Week 1 - B - Anatomy of Lower Renal Tract and Male reproductive tract Flashcards
The urinary tract consists of the kidneys, ureters, bladder, and urethra Which part is located in the abdomen?
The right and left kidneys and their proximal ureters
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?
Travel to the bladder
WHat is the location of the true and false pelvis?
False pelvis - iliac crests to the pelvic inlet (brim) True pelvis - pelvic inlet to the pelvic floor
the pelvic floor is formed by the “bowl shaped” pelvic diaphragm What is the main muscle of the pelvic diaphragm called?
Levator ani muscle (innervated by pudendal nerve)
The pelvic floor contains holes for GI and Urinary structures, what are these structures?
These are the rectum and the urethra that pass through the pelvic floor
What is the shallow compartment between the pelvic floor and the skin known as? (it is the space between external genitalia and the anus)
The perineum
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?
Renal vein anteriorly Renal artery posteriorly Ureter inferiorly The ureter runs over the anterior aspect of the common iliac artery
At what level do the ureters rotate medially to enter the posterior aspect of the bladder?
They rotate medially at the level of the ischial spine
The ureters enter the posterior bladder wall in an inferomedial direction What does this help prevent?
This helps prevent reflux of the urine into the ureter when the bladder contracts
In the anatomical position, what is the most inferior part of the male peritoneal cavity?
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
in the anatomical position what is the most inferior part of the female peritoneal cavity ?
This is the rectouterine pouch - Pouch of Douglas
What is the pouch between uterus and the bladder in females?
In Females: Shallow pouch that occurs between the bladder and the uterus.
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)?
It runs inferiroly when supine and posteriorly when in the anatomical position
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?
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)
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?
This structure is known as the trigone
What is the orifice where urine exits the bladder known as?
This is known as the internal urethral orifice
What is the muscle forming the main bulk f the bladder wall known as? What happens when this muscle contracts?
This is the detrusor muscle Bladder empties when this contracts
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?
Lined by the peritoneum detrusor muscle fibres encircle the ureteric orifices, these fibres tighten when the bladder contracts helping prevent reflux
around the neck of the male bladder, the detrusor muscle forms the internal urethral sphincter muscle When does this contract?
Contracts during ejaculation to help prevent retrograde ejaculation of semen into the bladder
Is the internal or external urethral sphincter under voluntary control?
Internal urethral sphincter - involuntary (detrusor muscle which is smooth muscle forms this sphincter) External urethral sphincter - under voluntary control
What is the urethra known as passing from the internal urethral orifice to the external and why?
Known as the prostatic urethra as it travels through the prostate gland
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?
The prostate gland
In the female, the body of the uterus usually lies superior to the bladder What is this normal position known as?
Anteflexed position - due to this most of the weight of the uterus presses on the bladder
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?
peritoneum still only covers its superior surface
What is the most common way for catheterising a patient?
Urethral catheter (suprapubic is the other way to cathertise a paitent)
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?
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
Is there an internal urethral sphincter in females?
NO The external urethral sphincter in males and females is skeletal muscle arranged circularly around the urethra
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?
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)
What is the embryological position of the testis from which they descend?
The originate in the posterior abdomen
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?
Inguinal ligament - located from anterior superior iliac spine (ASIS) to the pubic tubercle
What structures are located within the spermatic cord? Which drains into the testicular vein?
The testicular artery The vas deferens Lymphatic vessels The testicular vein - the pampiniform plexus of veins drains into this
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?
The cremaster muscle The deep inguinal ring is the entry to the inguinal canal, the superficial inguinal is the exit into the spermatic cord
What is the layer immediately superifical to the testis which the testis sit inside?
This is the visceral layer of the tunica vaginalis
What is a usually painless sweling occuring due to a patent tunica vaginalis causing fluid to form around the testis? Usually occurs infants
A hydrocele
What is The most common cause of acute testicle in boy? Torsion of this can result in a blue dot discolouration on the scrotum
This is due to torision of the appendix testos (Hydatid or Morgagni)
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?
Rapid onset causing extreme pain with necrosis settling in after a few hours - urgent surgery
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?
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
Where is sperm produced and where does it travel after production? (go as far as the inferior pole of the testis)
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
After reaching the vas deferens, where does the sperm travel? (all the way to ejaaculatory duct)
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
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?
It is in contact with the levator ani muscle
Which part of the prostate gland do most cancers of the prostate arise in? This is the pat felt on PR examination
The peripheral zone
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?
The right and left corpus cavernosum
In the anatomical position, is the coprus spongiosum or right and left corpus cavernosum posterior?
In anatomical position of the penis The right and left corpus cavernosum are posterior
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?
Blood supply to the scrotum is from scrotal branches via the internal pudendal and branches from the external iliac artery
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)
Drains into the lumbar nodes around the abdominal aorta
