5) The Genitourinary System Flashcards
(85 cards)
1
Q
What is the pelvis?
A
- The pelvis consists of two hip bones along with the lower part of the vertebral column, sacrum (located next to the vertebral column) and the coccyx (below the spinal column)
- They form a basin like structure
2
Q
What is the pelvic inlet?
A
- The hole at the centre of the superior part of the pelvis.
- Anything below the pelvic inlet is said to be in the pelvis and anything above is said to be in the abdominal cavity
3
Q
What is the true pelvis?
A
- The part of the pelvis that is located below the pelvic inlet (in the pelvic region)
- It consists of the ischium and the pubis
4
Q
What is the false pelvis?
A
- The parts of the pelvis located above the pelvic inlet (in the abdominal region)
- It consists mainly of the ilium
- It helps support abdominal contents and also helps guide the foetus into the true pelvis during labour
5
Q
How is the false pelvis held in place?
A
- The false pelvis is bounded posteriorly by the lumbar vertebrae,
- The false pelvis is bounded laterally by the iliac fossae and the iliac muscles
- The false pelvis is bounded anteriorly by the lower part of the anterior abdominal wall
6
Q
How are the two hip bones joined together?
A
- A cartilaginous joint called the pubic symphysis
7
Q
What is the pubic crest?
A
- A roughened surface found on the superior surface of the pubic bone
8
Q
What is the pubic tubercle?
A
- Laterally (to the side) of the pubic symphysis there are bumps known as the pubic tubercles
9
Q
What is the pubic arch?
A
- The arch made by the inferior surface of the pubic bone and is continuous with the hip bone at the ischium
10
Q
What are the ischial tuberosities?
A
- Bumpy area on the lower surface of the ischium which the part of the pelvis that we sit on
- It sits in the perineal region outside of the pelvic cavity
11
Q
What is the anterior superior iliac spine?
A
- There is a broad crest on the superior part of ileum has which can be palpated (called the iliac crest)
- If we follow this crest anteriorly we find it terminates at its more anterior point called the anterior superior iliac spine
- It acts as a site of attachment for important ligament structures
12
Q
What are the different parts of the hip bone?
A
- The ilium (superior part of the hip bone)
- Ischium
- Pubis
13
Q
What is the ilium?
A
- The broad parts of the hip bone which can be palpated
14
Q
What is the iliac fossa?
A
- The depression found in the iliac bone
- It contains iliacus muscle
15
Q
What is the acetabulum?
A
- It is a socket/indentation in the hip bone where the head of the femur/bone of the thigh articulates with the hip joint
- It is formed by all three bones/regions fused together
16
Q
Describe the orientation of the pelvis.
A
- The posterior part of the pelvic cavity is deeper than the anterior part of the pelvic cavity
- It is curved where the pubic tubercle is in line (the same plane as) with the anterior superior iliac spine
17
Q
What is the pelvic floor?
A
- A big muscular sheet which separates the pelvic cavity from the perineum
18
Q
What is the perineum?
A
- The area below the pelvic cavity where the external genitalia is attached to the body
19
Q
What is the pelvic outlet?
A
- The lower margin of the pelvis.
- It does not have a smooth line but rather has three wide notches which are the pubic arch (anteriorly) and the sciatic nodes (laterally)
- Anything below this is said to be in the perineum
20
Q
How is the pelvic outlet held in place?
A
- It is bonded posteriorly by the coccyx
- It is bonded laterally by the ischial tuberosities
- it is bonded anteriorly by the pubic arch
21
Q
How do blood vessels pass from the pelvic region to the perineal region?
A
- First they pass out of the spinal chord via the greater sciatic foramen.
- They travel through the lesser sciatic foramen, under the pelvic floor and into the perineum.
22
Q
What is the greater sciatic notch?
A
- A notch at the back of the hip bone which forms the greater sciatic foramen with the help of a ligament
- It is the most superior notch found opposite to the anterior superior iliac spine
23
Q
What is the lesser sciatic notch?
A
- A notch at the back of the hip bone which forms the lesser sciatic foramen with the help of a ligament
- It is the most inferior notch found below the greater sciatic notch
- The bottom of the notch marks the end of the margin of the pelvic outlet
24
Q
What is the ischial spine?
