Week 1 - B - Anatomy of Lower Renal Tract and Male reproductive tract

Question 1

The urinary tract consists of the kidneys, ureters, bladder, and urethra Which part is located in the abdomen?

Answer 1

The right and left kidneys and their proximal ureters

Question 2

The ureters pass from the retroperitoneum through the flase pelvis to the true pelvis Where do the ureters travel to which is located in the false pelvis?

Answer 2

Travel to the bladder

Question 3

WHat is the location of the true and false pelvis?

Answer 3

False pelvis - iliac crests to the pelvic inlet (brim) True pelvis - pelvic inlet to the pelvic floor

Question 4

the pelvic floor is formed by the “bowl shaped” pelvic diaphragm What is the main muscle of the pelvic diaphragm called?

Answer 4

Levator ani muscle (innervated by pudendal nerve)

Question 5

The pelvic floor contains holes for GI and Urinary structures, what are these structures?

Answer 5

These are the rectum and the urethra that pass through the pelvic floor

Question 6

What is the shallow compartment between the pelvic floor and the skin known as? (it is the space between external genitalia and the anus)

Answer 6

The perineum

Question 7

What are the contents of the renal hilum and their location in relevance to one another? What surface of the common iliac artery does the ureter run by?

Answer 7

Renal vein anteriorly Renal artery posteriorly Ureter inferiorly The ureter runs over the anterior aspect of the common iliac artery

Question 8

At what level do the ureters rotate medially to enter the posterior aspect of the bladder?

Answer 8

They rotate medially at the level of the ischial spine

Question 9

The ureters enter the posterior bladder wall in an inferomedial direction What does this help prevent?

Answer 9

This helps prevent reflux of the urine into the ureter when the bladder contracts

Question 10

In the anatomical position, what is the most inferior part of the male peritoneal cavity?

Answer 10

The rectovesical pouch Once reached vesicle we are no longer in the pertioneal cavity and are in the pelvic cavity Can see the pouch here with the rectum being a retroperitoneal organ

Question 11

in the anatomical position what is the most inferior part of the female peritoneal cavity ?

Answer 11

This is the rectouterine pouch - Pouch of Douglas

Question 12

What is the pouch between uterus and the bladder in females?

Answer 12

In Females: Shallow pouch that occurs between the bladder and the uterus.

Question 13

The uterine tube - aka the follapian tube connects to the uterus Does the ureter run inferiorly/superiorly (when supine) or posteriorly/anteriorly (when in the anatomical position)?

Answer 13

It runs inferiroly when supine and posteriorly when in the anatomical position

Question 14

The common iliac artery bifurcates to form the external and internal iliac arteries Which artery gives off the femoral artery deep to the inguinal ligament? Which artery mainly gives off the branches for arteries entering the pelvis?

Answer 14

Femoral artery is a continuation of the external iliac the arteries entering the pelvis are mainly branches from the internal iliac artery (veins drain to the internal iliac vein)

Question 15

the 2 ureteric orifices and the internal urethral orifice form the 3 corners of a triangle shape on the internal aspect of the bladder known as what?

Answer 15

This structure is known as the trigone

Question 16

What is the orifice where urine exits the bladder known as?

Answer 16

This is known as the internal urethral orifice

Question 17

What is the muscle forming the main bulk f the bladder wall known as? What happens when this muscle contracts?

Answer 17

This is the detrusor muscle Bladder empties when this contracts

Question 18

What is the superior surface of the bladder lined by? The inferomedial angle of the ureters entering the posterior apsect of the bladder helps prevent reflux of urine What is another mechanism to help prevent reflux of urine into the ureter?

Answer 18

Lined by the peritoneum detrusor muscle fibres encircle the ureteric orifices, these fibres tighten when the bladder contracts helping prevent reflux

Question 19

around the neck of the male bladder, the detrusor muscle forms the internal urethral sphincter muscle When does this contract?

Answer 19

Contracts during ejaculation to help prevent retrograde ejaculation of semen into the bladder

Question 20

Is the internal or external urethral sphincter under voluntary control?

Answer 20

Internal urethral sphincter - involuntary (detrusor muscle which is smooth muscle forms this sphincter) External urethral sphincter - under voluntary control

Question 21

What is the urethra known as passing from the internal urethral orifice to the external and why?

Answer 21

Known as the prostatic urethra as it travels through the prostate gland

Question 22

The bladder is the most anterior organ in the pelvis lying posterior to the pubic bone (when empty) What lies immediately inferior to the bladder?

Answer 22

The prostate gland

Question 23

In the female, the body of the uterus usually lies superior to the bladder What is this normal position known as?

Answer 23

Anteflexed position - due to this most of the weight of the uterus presses on the bladder

Question 24

An empty bladder lies within the pelvis posterior to the pubis with peritoneum covering its superior surface only When their is a full bladder it can expand into the out of the pelvis, what happens to the peritoneum now?

Answer 24

peritoneum still only covers its superior surface

Question 25

What is the most common way for catheterising a patient?

