Urinary Tract Flashcards
What are the layers of cells in a urinary bladder?
- Subepithelial connective tissue
- basement membrane – only visible via EM b/c it’s soo thin
- basal cells
- intermediate cells
- umbrella cells
* these are from bottom up
what are the layers in an ureter
- Mucosa - composed of transitional epithelium and lamina propria
- Muscularis - has external, intermediate, and internal muscle bundles
- Adventitia of CT
* uses peristaltic contractions
What are acquired strictures of the ureter a result of
chronic inflammation or sclerosing retroperitoneal fibrosis
What does obstruction of the ureters give rise to
hydroureter, hydronephrosis, and sometimes pyelonephritis
Does the ureter more commonly get primary tumors or it is impacted by metastatic tumors?
Mets
What are the 2 MC benign primary tumors of the ureter
fibroepithelial polyps and leiomyomas
What is the majority of primary malignant tumors of the ureter
transitional cell carcinoma – same type is seen in renal pelvis and urinary bladder
What is hydronephrosis
obstruction of ureter causes distention of renal pelvis and increased pressue on the parenchyma of the kidney.
What are examples of periureteral inflammation of
- salpingitis (inflammation of fallopian tube)
- Diverticulitis (inflammation of intestional diverticulum and surrounding tissues)
- Peritonitis (inflammation of peritoneum)
- Sclerosing retroperitoneal fibrosis
what is sclerosing retroperitoneal fibrosis
fibrous proliferative inflammatory process encasing the retroperitoneal structures including ureter and causing compression of it.
- Rare!
What is endometriosis of ureter
presence of endometrial tissue in ureter. Functionally active. Proliferation is followed by bleeding and eventually by scarring and can cause compression of ureter
What is ureteritis cystica
- may develop due to UTI
- accumulation of lymphocytes in subepithelial region of ureter may produce a fine granularity
- another form is mucose of ureter shows fine cysts filled w/ clear yellow fluid
who is uteropelvic junction obstruction common in
on the left side of male infants/kids
What are congential and acquired anomalies of the bladder caused by
- enlargement of prostate
- cystocele of bladder
- strictures of urethra
- post inflammation fibrous and contraction
- bladder tumors
- mechanical obstruction
- injury to innervation of bladder
What will obstruction to the bladder neck result in
increased pressure w/in the bladder cuases hypertrophy of its muscle. Trabeculations forms. time crypts form and may become true acquired diverticula.
What are diverticuli
pouch like evaginations of bladder wall
- congenital caused by focal muscular defect
- acquired caused by persistent urethral obstruction
What is exstrophy
development defect of anterior wall of abdomen, bladder communications w/ exterior of body via open sac. Increased incidence of adenocarcinoma
What is urachus
vestigial structure b/w apex of bladder and umbilicus
What was the normal function of the urachus
connected the bladder to the allantois.
What happens when the urachus is totally patent
fisutulous urinary tract forms that connects the bladder w/ the umbilicus. If central region of urachus persists then a urachal cysts can form
What will arise in urachal cysts
adenocarcinoma
What is cystocele
protrusion of the baldder into the vagina, caused by relaxation of pelvic support in females leading to uterine prolapse pulling the bladder floor downward
What is the normal angle that the ureters enter the bladder
oblique - allows enclosing bladder musculature to act like a sphincteric valve, blocking the upward reflux of urine
What is vesicoureteral reflux
a defect in the intravesical portion of the ureter. Ureters enter acutely and backward flow of urine is allowed