A
- A bony protrusion that separates the two sciatic notches.
- There are ligaments that join to the ischial spine which form the two sciatic foramina
25
What is the different between the male and female pubic arch?
- The pubic arch is taller and narrower in the male pubic arches
- The pubic arch is smaller and wider in female pubic arches
(This difference is because in childbirth there is movement in the pubic symphysis to allow the foetus to pass through the pelvic outlet)
26
What is the different in the shape of the pelvic inlet between males and females?
- In males it is said to be heart shaped whereas in females it is more oval shaped.
- In females this difference changes the shape which gives the female pelvis its distinct shape which helps during childbirth
27
How does the formation of the pelvis take place?
- First the ischium and the pubis fuse together to form the ischiopubic ramus
- Next the ilium fuses to the ischiopubic ramus at the acetabulum
28
What are the different parts of the urinary tract?
- The kidneys
- The ureters
- The urinary bladder
- Urethra
29
What is the function of the kidneys?
- Excrete waste products of metabolism as urine
- Water and electrolyte balance in the body
- Maintaining acid-base balance of the blood
30
What is the function of the ureters?
- Transports urine from the kidneys to the urinary bladder
31
What is the function of the urinary bladder?
- Stores urine before it is excreted
32
What is the function of the urethra?
- Excretes urine
33
What vein drains into the reproductive organs?
- The left and right gonadal (testicular/ovarian depending on gender) vein
- These veins drains into the left and right renal veins where it blood then flows into the inferior vena cava
34
Where are the adrenal glands found?
- They sit on the superior surface of the kidneys and share the blood supply and venous drainage of the kidneys
35
Where are the kidneys found?
- They are posterior abdominal organs that lie on the back of the abdominal wall
- They are retroperitoneum (sit behind the peritoneum) and are either side of the vertebral column
- The right kidney is slightly lower than the left due to the fact that the right lobe of the liver is much larger
- As the diaphragm contracts during breathing the kidneys slide up and down the posterior abdominal wall
36
What ribs protect the kidneys?
- The left kidney is protected by ribs 11 and 12
| - The right kidney is protected only by rib 12
37
How does formation and development of the kidney take place?
- The kidneys begin development in the pelvic region of the body and ascend up the posterior abdominal wall to their final position
38
What are the different abnormalities with the formation of the kidneys?
- Pelvic kidney: Where the kidney remains in the pelvis
- Horseshoe kidney: Where the kidneys fuse at their bottom poles to form a large kidney. As it tries to ascend during migration it gets stuck behind vessels of the abdomen at the centre giving it the horseshoe shape
- Unilateral double kidney: Where both kidneys end up on the same side
39
What can formation abnormalities of the kidneys cause?
- They can be difficult to diagnose as the kidneys are not where they are meant to be
- It can also cause compression of other vessels which can be harmful
40
What is the renal cortex?
- The structure on the outside of the kidney
41
What is the Medulla?
- The structures found in the middle which are separated into pyramidal structures known as renal pyramids
- The apex of the pyramids project towards the middle while the base of the pyramids project outwards towards the cortex
42
What is the renal columns?
- The projection of the renal cortex in between the renal pyramids
43
What is the minor calyx?
- Tube structures that are connected to the apex of the renal pyramids.
- Many minor calyces come together to form a major calyx
- In total there are two major calyces which join together and drain into the renal pelvis
44
What is the renal sinus?
- The space in the kidneys where all the structures sit in
45
What is the hilum of the kidneys?
- It is the point at which the vessels enter and leave the kidneys
- The blood vessels that flow into the hilum are the renal veins and renal arteries which arise around L2
46
What veins drain from the kidneys?
- The renal veins drain blood from the kidneys into the inferior vena cava
- The inferior vena cava is located closer to the right kidney and so as a result the left renal vein is longer than the right renal vein
- The left renal vein passes over the aorta but underneath the superior mesenteric artery of the aorta and so as a result can lead to an obstruction of the left renal vein
47
What arteries drain blood into the kidneys?
- The renal arteries drain blood into the arteries from the aorta.
