Week 1 - Anatomy of the Ureters, Bladder and Urethra

Question 1

Where do the ureters arise?

What is this point called?

Answer 1

Arise from the renal pelvis at the ureteropelvic junction

Question 2

Describe the anatomical course of the ureters as they move from the abdomen to the pelvis

Answer 2

At the level of the sacroiliac joints, they cross the pelvic brim, anterior to the bifurcation of the common iliac arteries

Question 3

Describe the anatomical relationship of the vas deferens and the ureters in males.

Answer 3

The ureters pass posteriorly to the vas deferens

Question 4

In males, the ureters pass posteriorly to the vas deferens.

What reproductive structures do the ureters pass posteriorly to in the female?

Answer 4

The ovaries

Question 5

Explain the saying “water under a bridge” in relation to the ureters

Answer 5

The ureters pass underneath the uterine arteries in the female

Question 6

Describe the course of the ureters upon entering the bladder.
This is the same in both genders.

Answer 6

Enter posterolateral surface of bladder and run obliquely through bladder wall

Question 7

What is the blood supply to the ureters?

Answer 7

Segmental artery from the renal, gonadal, and vesicle/uterine arteries

Question 8

State the anatomical position of the urinary bladder

Answer 8

Lies posterior to the pubic bones and pubic symphysis, within the pelvic cavity

Question 9

What shape is the bladder when empty?

Answer 9

Tetrahedral - base (posterior surface), superior surface and 2 infero-lateral surfaces

Question 10

What is the trigone, and what landmarks define it?

Answer 10

An triangular area of the internal bladder.
The superior corners are the ureteric openings, joined by the inter-ureteric ridge, and the inferior corner is the internal urethral opening.

Question 11

What shape is the bladder when full?

Answer 11

Oval

Question 12

What are the important external features of the full bladder?

Answer 12

Apex - point of attachment of median umbilical ligament
Body
Fundus (base)
Neck - joins bladder to urethra

Question 13

What is the specialised muscle of the bladder wall called?

Why is it special?

Answer 13

Detrusor muscle

Fibres run in 3 directions, hence bladder retains structural integrity when stretched

Question 14

What is significant about the trigone when the bladder is full?

Answer 14

It is non-distensible so does not stretch

Question 15

What sort of epithelium lines the urethra? Why?

Answer 15

Stratified columnar

Has mucus-secreting glands to protect against corrosion by urine

Question 16

How long is the male urethra?

Answer 16

15 - 20cm

Question 17

What are the 4 divisions of the male urethra?

Answer 17

Pre-prostatic
Prostatic
Membranous
Spongy

Question 18

Where does the pre-prostatic urethra run from?

Answer 18

Internal urethral orifice of bladder to prostate

Question 19

Where does the membranous urethra run between?

Answer 19

Runs from the inferior end of the prostate through the pelvic floor and deep perineal pouch.

Question 20

Where does the spongy urethra run between?

Answer 20

Passes through corpus spongiosum of penis. Ends at external urethral orifice

Question 21

Where is the involuntary internal sphincter found?

What is it formed by?

Answer 21

Found at the neck of the bladder

Formed from detrusor muscle running circularly around the neck.

Question 22

What is the role of the involuntary internal sphincter in the male?

Answer 22

Prevents semen from regurgitating into the bladder during ejaculation

Question 23

In which part of the male urethra would you find the external urethral sphincter?

Answer 23

The membranous region

Question 24

How long is the female urethra?

Why is this clinically relevant?

Answer 24

Around 4cm long

Leaves women prone to UTIs

Question 25

Describe the anatomical course of the female urethra

Answer 25

Begins at neck of bladder.
Passes inferiorly through the perineal membrane and muscular pelvic floor
Opens directly onto the perineum

Question 26

What is the function of the ureters, and how does their structure relate to this?

Answer 26

Transport urine from the kidney to the bladder.

Walls comprised of smooth muscle which contracts in peristaltic waves