Anatomy Flashcards
(158 cards)
1
Q
What does the urinary tract consist of?
A
Kidney Ureter Bladder Urethra
2
Q
Function of kidney?
A
Produces urine
3
Q
Function of ureter?
A
Drains urine (from kidney to bladder)
4
Q
Function of bladder?
A
Stores/ voids (empties) urine
5
Q
Function of urethra?
A
Excretion of urine (& semen in males)
6
Q
Upper urinary tract?
A
Kidneys Ureters
7
Q
Lower urinary tract?
A
Bladder Urethra
8
Q
Where may an upper urinary tract infection spread to?
A
Kidneys
9
Q
Where in abdominal cavity are the kidneys?
A
Retroperitoneal
10
Q
Where are the kidneys located?
A
Posterior to visceral peritoneum Enclosed within renal fat capsule Surrounded by skeletal muscles
11
Q
Which muscles surround the fat capsule?
A
Muscles of the posterior abdominal wall Muscles of the antero-lateral abdominal wall Muscles of the back
12
Q
What are the anterolateral abdominal wall muscles?
A
External oblique Internal oblique Transversus abdominis
13
Q
Which important structures are situated at hilum of kidney?
A
Renal artery Renal vein Ureter
14
Q
What is the most anterior structure at the hilum of kidney?
A
Renal vein
15
Q
What surrounds kidney?
A
Renal capsule
16
Q
What is the renal capsule?
A
Tough fibrous tissue Closely encapsulates kidney all around its surface
17
Q
What lies anterior to renal capsule?
A
Perinephric fat
18
Q
Perinephric fat?
A
Liquid-y, fatty layer surrounding renal capsule
19
Q
Anterior to perinephric fat?
A
Renal (deep fascia)
20
Q
Anterior to renal fascia?
A
Paranephric fat
21
Q
Final layer anterior to kidney?
A
Visceral peritoneum
22
Q
Beyond visceral peritoneum?
A
Peritoneal cavity
23
Q
What lies posterior to kidney?
A
Posterior abdominal wall muscles Quadratus lumborum Psoas major
24
Q
Where do kidneys lie in relation to quadrates lumborum?
A
Kidneys lie anterior to quadrates lumborum
25
Where do kidneys lie in relation to psoas major?
Kidneys lie lateral to psoas major
26
Which kidney lies more inferiorly and why?
Due to the size of the liver the right kidney lies at a slightly inferior vertebral level
27
What vertebral level does right kidney lie at?
L1-L3
28
Which vertebral level does left kidney lie at?
T12- L2
29
Where do floating ribs 11 and 12 lie in relation to kidneys?
Posteriorly
30
Which regions/ quadrants are kidneys found in?
Both upper quadrants or lumbar (flank) regions
31
Anatomical relations to right kidney?
Posterior to: - Liver (& hepatorenal recess) - 2nd part of duodenum - Ascending colon - Right colic flexure
32
Anatomical relations to left kidney?
Posterior to: - Stomach - Tail of pancreas - Hilum of spleen - Splenic vessels
33
Hepatorenal recess?
Pouch between right kidney and liver One of most dependent parts of greater sac of peritoneal cavity
34
Where are renal veins in relation to renal arteries?
The renal veins are anterior to the renal arteries
35
Where do renal veins drain back towards?
Inferior vena cava
36
Where does ureteric arterial bloody supply branch from?
The renal artery The abdominal aorta The common iliac artery the internal iliac artery The vesical (bladder) artery
37
Common iliac arteries in relation to common iliac veins?
Common iliac arteries are anterior to the common iliac veins
38
Where does lymph from kidneys drain to?
Lumbar nodes
39
Where does abdominal aorta bifurcate?
At level of umbilicus
40
Where does lymph from ureters drain to?
Lumbar nodes & iliac nodes
41
Anatomical variations in renal system?
Bifurcation of renal pelvis Bifid ureter (ureter should be single structure) Retrocaval ureter (ureter passing anterior to vena cava rather than behind) Horseshoe kidney (union between right- and left-hand kidneys) Ectopic kidney (located down within pelvis) Solitary kidney
42
What does kidney consist of?
Outer cortex and inner medulla
43
What does the medulla contain?
Renal pyramids
44
What does the renal pyramids contain?
Nephrons (50000)
45
What gives pyramids their striped appearance?
Regularly arranged nephrons
46
47
How does urine drain from kidney?
