Week 11 - Genitourinary System Flashcards
Three regions of the ureter that can be blocked by kidney stones
Trigone
Pelvic brim
Pelvouretic junction
How many layers of muscle in upper 2/3 of ureter and what are they
2 layers - inner longitudinal and outer circular (opposite to GI tract)
How many layers of muscle in lower 1/3 of ureter and what are they
3 layers - inner longitudinal, middle circular and outer longitudinal
Function of outer serosa/adventitia in ureter
Connective tissue containing blood, vessels and nerves
What structural feature prevents the reflux of urine from a full bladder
Folds of mucosa
Layers that envelope the kidney from innermost to outermost
Renal capsule, perirenal fat, renal fascia, pararenal fat
What vertebral level are the kidneys
T12-L3
What do adrenal glands secrete
Cortisteroids (cortisol), androgens (hormones that promote growth and reproduction) and mineralocorticoids (aldosterone - regulates bp)
Sympathetic innervation of bladder and sphincters
Innervates the internal sphincter and bladder wall
L1,2
Parasympathetic innervation of the bladder/spincters
Innervates the bladder wall
S2,3,4
Somatic innervation of the bladder/spincters
S2,3,4
Sensory and motor to the external sphincter
Through which nerve do the afferents from bladder wall run
Hypogastric nerve and enter the cord in the upper lumbar roots
Where are the locations of the 3 afferents
Bladder wall stretch
Sensors in the urethra
Skeletal muscle sensors in the external sphincter
What are the 3 efferents
External sphincter via somatic
Internal sphincter via the sympathetic
Detrusor via the parasympathetic
Parasympathetic/sympathetic during storage phase
Sympathetic
Parasympathetic/sympathetic during voiding phase
Parasympathetic
Hypogastric nerve
This nerve surpasses the contraction of the detrusor muscle in the storage phase
Pudenal nerve
This nerve controls the external sphincter in the storage phase
Pelvic splanchnic nerve
Causes detrusor to contract in the voiding phase
Neurogenic bladder
Bladder wall contractions start at lower volumes, therefore people will have sudden urge to pee even though their bladders remain fairly empty
Atonic bladder
Bladder fills with little sensation of this happening - too compliant. Person will find it difficult to empty bladder and therefore may require catheter.
What is the site of structural abnormality of the prostrate in older men
Transitional zone of the prostate gland
Layers of tissue that envelope the kidneys from innermost to outermost
Capsule -> Perirenal fat -> Renal fascia -> Pararenal fat
What vertebral level are the kidneys
T12-L3
Blood supply to the adrenal gland
Superior adrenal artery from the inferior phrenic, middle adrenal artery from abdominal aorta and inferior adrenal artery from renal artery.
Difference between retroperitoneal and intraperitoneal
Retroperitoneal usually means fixed to posterior abdominal wall
Intraperitoneal usually means mobile
Examples of retroperitoneal organs
SAD PUCKER
S- suprarenal (adrenal gland)
A - Aorta and inferior vena cava
D - duodenum (2nd and 3rd segments)
P - pancreas
U - ureters
C - colon (ascending and descending)
K - kidney
E - oesophagus
R - rectum
Length of ureter
25cm
Anatomical parts of ureter
Abdominal and pelvic region
In what motion does urine move down the ureter
Peristalsis
3 areas where kidney stones may cause blockage
Pelvouretic brim
Trigone
Pelvic brim
3 areas where ureter is most narrow
Pelvic brim
Point where ureter meets bladder
Uteropelvic junction
Upper two thirds of ureter is…
2 layers - Smooth muscle - inner longitudinal and outer circular
Lower third of ureter is…
3 layers - Smooth muscle - inner longitudinal, middle circular and outer longitudinal
What is different about submocosa of the ureter
There is no submucosa
Why is ureter highly folded
To prevent reflux of urine when bladder becomes full
What are the 3 main regions of the male urethra
Prostatic urethra
Membranous urethra
Spongy/penile urethra
What are the 2 main regions of the female urethra
Proximal and distal urethra
What is the trigone region formed by
The two ureters and the urethra
bladder capacity
300-500ml
Blood supply of the urinary bladder
Internal iliac vessels
When relaxed what is the appearance of the transitional epithelium of the bladder
Cuboidal/columnar lower cells and cuboidal apical cells
When distended what is the appearance of the transitional epithelium of the bladder
Superficial cells become squamous in appearance
Difference between the L+R gonadal veins
L gonadal vein drains into the renal vein whereas R gonadal vein drains directly into the inferior vena cava
If there is kidney pathology, how might this be shown in the left testicle
Increases pressure in left renal vein and causes varicocele of the pampiform venous plexus
In what anatomical direction does the left renal vein cross the aorta
Posteriorly
What constitutes the spermatic cord
Vas deferens and surrounding tissue
What is the serosal covering of the spermatic cord typically called
Tunica vaginalis
3 layers that make up the spermatic cord
External spermatic fascia
Cremasteric muscle
Internal spermatic fascia
