Urinary and Reproductive system

Question 1

How is systema Genitale Femininum divided?

Answer 1

Divived into:

1. Organa genitalia feminina interna in pelvis minor
o Ovarium (produce female ova)
o Tuba uterine
o Uterus
o vagina

2. Organa genitalia feminina externa s. pudenda feminina s. vulva in perineum, below and in front of symphysis pubica
   –> Latin sg. Pudendum pl. Pudenda – ”that where of one ought to feel shame”
   o Mons pubis
   o Labium majus pudendi
   o Labium minus pudendi
   o Vestibulum vaginae
   o Bulbus vestibule
   o Clitoris
   o Glandulae vestibulares
   majores
3. Mamma s. glandula mammaria

Question 2

Ovarium

Answer 2

• Lies in peritoneal cavity, but is NOT covered by peritoneum, pelvis minor. ~ 5-8 g, 3-5 cm.
• Almos vertically positioned ovarium is attached to uterus by lig. latum uteri
• Extremitas tubaria et uterina
• Facies medialis et lateralis
• Margo liber –> free, convex, looking backward
• Margo mesovaricus
• Is attached to the posterior part of lig. latum uteri by mesovarium
• Mesovarium is a fold of peritoneum
• Between 2 layers of mesovarium is blood vessels and nerves, which pass to hilum ovarii

Ovarium is fixed by 3 strucrutes:

1. Lig. ovarii proprium
   * from ovarium to uterus , lies within lig. latum uteri
2. Lig . Suspensorum ovarii
   * From ovarium to lateral wall of pelvis minor
   * Contains blood vessels and nerves
3. Mesovarium
   * Part of lig. latum uteri

• Surface is coverd by tunica albuginea
• Medulla ovarii
• Nerves, BV, lymph vessels
• Cortex ovarii
• 50 000 - 80 000 follicles in each organ
• Folliculi ovarici vesiculosi mature periodically once in 28 days (after puberty to the age of 45)
• Corpus luteum –> corpus albicans

Question 3

Tuba uterine s. salpinx

Answer 3

 ~ 10-12 cm long
 Extends from lateral wall of pelvis minor to uterus
 Intraperitoneal in the upper part of lig. latum uteri (mesosalpinx, which is a part of lig. latum uteri,
surrounds tuba uterine)
 2 openings:
1. Ostium abdominale tubae uterinae
 Communicates with cavitas peritonealis
2. Ostium uterinum tubae uterinae
 Communicates with cavitas uteri

 4 parts:
1. Infundibulum tubae uterinae
 Abdominal end. Opens to cavitas peritonealis
 Surrounded by 1-1,5 cm long fimbriae tubae uterinae
o One of them is fimbria ovarica reaching extremitas tubaria ovarii

2. Ampulla tubae uterinae
    Oval shape enlargement, place for fertilization
3. Isthmus tubae uterinae
    Narrow part close to uterus
4. Pars uterinae
    Penetrates wall of uterus and opens to cavitas uteri by ostium uterinum tubae uterinae

Tunica mucosa
o Ciliated epithelium, producing fluid flowing towards uterus . Mucosa has plicae tubariae folds.
Tunica muscularis
o Inner circular muscle layer
o Outer longitudinal muscle layer
o Peristaltic movement for oocyte transport to uterus and antiperistaltic movement for spermatozoa
Tela subserosa
o Loose connective tissue
Tunica serosa
o Intraperitoneal covering, except at mesosalpinx, where perotineum folds to formate passway for blood
and lymph vessels and nerves.

Question 4

Uterus s. Metra

Answer 4

 Hollow pear-shaped muscular organ, 7-8 cm in lenght and 40-50 g in weight
 Mesoperitoneal organ
 Syntopia
o Anteriorly: vesica urinaria, Excavatio vesicouterina
o Posteriorly: rectum, Excavatio rectouterina

3 parts:
1. Fundus uteri
 Above ostium uterinum tubae uterinae dextrae et sinistrae
2. Corpus uteri
 2 walls:
i. Facies vesicalis - facing vesica urinaria
ii. Facies intestinalis, separated from rectum by coils of intestinum tenue
 Lower part is narrow, isthmus uteri
3. Cervix uteri
 Lower portion lies in vagina, divided into:
i. Portio supravaginalis cervicis – upper part above vagina
ii. Portio vaginalis cervicis – lower part inside vagina