Nephrons collecting duct --\> Minor calyx --\> major calyx --\> renal pelvis --\> ureter
48
Anatomical sites of constriction in the urinary tract?
Pelviureteric junction
Ureter
Ureteric orifice
49
50
What are common iliac arteries branches of?
Abdominal aorta
51
What can cause obstruction of ureter?
Internal (e.g. impacted calculus or blood clot)
External (e.g. expanding mass (tumour))
52
What do ureter walls contain?
Smooth muscle
53
Urinary tract response to obstruction?
Increased peristalsis proximal to site of obstruction
Peristalsis comes in waves -\> pain that comes and goes/ colicky
54
How do ureters enter pelvis?
Ureters pass from retroperitoneum, through false pelvis and into true pelvis
55
False pelvis?
From iliac crests to pelvic inlet
Part of abdominal cavity
56
True pelvis?
(Pelvic cavity)
Pelvic inlet to pelvic floor
57
Where is bladder found?
Pelvic cavity
58
Pelvic floor muscles?
Levator ani (pelvic diaphragm)
59
Where does urethra pass through?
Urethra passes through pelvic floor into perineum
60
Openings in pelvic floor?
Distal parts of alimentary, renal and reproductive tracts pass through
61
Where is the pelvic floor?
From pelvic cavity into perineum
62
Perineum?
Shallow compartment between pelvic floor and skin
63
Where do the ureters pass to enter pelvis?
Ureters pass anterior to common iliac vessels to enter pelvis
64
Where do the ureters pass to enter bladder?
At level of ischial spine, ureters turn medially to enter posterior aspect of bladder
65
How can the route of the ureters be described?
Sub peritoneal (below peritoneal cavity)
66
In what direction to the ureters enter the posterior bladder wall?
Inferomedial direction
67
Male rectovesicle pouch?
Forms between rectum & bladder
Most dependent part of peritoneal cavity (deepest) when in anatomical (standing upright) position
68
Anatomical relations of pelvic ureters in female?
Ureter runs inferior to uterine tubes and uterine artery
69
Anatomical relations of pelvic ureters in male?
Ureter runs inferiorly to vas deferens
70
Vasculature in females?
Vesical arteries -\> bladder
Uterine artery-\> uterus
Middle rectal artery -\> part of rectum
Vaginal artery -\> vagina
71
Vasculature in males?
Vesical arteries -\> bladder
Middle rectal artery -\> part of rectum
Prostatic arteries (often branches of vesical arteries) -\> prostate gland
72
Common iliac arteries?
2 large arteries which originate from aortic bifurcation at level of 4th lumbar vertebra
They end in front of sacroiliac joint
Each bifurcates into external and internal iliac arteries
73
Ureteric orifices?
L & R ureteric orifices are openings in which bladder will receive urine from ureters
74
What is the interal urethral orifice?
Below ureteric orifice
Opening of bladder into urethra
75
Where are ureteruc orifices situated?
In base (posterior aspect) of bladder
76
Where is internal urethral orifice situated?
On inferior aspect (floor) of bladder
77
Trigon of bladder?
Triangle between 3 openings
78
Which muscle forms bulk of bladder wall?
Detrusor muscle
79
Detrusor smooth muscle fibers encircle ureteric orifices
These muscles also contract when bladder contracts -\> closes off the ureteric orifices and prevents reflux of urine back up and into ureters
80
What does detrusor muscle form around neck of male bladder?
Internal urethra sphincter muscle
81
Function of internal urethra sphincter muscle in males?
Contracts during ejaculation to prevent retrograde ejaculation of semen back into the bladder
82
In males what is the common tube for urine and semen
Urethra
83
What is the most anterior organ ltying posterior to pubic bone in females?
Bladder (when empty)
84
In females where does body of uterus lie in relation to bladder?
Superior
85
What separates bladder and body of uterus?
Uterovesicle pouch
86
What is the most anterior organ lying posterior to pubic bone in males?
Bladder (when empty)
87
Where does prostate gland lie in relation to bladder?
Inferiro
88
Where does rectum lie in relation to bladder?
Posterior
89
Most dependent pouch of peritoneal cavity in male?
Rectovesicle pouch
90
Where does an empty bladder lie and what happens when bladder fills?
Empty bladder lies within true pelvis
When bladder starts to fill -\> extends superiorly and can leave true pelvis and enter false pelvis (part of abdominal cavity)
91
Which part of bladder wall is in contact with peritoneum?
ONLY the superior part of bladder wall
92
In what position does uterus sit on top of empty bladder?
