the ureter, prostate and bladder

Question 1

What is the function of the ureters?

Answer 1

They transport urine from the kidneys to the urinary bladder.

Question 2

Which system do the ureters belong to?

Answer 2

The urinary system.

Question 3

What is the anatomical path of the ureters?

Answer 3

1. Run inferiorly from the renal pelvis
2. Cross over the bifurcation of the common iliac arteries
3. Pass the pelvic brim (pelvic inlet)
4. Run along the lateral pelvic wall
5. Enter the urinary bladder

Question 4

What are the three anatomical parts of the ureter?

Answer 4

Abdominal – From kidney to pelvic inlet
Pelvic – From pelvic inlet to bladder wall
Intramural – Passes through the bladder wall

Question 5

After crossing the pelvic brim, which arteries do the ureters run alongside?

Answer 5

the internal iliac arteries.

Question 6

How do the ureters enter the bladder?

Answer 6

They curve anteromedially and enter the bladder in an inferomedial direction.

Question 7

What is the relationship between the ureter and the ductus deferens in males?

Answer 7

The ureter passes posterior to the ductus deferens.

Question 8

What is the relationship between the ureter and the uterine artery in females?

Answer 8

The uterine artery crosses superoanteriorly over the ureter.

Question 9

What is the significance of the phrase “water under the bridge”?

Answer 9

It describes how the ureter (“water”) runs beneath the uterine artery (“bridge”) in females.

Question 10

Answer 10

Question 11

Answer 11

Question 12

Why does the blood supply to the ureter vary along its course?

Answer 12

Because the ureter is a long structure passing through different regions.

Question 13

What are the main arterial branches supplying the ureter in the abdominal region?

Answer 13

Renal artery
Gonadal arteries (ovarian/testicular)

Question 14

What artery supplies the ureter as it crosses the pelvic brim?

Answer 14

The common iliac arteries.

Question 15

What are the main arteries supplying the ureter in the pelvic cavity?

Answer 15

Superior vesical artery (also supplies the bladder)

Inferior vesical artery (also supplies the bladder)

Uterine artery (in females, also supplies the uterus)

Question 16

What is the significance of the uterine artery in ureteric blood supply?

Answer 16

It provides pelvic blood supply to the ureter in females.

Question 17

Answer 17

Question 18

Answer 18

Question 19

How many normal constrictions do the ureters have?

Answer 19

Three main constrictions.

Question 20

Where is the first ureteric constriction located?

Answer 20

At the ureteropelvic junction (junction of the ureter and renal pelvis).

Question 21

Where is the second ureteric constriction located?

Answer 21

Where the ureters cross the brim of the pelvic inlet over the bifurcation of the common iliac artery.

Question 22

Where is the third ureteric constriction located?

Answer 22

At the ureterovesical junction, where the ureter enters the bladder wall.

Question 23

Why are ureteric constrictions clinically significant

Answer 23

They are common sites of obstruction by ureteric stones.

Question 24

What is a possible fourth constriction?

Answer 24

Where the gonadal vessels pass anterior to the ureter.

Question 25

Where is pain from ureteric stones referred?

Answer 25

T11-L2 dermatome (loin to groin region) Can also be felt in the lower back

Question 26

What is the function of the urinary bladder?

Answer 26

It is a reservoir for urine.

Question 27

Where is the urinary bladder located when empty?

Answer 27

In the lesser pelvis, close to the pubic bones.

Question 28

How high can the bladder extend when full?

Answer 28

It can reach as high as the umbilicus.

Question 29

Is the bladder intraperitoneal or extraperitoneal?

Answer 29

It is mostly extraperitoneal, meaning it lies inferior to the peritoneum.

Question 30

What structure lies posterior to the bladder in males?

Answer 30

The rectum.

Question 31

What structure lies superoposterior to the bladder in females?

Answer 31

The uterus.

Question 32

How does the peritoneum relate to the bladder?

Answer 32

It extends from the posterior abdominal wall to the superior bladder surface and reflects onto the organ posterior to it.

Question 33

Where does the apex of the bladder point when empty?

Answer 33

Toward the superior edge of the pubic symphysis.

Question 34

What is the fundus of the bladder?

Answer 34

The part opposite the apex, with the body of the bladder in between.

Question 35

What muscle forms the walls of the bladder?

Answer 35

The detrusor muscle, composed of multiple layers running in different directions.