 Margo uteri dexter et sinister (border of uterus)
o Lig. latum uteri starts from the border and extends to pelvic walls
 Cavitas uteri
o Antero-posteriorly flattened, sagittally triangular
o Basis cavi uteri, between ostium uterinum tubae uterinae d. et s.
o Apex cavi uteri, projects down, continues as canalis cervicis uteri
o Canal opens into vagina by ostium uteri externum
  bordered by:
 labium anterius
 labium posterius

Question 5

Uterus s. Metra wall structure and structures fixing it

Answer 5

Tunica mucosa s. endometrium
 Lining of cavitas uteri et canalis cervicis uteri
 Glandulae uterinae et plicae palmatae in anterior and posterior walls of canalis cervicis uteri
 Endometrium, except lamina basalis endometrii, is desquamated during mestruation
Tunica muscularis s. myometrium
 Internal longitudinal, middle circular, outer longitudinal muscle layers
Tunica serosa s. perimetrium
 Mesoperitoneal covering by peritoneum
Structures fixing the uterus:
 M. levator ani
 Lig. teres uteri
o Starts from upper part of uterus  lies between layers of lig. latum uteri  through canalis
inguinalis  reaching mons pubis

 Lig. latum uteri
o Dublication of peritoneum in planum frontale
o from margo uteri to walls of cavitas pelvis
o Superior part surrounds tubae uterinae , inferior part fuses with perineum
o Has topographical subdivision into 3 parts:
1. Mesosalpinx – surrounding tubae uterinae
2. Mesovarium – attaching to margo mesovaricus ovarii
3. Mesometrium – lower portion, laterally to uterus

 Lig. cardinale uteri s. lig. transversum cervicis
o from cervix uteri to lateral wall of pelvis minor
 Lig. pubocervicale
o from cervix uteri to fundus vesicae urinariae and symphysis pubica ossis pubis
 Lig. Rectouterinum
o from cervix uteri to rectum and os sacrum
o in plica rectouterina

Normal position is anteflexio 70 – 100 ̊ and anteversio 90 – 100 ̊.

Question 6

Vagina

Answer 6

 ~8-12 cm in lenght, bordered by uterus et ositum vaginae
 Ostium vaginae
o Partly closed by hymen (mucosal fold)
o After first coitus hymen is broken and becomes caranculae hymenales
 Paries anterior vaginae
 Paries posterior vaginae
 Upper parts of vagina surrounds portio vaginalis cervicis uteri
o Between portio vaginalis cervicis uteri and the inner surface of vagina wall is Fornix vaginae
 Posterior part of Fornix vaginae is higher
 Mucosa on the inner surface of vagina forms rugae vaginales
o medial part higher to lateral part
 In paries anterior et paries posterior these rugae vaginales form two longitudinal colums – columna
rugarum anterior et columna rugarum posterior

Tunica muscularis
 Smooth muscles fibers, with inner circular and outer longitudinal layers

Tunica adventitia
 Loose connective tissue connecting to surrounding organs

Question 7

Organa genitalia feminina externa s. vulva s. pudenda feminina

Answer 7

Mons pubis
 Round eminence anteriorly to symphysis pubica, superiorly to labia majora
 Triangular in shape, adipose tissue, becomes covered by hair after puberty
Labium majus pudendi dextrum et sinistrum
 Longitudinal cutaneous folds, sagitally downwards and backwards from mons pubis
 Rima pudendi between labia majora
 Outer surface is pigmented and has hair covering
 Inner surface is smooth non-pigmented with sebaceous glands
 Glandula vestibularis major dextra et sinistra
o Located in the base of labia majora between musculi perinei
o Ducts open to lateral part of ostium vaginae

Labium minus pudendi dextrum et sinistrum
 Sagittal cutaneous folds between labia majora
 Posterior ends join at midline
 Each anterior end divides to 2 portions:
1. Preputium clitoridis – fuses above glans clitoridis
2. Frenulum clitoridis – fuses below glans clitoridis
 Glandulae vestibulares minores in the inner surface
o Function is to moisten vestibulum vaginae
 Vestibulum vaginae
o Cleft between labia minora pudendi, behind glans clitoridis
o 2 openings in vestibulum vaginae:
1. Ostium urethrae externum
2. Ostium vaginae

Bulbus vestibule
 Unpaired organ, similar to corpus spongiosum penis with erectile tissue with venous blood
 Two lateral portions around ostium vaginae
o Median portion between glans clitoridis and ostium urethrae externum

