Urinary bladder and male internal genetalia

Question 1

How is the bladder related to the peritoneum

Answer 1

Lies in extraperitoneal fat

Question 2

Where is the badder in adults vs. infants

Answer 2

Adults - lesser pelvis

Inflants = abdomen

Question 3

What is the shape of the bladder

Answer 3

Tetrahedral

Question 4

What are the different parts of the bladder

Answer 4

Apex
Body
Fundus/base
Neck
Uvula - trigone projections

Question 5

What are the surfaces of the bladder

Answer 5

Superior
Inferolateral
Posterior

Question 6

What makes up the trigone of the bladder

Answer 6

Two ureteric openings

Internal urethral opening

Question 7

What is characteristic of the histological structure of the trigone of the bladder

Answer 7

Mucosa is smooth

Question 8

What are the characterists of the bladder wall

Answer 8

Made of detrusor muscle (Smooth Muscle)

Neck contains the Internal spincter

At the opening of the ureter - there is no backflow of urine

• efficient sphincter
• angle

Mucosa is folded into rugae

Vesical (bladder) fascia is made of Loose CT

Question 9

What are the relations of the bladder

Answer 9

Superior:

• peritoneum
• Ileum
• sigmoid colon

Inferolateral

• Obturator internus muscle
• Superior vesical artery and vein
• Levator Ani muscle
• Obturator nerve, artery and vein

Anterior:

• Retropubic space
• Pubic crest

Posterior (male):

• seminal vesicles
• ampulla of ductus deferens
• retrovesical pouch
• ampulla of rectum

Inferior (male)
-prostate gland

Posterior (female):

• anterior wall of vagina
• cervix

Posteriosuperior (female)

• uterovesical pouch
• body of uterus

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Allow people’s children unwarmed bread.

Question 10

What is the arterial supply of the bladder

Answer 10

Superior Vesical Aa. (from Umbilical A.)
-Supplies Anterosuperior Part

Uretral Branches (from Superior Vesical Aa.)

Inferior Vesical A. / Vaginal A.

Prostatic Branches (from Inferior Vesical A. - Males Only)

LOOK AT SCHEMATIC PICTURE IN LECTURE SLIDES

Question 11

What is the venous drainage of the bladder

Answer 11

Vesical venous plexus (into Int. Iliac Plexus)

Males - Prostatic Plexus
Females - Uterovaginal Plexus

Question 12

What is the lymphatic drainage of the bladder

Answer 12

Superior:
-Ext. Iliac LN

Fundus:
-Int. Iliac LN

Neck/Urethra:

• Sacral LN
• Common Iliac LN

Question 13

What is the innervation of the bladder

Answer 13

Parasympathetic:

• Inferior Hypogastric Plexus
• Contracts detrusor muscle
• Relaxes internal sphincter

Sympathetic:
- T11-T12

LOOK AT SCHEMATIC PICTURE IN LECTURE SLIDES

Question 14

What are the four parts of the Urethra

Answer 14

Preprostatic (bladder neck)
Prostatic
Membranous
Spongy

These parts are found only in males

Question 15

How long is the Preprostatic part of the Urethra (Males)

Answer 15

1-1.5cm

Question 16

Describe the GENERAL structure of the Prostatic part of the Urethra. (Males)

Answer 16

3-4cm long

Most dilatable

Widest

Posterior wall internally

Question 17

What are the structures that are found in the Prostatic part of the Urethra (Males)

Answer 17

Urethral crest

NBProstatic sinus - ductules of the gland

Seminal Colliculus (opening)

NBProstatic Utricle (uterine primodium)

Ejactulatory ducts into utricle (or adjacent it)

Question 18

What is the general structure of the urethra in females?

Answer 18

4cm

Anterior to vagina

Traverses the pelvic diaphragm

Contains paraurethral glands

Opens into vestibule

Question 19

In males, how long is the Ductus Deferens

Answer 19

20-25cm long

Question 20

What are the attachments of the Ductus Deferens

Answer 20

• Tail of epididymis
• Ejaculatory duct

Ampulla:

• Near Ejaculatory Duct –> into Prostatic Urethra
• Connects Ductus Deferns with Seminal Vesicle duct

Question 21

What is the arterial supply of the Ductus deferens

Answer 21

Deferential A.

Question 22

How long are the seminal vesicles

Answer 22

5cm

Question 23

What are the relations of the seminal vesicles

Answer 23

Rectum lies behind

Question 24

What is the blood supply of the seminal vesicles

Answer 24

Inferior Vesical A

Middle Rectal A.

Question 25

Explain the formation, ending and structure of the Ejactulatory Ducts

Answer 25

Formed from union of Ductus Deferens with Duct of Seminal Vesicle Converge and open on seminal colliculus (on prostatic utricle) 2,5cm

Question 26

What is the blood supply and venous drainage of the Ejaculatory ducts

Answer 26

Arterial supply: Deferential Aa. Venous drainage: - Prostatic plexus - Vesical Plexus

Question 27

What are the relations of the Prostate Gland?

Answer 27

Directly behind inferior edge of pubic symphysis

Question 28

What is the lobular composition of the Prostate Gland

Answer 28

Two lateral lobes ``` Anterior lobe (isthmus): -connecting lateral lobes anteriorly ``` Posterior lobe: - below ejaculatory ducts - posterior to urethra Middle lobe: -Between urethra and ejaculatory ducts

Question 29

How much of the semen does the prostate gland produce?

Answer 29

20%

Question 30

Where does the duct of the prostate gland open?

Answer 30

Prostatic sinus

Question 31

What is the arterial supply of the Prostate gland

Answer 31

Prostatic arteries (from inferior vesical a.)

Question 32

Where are the bulbourethral glands

Answer 32

Lie in external urethral sphincter Opens into spongy urethra

Question 33

When does the bulbourethral gland secrete

Answer 33

During sexual arousal

Question 34

What are the clincal implications of the bladder

Answer 34

Damaged with pelvic fractures Problems with micturation (discharge of urine) usually due to cancers

Question 35

What are the clinical implications with the male internal genetalia

Answer 35

Problems with ejaculation Prostatic Carcinomas and Benign Tumours thereof