Question 36

What is the function of the involuntary internal urethral sphincter?

Answer 36

Controls urine outflow Prevents retrograde ejaculation (in males)

Question 37

What is the trigone of the bladder?

Answer 37

A triangular region marked by the ureteric orifices and the internal urethral orifice.

Question 38

Which nerves carry preganglionic sympathetic fibres to the bladder?

Answer 38

The lumbar splanchnic nerves (L1-L3).

Question 39

Where do the preganglionic sympathetic fibres synapse?

Answer 39

In the inferior mesenteric ganglion.

Question 40

Where do the postganglionic sympathetic fibres travel?

Answer 40

They pass through the superior hypogastric plexus, then descend to the inferior hypogastric plexus.

Question 41

Which nerves provide parasympathetic innervation to the bladder?

Answer 41

The pelvic splanchnic nerves (S2-S4).

Question 42

What stimulates the micturition reflex?

Answer 42

Stretching of the bladder wall, which activates visceral afferent fibres.

Question 43

What type of innervation controls micturition?

Answer 43

Parasympathetic innervation.

Question 44

What effect does parasympathetic innervation have on the bladder?

Answer 44

Contracts the detrusor muscle Inhibits the internal urethral sphincter (causing relaxation)

Question 45

What happens when the detrusor muscle contracts?

Answer 45

The bladder empties, and urine flows into the urethra.

Question 46

Is there an internal urethral sphincter in females?

Answer 46

It is suggested that females do not have an internal urethral sphincter, and continence is maintained by the levator ani and external urethral sphincter.

Question 47

Is there an internal urethral sphincter in males?

Answer 47

yes, both internal and external

Question 48

How is the external urethral sphincter innervated?

Answer 48

By somatic nerve fibres.

Question 49

How is the internal urethral sphincter innervated?

Answer 49

By autonomic nerve fibres.

Question 50

What are the three accessory reproductive glands in males?

Answer 50

Prostate gland Seminal vesicles Bulbourethral glands

Question 51

What is the function of the seminal vesicles?

Answer 51

They produce 70% of the ejaculate volume and provide an energy source for spermatozoa.

Question 52

What is the function of the bulbourethral glands?

Answer 52

They secrete a clear watery fluid that prepares the urethra for sperm passage.

Question 53

Where is the prostate gland located?

Answer 53

It is located at the bladder outlet, encircling the urethra, and anterior to the rectum.

Question 54

What are the 2 functions of the prostate gland?

Answer 54

Produces 30% of the ejaculate volume Plays a role in spermatozoa motility

Question 55

Answer 55

Question 56

How are the ejaculatory ducts formed?

Answer 56

By the union of the ducts of the seminal vesicles with the ductus deferens.

Question 57

Where do the ejaculatory ducts originate?

Answer 57

Near the neck of the bladder.

Question 58

How do the ejaculatory ducts travel through the prostate?

Answer 58

They pass anteroinferiorly through the posterior part of the prostate.

Question 59

Where do the ejaculatory ducts open?

Answer 59

Into the prostatic urethra.

Question 60

Which nervous system controls ejaculation?

Answer 60

The sympathetic nervous system.

Question 61

Which nerves carry the preganglionic sympathetic fibres for ejaculation?

Answer 61

Lumbar splanchnic nerves (L1-L3).

Question 62

Where do the preganglionic sympathetic fibres synapse?

Answer 62

In the hypogastric plexuses.

Question 63

What are the two main effects of sympathetic stimulation during ejaculation?

Answer 63

1. Contraction of the internal urethral sphincter (to prevent retrograde ejaculation). 2. Rapid contraction of the ductus deferens and accessory glands (to expel semen).

Question 64

What prevents retrograde ejaculation?

Answer 64

Contraction of the internal urethral sphincter.

Question 65

What is benign hypertrophy of the prostate (BHP)?

Answer 65

A common enlargement of the prostate after middle age, which impedes urination by distorting the prostatic urethra.

Question 66

What are the 3 main symptoms of BHP?

Answer 66

Shortened micturition interval (frequent urination) Weak urinary stream Strained efforts or pain during urination

Question 67

What 4 complications can arise from sustained bladder outlet obstruction due to BHP?

Answer 67

1. Bladder wall hypertrophy 2. Residual urine retention 3. Urine backup into ureters and kidneys 4. Increased risk of infections