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Anatomy Test Block IV > Urogenital System and Pelvic Structures > Flashcards

Urogenital System and Pelvic Structures Flashcards

1
Q

Where is the ureter system located?

A

completely outside of the peritoneum

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2
Q

What is the relation of the kidney to the ribs?

A

1/2 of kidney is contained w/i the 12th rib.

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3
Q

Due to the relationship w/ the kidney and 12th rib, what do you test in possibly kidney disease?

A

CVA (costovertebral angle) - will have pain there if any kidney disease is present

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4
Q

What is the asymmetry of the renal vein?

A

left renal vein is longer than the right

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5
Q

Where do the gonadal veins drain?

A

left: drains to left renal vein
right: drains to IVC

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6
Q

Renal fascia

A

surrounds kidney and suprarenal gland; have fat on both sides of it (order would be fat, renal fascia, then fat again)

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7
Q

The anterior renal fascia blends with that?

A

coverings of the renal vessels

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8
Q

The posterior renal fascia blends with what?

A

psoas fascia

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9
Q

medulla of kidney

A

the collecting parts

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10
Q

What is the makeup of the cortex of the kidney?

A

Arranged in pyramids which come to a cone (cribriform area) which drain urine into minor calyces, which drain into major calyces which drain into renal pelvis then on into ureter

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11
Q

What is the reationship, in both males and females, between the ureter and other structures?

A

water under the bridge:

males: ureter passes beneath ductus deferens
females: ureter pases under the uterine a.

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12
Q

What is responsible for the wave-like pain in kidney stones?

A

peristalsis in the ureter; if pain is constant, likely not a ureter problem

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13
Q

Trigone

A

non-distensible part of bladder wall b/w the entrance of the ureters and exit of urethra

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14
Q

What is the contractile portion of the bladder?

A

detrusor muscle

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15
Q

bladder cancer is almost always due to what?

A

nicotene exposure

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16
Q

What prevents ureteral reflux? aka urine backing up into the ureter

A

the ureters course indie of the muscle before opening into the bladder

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17
Q

When autonomics say the bladder is full, which sphincter is released out of our control?

A

the internal urethral sphincter at the bladder outlet

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18
Q

Which sphincter is under somatic control?

A

external urethral sphincter

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19
Q

In females, the tone of the external urethral sphincter is dependent on what?

A

estrogen; between menopause and giving birth it loses a lot of tone causing incontinence issues

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20
Q

What innervates the internal urethral sphincter?

A

sympathetics

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21
Q

What innervates the detrusor muscle?

A

parasympathetics via pelvic splanchnics S2-4; synapse right by muscle

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22
Q

What innervates the external urethral sphincter?

A

pudendal n.; (voluntary and somatic) through SOMATIC S2-4

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23
Q

What is inhibited while peeing?

A

sympathetics to the internal sphincter

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24
Q

Renal calculi

A

aka kidney stones; pain starts in CVA and as stone travels down ureter, pain shifts to flank then into labia or scrotum. Pain is gone when stone reaches bladder.

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25
Q

Where is the new kidney placed during transplant?

A

the pelvic area; the bad kidney is left in place unless gangrenous

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26
Q

What is one of the most common anomilies related to the kidneys?

A

the kidney never loses it’s original blood supply

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27
Q

pelvic kidney

A

one that never ascended

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28
Q

horseshoe kidney

A

kideny never separated into 2 different elements so wraps around the front of IVC and aorta; can compress arteries and need correction

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29
Q

What is the vascular supply to the suprarenal aka adrenal glands?

A

huge vascular supply; from inferior phrenic, aorta and renal arteries

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30
Q

Where does the suprarenal vein drain?

A

Right: IVC
Left: left renal vein

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31
Q

What are the two parts of the adrenal gland?

A

cortex: under hormonal control so not highly vacularized
medulla: highly vascularized

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32
Q

How is the medulla innervated?

A

sympathetics synapse in celiac ganglion then travel via blood vessels to adrenal medulla

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33
Q

What is the effect of sympathetics to the adrenal medulla?

A

dumping a ton of epinephrine into suprarenal vein which goes to heart and gives you the “heart skips a beat” feeling

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34
Q

All the major nerves of the pelvis (like obturator, femoral, subcostal, etc.) are what?

A

ventral primary rami

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35
Q

What nerve supplies the skin of the thigh?

A

lateral femoral cutaneous

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36
Q

What nerve supplies the cremaster muscle?

A

genitofemoral

37
Q

What divides the false and true pelvis?

A

arcuate line aka pelvic inlet

38
Q

What is the anterior deficit in the pelvic floor?

A

perineum

39
Q

perineal body

A

behind scrotum/vagina and infront of anus (whole are is perineum itself)

40
Q

The acetabular fossa is formed by what 3 bones?

A

ischium ileum and pubic bones

41
Q

What is the difference in the shape of the infrapubic angle for males and females?

A

males: more V shaped
females: more U shaped

42
Q

Where does the growth plate sit in relation to the coxal bone?

A

at the top of the wing (ala) of the ilium

43
Q

What is significant about the growth plate above the ilium?