Answer 25

Urethral catheter (suprapubic is the other way to cathertise a paitent)

Question 26

What is the rough distance in lengths between the male and female urethras? What does the distance in urethra length cause the female patient to more likely get?

Answer 26

The rough distance for male is 20cm For female urethra it is 4cm Female patient is more likely to get UTI due to shorter urethra

Question 27

Is there an internal urethral sphincter in females?

Answer 27

NO The external urethral sphincter in males and females is skeletal muscle arranged circularly around the urethra

Question 28

Once the urethra extends into the penis - its name changes to penile urethra What can it also be known as due to the tissue it resides within? what is this tissue? What is the exit from the penis knwon as?

Answer 28

Can also be known as the spongy urethra as it travels through the corpus spongiosum Exit is the external urethral orifice (also knwon as urinary meatus)

Question 29

What is the embryological position of the testis from which they descend?

Answer 29

The originate in the posterior abdomen

Question 30

The opening of the inguinal canal (the opening is the deep inguinal ring) is located just superior to the midpoint of the inguinal ligament Where is the inguinal ligament located? What descends from the posteiro abdomen wall to pass through the inguinal canal on route to its final destination?

Answer 30

Inguinal ligament - located from anterior superior iliac spine (ASIS) to the pubic tubercle

Question 31

What structures are located within the spermatic cord? Which drains into the testicular vein?

Answer 31

The testicular artery The vas deferens Lymphatic vessels The testicular vein - the pampiniform plexus of veins drains into this

Question 32

is found only within the male human body and covers the testis and spermatic cord. The muscle moves the testis, promoting healthy and motile sperm. Its muscle lowers and raises the testis in order to control its temperature. What is this muscle?

Answer 32

The cremaster muscle The deep inguinal ring is the entry to the inguinal canal, the superficial inguinal is the exit into the spermatic cord

Question 33

What is the layer immediately superifical to the testis which the testis sit inside?

Answer 33

This is the visceral layer of the tunica vaginalis

Question 34

What is a usually painless sweling occuring due to a patent tunica vaginalis causing fluid to form around the testis? Usually occurs infants

Answer 34

A hydrocele

Question 35

What is The most common cause of acute testicle in boy? Torsion of this can result in a blue dot discolouration on the scrotum

Answer 35

This is due to torision of the appendix testos (Hydatid or Morgagni)

Question 36

the testis and epididymis are attached to the spermatic cord superiorly and are quite mobile within the scrotum this can put the testis at risk of twisting the testis and epididymis are attached to the spermatic cord superiorly and are quite mobile within the scrotum this can put the testis at risk of twisting What dose testicular torsion present like?

Answer 36

Rapid onset causing extreme pain with necrosis settling in after a few hours - urgent surgery

Question 37

The pampiniform plexus of the testis (located in the spermatic cord) drain back into the right and left testicular veins Where do these veins drain back into?

Answer 37

Right testicular vein - drains back into the Inferior vena cava Left testicular vein - drains back into the left renal vein which drains into the inferior vena cava

Question 38

Where is sperm produced and where does it travel after production? (go as far as the inferior pole of the testis)

Answer 38

Sperm is produced in the seminiferous tubules of the testis and then travel to the rete testis It then travels to the superior pole of the testis where the head of the epididymis is located. Sperm runs down the epididymis to the inferior pole where the vas deferens is located

Question 39

After reaching the vas deferens, where does the sperm travel? (all the way to ejaaculatory duct)

Answer 39

Sperm travel superiorly through the spermatic cord to the deep inguinal ring (still within the vas deferens) and then turns medially into the pelvis The vas deferens reaches the seminal vesicle (which secretes fluid to make sperm semen) and joins with the seminal vesicle duct to form the ejaculatory duct

Question 40

The ejaculatory duct enters the prostate gland now becoming the prostatic urethra What is the inferior aspect of this walnut sized gland in contact with?

Answer 40

It is in contact with the levator ani muscle

Question 41

Which part of the prostate gland do most cancers of the prostate arise in? This is the pat felt on PR examination

Answer 41

The peripheral zone

Question 42

The penis is located within the perineum The corpus spongiosum transmits the spongy (penile) urethra There are three cylinders of erectile tissue, what are the name of the two which transmit the deep arteries to the penis?

Answer 42

The right and left corpus cavernosum

Question 43

In the anatomical position, is the coprus spongiosum or right and left corpus cavernosum posterior?

Answer 43

In anatomical position of the penis The right and left corpus cavernosum are posterior

Question 44

Blood supply to the penis is via the deep arteries of the penis; branches of the internal pudendal artery (from the internal iliac) What is the blood suply to the scrotum?

Answer 44

Blood supply to the scrotum is from scrotal branches via the internal pudendal and branches from the external iliac artery

Question 45

Lymph from the scrotum & most of the penis (not the glans) drains to the superficial inguinal lymph nodes found in the superficial fascia in the groin Where does lymph from the testis drain? (remember its anatomical position)

Answer 45

Drains into the lumbar nodes around the abdominal aorta