01: Anatomy

Question 1

T/F: Entire urinary system is retroperitoneal.

Answer 1

False - not urethra

Question 2

Both kidneys lie deep to which ribs?

Answer 2

11 and 12

Question 3

Kidney and surrounding fat are held in place by (X) tissue.

Answer 3

X = renal fascia

Question 4

Outermost fascia layer surrounding kidney.

Answer 4

Anterior: peritoneum
Posterior: transversalis fascia

Question 5

Fascia layer surrounding kidney, just interior to peritoneum and transversalis fascia.

Answer 5

Paranephric (extraperitoneal) fat

Question 6

Renal fascia is composed of which parts?

Answer 6

1. Gerota’s fascia (anterior)

2. Zuckerkandl fascia (posterior)

Question 7

The part of renal fascia that extends inferiorly along (X) is referred to as (Y).

Answer 7

X = ureter
Y = periureteric

Question 8

List layers of fascia layers surrounding kidney, from outermost to medulla.

Answer 8

1. Peritoneum/transversalis fascia
2. Paranephric fat
3. Renal fascia
4. Perinephric fat
5. Renal capsule
6. Renal cortex
7. Renal medulla

Question 9

T/F: The entire path of ureter is retroperitoneal.

Answer 9

True

Question 10

List the places where the ureter is normally constricted to some degree.

Answer 10

1. Junction with renal pelvis
2. Its crossing at brim of pelvic inlet
3. Entering wall of bladder

Question 11

Ureter passes over pelvic brim at which other landmark?

Answer 11

Bifurcation of common iliac arteries

Question 12

Pain associated with kidney/ureters can be caused by:

Answer 12

1. Stretching
2. Direct injury
3. Irritation of surrounding tissue

Question 13

Pain fibers of kidneys are primarily:

Answer 13

Preganglionic sympathetic nerves (T11-L2)

Question 14

Pain fibers of ureters are primarily:

Answer 14

Preganglionic sympathetic nerves (T11-L2)

Question 15

Irritation of renal capsule or kidney’s surrounding tissue irritates (X) nerves.

Answer 15

X = T11-L1 body wall nerves

Question 16

CVAT stands for (X), a clinical sign of:

Answer 16

X = Costovertebral angle tenderness

Irritation of renal capsule or inflammation of tissue around kidney

Question 17

Ureter passes (anterior/posterior/superior/inferior) to psoas major.

Answer 17

Anterior

Question 18

Ureter is crossed (anteriorly/posteriorly) by gonadal vessels.

Answer 18

Anteriorly

Question 19

In females, ureter passes immediately (anterior/posterior/superior/inferior) to uterine vessels.

Answer 19

Inferior

Question 20

In males, ureter passes (anterior/posterior/superior/inferior) to ductus deferens.

Answer 20

Posterior and inferior

Question 21

In males, ureter passes (anterior/posterior/superior/inferior) to seminal vesicle.

Answer 21

Anterior

Question 22

T/F: Ureter enters apex of bladder obliquely.

Answer 22

False - enters base of bladder obliquely

Question 23

Which structure prevents reflux of urine from bladder to ureter?

Answer 23

1. Valve: Slit-like orifice as ureter enters bladder

2. Sphincter: Circular fibers in wall of bladder

Question 24

(X) activates (Y) which initiates peristaltic contractions of ureter.

Answer 24

X = parasympathetics (vagus nerve)
Y = pacemaker cells in collecting system

Question 25

List blood vessels that supply abdominal ureter.

Answer 25

Gonadal and renal

Question 26

List blood vessels that supply middle portion of ureter.

Answer 26

Common iliac and gonadal

Question 27

List blood vessels that supply pelvic/distal ureter.

Answer 27

Common and internal iliacs

Question 28

T/F: Sympathetics have no role in motor innervation of collecting system.

Answer 28

False - regulate vascular tone

Question 29

Stretching of ureter causes (parietal/visceral) pain that's accompanied by reflex-like activation of (X). This pain radiates in which areas?

Answer 29

Visceral; X = subcostal, ilioinguinal, genitofem nerves Flanks, groin, genitals

Question 30

Trigone at (apex/base) of bladder is formed by which structures?

Answer 30

Base; | Ureters and urethra

Question 31

Female urethra length. And male?

Answer 31

F: 4 cm M: 20 cm

Question 32

UTIs more common in (M/F) because:

Answer 32

F; shorter urethra, so shorter distance for bac to travel

Question 33

Prostatic benign hyperplasia (PBH) causes (widening/narrowing) of urethra and which symptoms?

Answer 33

Narrowing; 1. Frequent/urgent need to urinate (esp at night) 2. Difficulty starting urination 3. Weak urine stream

Question 34

T/F: Both males and females have two urethral sphincters.

Answer 34

True

Question 35

Internal urethral sphincter is composed of (X) muscle type. It's controlled by (autonomics/somatics).

Answer 35

X = detursor (bladder) smooth and striated muscle Autonomics

Question 36

External urethral sphincter is composed of (X) muscle type. It's controlled by (autonomics/somatics).

Answer 36

X = skeletal | Somatics (pudendal nerve)

Question 37

At rest, bladder emptying is (stimulated/inhibited) via (symp/parasymp) signals that (relax/contract) (X).

Answer 37

Inhibited; symp 1. Relax bladder wall 2. Contract/constrict internal urethral sphincter

Question 38

Which fibers sense activation of stretch receptors when bladder fills?

Answer 38

GVA fibers of pelvic splanchnic nerves

Question 39

Bladder fills and stretches. (X) fibers induce reflex (contraction/relaxation) of:

Answer 39

X = GVE fibers of pelvic splanchnic nerves 1. Contraction of detrusor muscle 2. Relaxation of internal sphincter

Question 40

Difference in location between kidney and ureter pain.

Answer 40

Kidney: flank pain Ureter: radiates down to groin