PBL questions

Question 1

male urinary system

Answer 1

shares common pathway with reproductive system

urethra passes through penis and is 10-15cm long

Question 2

what does the male urethra pass through?

Answer 2

prostate
internal and external sphincters
urogenital diaphragm
cowper’s gland

Question 3

female urinary system

Answer 3

doesn’t share common pathway with reproductive system - only close proximity
urethra only functions to excrete urine and is 3-4cm long
higher risk of UTIs due to proximity to vagina and anus

Question 4

female urethra

Answer 4

extends from neck of bladder, internal and external sphincters and urogenital diaphragm

Question 5

shape of the bladder

Answer 5

when full oval-shaped

when empty it is flattened by the bowel

Question 6

parts of the bladder

Answer 6

apex
body
fundus
neck 
trigone

Question 7

what is the trigone?

Answer 7

smooth walled area that marks the entry of ureters and exit of urethra

Question 8

origin of trigone

Answer 8

mesonephric ducts

Question 9

muscle of the bladder

Answer 9

detrusor muscle - specialised smooth muscle

fibres run in multiple directions

Question 10

innervations of the bladder

Answer 10

sympathetic and parasympathetic

Question 11

muscular sphincters

Answer 11

2 - internal and external urethral sphincters

Question 12

internal urethral sphincter

Answer 12

differs in males and females

Question 13

male internal urethral sphincter

Answer 13

consists of circular smooth fibres under autonomic control

Question 14

female urethral sphincter

Answer 14

formed by the anatomy of the bladder neck and proximal urethra
no sphincteric muscle present

Question 15

external urethral sphincter

Answer 15

same structure in both sexes
skeletal muscle under voluntary control
however, more complex in males

Question 16

arterial blood supply to bladder

Answer 16

derived from internal iliac vessels
superior vesical branch
obturator and inferior gluteal arteries may contribute small branches

Question 17

arterial supply to female bladder

Answer 17

superior vesical branch is supplemented by vaginal arteries

Question 18

arterial supply to male bladder

Answer 18

superior vesical branch is supplemented by inferior vesical artery

Question 19

venous drainage of bladder

Answer 19

vesical venous plexus

drains into internal iliac veins

Question 20

nervous supply of bladder

Answer 20

autonomic and somatic

Question 21

autonomic supply to bladder

Answer 21

sympathetic and parasympathetic

Question 22

sympathetic innervation of bladder

Answer 22

hypogastric nerve

Question 23

hypogastric nerve root

Answer 23

T12-L2

Question 24

what does the hypogastric nerve do?

Answer 24

relax the detrusor muscle

promotes urine retention

Question 25

parasympathetic innervation of bladder

Answer 25

pelvic nerve

Question 26

pelvic nerve root

Answer 26

S2-4

Question 27

what does the pelvic nerve do?

Answer 27

causes contraction of detrusor muscle and stimulates micturition

Question 28

somatic innervation to bladder

Answer 28

pudendal nerve

Question 29

pudendal nerve root

Answer 29

S2-4

Question 30

sensory nerves to bladder

Answer 30

report to brain from bladder wall to signal when the bladder is full

Question 31

bladder stretch reflex

Answer 31

micturition is stimulated in response to stretch of the bladder wall

Question 32

how does the bladder stretch reflex work?

Answer 32

bladder fills with urine walls stretch sensory nerves detect stretch and transmit to spinal cord interneurons relay signal to parasympathetic efferent nerves - pelvic nerve contracts the detrusor muscle stimulates micturition

Question 33

when does the bladder reflex occur?

Answer 33

only functional in childhood

Question 34

what are the normal parameters for urine output?

Answer 34

1L/ day | ranges from 800-2000ml/ day with 2L fluid intake / day

Question 35

what happens in a routine health check?

Answer 35

helps to tell you if you are at a higher risk of getting certain serious health problems

Question 36

what health problems does the routine health check focus on?

Answer 36

``` heart disease diabetes kidney disease stroke dementia (if over 65) ```

Question 37

when is the routine health check carried out?

Answer 37

every 5 years for those between 40 and 74

Question 38

what is involved in the routine health check?

Answer 38

``` full medical history questions about lifestyle family history measure height and weight BP blood test receive personalised advice medications for BP and cholesterol prescribed if necessary lifestyle advice ```

Question 39

common renal system diseases

Answer 39

``` acute and chronic kidney failure/ disease congenital malformations - PKD UTIs urinary retention bladder incontinence ```