Urinary Tract Development - Bolender Flashcards

1
Q

Division of what structure provides for separate outlets for the UG and GI systems?

What subdivides this structure?

What is the precursor tissue of this structure?

A

The cloaca

Urorectal septum

Splanchnic mesenchyme

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2
Q

The cranial part of the UG sinus forms what?

A

The urinary bladder and urethra

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3
Q

The lining of the UG sinus is derived from what?

The smooth muscle and CT of the bladder wall is derived from what?

A

endoderm

surrounding splanchnic mesoderm

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4
Q

What structure is associated with the entrance of the ureters and exit of the urethra?

How is the process forming this structure different in males?

A

Trigone

In males, additional growth/differentiation along the trigone region forms the mesonephric ducts, which migrate inferiorly and open directly into the urethra rather than the bladder.

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5
Q

What is the fate of the mesonephric diverticulum in males?

A

Forms the vas deferens

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6
Q

A vesico-umbilical fistula forms due to the failure of what?

A

Failure of regression of the allantois and urachus

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7
Q

What is extrophy of the bladder?

Are these babies typically healthy? What about gonadal structures?

What are some associated anatomical findings?

A

A defect in the ventral abdominal wall that causes the lining of the bladder and urethra to be open to the surface.

Yes - typicall healthy except for anatomical abnormalities. Gonadal structures are usually normal.

Associated findings: epispadius (dorsal splaying of the penis), shortened vagina, bifid clitoris

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8
Q

Higher ureteral reflux is associated with greater risk of what?

A
  • greater risk of scarring
  • increased risk of associated anatomical abnormalities
  • spontaneous resolution less likely
  • need for surgical intervention more likely
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9
Q

What is the general treatment strategy for ureteral reflux?

A

Antibiotic prophylaxis

surgical repair

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10
Q

What is the usual treatment for bladder extrophy?

What is the most prevalent long-term complication?

A

Surgical repair shortly after birth

Incontinence issues long-term

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11
Q

The caudal portion of the UG sinus forms what structures in males?

In females?

A

Male: proximal portion of prostatic urethra

Female: Most of the urethra

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12
Q

The pelvic portion of the definitive UG sinus contributes to what structures in males?

In females?

A

Male: epithelium of distal prostatic and membranous urethra

Female: epithelium of lower half of vagina

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13
Q

The phallic portion of the definitive UG sinus contributes to what structures in males?

In females?

A

Male: epithelium of penile urethra

Female: epithelium of the vestibule

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14
Q

Urinary obstruction and Prune Belly Syndrome are associated of what anomaly of urethral development?

A

agenesis and atresia of the urethra

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15
Q

What is a posteiror urethral valve?

Posterior urethral valves are a common cause of renal failure in what population?

A

Mucosal folds which obstruct the lumen of the urethra

common cause of renal failure in boys (affects males only)

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16
Q

Describe the pathology of posterior urethral valves

What is the prognosis?

A

Obstructing membrane/valve forms at the membranous urethra

results is a massively distended bladder (obstruction), oligohydramnios, poorly developed chest cavity (due to compression), and small echo-bright kidneys

The valves are easy to ablate surgically, but in most cases the damage is already permanent - irreversible dysplasia