Pelvicalyceal System, Ureters, Bladder and Urethra Flashcards
(29 cards)
This study, performed by cystoscopic catheterization of the ureteral orifice followed by injection of contrast, is independent of renal function, and provides high-quality images of the ureter and the collecting system.
Retrograde pyelography
When a percutaneous nephrostomy catheter has been placed in the collecting system, anterograde pyelography is an additional choice.
This is the imaging method of choice for screening for hydronephrosis but is limited in its ability to demonstrate small uroepithelial tumors.
Ultrasound
The collecting tubules of a medullary pyramid coalesce into a variable number of papillary ducts that pierce thee tip of the papilla and drain into the receptacle of the collecting system called what?
A minor calyx
The sharp-edged portion of the minor calyx projecting around the sides of a pipilla is called what?
The fornix of the calyx
This extend between the minor calyces and the renal pelvis.
Infundibula
This is predominantly outside the renal sinus and is larger and more distensible than the more common intrarenal pelvis, which is surrounded by renal sinus fat and other structures.
Extrarenal pelvis
This is a normal variant that should not be confused with hydronephrosis.
It is the mucosal lining of the entire pelvicalyceal system, ureters, and bladder.
Transitional epithelium
What are the tree main points of ureteral narrowing, where calculi are likely to become impacted?
- The ureteropelvic junction (UPJ)
- The site at which the ureter crosses the pelvic brim
- The ureterovesical junction (UVJ)
The normal filled urinary bladder is oval, with the floor parallel to, and 5 to 10 mm above, what structure?
The superior aspect of the symphysis pubis
What structures lie on top of the bladder and may cause impressions on the bladder dome?
Sigmoid colon and loops of small bowel, as well as the uterus in females
Anteriorly, the bladder is separated from the symphysis pubis by fat in what space?
Extraperitoneal space of Retzius
Posteriorly, the bladder from the uterus by what recess?
Uterovesical peritoneal recess
Posteriorly, the bladder is separated from the rectum by what recess?
Rectovesical peritoneal recess
The bladder wall has four layers. What are his layers?
An outer connective tissue adventitiia, smooth muscle consisting of circular muscle fibers sandwiched between inner and outer layers of longitudinal fibers, submucosal connective tissue (the lamina propria), and the mucosa of transitional epithelium.
This is a triangle at the bladder floor formed by the two ureteral orifices and the internal urethral orifice.
Trigone
With voiding, the trigone descends 1 to 2 cm and transforms from a flat surface into a cone with the urethra at the apex.
This is a simple study of the anterior male urethra.
Contrast medium is injected into the anterior urethra by means of a syringe or catheter that occludes the meatal orifice.
Retrograde urethrogram
Radiographs are exposed in the right posterior oblique projection.
The anterior urethra normally distends fully because of resistance of the external sphincter at the level of the urogenital diaphragm.
Complete filling of the posterior urethra is not possible because contrast runs freely into the bladder.
This is performed by filling the bladder with contrast through a catheter.
The catheter is removed, and radiographs are obtained while the patient urinates into a basin on the fluoroscopy table.
Voiding cystourethrography
The voiding urethrogram demonstrates distension of both the posterior and anterior urethra.
The male urethra is divided into posterior and anterior portions by what structure?
The inferior aspect of the urogenital diaphragm
The posterior urethra consists of what urethral structures?
Prostatic urethra - within the prostatic gland, from bladder neck to urogenital diaphragm
Membranous urethra - which is totally contained within the 1-cm-thick urogenital diaphragm
The anterior urethra extends from the urogenital diaphragm to the external urethral meatus.
It consists of what urethral structures?
Bulbous urethra - extending from the urogenital diaphragm to the penoscrotal junction
Penile urethra - extending to the urethral meatus
The anterior urethra is entirely contained within the corpus spongiosum penis except for the proximal 2 cm of the bulbuous urethra, called what?
Pars nuda
This unprotected protion of the urethra is particularly susceptible to straddle injury.
The prostatic urethra runs vertically through the prostate over a length of how many cm?
3 to 4 cm
It is an oval filing defect in the mid portion of the posterior wall of the prostatic urethra.
Verumontanum
The ejaculatory ducts open into the urethra on either side of the verumontanum, and the prostatic glands empty into the urethra by multiple small openings that surround the verumontanum.
This is a mullerian remnant, a small, saccular depression in the middle of the verumontanum.
Utricle
