Genito-Urinary Anatomy Flashcards
(145 cards)
1
Q
what is the role of the functional valve of bladder
A
prevents reflux into ureter
2
Q
whats the diff btwn internal and external urethral sphincters
A
internal: smooth muscle from bladder
externa: skeletal muscle from pelvic floor
3
Q
what are the 3 parts of male urethra
A
- prostatic urethra
- membranous urethra
- penile urethra
4
Q
what is the inguinal canal
A
an oblique passage through the muscles of the anterior abdominal wall: extends from deep inguinal ring to superficial ring
5
Q
what does the inguinal canal convey in males
A
spermatic cord (and ilio-inguinal nerve) also vas deferens, testicular artery, pampniform plexus of veins and neves/lymphatics of testis
6
Q
what does the inguinal canal convey in females
A
round ligament
olio-inguinal nerve
genital branch of genitofemoral artery
7
Q
what happens to structures as they pass through each of the abdominal wall layers
A
they gain a layer of tissue from each layer
8
Q
what are the testes covered by
A
same 3 layers of spermatic fascia that cover the spermatic cord
9
Q
what is the epidydmis
A
coiled tube laying along posterior border of each testis
10
Q
what does the scrotum contain
A
testes
epididymis
lower part of spermatic cord
11
Q
what is the glans penis
A
common outlet for urine and semen
12
Q
what is the diff btwn direct/indirect hernia
A
direct: passes through transverse fascia of post wall, directly through internal oblique layer and directly through external ring
indirect: passes through each of 3 layers of abdominal wall in diff position
13
Q
where do the gonads form in embryo
A
post abdominal wall and migrate from kidney level down to adult position
14
Q
what is the kidney’s/gonads autonomic nerve supply from
A
t10-l2 nerve root
15
Q
what is the tunica vaginalis
A
sac of peritoneum that partially surrounds testis
16
Q
what factors normally prevent herniation of abdominal contents through inguinal canal
A
deep/superficial inguinal ring are in diff positions
- lower fibres of transversalis/internal oblique arch over canal and close it off during abdominal wall contraction
17
Q
where would the ductus deferent be palpated?
A
it is attached to back of the testis and difficult to feel here. easy to feel in spermatic cord, feels like a hard cord
18
Q
what is a varicocele
A
high pressure of venous blood in pampniform plexus of veins in the scrotum causes the veins to enlarge
19
Q
what does the pampiniform plexus help regulate
A
temp
arteries supplying the testes run thro’ plexus where blood is cooled from abdominal arterial temp to testicular temp
20
Q
where would lymph nodes be palpated to assess spread of testicular cancer
A
cancer of testis will spread to lymph nodes around aorta where testicular arteries arise
21
Q
where is lymph drainage usually
A
lymph drainage of any organ follows arteries (but flow in opposite direction)
22
Q
should undescended testis be corrected
A
yes bc spermatogenesis doesn’t occur at body temp: vital to ensure fertility
23
Q
what anatomical structure in glans penis might impede progress of a catheter
A
navicular fossa
24
Q
which nerves provide sensory innervation to scrotal skin
A
anterior 1/3 through ilii-inguinal nerve (L1)
posterior 2/3 is pudendal nerve (s2-4)
25
where does the aorta bifurcate
L4
26
what does the aorta bifurcate into at L4
common iliac arteries
27
where is the IVC formed by the unification of the common iliac veins
L5
28
what is the cremaster muscle
muscle of spermatic cord
29
what are renal calculi
small stones pass down ureter intobladder
30
what is left varicocoel
left testicular vein passes into left renal vein
| disease of left kidney may block drainage of blood from lest testicle - scrotum veins become varicose
31
what is psoas spasm
appendix may lie on psoas, when it becomes inflamed the muscle goes into spasm: patient will have flexed hip. extending hip will be painful
32
renal tumours can become v large before they invade adjacent structures. what anatomical features explain this
they have thick and resilient capsule, surrounded by perinephric fat which is surrounded by perinephricfascia
33
what are 2 common variations in anatomy of renal pelvis and ureter
can be 2 ureters arising from kidney; sometimes they join and there is a single ureter entering bladder but sometimes they enter separately.
bladder doesn't have valve mechanism; prone to urine passing back up to kidney when bladder contracts
34
what veins do r and l gonadal veins drain into
r - IVC
| l - left renal vein
35
what is a polar artery?
when kidneys develop, they have a segmental pattern w a separate artery to each part.