Clitoris
 Similar to corpora cavernosa penis
 Erectile tissue with significant amount of nerve endings
 It has 3 parts:
1. Crus clitoridis dexter et sinister
 Connected to ramus inferior ossis pubis
2. Corpus clitoridis
3. Glans clitoridis
 Beneath anterior connection of
labium majus, hidden by preputium clitoridis

Question 8

Perineum

Answer 8

 consists of structures covering apertura pelvis minor and formating exitus pelvis minor
o skin, fasciae, skeletas muscles, CT, fat
 Topographical subdivision into 2 triangles
o Trigonum anale
 anus
 Borders: os coccygis , tuber ischiadicum dexter et sinister
o Trigonum urogenitale
 ostium urethrae externum, ostium vaginae
 Borders: tuber ischiadicum dexter et sinister, symphysis pubica
 Diaphragma pelvis
o separates cavitas pelvis from the underlying structures

Question 9

Diaphragma pelvis muscles

Answer 9

Diaphragma Has 3 muscles:
M. levator ani (3 parts)
1. M. pubococcygeus
 o. ramus inferior ossis pubis
 i. os coccygis
2. M. puborectalis  fibers laterally from m.
pubovaginalis toward rectum
 o. symphysis pubica
 i. rectum
3. M. iliococcygeus
 o. spina ischiadica
 i. os coccygis
f. stabilies pelvic organs

M. coccygeus

 o. spina ischiadica
 i. os coccygis
 F. elevatio diaphragmae pelvis

M. sphincter ani externus

 Surrounds anus, constricts analis canalis
 Subdivided into 3 parts:
 Pars subcutanea
 Pars superficialis
 Pars profunda

 Musculi diaphragmae pelvis are covered by:
 Superiorly: fascia diaphragmatis pelvis superior
 Inferiorly: fascia diaphragmatis pelvis inferior

Question 10

Perineal muscles

Answer 10

 divided into deep and superficial muscles.
o 2 Musculi perinei profundi
M. transversus perinei profundus
 o. tuber ischiadicum
 i. centrum tendineum (by fusion with
controlateral m. transversus perinei profundus)
 f. fixation and stabilisation of perineum

M. sphincter urethrae externus
 In females encircles urethra et vagina
o Musculi perinei superficialis

M. transversus perinei superficialis
 o. tuber ischiadicum
 i. centrum tendineum (by fusion with
controlateral m. transversus perinei
superficialis)
 f. fixation and stabilisation of perineum

M. ischiocavernosus (=common name)
in females: m. erector clitoridis
in males: m. erector penis
 o. ramus ossis ischii
 i. tunica albuginea clitoridis
 f. erectio clitoridis

M. bulbospongiosus (=common name)
in females: m. sphincter vaginae
in males: m. ejaculatorius seminis
 o. centrum tendineum
 i. fascia clitoridis
 f. narrowing of vestibulum vaginae

 Fascia perinei covers musculi perinei inferiorly.

Question 11

Perineal space and region

Answer 11

 Deep perineal space contain:
o M. transversus perinei profundus
o m. sphincter urethrae externus
for male also
o urethra pars membranacea
o bulbus penis
o glandulae vestibulares majors
for female also
o urethra
o vagina
o glandula vestibulares majors
 Superficial perineal space contain:
o M. transversus perinei superficialis
o M. external genitalia
 m. erector clitoridis
 m. sphincter vaginae
 Membrana perinei separates deep and superficial perineal spaces

 In perineal region on both sides is fossa ischioanalis
o Contain fat, loose CT, BV, nerves
o Each fossa is borered by:
 Laterally
 Tuber ischiadicum
 M. obturatorius internus
Covered by fascia and lig. sacrotuberale
 Medially
 M. levator ani
 M. sphincter ani externus
 Posteriorly
 Os coccygis
 M. levator ani (posterior part)
 M. gluteus maximus
 Lig. sacrotuberale
 Anteriorly
 M. transversus perinei superficialis et profundus
 Inferiorly
 Fascia perinei

Question 12

Mamma s. Glandula mammaria

Answer 12

Papilla mammaria
Areola mammae
Glandulae areolares
Ligg. mammaria suspensoria  fascia pectoralis/clavicula
Corpus mammae
15 – 20 x Lobi glandulae mammariae
Ductus lactiferi
Sinus lactiferi