Anti- flexed
93
Path of urine in females?
Urine from bladder -\> through internal urethral orifice -\> into urethra
Female then relaxes external urethral sphincter (voluntary skeletal muscle) -\> urine exits out through external urethral orifice
No internal urethral sphincter
94
Path of urine in males?
Urine passes through internal urethral orifice -\> passes through part of urethra contained within prostate gland (prostatic urethra) -\> then through external urethral sphincter (relaxes) -\> urine passes into spongy urethra (within corpus spongiosum (in penis)) -\> urine exits through external urethra orifice
95
Where is sperm produced?
In seminferous tubules in testes which are in scrotum
96
Where is sperm stored?
Epididymis
97
Embryological development of tested?
Testes move from their original position in the posterior abdomen, through the inguinal canal to the scrotum
98
Spermatic cord?
A collection of structures which support the functioning of the testis (testicular artery, testicular vein, vas deferens, lymphatic vessels draining testis, nerves (autonomic for smooth muscle of vas) and somatic (for cremaster muscle
99
Inside scrotum where do testes sit?
Within sac called tunica vaginalis
100
Main articular supply to testicle?
Testicualr artery
101
Pampiniform venous plexus?
Plexus of veins which wraps itself around testicular artery to drain deoxygenated venous blood from testicle
102
Where do right & left testicular ateries arise?
From abdominal aorta
103
Venous drainage of right testicular vein?
Right testicular vein drains right testicle directly back to right inferior vena cava
104
Venous drainage of left testicular vein?
Drains left tesicle back to left renal vein
105
Route of vas deferens?
Vas deferens pass superiorly within spermatic cord
Then enters inguinal canal via superficial ring outlined
Pass through inguinal canal and exit via deep inguinal ring
Then within abdominal cavity
Pass posterior to bladder
106
Where does ureter pass in relation to vas deferens?
Posteriorly
107
Prostatic ducts?
Through which glandular secretions from prostate gland drain into prostatic urethra
108
Prostate gland?
Walnut sized
Surrounds prostatic urethra
109
Zones of prostate?
Peripheral
Central (internal)
110
What does penis consist of?
Root
Body
Glands
Opening (external urethral orifice)
Superficial and deep fascia
Erectile tissue (corpus spongiosum, R&L corpus cavernosum)
111
Corpus spongiosum?
Transmits spngy urethra and expands directly to form glans
112
Arterial blood supply to penis?
Deep arteries of penis
Branch of internal pudendal artery which is a branch of internal iliac
113
Blood supply to scrotum?
## Footnote
Dual origin (internal and external iliac arteries)
From internal pudendal and branches from external iliac artery
Dual origin (internal and external iliac arteries)
From internal pudendal and branches from external iliac artery
114
Lymphatic drainage of scrotum and penis?
Lymph from scrotum and most of penis drains to superficial inguinal lymph nodes
115
Lymphatic drainage of testis?
Drains to lumbar nodes around abdominal aorta
116
Somatic sensory nerves?
Sensations from the body wall (soma) i.E. Our external environment are conveyed to the CNS by nerve fibres called “somatic sensory” nerve fibres
117
Visceral afferent nerve fibers?
Sensations from our organs i.E. Our internal environment are conveyed to the CNS by nerve fibres called “visceral afferent” nerve fibres
118
Somatic motor nerve fibers?
Motor responses to our body wall (soma) i.e. our external environment are conveyed from the CNS by nerve fibres called “somatic motor” nerve fibres and stimulate skeletal (voluntary) muscles to contract
119
Motor responses to organs are conveyed from CNS by which nerve fibers?
Parasympathetic and sympathetic nerve fibers
120
Which nerve fibers control ureteric peristalsis?
Sympathetic/ parasympathetic
121
Which nerve fibers control bladder contraction?
Sympathetic/ parasympathetic (internal sphincter)
Somatic motor (external sphincter & levator ani)
122
Which nerve fibers associated with pain from kidneys, ureters, bladder?
Visceral afferent
123
Which nerve fibres associated with pain from urethra?
Visceral afferent (in pelvis)
Somatic sensory (in perineum)
124
Which nerve fibers associated with pain from testes?
Visceral afferent (somatic presentation also)
125
Nerve fibers responsible for voluntary control of elimination of urine from bladder?
Sympathetic
Parasympathetic
Somatic moto
Visceral afferent
126
Lumbar and sacral (motor & sensory) nerve fibers associated with perineum and lower limbs?