- usually these arteries join to form single renal artery. 1 in 4 ppl have 2 renal arteries to 1 kidney; usually large renal artery and a smaller 1 to inferior pole of kidney; polar artery.
polar artery can compress ureter and stop urine flow
36
where would u palpate an abdominal aortic aneurysm
aorta finishes just above umbilicus so can only be felt in upper abdomen
37
what are the narrow parts of the ureter where a stone may get stuck
1. where renal pelvis becomes ureter
2. at pelvic brim
3. where ureter passes through bladder wall
38
describe the relationship of the ureter to bony landmarks of abdomen/pelvis
- pelvis of L kidney is approximately L2-3 and R kidney is L3
- ureter commences at lower part of pelvis and runs down tips of transverse processes of lumbar vertebrae
- runs just medial to sacroiliac joint but usually directly over it inferiorly
- it runs across tip of spinous process of pelvis and medially into bladder
39
where does the femoral nerve pass from abdomen into thigh
under inguinal ligament
40
where does the obturator nerve pass from abdomen into the thigh
through obturator foramina
41
where does sciatic nerve pass from abdomen into thigh
through the greater sciatic foramen
42
what is the path of the ureter
1. ureter enters pelvis
2. crosses anteriorly to iliac vessels
3. courses out to ischial spines
4. courses medially to penetrate bladder base
43
what is the origin of the psoas
from the fascia on the sides of lumbar vertebra
44
what is the insertion of psoas
lesser trochanter of femur
45
which nerve supplies lateral thigh skin
lateral cutaneous nerve of the thigh (runs under inguinal ligament)
46
what is the recto-vesical pouch
lies btw rectum and urinary bladder (lowest part of peritoneal cavity)
47
what is the recto-uterine pouch aka
pouch of Douglas
48
what is most of the bladder's mucosa like
rugose (wrinkled/conjugated)
49
what is the trigone
smooth triangular area of mucosa on inner aspect of bladder base (it's sensitive to expansion)
50
what does the uterine artery arise from
anterior division of internal iliac artery
51
what is benign prostatic hypertrophy
enlargement of prostatic gland; may lead to blockage of urethra and inability to pass urine (requires emergency catheterisation)
52
where does venous drainage from the prostate pass
into a plexus of veins which lie anterior to the sacrum and communicate with veins which run up to azygous vein in chest
53
what are the 3 components of micturition control
1. control from brain
2. control from spinal cord
3. sensory input from bladder
54
why is the ureter in danger of damaging during hysterectomy
ureter runs immediately under uterine artery
55
what steps urine passing from bladder back up to the ureter
ureter enters bladder at an oblique angle. as pressure in bladder rises, this presses on part of ureter which is in bladder and stops using passing back up to kidney
56
where does the bladder lie when full
against the lower abdominal wall, with no peritoneum between the bladder and the abdominal wall
57
a 25 yr old woman is in a car crash; suffered complete transection of SC at T6. is she able to tell when bladder is full?