Question 13

Systema genitale masculinum

Answer 13

The genital system
 Comprised of organs located outside and inside of the body around the pelvic region
 Organa genitalia masculina interna:
- Testis (2)
- epididymis (2)
- ductus deferens (2)
- vesicula seminalis (2) / glandula vesiculosa
- ductus ejaculatorius (2)
- prostate
- glandula bulbourethralis (2)
o Organa genitalia masculina externa: (below symphysis pubica)
- Penis et scrotum

Question 14

Testis s. Orchis s. Didymis

Answer 14

o Paired glandular organ producing spermatozoa and sex hormones
o Oval shape, 4-4,5 cm long and weighs about 20-30g
o Situated into the scrotum in the saggital plane.
o Poles
o Extremitas superior (17)
o Extemitas inferior (18)
o Surfaces
o Facies lateralis (19)
o Facies medialis
o Margins
o Margo anterior (21)
o Margo posterior (close to the epididymis) (22)
o Tunica albuginea (24)

 connective tissue capsule of the testis

o Mediastinum testis (25)
 connective tissue mass projecting into the interior of the testis from the posterior margin
of the tunica albuginea

o Septula testis (26)
 Connective tissue partitions radiating out from the mediastinum to the tunica albuginea,
divide into lobules
o Parenchyma of testis (27)

 specific testicular tissue made up of seminiferous tubules

o Lobuli testis (28)
 Compartmentalized lobules of testicular parenchyma formed by the septa, 200-300

o Tubuli seminiferi contorti (29)
 convoluted tubules where spermatogenesis take place

o Tubuli seminiferi recti (30)
 short straight tubules extending from the convoluted seminiferous tubules to the rete
testis

o Rete testis (31)
 Network of canals within the mediastinum testis, they connect the straight seminiferous
tubules with the efferent ductules

o Ductuli efferentes testis (30)
 ductulus between the rete testis and the duct of the epididymis

Question 15

Testis coverings

Answer 15

o Tunica vaginalis testis:
- Lamina visceralis; fuses with tunica albuginea
- Lamina parietale
-  between layers is a space with serous fluid, sinus epididymidis
o Fascia spermatica interna (continuation of fascia transversalis)
o Musculus cremasterica
o Fascia cremasterica
o Fascia spermatica externa (continuation of fascia abdominalis superficialis)
o Tunica dartos
o Cutis
 There is a space between the layers and a pouch at the lateral surface
- sinus epididymis.

Question 16

Epididymis

Answer 16

o Caput epididymis (2)
- upper enlarged part, ductuli efferentes testis enters
o Corpus epididymis (3)
- central part, consists of ductus epididymis. (6)
o Cauda epididymis (4)
- lower part, consists of ductus epididymis. (6)
o Ductus epididymis (6)
- continuous with ductus deferens(13)
o Ductus deferens (13)
- spermatic duct between the epididymis and the spermal
vesicle.

Question 17

Ductus deferens

Answer 17

Topographical division:
o Pars scrotalis
- behind the testis in the scrotum
o Pars funicularis
- extremitas superior testis  anulus inguinalis superficialis
o Pars inguinalis
- passes through the inguinal canal
o Pars pelvina
- anulus inguinalis profundus  ampulla ductus deferentis.

Ampulla ductus deferentis fuses with ductus excretorius vesiculae seminalis and form ductus ejaculatorius.

Ductus deferens histology
o Tunica mucosa:
- Arranged in 3-5 longitudinal folds
o Tunica muscularis:
- Arranged in three smooth muscle layers; external and
internal layers are longitudinal and the middle layer is
circula.
o Tunica adventitia
- Formed by loose connective tissue

Funiculus spermaticus
o A bundle formed by
- ductus deferens (pars scrotalis, pars funicularis and pars
inguinalis)
- blood vessels, nerves and lymphatics in the center
 which are surrounded by covering of the testis
from periphery
 fascia spermatica interna
 m. Cremaster
 fascia cremasterica
 fascia spermatica externa
o Extends from cauda epididymis to anulus inguinalis profunda

o Contents:
- Parts of ductus deferens: pars scotalis, pars funicularis and pars inguinalis.
- Blood vessels and nerves
- Covering of the testis, epididymis and ductus deferens:
 fascia spermatica interna
 m. Cremaster
 fascia cremasterica
 fascia spermatica externa

Question 18

Vesicula seminalis and ductus ejaculatorius

Answer 18

o Paired, placed posteriorly to the base of the urinary bladder
o Situated extraperitoneally
o Secretes fluid to be added to the secretion of the testis.
o Each sac is pyramidal in shape and consists of a single convoluted tube, its end becomes constricted
into ductus excretorius.
o Ductus excretorius and ampulla ductus deferentis joins to form ductus ejaculatorius.
o Ductus ejaculatorius passes through the prostata and opens on colliculus seminalis into urethra.

