Lower Urinary Tract Anatomy

Question 1

What is the False Pelvis?

Answer 1

Part of the Abdominal Cavity which extends from the Iliac Crests to the Pelvic Inlet
Contains abdominal viscera

Question 2

What is the True Pelvis?

Answer 2

The Pelvic Cavity, extends from the Pelvic Inlet to the Pelvic Floor
Contains pelvic viscera

Question 3

What is the Pelvic Floor made up of?

Answer 3

The Pelvic Diaphragm i.e. Group of muscles, predominantly the Levator Ani, which make up the pelvic floor

Question 4

What is the purpose of the Openings in the Pelvic Floor?

Answer 4

Allows the distal parts of the Alimentary, Reproductive and Urinary Tracts to pass into the Perineum

Question 5

What is the Perineum?

Answer 5

Shallow compartment which extends from the Pelvic Floor to the Skin of the External Genitalia

Question 6

At what anatomical spot do the Ureters enter the True Pelvis?

Answer 6

Pelvic Rim

Question 7

What is Angulation?

Answer 7

1/2 Mechanisms which prevent urine reflux in the urinary tract
Ureters change direction and enter the posterior aspect of the bladder infero-medially to prevent backflow

Question 8

What is the ‘Water under the Bridge’ in Males and Females?

Answer 8

In Males: Ureter passes inferior to the Vans Deferens

In Females: Ureter passes inferior to the Uterine Tubes and Arteries

Question 9

In the Female, which arteries are anatomically related to the Ureter?

Answer 9

Common Iliac Artery
Uterine Arteries
Vaginal Arteries
Middle Rectal Artery

Question 10

In the Male, which arteries are anatomically related to the Ureter?

Answer 10

Common Iliac Artery
Middle Rectal Artery
Prostatic Artery

Question 11

What are the 3 Orifices of the Bladder?

Answer 11

2 Ureteric Orifices

1 Internal Urethral Orifice

Question 12

What do the 3 Bladder Orifices form?

Answer 12

Trigone

Smooth triangular surface on the inside of the bladder wall

Question 13

Which Muscle forms the bulk of the bladder wall?

Answer 13

Detrusor Muscle

Question 14

What is the 2nd Mechanism for preventing urine reflux in the urinary tract?

Answer 14

Detrusor muscle has fibres which encircles the Ureteric Orifices which tighten when contraction of the bladder occurs, closing off the orifices, preventing urine backflow

Question 15

The External Urethral Sphincter Muscle is found in only Males. True or False?

Answer 15

False!

The External Urethral Sphincter Muscle is a skeletal muscle found in both; males and females.

Question 16

What is the Internal Urethral Sphincter?

Answer 16

A Smooth Muscle found only in Males at the neck of the bladder which contracts on ejaculation to prevent retrograde semen flow into the bladder.

Question 17

What separates the Bladder from the Uterus in females?

Answer 17

The Utero-Vesicular Pouch

Question 18

Where is the Bladder situated when empty?

Answer 18

Immediately tucked posterior to the Pubic Bone, near the Pubic Symphysis

Question 19

Where does the Uterus lie in relation to the bladder?

Answer 19

Superiorly - its weight is borne by the bladder

Question 20

What is the deepest aspect of the Female Peritoneal Cavity?

Answer 20

Rectouterine Pouch - abnormal fluid will collect here

Question 21

What lies inferior to the Male Bladder?

Answer 21

Prostate Gland

Question 22

What is the deepest aspect of the Male Peritoneal Cavity?

Answer 22

Rectovesical Pouch - abnormal fluid will collect here

Question 23

Which surface of the bladder is covered by Peritoneum?

Answer 23

Superior surface

Question 24

How can the Bladder extend out of the Pelvis when full?

Answer 24

Its superior surface lies superior to the pubic bone.

It extends superiorly so moves out of the True Pelvis into the False Pelvis

Question 25

Name the 2 types of Bladder Catheterisation

Answer 25

``` Urethral Catheterisation (more common) Suprapubic Catheterisation ```

Question 26

What happens in Urethral Catheterisation?

Answer 26

The catheter is inserted directly into the urethra

Question 27

What happens in Suprapubic Catheterisation?

Answer 27

The catheter is inserted into the Anterior Abdominal Wall, avoiding the Peritoneal Cavity

Question 28

Why can you not perform Suprapubic Catheterisation on an empty bladder?

Answer 28

You will pierce the Peritoneum. | An filled and therefore, expanded bladder pushes the peritoneum out of the way to allow direct bladder catheterisation

Question 29

What is the name of the Urethra when it descends through the Prostate Gland?

Answer 29

Prostatic Urethra

Question 30

What is the name of the Urethra when it descends through the Corpus Spongiosum of the Penis?

Answer 30

Spongy Urethra

Question 31

Where is Sperm produced?

Answer 31

Seminiferous Tubules of the Testes

Question 32

Where is Sperm stored?

Answer 32

Epididymis

Question 33

What forms the Ejaculatory Duct?

Answer 33

The Vans Deferens and the Duct of the Seminal Gland

Question 34

What are the 2 Layers of the Tunica Vaginalis?

Answer 34

Parietal Layer - in contact with the Scrotum | Visceral Layer - in contact with the Testes

Question 35

Which gland is palpated in the PR Exam

Answer 35

Prostate Gland The Peripheral Zone of the Prostate Gland (i.e. The Region of the Prostate Gland where Prostate Cancers tend to develop) is being Palpated.

Question 36

The Penis is found within the Perineum. True or False?

Answer 36

True

Question 37

What does the Root of the Penis attach to?

Answer 37

Ischium, laterally

Question 38

What are the 3 Erectile Tissue Compartments of the Penis?

Answer 38

Left and Right (2) Corpus Cavernosum, which transmit the Deep Arteries of the Penis Corpus Spongiosum, which transmits the Spongy Urethra and Expands Distally to form the Glans (Mushroom-Shaped aspect of Penis)

Question 39

What happens to the 3 Erectile Tissues of the Penis during an erection?

Answer 39

They become engorged with Blood

Question 40

What is the Blood Supply to the Penis and Scrotum?

Answer 40

The Internal Pudendal Arteries, which come off the Internal Iliac Artery, are deep arteries of the Penis which Supply the Erectile Tissue. The Scrotum receives a Dual Blood Supply from Arterial Branches, which arise from the Internal and External Iliac Arteries.

Question 41

What is the Lymphatic Drainage of the Penis and Scrotum?

Answer 41

Lymphatic Drainage of the Scrotum and Penis is Drained to the Superficial Lymph Nodes. Lymphatic Drainage of the Testes will drain back to the Lumbar Lymph Nodes as their Embryological Site of Origin, prior to Descension is near these Lymph Nodes.