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MRCEM Primary > Renal tract anatomy (excl. kidneys) > Flashcards

Renal tract anatomy (excl. kidneys) Flashcards

1
Q

How long are the ureters?

A

25-30cm long

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2
Q

How wide are the ureters?

A

3-4mm in diameter

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3
Q

Where do the ureters lie?

A

In the retroperitoneal space

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4
Q

Where do the ureters arise from?

A

Pelvis of kidney

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5
Q

Where do the ureters exit the kidney?

A

Hilum in the transpyloric plane at L1

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6
Q

Where do the ureters pass in relation to the posts major?

A

Pass anteriorly to the posts major

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7
Q

Which part of the bladder do the ureters enter at?

A

Lateral aspect in an oblique fashion

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8
Q

Why do the ureters enter the bladder in an oblique direction?

A

Creates a valve that prevents back flow of urine

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9
Q

What are the 3 main points of constriction of the ureters?

A

Pelvicoureteric junction of renal pelvis and ureter (PUJ)
Bifurcation of the common iliac arteries
Vesicoureteric junction (VUJ)

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10
Q

Mass effects of what can cause ureteric obstruction?

A

Constipation
Pregnancy
Ovarian cysts

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11
Q

Nerves to the ureters arise from where?

A

Renal plexus

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12
Q

The renal plexus is supplied by nerves from where?

A

Thoracic splanchnic nerves

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13
Q

Sensory input from the ureters travels to what spinal levels?

A

T11-L2

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14
Q

Referred pain from the ureters can be felt where?

A

Posterior lumbar/ flank region

OR

hypogastrium

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15
Q

How much urine can the bladder hold?

A

300-600ml

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16
Q

At what volume does the bladder need to be at to cause the sensation of needing to void?

A

400ml

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17
Q

What is the bladder enveloped in?

A

Extraperitoneal fat + connective tissue

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18
Q

What is the bladder separated from the pubic symphysis by?

A

Anterior premedical space (space of retzius)

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19
Q

What are the 4 surfaces of the bladder?

A

Superior surface
Two inferolateral surfaces
Posterior surface

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20
Q

What are the 4 areas of the bladder?

A

Apex
Body
Fundus
Neck

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21
Q

What is the trigone of the bladder?

A

A smooth triangular region situated in the fundus of the bladder

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22
Q

What form the trigone?

A

2 ureteral orifices and urethral orifice

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23
Q

What is the name of the muscle in the wall of the bladder?

A

Detrusor

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24
Q

When does the detrusor muscle contract?

A

During micturition

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25
Q

Who is the internal urethral sphincter present in?

A

Males

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26
Q

Who is the external urethral sphincter present in?

A

Both sexes

27
Q

What is the function of the internal urethral sphincter?

A

Prevents se final regurgitation during ejaculation

28
Q

What type of control is the internal urethral sphincter under?

A

Autonomic

29
Q

What type of control is the external urethral sphincter under?

A

Voluntary

30
Q

What does the external urethral sphincter do during micturition?

A

Relaxes

31
Q

What is the arterial supply to the bladder?

A

Superior vesical bronco of the internal iliac artery

**also the inferior vesical artery in men/ vaginla artery in women

32
Q

What is the venous drainage of the bladder?

A

Vesical venous plexus

33
Q

The superior aspect of the bladder drains to which nodes?

A

External iliac nodes

34
Q

The posteroinferior aspect of the bladder drains to which nodes?

A

Internal iliac drugs

35
Q

Some vessels from the neck of the bladder drain to which nodes?

A

Sacral/ common iliac nodes

36
Q

What is the sympathetic innervation of the bladder?

A

Hypogastric nerve (T12-L2)

37
Q

What does sympathetic stimulation of the bladder cause?

A

Relaxation of detrusor = retention of urine

38
Q

What is the parasympathetic innervation of the bladder?

A

Pelvic splanchnic berves

39
Q

Parasympathetic stimulation of the bladder causes what?

A

Contraction of detrusor = micturition

40
Q

What is the somatic innervation of the bladder?

A

Pudendal nevre (S2-S4)

41
Q

What does somatic innervation of the bladder act on?

A

External urethral sphincter

42
Q

Somatic control over the bladder causes what?

A

Voluntary control of the external urethral sphincter = relaxation/ constriction

43
Q

What do sensory afferents of the bladder detect?

A

Sense when the bladder is stretched and full

44
Q

Spinal cord transection above T12 causes what to happen to the bladder?

A

Spastic (reflex) bladder

45
Q

What happens in a spastic bladder?

A

The bladder automatically empties as it fills as the parasympathetic efferents are intact, but the other nerves are not.

46
Q

Spinal cord transection below T12 causes what to happen to the bladder?

A

Flaccid bladder

47
Q

What happens in a spastic bladder?

A

Urinary retention (can sometimes lead to reflux nephropathy)

48
Q

How long is the male urethra?

A

15-20cm long

49
Q

What are the 3 points of constriction in the male urethra?

A

Internal urethral sphincter
External urethral sphincter
External urethral orifice

50
Q

What are the 4 parts of the urehtra?

A

Pre-prostatic
Prostatic
Membranous
Spongy

51
Q

What is the widest and most dilatable part of the male urethra?

A

Prostatic part

52
Q

What is the narrowest part of the male urethra?

A

Membranous

53
Q

Where is the membranous part of the male urethra located in?

A

Deep perineal pouch

54
Q

The spongy part of the urethra passes through what?

A

Penis

55
Q

Which part of the male urethra are Cowper’s glands located in?

A

Spongy part

56
Q

How long is the female urethra?

A

4cm

57
Q

What is the arterial supply to the prostatic urethra?

A

Inferior vesical artery

58
Q

What is the arterial supply to the membranous urethra?

A
59
Q
A
60
Q

What is the arterial supply to the female urethra?

A

Pudendal, vaginal and inferior vesical branches of the vaginal arteries

61
Q

What is the lymphatic drainage of the urethra?

A

Internal iliac nodes
Deep inguinal nodes

62
Q

What is the innervation of the male urethra?

A

Pudendal nerve
Prostatic plexus (arises from inferior hypogastric plexus)

63
Q
A

MRCEM Primary (39 decks)

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