Question 19

Prostata

Answer 19

o Partly glandular and partly muscular body
o Situated in the pelvic cavity around the beginning of the urethra behind
symphysis pubica.
o The prostatic part of the urethra runs through the prostata.
o Has two parts: apex prostatae et basis prostatae
o Has right and left lobes: lobi prostatae dexter et sinister
 Between the lobes anteriorly is isthmus prostatae

Surfaces:
Facies anterior
Facies posterior
Facies inferolateralis dexter et sinister
Prostata parenchyma
o Consists of glands with ductuli prostatici
- open into the prostatic part of urethra. (24)
o The secretion of these glands forms sperm together with secretions of the
testis, the seminal vesicles and the bulbourethral glands.
o Substantia muscularis: smooth muscular tissue in the central part around
the urethra.

Prostata topography
Holotopia: Pelvis minor
Sceletotopia: Behind symphysis pubica
Syntopia: Posterior rectum
Lateral venous plexus
Superior fundus vesicae urinariae
Inferior diaphragm urogenitalis

Question 20

Glandula bulbourethralis

Answer 20

o Two small, round and lobulated bodies, about the size of a pea, placed in the perineum.
o Lies close above bulbus penis
o The excretory duct, ductus glandulae bulbourethralis, of the gland opens at the beginning part of pars
spongiosa urethrae
o The secret of the gland is added to spermatozoa and secrets of the rest of the glands to form sperm.

Question 21

Organa genitalia masculina externa

Answer 21

Penis
Glans
Scrotum

Question 22

Scrotum

Answer 22

o Cutaneous and muscular pouch
o Contains testis, epididymis and commencement of funiculus spermaticus.
o Consists of 2 layers
Layers:
1. Cutis (1) - outer
- Very thin skin generally thrown into fold. Contains sebaceous glands and hair
2. Tunica dartos (4) - inner
- Layer of connective tissue with elastic fibres and smooth muscles
o Septum scroti (3)
- Divides the scrotal pouch into two cavities

Question 23

Glans

Answer 23

Corona glandis (2)
- Rounded border

Collum glandis (4)
- neck of glans, constricted portion behind the corona.

Septum glandis (3)
- median part of the glans

-> Through the corpus spongiosum runs the spongy part of urethra, terminating on the glans penis by a
slit-like external orifice of the urethra.

Question 24

Penis structural parts

Answer 24

Corpora cavernosa
o Covered by tunica albuginea coporum cavernosum (11)
o Forms septum penis (13)
o From tunica albuginea into bodies enter trabeculae

corporis cavernosi (14)
o Cavernae corporis cavernosi (16)  bloodfilled spaces

Corpora spongiosum
o Covered by tunica albuginea corporis spongiosi (12)
o Trabeculae corporis spongiosis (15)
o Cavernae corporis spongiosi (17) blood-filled space

Above tunica albuginea are
o Fascia penis profunda (21)
o Fascia penis superficialis (20)
o Subcutis(only present in the corpus penis region) and cutis

Penis structure
o The skin is thin and can slide across the penis, but it is firmly attached to the glans penis.
o At the region of the glans penis the skin forms a fold (foreskin) – preputium penis, which embraces the
glans penis.
o At the lower surface the glans penis and the foreskin are connected by the vertical fold (frenulum) –
frenulum preputii.

Question 25

Penis

Answer 25

Bodies:
o Corpus cavernosum penis (8)
- cavernous body divided into two halves by the septum of the penis, serves only for erection.
Their posterior ends are sharp crura penis, and they fuse with os pubis and os ischii.

o Corpus spongiosum penis (9)

• urethra passes through it and the anterior expanded end forms glans penis.
• The posterior end lies between bulbus penis.

Portions:
o Pars fixa penis
- includes radix penis and upper part of the corpus penis, situated below the perineum and is
fused with os pubis and os ischii

o Pars mobilis penis
- rest part of the penis

Parts:
o Radix penis (28)
- covered by skin and muscles, fixed to the inferior part of the subpubic angle.
o Corpus penis (29)
- movable part of penis and has two subparts: dorsum penis (anterior surface) and facies
urethralis (posterior or lower surface)

o Glans penis
- expanded end of the corpus spongiosum penis.

