WEEK 3 LECTURE FINISHED Flashcards
What are the 2 parts of the autonomic nervous system?
SNS
PNS
Hypogastric plexi: How many are there and what are their names?
3
1 x Superior hypogastric plexus
2 x inferior hypogastric plexi
Superior hypogastric plexus:
What type of nerves?
Location?
What spinal nerves make it?
Just SNS
Just below bifurcation of abdominal aorta, just below L4
Sympathetic nerves T10-L2
Hypogastric nerves - 2 of these come off the plexus and descend down to join with inferior hypogastric plexi
Inferior hypogastric plexi:
Location?
Formed by?
Both SNS and PNS
Paired
Male - beside the rectum
Female - beside rectum and vagina
Former by:
- Hypogastric nerves from SHP
- Nerves from sacral ganglia (S3-S4) (Sympathetic)
- Pelvis splanchnic nerves (S2-S4 (Parasympathetic)
Ureters: What do they do? Length? Location? What do they look like?
- They convey urine form the kidneys to the bladder
- 1200ml - average amount of urine per day
- 25cm long
- Upper half is in the abdomen and half in the pelvis (changes where the common iliac artery divides)
- Long thin tubes with a thick muscular wall (Transitional epithelium in the walls)
Are the ureters retroperitoneal?
Yes
Where does the ureters travel in relation to psoas? What about in relation to the genitofemoral nerve?
Along the anterior part of psoas.
They cross in front of the genitofemoral nerve
What vessels cross the ureters?
Gonadal
What is the pathway of the ureters?
They pass down on psoas under the cover of the peritoneum
They cross in front of the genitofemoral nerve (L1,2 skin genital region, thigh)
They are crossed by the gonadal vessels.
They leave the psoas muscle at the level of the bifurcation of the common iliac artery and pass over the S/I joint to enter the pelvis
The terminal parts pierce the posterior lateral angle of the bladder
In males just before they enter the bladder they are crossed by the vas deferens.
How many parts does the ureter have in terms of arterial supply? What are these parts called and what arteries supply each of these parts?
3
Upper Part - ureteric branch of renal artery
Middle part - AA, gonadal, common iliac, internal iliac
Lower part - branches from sup and inf vesicle arteries and uterine arteries.
Lymphatic drainage of ureters:
Abdominal portion - para aortic lymph nodes
Pelvic portion - common iliac and internal iliac lymph nodes
What is the nerve supply of the ureter:
Sympathetics: T10-L1
Parasympathetic - pelvic splanchnic
What is the structure of the ureters? What is it lined with and what are the layers of muscle?
Smooth muscle lines by mucous membrane
Inner and outer longitudinal later of muscle
Middle circular layer
Lined with transitional epithelium - (4-5 layers) 2 layers of cuboidal, 1 layer of polygonal, 2 layers of squamous which are large, more circular that stratified squamous and can be bi-nucleated.
The Bladder:
Describe
Location full and empty
A hollow organ with strong muscular walls.
When empty it is entirely within the pelvic
When it is full it can distend and dome up into the abdomen, even to the level of the umbilicus
What is the shape when empty
Tetrahedral
What are the surfaces and angles of the bladder
Inferior/posterior surface = base (1) Inferior/lateral surfaces (2) superior surface (1)
Where does the urethra come out of the bladder
Where the base and the inferior/lateral surfaces meet
Which direction of the apex point and where does it point?
Anteriorly to the top of the pubic symphysis
What separates the apex and the pubic bone?
Retropubic space
What forms the fundus of the bladder?
The posterior aspect
Where is the neck of the bladder formed:
Where the fundus/ base and inferiolateral surfaces meet.
What is the bladder neck pierced and what is it pierced by?
It is pierced by the urethra at the internal urethral orifice