Anatomy Topic 4 Case 8

Question 1

In which direction does the apex of the bladder face?

Answer 1

• To top of pubic symphysis

- A structure called the median umbilical ligament

Question 2

In which direction does the base of the bladder face?

Answer 2

• Posterolaterally

- Where the ureters enter the bladder

Question 3

What is the trigone?

Answer 3

• Smooth triangular area

- Between the openings of the ureters and urethra on either side of the bladder inferiorly

Question 4

The inferolateral surfaces of the bladder are cradled between which muscles?

Answer 4

• Levator ani

- Obturator internus

Question 5

Where is the neck of the bladder located?

Answer 5

• Surrounds the origin of the urethra

- At the point where the inferolateral surfaces and base intersect

Question 6

Why is the neck of the bladder the most fixed part?

Answer 6

• It is anchored by a pair of fibromuscular bands

- Which connect the neck of the bladder and pelvic part of the urethra to the posteroinferior aspect of each pubic bone.

Question 7

What is the name of these fibromuscular bands in males and females?

Answer 7

• Females: Pubovesical ligaments

- Males: Puboprostatic ligaments

Question 8

Outline the arterial supply to the bladder

Answer 8

• Superior and inferior vesical arteries

- From internal iliac artery

Question 9

Outline the venous drainage of the bladder

Answer 9

• Pelvic plexus of veins

Question 10

Pain from the bladder is carried by which nerves?

Answer 10

• Pelvic splanchnic nerves (S2-S4)

Question 11

What is the function of parasympathetic fibres to the bladder?

Answer 11

• Stimulates bladder contraction

Question 12

How long is the female urethra?

Answer 12

• 4cm long

Question 13

Describe the course of the female urethra

Answer 13

• Beings at base of bladder
• Passes inferiorly through pelvic floor into perineum
• Passes through deep perineal pouch and perineal membrane
• Opens into vestibule between labia minora

Question 14

Identify and describe the glands associated with the female urethra

Answer 14

• Lesser vestibular glands / Skene’s glands
• Which are small para-urethral mucous glands
• Which drain via a duct that opens onto the lateral margin of the external urethral orifice

Question 15

How long is the male urethra? How many times does it bend along its course?

Answer 15

• 20 cm

- Twice

Question 16

Outline the course of the male urethra

Answer 16

• Begins at base of the bladder
• Passes inferiorly through the prostate
• Passes through the deep perineal pouch and perineal membrane
• Enters the root of the penis.

Question 17

Identify the four parts of the male urethra

Answer 17

• Pre-prostatic
• Prostatic part
• Membranous part
• Spongey part

Question 18

How long is the pre-prostatic part of the male urethra? Which muscle is it associated with?

Answer 18

• 1 cm long

- Internal urethral sphincter

Question 19

How long is the prostatic part of the urethra?

Answer 19

• 3 - 4 cm

Question 20

Describe the structure of the prostatic part of the urethra

Answer 20

• Midline urethral crest
• Depression on either side (prostatic sinus) through which prostate ducts empty through
• Midway along its length the enlarges to form seminal colliculus
• Small blind ended pouch, prostatic utricle, opens into seminal colliculus
• Opening of ejaculatory duct on either side of prostatic utricle

Question 21

Identify the glands and muscle associated with the membranous part of the urethra

Answer 21

• Bulbo-urethral glands

- Externa urethral sphincter

Question 22

What is the spongy part of the urethra surrounded by?

Answer 22

• Corpus spongiosum

Question 23

What is the navicular fossa?

Answer 23

• Spongy urethra forms an enlarged bulb at apex of penis

Question 24

Identify the anterior, posterior and superior relations of the prostate

Answer 24

• Anterior: Pubic symphysis
• Posterior: Rectum
• Superior: Bladder

Question 25

Which muscles is the prostate in contact with?

Answer 25

• Levator ani

Question 26

Identify the arterial supply to the prostate

Answer 26

• Inferior vesical artery and middle rectal artery

- Both of which are branches of the anterior trunk of the internal iliac artery

Question 27

Identify the venous drainage of the prostate

Answer 27

• Prostatic venous plexus
• Which lies outside capsule of prostate
• And drains into internal iliac veins

Question 28

Identify the lymphatic drainage of the prostate

Answer 28

• Internal iliac nodes

Question 29

Identify the nerve supply of the prostate

Answer 29

• Inferior hypogastric plexus

- Sympathetic nerves stimulate smooth muscle during ejaculation

Question 30

Identify the muscular layers of the bladder

Answer 30

• Inner longitudinal
• Outer circular
• Outermost longitudinal
• Collectively referred to as detrusor muscle

Question 31

What type of epithelium lines the bladder?

Answer 31

• Transitional epithelium
• Stratified layer
• Consisting of a layer of basal cuboidal cells
• And intermediate columnar cells
• With an underlying lamina propria

Question 32

What is the function of umbrella / dome cells of transitional epithelia?

Answer 32

• Maintains the impermeability of the epithelium to urine even at full stretch

Question 33

Identify the three zones of the prostate

Answer 33

• Transition zone surrounding proximal prostatic urethra
• Central zone surrounding the ejaculatory ducts
• Peripheral zone making up the bulk of the gland

Question 34

What is corpora amylacea?

Answer 34

• Prostatic secretions become thicker and calcified with age

Question 35

Which cells of the prostate are associate with hyperplasia?

Answer 35

• Basal cells