Question 26

Organa urinaria s. organa uropoetica

Answer 26

Systema urinarium consists 2 Ren, 2 Urete, 1 Vesica urinaria, 1 Urethr

Question 27

Ren s. Nephrons

Answer 27

• Urine production (filtration, reabsorption and concentration)
• 1 – 1.5l urine per day
• Total blood flow per day: 1500l
• Total amount of blood: 4-5l
• Regulation of electrolytes, acid-base balance, and blood pressure
• Endocrine organ: Renin, erythropoietin

Question 28

Structure of Ren

Answer 28

Extremitas superior
Extremitas inferior
Margo lateralis
Margo medialis
Hilum renalis
Capsula adiposa (protects from concussion and cooling, around kidney)
Capsula fibrosa (dense CT covering)

Fascia renalis surrounds capsula adipose and it consists of 2 plates: Both plates are fused together at upper
extremity and laterally. Medially and inferiorly it is open for ureter and BV.
1. Lamina prerenalis, (anterior lamina) –> Medial over kidney‘s surface, renal vessels, aorta abdominalis, v. cava inferior
2. Lamina retroreanlis, (posterior lamina) –> Medial connected to Columna vertebralis
* Ineriorly plates do not connect and continue into retroperiotoneal rissue.
* Peritoneum covers kidneys from the anterior side (=retroperitoneal organ)

Cortex

• Soft, granular, 4-5mm wide
• Parts extend into medulla as columnae renales

Medulla
- 12-15 pyramides renales (base towards the cortex), columnae renales between pyramids. Several apices fuse to form papilla renalis

Gl. Suprarenalis
Hilum renale
Sinus renalis (pelvis renalis is located here)
Pelvis renalis (togerher with fat and BV)
Calyces renales
Foramina papillaria (on the renal papilla)
- Surrounded by: calces renales minors, which unite to form 2-3 calces renales majors. These fuse and form pelvis renalis.

Question 29

Finestructure of Ren

Answer 29

Corpusculum renis
Portio nephroni proximalis
Ansa nephroni
Portio nephroni distalis
Pars intercalate

Question 30

Topography of ren

Answer 30

Skeletopia
Ren dextrum (lower)
- Th12 – L3
- Costa 12 crosses upper third
- L2 Hilium

Ren sinistra (higher)

• Th11 – L2
• Costa 12 crosses middle third
• L1 Hilium

Syntopia
Facies posterior
- M. psoas major
- Pars lumbalis diaphragmae
- M. quadratus lumborum

Facies anterior ren dexter

• Glandula suprenalis
• Hepar
• Pars descendens duodeni
• Colon (flexura dextra)
• jejunum

Facies anterior ren sinister

• Glandula suprenalis
• Splen s. Lien
• Gaster
• Pancreas
• Colon descendens
• jejunum

Holotopically
Regio lateralis

Question 31

Ureter and its parts

Answer 31

Convey urine from ren to vesica urinaria. ~ 30cm long. Commences pelvis renalis ( = munuaisallas).
Descendens along posterior abdominal wall, anteriorly to m. psoas major –> crosses linea terminalis, continues
into pelvis minor.
- Male: crosses ductus deferens
- Female: passes between layers of lig. latum uteri together with lig. cardinale uteri and a. uterina

3 parts
1. Pars abdominalis (in retroperitonel space)
Ureter dexter
- Anterior upper third
** Pars descendens duodeni
- Middle third
** A. et v. testicularis (male)
** A. et. v. ovarica (femle)
- Lower third
** Radix mesenterii

Ureter sinister

• Anterior upper third
• • Flexura duodenojejunalis
• Middle third
• • A. et v. testicularis (male)
• • A. et. v. ovarica (female)
• Lower third
• • Mesocolon sigmoideum

2. Pars pelvina, in pelvis minor
   - Linea terminalis until vesica urinaria
3. Pars intramuralis, transverses the wall of the urinary bladder
   - Through wall of vesica urinaria. Opens into its fundus by ostium ureteris

Question 32

Narrowings (physiolgical) of ureter and histology

Answer 32

Upper narrowing - Hilum renale/exit from renal pelvis

Middle narrowing - Level of linea terminalis/crossing a. iliaca
communis or a. iliaca dextra