Somatic sensory & somatic motor
127
How do sympathetic nerve fibers leave CNS?
Only within the spinal nerves between spinal cord levels T1-L2 (“thoracolumbar outflow”)
128
How do sympathetic fibers reach smooth muscle/ glands of body wall?
Within spinal nerves
129
How do sympathetic nerve fibres reach smooth muscle/ glands of body other than body wall?
Within nerves called splanchnic nerves – cardiopulmonary or abdominopelvic
130
How do sympathetic nerve fibers reach glands of the head?
By following (“hitching a ride with”) the arteries which supply the same structures
131
How do sympathetic nerve fibers get from CNS to kidneys, ureters and bladder?
Leave the spinal cord approx. between levels T10 and L2
Enter the sympathetic chains (bilaterally) but do not synapse
Leave the sympathetic chains within abdominopelvic splanchnic nerves
Synapse at the abdominal sympathetic ganglia which are located around the abdominal aorta
Postsynaptic sympathetic nerve fibres pass from the ganglia onto the surface of the arteries which are heading towards the organs they need to innervate.
132
133
How do parasympathetic fibers leave CNS?
Only within 4 cranial nerves and the sacral spinal nerves (“craniosacral outflow”)
134
How do parasympathetic fibres reach smooth muscle/ glands of head and body?
Via cranial nerves
135
How do parasympathetic fibres reach the smooth muscle/glands of the hindgut and pelvic organs?
Via pelvic splanchnic nerves
136
How do parasympathetic nerve fibres get from CNS to kidneys and ureter?
Carried within the vagus nerves (CNX)
137
How do parasympathetic nerve fibres get from CNS to bladder?
Carried within pelvic splanchnic nerves
138
How do somatic motor nerve fibres get from CNS to kidneys, ureters and bladder?
THEY DON'T
Somatic fibres only go to body wall structures
139
Where do somatic fibres go in renal system?
Parts of perineum e.g. urethra and its sphincter (external urethral sphincter and levator ani)
140
Above levator ani muscle?
Pelvis
141
Below levator ani muscle?
Perineum
142
Where is kidney pain felt?
Loin
Posterior aspect of flank region on affected side
143
Pain from bladder?
Suprapubic region (midline)
144
Pain from obstruction of ureter?
Radiating from "loin to groin" on affected side
145
Pain from perineal part of urethra?
Localised in perineum
146
How do visceral afferent nerve fibres get from kidneys to CNS?
Visceral afferents from the kidneys run alongside sympathetic fibres back to the spinal cord
They enter the spinal cord approx. Between levels T11 and L1
147
How do visceral afferent nerve fibers get from ureters to CNS?
Visceral afferents from the ureters run alongside sympathetic fibres back to the spinal cord
They enter the spinal cord between levels T11 and L2
148
How do visceral afferent nerve fibres get from part of bladder touching peritoneum to CNS?
Visceral afferents carrying pain from that part of the bladder which touches the peritoneum (superior part) run alongside sympathetic fibres back to the spinal cord
They enter the spinal cord between levels T11 – L2 and the pain is perceived by the patient as suprapubic pain (midline)
149
How do visceral afferent nerve fibres get from part of bladder not touching peritoneum to CNS?
Visceral afferent fibres from the rest of the bladder (that not touching the peritoneum) run alongside the parasympathetic nerve fibres back to spinal cord levels S2,S3, S4
150
Visceral afferent nerve fibers?
Conduct sensory impulses (pain or reflex) from internal organs, glands, blood vessels to central nervous system
151
How do visceral afferent and somatic sensory nerve fibres get from proximal urethra to CNS?
Run alongside the parasympathetic nerve fibres back to spinal cords levels S2,S3,S4
152
How do visceral afferent and somatic sensory nerve fibres get from non proximal part of urethra to CNS?
carried within the pudendal nerve also back to spinal cord levels S2,S3,S4
153
How do pain fibres get from testis to CNS?
Visceral afferents run alongside sympathetic fibres back to the spinal cord to levels T10-11
154
Which nerve fibers are key in controlling micturition (urine flow)?
Nerve fibers entering and leaving spinal cord at S2-S4
155
Control of detrusor muscle contraction?
parasympathetic
156
Internal urethral sphincter control?
Parasympathetic
157
Control of external urethral sphincter and levator ani muscles?
Somatic motor
158
Control of external urethral orifice?
Somatic motor nerve fibres