A

it is the last to close at 19 y/o

44
Q

What come out of the foramena of the sacrum?

A

VPR and DPR

45
Q

sacral promontory

A

S1; can feel when doing a pelvic exam

46
Q

What muscles make up the levator ani?

A

pubococcygeus/puborectalis

ileococcygeus

47
Q

What are the 3 muscles that form the pelvis diaphragm?

A

pubococcygeus/puborectalis
ileococcygeus
ischiococcygues aka coccygeus

48
Q

Where is the pelvic diaphragm suspended from?

A

the tendonous arch of obturator internus

49
Q

What innervates the pelvic diaphragm?

A

(somatic) pudendal n. S2-4 (keeps pelvis off the floor)

50
Q

There is a pelvic defect anteriorly for what?

A

urethra and vagina

51
Q

Almost everything leaving the pelvis does so via what?

A

greater sciatic foramen

52
Q

What ligament forms the greater sciatic foramen?

A

sacrospinous ligament

53
Q

What does the obbturator n. innervate?

A

adductors of the thigh

54
Q

What muscle runs w/ the greater sciatic foramen?

A

pyriformis muscles

55
Q

What is unique about the way the pundendal n., internal pudendal a and v travel?

A

they leave the pelvis through greater sciatic foramen then turn and go back through the lesser sciatic foramen

56
Q

What is the control of the internal and external anal sphincters?

A

external: somatic
internal: autonomic

57
Q

What vein drains the rectal area?

A

superior rectal v. - part of inferior mesenteric vein

58
Q

What is the anastomses around the rectum?

A

superior rectal vein, middle rectal and inferior rectal

59
Q

internal vs external hemorrhoids

A

internal: autonomic
external: somatic

unless you can see that the blood is coming driectly from an external hemorrhoid, refer to GI

60
Q

What are the rectal arteries branches of?

A

superior: inf. mes
middle: internal iliac
inferior: pudendal

61
Q

What give parasympathetic innervation to the rectum?

A

pelvic splanchnics - defecation

62
Q

What gives somatic innervation to skin and external sphincter (below pectinate line)

A

inferior rectal branches of the pudendal

63
Q

What gives visceral innervation to the internal sphincter and mucous membranes?

A

hypogastric plexus

64
Q

broad ligament

A

parietal peritoneum reflection over the pelvic organs in the female

65
Q

top of the uterus

A

fundus

66
Q

Rectouterine pouch of Douglas

A

b/w the uterus and rectum - if there is fluid in peritoneal cavity (like from ovarian cancer) it will collect in this pouch. Can sample fluid by passing need through fornix of vagina into pouch

67
Q

Where do secretions tend to collect in the female pelvis?

A

posterior fornix

68
Q

What anchors the ovary to the back wall?

A

suspensory ligament

69
Q

What is contained w/i the suspensory ligament?

A

ovarian a. and v.

70
Q

Where does most ferilization occur?

A

ampulla

71
Q

What are the variations of the external os?

A

mulaiparous (had kids) is flattened oval

nulliparous (no kids) round hole

72
Q

Round ligament

A

attaches to labia majora; stretches w/ pregnancy and can get lateral pain

73
Q

What is the relationship between the ureter and uterine a.?

A

ureter goes under the uterine a.

ureter is often clipped when removing uterus - need to watch for peristalsis before cutting

74
Q

cardinal ligament

A

connects cervix laterally to pelvic wall; supports uterus; if lax can get prolapse

75
Q

What is the route of the ductus deferens?

A

through the superficial and deep ring, wraps around bladder, goes under ureter where it picks up duct from seminal vesicle to form ejaculatory duct

76
Q

Any injury above the pubic bone in a male runs risk of what?

A

penetrating bladder, especially if it’s full

77
Q

What holds the prostate to the pubic bone?

A

puboprostatic ligament

78
Q

unable to urinate and blood at tip of penis could indicate what?

A

ruptured urethra

79
Q

What is the relationship b/w the ductus deferens and seminal vesicles?

A

ureter goes under the ductus deferens

80
Q

Why are the renal a. and testicular a. close together?

A

b/c the testicles develop from mesoderm near the kidney and move anterior over the ureters

81
Q

What can happen in males w/ a deceleration injury?

A

rip the urethra at the prostate - never try to cath someone w/ blood coming ut of penis

82
Q

prostatic hyperplasia

A

overgrown prostate; can obstruct prostatic urethra and get problems w/ hesitancy of urination and decreaesed force of stream

83
Q

What arteries go out the superior sciatic foramen to supply the gluteal region?

A

sup and inf gluteals

84
Q

How does the superior gluteal a. travel?

A

it passes above the pyriformis and then out the greater sciatic foramen

85
Q

Where do the inferior gluteal and internal pudendal travel?

A

below the pyriformis and exit the greater sciatic foramen

86
Q

What does the obturator a. pass through?

A

obturator foramen

87
Q

Where do pelvic organs drain lymphatics?

A

internal iliac nodes

88
Q

Where do gonads drain lymphatics?

A

toward channels along the aorta

Anatomy Test Block IV (5 decks)

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