Lower narrowing - Wall of vesica urinaria

Histology
• Tunica mucosa
• Tela submucosa (not well developed)
• Tunica muscularis
- Upper 2/3 internal longitudinal, external circular
- Lower 1/3 external and internal longitudinal, middle circular
• Tunica adventitia (from all sides)
• Transitional epithelium
• Gll. Urtericae (glandulae?) 
• Situaited retroperitoneally

Question 33

Vesica urinaria s. Cystis. Empty and distended

Answer 33

Located in the subperitoneal space
Apex vesicae
Corpus vesicae
Fundus vesicae
--> consists 3 openings: 
Ostium ureteris dextrum et sinistrum
Ostium urethrae internum
** Openings border Trigonum vesicae
** Plica interureterica is between ostium ureteris dextrum et sinistrum

Empty vesica urinaria
- Behind symphysis pubica
- Tunica serosa posterior and lateral sides (lies preperitioneally), upper surface covered by peritoneum
parietale

Distended vesica urinaria

• Directed upward and forward above symphysis pubica, Oval-shape.
• Tunica serosa covers also apex vesicae (lies mesoperioneally)

Question 34

Histology of vesica urinaria

Answer 34

• Tunica mucosa
• Tela submucosa
• Tunica muscularis
• Tunia adventitia (anterior)/ serosa
• Plicae vesicae (empty)
• Gll. Vesicales
• 3 muscle layers ( m. detrusor vesicae)
- external and internally longitudinal
- middle layer circular (m. sphincter vesicae)

Question 35

Topography of vesica urinaria

Answer 35

Holotopia
- Pelvis minor

Skeletopia
- Behind symphsis pubica

Syntopia
males
 - Anterior: symphysis pubica
- Posterior ductus:
* deferentes dextra et sinistra
* vesiculae seminales dextra et sinistra
* rectum
* excavatio rectovesicales with coils of ileum and part of colon
* sigmoidem
- Lateral: plexus venosus
- Inferior: prostate

females

• Anterior: symphysis pubica
• Posterior: uterus, excavatio vesicouterina
• Lateral: plexus venosus
• Inferior: vagina

Question 36

Urethra masculina and its parts

Answer 36

• Eliminating urine and sperm, ~20 cm
• From Ostium urethrae internum (vesica urinaria) to ostium urethrae externum

Pars prostatica
- Through prostata from base to apex
* Colliculus seminalis
* Utriculus prostaticus
--> Ductus ejaculatorii enter on colliculus
seminalis and prostatic ducts on both
sides

Pars membranacea

• From Apex prostea to bullbus penis.
• Transverse the pelvis floor.
• M. sphincter urethrae

Pars spongiosa
- From Pars membranacea to Ostium
urethrae externum.
- Located in corpus spongiosum penis.
- At bulbus penis ductus glandulae bulbourethralis opens into the urethra

Question 37

Urethra masculina Narrowings, enlargements, curves

Answer 37

Narrowings

• Upper narrowing: Ostium urethrae internum
• Middle narrowing: Pars membranacae
• Lower narrowing: Ostium urethrae externum

Enlargements

• Upper enlargement: Pars prostacia
• Middle enlargement: Regio bulbus penis
• Lower enlargement: End of pars spongiosa (fossa navicularis urethrae)

Curves
- Curvatura infrapubica: Below symphysis pubica
* Transition from Pars prostatica to pars membranacea
- Curvatura prepubica: Uncostant curve. In the middle of pars spongiosa. Disappears when Penis is
lifted

Question 38

Urethra masculina histology

Answer 38

• Tunica mucosa

• Lacunae urethrales
• Gll. Urethrales open in lacunae
• Fossa navicularis region valvula fossae navicularis

• Tunica muscularis

• presented in Ostium urethrea internum (m. sphincter vesicae)
• Pars membranacea (m. sphincter urethre)

Question 39

Urethra feminine and its histology

Answer 39

• 3-5 cm
• Extends from ostium urethrae internum
• Passes through diaphgrama urogenitalis
• Terminates by ostium urethrae externum in vestibulum vaginae
• Behind symphysis pubica
• Embedded into anterior wall of vagina

Histology
• Tunica muscosa
Lacunae urethrales Gll. Urethreales
• Tunica muscularis
External circular layer
Internal longitundinal layer
• Tunica adventita