no, signals cannot reach brain
58
what happens during micturition if there is loss of brain control
- bladder fills, SC knows bladder is full but this doesn't reach brain
- SC asks brain to empty, brain doesn't reply, SC completes normal emptying
- patient suddenly and unexpectantly passes urine with no control
(low pressure in bladder so no risk of renal failure)
59
what happens during micturition is there is loss of sensation
- SC and brain cannot know that bladder is full so don't tell it to empty
- bladders fills and patient continually dribbles w high pressure in bladder/kidney can lead to kidney damage
(patient has no awareness of full bladder)
60
what happens during micturition if there is loss of spinal cord motor
- patient knows bladder is full but cannot empty
| - high pressure in the bladder and renal failure
61
how is the body of the uterus usually placed
typically bent forwards and lies on superior surface of bladder
62
how does the cervix communicate with uterine cavity
via internal os (orifice)
63
how does cervix communicate with vagina
via external os (orifice)
64
how is the position of the cervix stabilised
levator ani muscle and cervical ligaments
65
how are ovaries attached to posterior of broad ligament
by a short mesentery (mesovarium)
66
what does the uterine artery anastomose with
ovarian artery
67
where does the vagina lie
- upper 2/3 in pelvic cavity
| - bottom 1/3 in the perineum
68
what is the perineum
area btwn anus and scrotum/vulva (diamond-shaped)
69
what is the mons pubis
a rounded, hair bearing skin elevation located in front of pubic symphysis
70
where does the ductus deferent terminate
by joining duct of seminal vesicle to form the ejaculatory duct
71
do the seminal vesicles store sperm
no, they secrete thick alkaline fluid which forms the bulk of seminal fluid
72
where does the prostate gland lie
against neck of bladder
73
what is the prostate gland pierced by
urethra and ejaculatory ducts
74
what does the shaft of the penis consist of
3 erectile cylinders:
1. corpus spongiousum
2. paid corpora cavernosa
75
where on the thigh, may inflammation of the ovary result in pain? and why
medial aspect of thigh
- ovary lies in space btwn internal/external iliac arteries on lateral wall of pelvis
- immediately deep to peritoneum is obturator nerve; relays sensory info from medial thigh
- ovary mar irritate nerve and cause pain
76
what is a retroverted uterus
body of uterus is at an angle to the cervix with the body position more posteriorly
(if it is more anterior, it is ante-versed)
77
what maintains the normal position of the uterus
cardinal and broad ligaments
78
to which lymph nodes would cervical cancer spread?
internal iliac group
79
what structures may be palpable during examination through the vagina
- cervix
- spinous process ofpelvis
- contains of recto-uterine pouch
- ovaries
- bladder
- urethra
- rectum
- anal canal
80
what is the superficial perineal pouch
space btwn perineal membrane and fascia which encloses external genitalia
81
what is the perineal membrane
fibrous membrane lying btwn inferior pubic rami as far as back as ischial tuberosities; triangular with holes in midline for vagina, urethra and anteriorly for venous drainage from external genitalia
82
what is the urogenital diaphragm
most superior layer of deep perineal pouch
83
what is anterior to the vagina
bladder and urethra
84
what is posterior to the vagina
rectum and anus
85
what is lateral to the vagina
ureters and uterine arteries
86
what are the 2 main holes in the pelvic floor
- urogenital hiatus: anteriorly situated, allows passage of urethra (and vagina in females)
- rectal hiatus: centrally positioned, allows passage of anal canal
87
what kind of muscle are the ureters
smooth muscle
88
what is the abdominal supply of ureters
renal artery
| testicular/ovarian artery
89
what is the pelvic supply of ureters
superior and inferior vesicle arteries
90
what is the bladder derived from
hindgut
91
how are the detrusor muscles fibres orientated
in 3 directions to retain structural integrity when stretched
92
what are the roots of the hypogastric nerve
t12-l2
93
what are the roots of the pelvic nerve
s2-4
94
what are the roots of the pudendal nerve
s2-4
95
what are the 3 parts of the penis
root, body, glans
96
what are the erectile tissues and what do they do
left/right crura and bulb of penis
these fill with blood during sexual arousal
97
what do the left and right crura form
the 2 corpora cavernosa
98
what are the leading cells responsible for
testosterone production
99
what are seminiferous tubules lined by
Sertoli cells
100
why is the scrotums skin wrinkled
helps to regulate temperature; decreases SA, heat loss is reduced
101
what does the scrotum receive arterial supply from
anterior and posterior scrotal arteries
102
what is the spermatic cord
a collection of vessels, nerves and ducts that run to and from the testes. surrounded by a fascia
103
what is the pampiniform plexus
a network of veins, responsible for the venous drainage of testes.
has a unique configuration; wraps itself around testicular artery
104
what is the prostate innervated by
inferior hypogastric plexus
105
what is the lumbar plexus formed from
anterior rami of l1/2/3/4
106
what is the Point and Shoot mnemonic for?
