Anatomy of the Lower Urinary Tract and Male Reproductive Tract

Question 1

How do the ureters pass to the true pelvis?

Answer 1

Pass from the retroperitoneum through the false pelvis and into the true pelvis

Question 2

What is the false pelvis?

Answer 2

From the iliac crests to pelvic inlet = part of the abdominal cavity

Question 3

What is the true pelvis?

Answer 3

Pelvic cavity = pelvic inlet to pelvic floor

Question 4

What forms the pelvic diaphragm?

Answer 4

Levator ani and other pelvic floor muscles

Question 5

What body cavity is the bladder found in?

Answer 5

The pelvic cavity

Question 6

What does the urethra pass through to reach the peritoneum?

Answer 6

The pelvic floor

Question 7

What forms the pelvic floor?

Answer 7

The bowl shaped pelvic diaphragm

Question 8

What structures pass through the pelvic floor?

Answer 8

Distal parts of alimentary, renal and reproductive tracts

Question 9

What is the perineum?

Answer 9

Shallow compartment between the pelvic floor and the skin

Question 10

What is the course of the ureters?

Answer 10

Pass anterior to the common iliac vessels to enter the pelvis, run anteriorly along the lateral pelvic walls

Question 11

What do the ureters do at the level of the ischial spine?

Answer 11

Turn medically to enter the posterior aspect of the bladder

Question 12

What can be said for the route of the ureters?

Answer 12

It is completely sub-peritoneal

Question 13

What direction do the ureters enter the posterior bladder wall?

Answer 13

Inferomedial direction = helps prevent reflux of urine back into ureters when the bladder contracts

Question 14

What is special about the rectovesicle pouch?

Answer 14

Most inferior part of the male peritoneal cavity in the anatomical position

Question 15

What structures does the round ligament of the uterus attach?

Answer 15

Attaches uterus to the perineum via the inguinal canal

Question 16

Where is the vesico-uterine pouch located?

Answer 16

Between the bladder and the uterus

Question 17

What is significant about the recto-uterine pouch of Douglas?

Answer 17

Most inferior part of the female peritoneal cavity in the anatomical position

Question 18

What does the inferior part of the parietal peritoneum form?

Answer 18

The floor of the peritoneal cavity and a roof and over the pelvic organs

Question 19

What are some anatomical relations of the ureter in females?

Answer 19

Runs inferiorly to the uterine tubes and the uterine artery

Question 20

What structure does the ureter in males run inferior to?

Answer 20

The vas deferens

Question 21

Where do the arteries that enter the pelvis originate from?

Answer 21

The internal iliac artery

Question 22

What are some branches that the internal iliac artery gives off into the pelvis?

Answer 22

Uterine artery, middle rectal artery, vaginal artery

Question 23

What vessels supply the bladder?

Answer 23

Vesical arteries

Question 24

What do the pelvic veins drain into?

Answer 24

The internal iliac vein

Question 25

What branches does the vesical artery give rise to?

Answer 25

The prostatic arteries

Question 26

What is the trigone of the bladder?

Answer 26

Internal aspect of bladder = formed by 2 ureteric orifices and the internal urethral orifice

Question 27

How are the orifices arranged in the trigone?

Answer 27

Ureteric orifices are the posterior aspect | Internal urethral orifice in the inferior aspect

Question 28

What does the detrusor muscle form?

Answer 28

The main bulk of the bladder wall

Question 29

How does the detrusor muscle prevent urine reflux?

Answer 29

Fibres encircle ureteric orifices and tighten when the bladder contracts

Question 30

What does the detrusor muscle form in the male bladder?

Answer 30

The internal urethral sphincter muscle = contracts during ejaculation to prevent reflux

Question 31

What is the most anterior organ in the pelvis?

Answer 31

The bladder (when empty) = lies posterior to the pubic bone

Question 32

What are the anatomical relations of the bladder in males?

Answer 32

Prostate lies inferior to bladder, rectum is posterior to bladder

Question 33

What are the anatomical relations of the bladder in females?

Answer 33

Body of uterus usually lies superior (separated by uterovesical pouch)

Question 34

What bears most of the weight of the uterus?

Answer 34

The bladder

Question 35

Where is the empty bladder located?

Answer 35

Lies within pelvis and it’s superior surface is covered by peritoneum

Question 36

Where is the full bladder located?

