Clinically Relevant Anatomy of the Lower Urinary Tract Involving the Male Reproductive Tract

Question 1

The pelvic cavity can be split into which two segments?

Answer 1

True pelvis

False pelvis

Question 2

Why is the false pelvis “false”?

Answer 2

Contains abdominal viscera versus pelvic viscera

Question 3

Where is the division between the true and false pelvis found?

Answer 3

Pelvic brim at the pelvic inlet

(Uteric constriction can occur here)

Question 4

What separates the perineum from the pelvic cavity?

Answer 4

Muscles including the levator ani

Question 5

When the ureter reaches the ischial spines, which direction do they turn?

Answer 5

Medially

(towards posterior bladder)

Question 6

Within the abdominal cavity, the ureter is ________ and in the pelvic cavity it is _________

Answer 6

Within the abdominal cavity, the ureter is retroperitoneal and in the pelvic cavity it is subperitoneal

Question 7

Which two anatomical properties prevent reflux of urine up the ureters as the bladder contracts?

Answer 7

1. Medial insertion of ureters into bladder
2. Detrusor muscle cotracts uteric orifices

Question 8

What is the name given to the space ony found in males between the rectum and bladder?

Answer 8

Rectovesicle pouch

Question 9

What is the most dependent area in males when standing up?

Answer 9

Rectovesicle pouch

Question 10

What is the space found in females

a) Between the uterus and the bladder
b) Between the rectum and uterus

Answer 10

a) Vesicouterine pouch- Between the uterus and the bladder
b) Rectouterine pouch- Between the rectum and uterus

Question 11

What is the pouch of Douglas?

Answer 11

Rectouterine pouch

Question 12

What is the most dependent area in females when standing up?

Answer 12

Rectouterine pouch

Question 13

The ureter runs posterior to which artery in females?

Answer 13

Uterine artery

(“water under the bridge” water = ureter, bridge = uterine artery)

Question 14

At which level does the aorta bifurcate?

Answer 14

Level of umbilicus

Question 15

In males the ureter runs inferior to what?

Answer 15

Vas deferens

Question 16

Which arteries supply the bladder?

Answer 16

Vesical arteries

Question 17

From which arteries do the vesical arteries branch from?

Answer 17

Internal iliac arteries

Question 18

What is the term given to the part of the urethra which passes through the prostate?

Answer 18

Prostatic urethra

Question 19

What is the “trigon”?

Answer 19

A triangular shape on the internal aspect of the bladder created by 3 points:

The 2 ureteric orifices

The internal urethral orifice

Question 20

What use does the trigon have?

Answer 20

It is very smooth and funnels urine into the urethra

Question 21

Which muscle forms the main bulk of the bladder wall?

Answer 21

Detrusor muscle

Question 22

Why does semen not enter the bladder during ejaculation?

Answer 22

Contraction of the internal urethral sphincter

Question 23

In females, the uterus normally sits “anteflexed”. What does this mean?

Answer 23

Lies superiorly over the bladder

Question 24

Normally an empty bladder resides within the _____ pelvis

Answer 24

Normally an empty bladder resides within the true pelvis

Question 25

How is voluntary control over urination conferred?

Answer 25

External urethral sphincter

Question 26

What are the two route to catheterising patients?

Answer 26

1. Urethral (more common) 2. Suprapubic (through anterior abdominal wall and avoiding peritoneal cavity)

Question 27

How long is the urethra in a) Females b) Males

Answer 27

a) 4cm b) 20cm

Question 28

How many sphincters associated with urination are found in a) Males b) Females

Answer 28

a) 2 b) 1

Question 29

The portion of the urethra that passes through the penis is called the spongy urethra, why is this?

Answer 29

It passes through the corpus spongiosum

Question 30

Where is sperm stored?

Answer 30

Epididymis

Question 31

Which two structures combine to form the prostatic urethra?

Answer 31

1. Ejaculatory duct 2. Urethra

Question 32

Where do the testes begin their development?

Answer 32

Posterior abdominal wall

Question 33

What can be found within the spermatic cord?

Answer 33

1. Testicular, deferential artery and cremasteric arteries 2. Nerve to cremaster and testicular nerves (sympathetic nerves) 3. Vas deferens 4. Pampiniform plexus 5. Lymphatic vessels 6. Tunica vaginalis

Question 34

What is the name of the sac that the testis sits within?

Answer 34

Tunica vaginalis

Question 35

What is the term used to describe excess fluid in the tunica vaginalis?

Answer 35

Hydrocele

Question 36

What is the name given to accessory tissue from the testes and epididymis?

Answer 36

Appendix teste

Question 37

Where do the gonadal (testicular/ovarian) arteries arise?

Answer 37

Aorta

Question 38

Which structures form the ejaculatory duct?

Answer 38

Vas deferens Seminal vesicles

Question 39

Besides the ejaculatory ducts, which other ducts can be found in the prostatic urethra?

Answer 39

Many prostatic ducts

Question 40

Which region of the prostate gland is most likely to develop malignancy?

Answer 40

Peripheral zone | (Can be felt on PR exam)

Question 41

How many erectile tissue cylinders are found in the penis?

Answer 41

3

Question 42

What are the names of the erectile tissue cylinders in the penis?

Answer 42

Corpus cavernosum (x2 large) Corpus spongiosum (x1 smaller)

Question 43

Which artery supplies the penis?

Answer 43

Deep artery of the penis

Question 44

Where does the deep artery of the penis arise?

Answer 44

Internal pudendal artery (arises from internal iliac)

Question 45

What is the arterial supply of the scrotum?

Answer 45

Scrotal branches from internal pudendal and external iliac artery

Question 46

What is the lymphatic drainage of the scrotum and penis?

Answer 46

Superficial inguinal lymph nodes | (found in superficial fascia of groin)

Question 47

What is the lymphatic drainage of the testes?

Answer 47

Lumbar nodes around the abdominal aorta