```
erection = Parasympathetic innervation
ejaculation = Sympathetic innervation
```
107
what are the nerve roots of the pudendal nerve
s2-4
108
what is the sensory innervation of pudendal nerve
external genitalia of both sexes
| and skin around anus, anal canal and perineum
109
what is the motor innervation of pudendal nerve
various pelvic muscles
external urethral sphincter
external anal sphincter
110
where is the sacral plexus located
posterior pelvic wall
111
where does the pudendal nerve leave the pelvis
greater sciatic foramen
112
what is the main arterial supply of pelvic cavity
internal iliac artery
113
where does the common iliac artery bifurcate
l5-s1
114
where does the internal iliac artery divide into anterior and posterior trunks
at the superior border of the greater sciatic foramen
115
what does the anterior trunk of int iliac artery supply
pelvic organs
perineum
gluteal and adductor regions of lower limb
116
what does the posterior trunk of int iliac artery supply
lower posterior abdominal wall
posterior pelvic wall
gluteal region
117
what are the 3 main vessels involved in pelvic venous drainage
external iliac
internal iliac
common iliac
118
what is the external iliac vein a continuation of
femoral vein (when it crosses under inguinal ligament)
119
what are the external genitalia collectively known as
vulva
120
what are 3 functions of the vulva
1. . to act as sensory tissue during sex
2. to assist in micturition by directing urine flow
3. to defend internal reproductive tract from infection
121
what is the blood supply to the external genitalia
paired pudendal arteries
122
what is the cervix
lower portion of the uterus
123
how does the cervix facilitate sperm passage into the uterine cavity
via dilation of the external and internal os
124
what are the 3 parts of the uterus
fundus
body
cervix
125
where does the broad ligament attach
sides of the uterus to the pelvis
| - contributes to maintaining it in position
126
where does the round ligament attach
extends from uterine horns to labia major via inguinal canal
| - maintains anteverted position of uterus
127
what are PS fibres of uterus derived from
pelvic splanchnic nerves (s2-4)
128
what is the main function of the uterine tubes
to assist in transfer/transport of ovum from ovary to uterus
129
what are the 4 parts of the fallopian tube (lateral to medial)
- fimbriae
- infundibulum
- ampulla
- isthmus
130
where do gonads develop within
mesonephric ridge
131
how are ovaries attached to the posterior surface of the broad ligament
by the mesovarium
132
what are the 2 coverings of the testicles
- tunica vaginalis
| - tunica albuginea
133
what is the path of the sperm from seminiferous tubules to epididymis
seminiferous tubules --> rete testes --> efferent tubules --> epididymis
134
how many days does the epididymis store sperm
50 days
135
where does the tail of the epididymis connect to
vas deferens
136
what branches off the abdominal aorta at t12
inferior phrenic arteries
137
what branches off the abdominal aorta at L1
coeliac trunk, middle suprarenal arteries
138
what branches off the abdominal aorta at lower L1
superior mesenteric artery
139
what branches off the abdominal aorta at L1/2
renal arteries
140
what branches off the abdominal aorta at L2
gonadal arteries
141
what branches off the abdominal aorta at L3
inferior mesenteric artery
142
what is diff btwn labia majora and minora
majora - hair bearing fold
| minora - non-hair bearing fold
143
what are the 3 layers of the uterus
endometrium
myometrium
perimetrium
144
what are the 3 zones of the prostate gland
central
peripheral
transitional
145
where is sperm produced
seminiferous tubules of testis