- The right renal artery passes behind the inferior vena cava
48
How do the ureters travel down the body?
- They travel down the transverse processes of the lumbar vertebrae
- It runs along the surface of the psoas major muscle
49
What are the normal anatomical constriction found in the ureter?
- First constriction: Found as it leaves the hilum of the kidneys
- Second constriction: As it bends over the top of the pelvic inlet to enter the pelvic cavity
- Third constriction: As it pierces/enters the back of the bladder
50
How are the ureters perfused?
- They have a segmental blood supply.
- This is because they have branches with the renal artery, the gonadal arteries and from the common iliac arteries which perfuse it
51
Where do kidney stones occur?
- They can occur anywhere along the urinary tract.
| - They are likely to become lodged in the constricted areas of the ureter
52
How is a kidney stone treated?
- It all depends on the size of the kidney stone and whether there needs to be any input to break down the kidney stone or if it can be passed out naturally
53
What are the risk factors of kidney stones?
- Diet
- Chronic infection
- Family history
- Dehydration
- Hypercalcaemia
54
Where is the bladder found?
- It is an anterior pelvic organ which sits behind the pubic symphysis
- It is pyramid in shape with the apex at the front and the base at the back
55
What are the different surfaces of the bladder?
- Apex: Which sits behind the pubic symphysis
- Base: The posteroinferior surface (sits at the back and at the bottom)
- Superior surface: Covered in peritoneum and expands as the bladder fills
- Inferolateral surfaces: cradled by levator ani and obturator muscles (they pass down one inferolateral surface and up the other to form a bowl shaped structure)
56
How do the ureters enter and drain from the bladder?
- The ureters enter the superolateral angles of the base of the bladder and drains inferiorly into the urethra
57
What is the function of the levator ani and obturator muscles?
- They wrap around the urethra and help to give muscular control of urine release from the bladder into the urethra
58
What are the detrusor muscle?
- The internal surface contains muscular folds containing detrusor muscle.
- It is a smooth muscle that has an interlacing pattern which allows the bladder to expand when it fills.
- They are controlled by the parasympathetic nervous system
59
What is the trigone?
- The internal surface of the base is smooth and is called the trigone (as it is triangular in shape) .
- On either corner we have the opening to the ureters and at the bottom of the trigone we find the urethra
- The trigone is fixed into place and doesn't move while the rest of the bladder contracts.
60
Where is the urethra found?
- The urethra is formed at the neck of the bladder both of the inferolateral surfaces meet
- In the male the urethra is surrounded by the prostate
61
How is the female urethra organised?
- The urethra originates from the neck of the bladder and is held in place by the pubovesical ligament
- It passes through the urogenital diaphragm that sits below the pelvic floor
- It also passes through the perineal membrane (where the external genitalia is connected to) which is very thick (and is referred to as the membranous urethra)
- The urethra opens up at the vestibule between the labia minora
62
What is the function of the urogenital diaphragm?
- Helps to control release of urine from the bladder and to support the female reproductive system
63
How is the male urethra organised?
(Consists of four different parts)
- Preprostatic: From bladder to prostate
- Prostatic: Part that passes through the bladder
- Membranous: Where it passes through the perineal membrane
- Spongy: Where it passes through the penis (sometimes called the penile urethra or spongy urethra)
- The urethra is supported by the prostate around the neck of the bladder along with a ligament known as the puboprostatic ligament
64
What is the erectile tissue that surrounds the penis?
- The erectile tissue which surrounds the penis is called the corpus spongiosum
65
What is the name of the muscle within the penis?
- Bulbospongiosus muscle
66
How do the male reproductive organs develop?
- The developing gonads begin high up in the posterior abdominal wall and superficially there is the scrotum and the penis
- The gonads (which give rise to the testes) and associated structures (e.g. blood vessels and lymphatics) have to descend down the posterior abdominal wall and end up in the scrotal sac
- The scrotum in men is similar to the labia majora in women however the labioscrotal swelling (in men) fuses across the midline to result in a single scrotum
67
How does the descent of the testes occur?