Answer 36

Can extend out of pelvis = superior part lies superior to pubic bone, peritoneum still only covers superior surface

Question 37

What are the two ways of catheterising the bladder?

Answer 37

``` Urethral = more common Supra-pubic = through anterior abdominal wall and avoids peritoneal cavity ```

Question 38

How long is the urethra?

Answer 38

``` Male = 20cm long Female = 4cm long ```

Question 39

Where is the spongy urethra located in males?

Answer 39

Within the corpus spongiosum

Question 40

How are the urethral sphincters controlled?

Answer 40

External urethral sphincter = voluntary | Internal urethral sphincter = involuntary

Question 41

Where should the testes be located at birth?

Answer 41

Within the scrotum

Question 42

What is the course of the testes during development?

Answer 42

Move from original position in the posterior abdomen, through the posterior inguinal canal and to the scrotum

Question 43

What is the spermatic cord?

Answer 43

Collection of structures which support the functioning of the testes

Question 44

What vessels are within the spermatic cord?

Answer 44

Testicular artery, testicular vein, lymphatic vessels

Question 45

What nerves are contained within the spermatic cord?

Answer 45

Autonomic nerves for the smooth muscle of the vas | Somatic nerves for the cremaster muscle

Question 46

What covers the epididymis and testis?

Answer 46

Visceral tunica vaginalis

Question 47

What is a hydrocele?

Answer 47

Excess fluid within the tunica vaginalis

Question 48

What venous plexus is contained within the spermatic cord?

Answer 48

Pampiniform plexus

Question 49

What is the function of the vas deferens?

Answer 49

Transports sperm = begins at inferior pole of testes

Question 50

What is testicular tortion?

Answer 50

Twisting of the spermatic cord = may disrupt blood supply and lead to testicular necrosis, causes severe pain

Question 51

What is the function of the deep inguinal ring?

Answer 51

Allows passage of the spermatic cord into and out of the inguinal canal

Question 52

Where can the epididymis be palpated?

Answer 52

At posterior aspect of testes

Question 53

Where is the proximal end (head) of the epididymis located?

Answer 53

At the posterior aspect of the superior pole of the testes

Question 54

Where can the vas deferens be palpated?

Answer 54

Within the spermatic cord = within scrotum superior to testes

Question 55

What is the course of the vas deferens?

Answer 55

Passes superiorly within the spermatic cord to the deep inguinal ring, where it turns medially into the pelvis

Question 56

Where do the secretions from the prostate gland drain in to?

Answer 56

The prostatic urethra via the prostatic ducts

Question 57

What structures form the ejaculatory duct?

Answer 57

Vas deferens and the duct from the seminal gland

Question 58

How big is the prostate gland?

Answer 58

Walnut sized = surrounds prostatic urethra

Question 59

What is the inferior aspect of the prostate in contact with?

Answer 59

The levator ani muscle

Question 60

What are the zones of the prostate gland?

Answer 60

Peripheral and central zones

Question 61

What part of the prostate can be felt during a PR examination?

Answer 61

The peripheral zone = site of most prostate cancers

Question 62

Where is the penis located?

Answer 62

Within the perineum

Question 63

What is the root of the penis attached to laterally?

Answer 63

Ischium of the pelvis

Question 64

What happens to the penis during an erection?

Answer 64

The three cylinders of erectile tissue become engorged with blood at arterial pressure

Question 65

What are the erectile tissues of the penis?

Answer 65

Right and left corpus cavernosum, corpus spongiosum

Question 66

Where are the right and left corpus cavernosum located?

Answer 66

Located posteriorly = transmit deep arteries of blood to penis

Question 67

Where is the corpus spongiosum located?

Answer 67

Located anteriorly = transmits spongy urethra

Question 68

What forms the glans of the penis?

Answer 68

Distal expansion of the corpus spongiosum

Question 69

What is the blood supply of the penis?

Answer 69

Deep arteries of penis = branches of internal pudendal artery from internal iliac artery

Question 70

What is the blood supply to the scrotum?

Answer 70

Internal pudendal artery and branches from the external iliac artery

Question 71

Where does lymph from the scrotum and most of the penis (not glans) drain to?

Answer 71

Superficial inguinal lymph nodes = in superficial fascia in the groin

Question 72

Where does lymph from the testis drain to?

Answer 72

Lumbar nodes around the abdominal aorta