomerular cells of the afferent arteriole
2. Macula densa cells in the DCT
What encapsulates the testes
Visceral layer of tunica vaginalis (closed peritoneal sac)
Where is the penis anchored to the body
Right and left crura are attached to the inferior pubic rami and the perineal membrane
Lymphatic drainage of the male urethra
- Prostatic and membranous = obturator and internal iliac nodes
- Penile = deep and superficial inguinal nodes
Venous drainage of the ovaries
- Right ovarian vein drains into IVC
- Left ovarian vein drains into left renal vein
Where is potassium reabsorbed and how is this regulated
- Active reabsorption in PCT and ascending loop of Henle
- Aldosterone stimulates secretion of K+ into the DCT
Describe the cardinal ligament
- Located at base of broad ligament
- Extends from cervix to lateral pelvic walls
- Contains uterine artery and vein
Embryological origins of the adrenal gland
- Medulla = neural crest (ectoderm)
- Cortex = mesoderm
Anatomical relations of the vagina
- Anterior = fundus of bladder and urethra
- Lateral = levator ani, visceral pelvic fascia, ureters
- Posterior = anal canal, rectum, recto-uterine pouch
Lymphatic drainage of prostate
Internal iliac nodes
Describe the structure of the fallopian tubes
- Covered by peritoneum (apart from intramural part)
- Outer longitudunal muscle coat
- Inner circular muscle layer
- Columnar ciliated lining
List the parts of the fallopian tubes
- Infundibulum
- Ampulla
- Isthmus
- Uterine
Function of Onuf’s nucleus
The neurons of Onuf’s nucleus are responsible for controlling external sphincter muscles of the anus and urethra in humans
Zones affected by carcinoma
Peripheral zone
Describe atonic bladder
- Occurs in initial phase of spinal shock and can last weeks
- Bladder wall muscle relaxed
- Sphincter vesicae is contracted
- Urethral sphincter relaxed
- Bladder becomes distended and eventually empties as overflow
Embryological origin of the urethra
Cloaca
Describe how the ureters enter the bladder
- Pass obliquely through the muscular wall
- Ureteric orifice is in the trigone
What is Gerotas fascia
Eponymous name for renal fascia
Describe the round ligament
- Remnant of the Gebernaculum
- Extends from uterine horns to the labia majora via the inguinal canal
- Maintains anteverted position of uterus
Innervation of the penis
Pudendal nerve
Blood supply to the prostate
Prostatic arteries - derived from internal iliac (especially inferior vesical)
What stimulates EPO production
- Haemorrhage
- Respiratory disease
- High altitude
- Vasoconstriction
- Increased levels of RBC degradation products
Describe the anterior relations of the left kidney
- Suprarenal glands
- Spleen
- Stomach
- Pancreas
- Left colic flexure
- Jejunum
Describe the course of the membranous urethra
- Passes through the pelvic floor and deep perineal pouch
- Surrounded by external urethral sphincter
- Narrowest and least dilatable portion of urethra
What covers the outer surface of each penile crus
Ischiocavernosus muscle
Injury at what spinal level would a patient lose awareness of bladder distension
L1-2
What surrounds the three cylinders of erectile tissue
Buck’s fascia
What is the isthmus of the uterus
Internal OS
What is the role of renin
Stimulates the conversion of angiotensinogen to angiotensin 1
Describe the renal fascia
- Encloses the kidney, suprarenal glands, and perirenal fat
- Extends along the ureter as periureteric fascia
- Superiorly is continuous with the fascia of the diaphragm
- Medially blends with fascia of aorta and IVC
- Laterally continuous with the transversalis fascia
Anatomical relations of the bladder
- Anterior = pubic symphysis
- Posterior: Males = rectum and seminal vesicles. Females = vagina and supravaginal cervix
- Superior = peritoneum, coils of small bowel, sigmoid, body of uterus
- Lateral = loose connective tissue
Innervation of the external urethral sphincter
Pudendal nerve
Pressure within Bowman’s capsule
10mmHg
Where does fertilisation typically occur
Ampulla of the tube
Lymphatic drainage of the kidney
Directly into the para-aortic nodes