- A chord of tissue (called gubernaculum) passes through the anterior abdominal wall and attaches the gonad to the scrotum
- The gonads descend with the gubernaculum into the scrotal sac
- They push through layers of the abdominal wall (via the inguinal canal) and acquire all the layers of muscle and tissue they push through and end up in the scrotal sac
68
What is the Ductus/vas Deferens?
- The duct through which the spermatozoa will pass through in order to reach the urethra and be expelled in ejaculation
- In the vas deferens the spermatozoa move into the pelvic cavity where it passes behind the bladder
- It empties into the urethra through the prostate gland during ejaculation
- As it passes into the urethra it flows through the ejaculatory duct
69
What are the testis?
- Ellipsoid shaped structures that sit within the scrotum
- They are enclosed in musculofascial pouch (made from the anterior abdominal wall it had to push through)
- It contains a spermatic chord which is a tube-shaped connection between the testes and the anterior abdominal wall
- Each testis is composed of seminiferous tubules and interstitial fluid that is surrounded by a connective tissue capsule
70
Where are the spermatozoa made and released?
- They are produced in highly coiled seminiferous tubules which eventually modify and straighten
- These tubules drain into a collection chamber (called the rete testis)
- The rete testis passes through ducts into the head of the epididymis where they are stored
- During ejaculation they move to the tail of the epididymis and out of the vas deferens
71
What are the erectile tissues of the penis
- There are two corpora cavernosa (superiorly) and one corpus spongiosum (inferiorly)
- The corpora cavernosa are attached to the ischiopubic arch via the perineal membrane
- They come together anteriorly and join with the corpus spongiosum.
72
What are the subdivisions of the penis?
- The root: Where the two crura are attached to the perineal membrane and the corpus spongiosum
- The bulb: The region where the corpus spongiosum is expanded and contains the opening of the urethra
- The body: Formed by the tethering of the corpora cavernosa and the corpus spongiosum
73
What happens at the tip of the penis?
- The corpus spongiosum expands distally (away from the root) and wraps around the distal part of the corpora cavernosa to form the glans penis
- The urethra opens out onto the external urethral orifice
74
Where are the female reproductive organs located?
- They are located internally between the bladder and the anal canal
75
What are the different pouches formed around the female reproductive system?
- Due to the orientation of the uterus, it is bent over the top of the bladder, we end up with two pouches around the female reproductive system.
- The uterovesicle pouch is found between the uterus and the bladder
- The rectouterine pouch/ pouch of Douglas pouch is found between the uterus and the rectum
- Within these pouches we find peritoneal fluid within the pouches and there can even be an accumulation of these fluids which can cause problems
76
What is the role of the ovaries?
- They produce the ova (female sex cells) and female sex hormones
77
What is the role of the uterine tube?
- They receive the ovum and conduct the spermatoza towards the ovum
- It is the site of fertilisation which takes place the ampulla.
It provides nourishment for the fertilised ovum and transports it to the uterus
78
What is the function of the uterus?
- Reception, retention and nutrition of the fertilised ovum
79
What is the function of the cervix?
- Narrow part found on the inferior aspect of the uterus
| - It pierces the anterior wall of the vagina
80
What is the function of the vagina?
- Muscular tube which is the female genital canal
| - It also forms part of the birth canal
81
What is the broad ligament of the uterus?
- It is the peritoneum which drapes over the uterus, ovaries and the uterine tubes
- The ovaries and uterine tubes are held in place by this peritoneum
- Blood vessels pass underneath the peritoneum
82
What is the round ligament of the uterus?
- It is attached to the inferior pole of the ovaries and pulled it down into the pelvic cavity during development
- It then forces itself through the anterior ligament wall and through the inguinal canal and attaches to the labia (equivalent of scrotum in the female)
83
How is the external female genitalia arranged?
- There are a pair of erectile structures (called bulb of vestiblues) that are situated on either side of the vaginal opening
- In the female the urethra opens seperately to the reproductive structure
- Small bands of erectile tissue connect the anterior ends of the bulb to a mass of erectile tissue (called glans clitoris)
84
What are the different subdivision of the external female reproductive system?
- Root: consisting of two crura
| - Body: formed by unattached parts of the two corpora cavernosa
85
How do we measure pregnancy?
- Using the fundus of the uterus
