Week 11 - Genitourinary System

Question 1

Three regions of the ureter that can be blocked by kidney stones

Answer 1

Trigone
Pelvic brim
Pelvouretic junction

Question 2

How many layers of muscle in upper 2/3 of ureter and what are they

Answer 2

2 layers - inner longitudinal and outer circular (opposite to GI tract)

Question 3

How many layers of muscle in lower 1/3 of ureter and what are they

Answer 3

3 layers - inner longitudinal, middle circular and outer longitudinal

Question 4

Function of outer serosa/adventitia in ureter

Answer 4

Connective tissue containing blood, vessels and nerves

Question 5

What structural feature prevents the reflux of urine from a full bladder

Answer 5

Folds of mucosa

Question 6

Layers that envelope the kidney from innermost to outermost

Answer 6

Renal capsule, perirenal fat, renal fascia, pararenal fat

Question 7

What vertebral level are the kidneys

Answer 7

T12-L3

Question 8

What do adrenal glands secrete

Answer 8

Cortisteroids (cortisol), androgens (hormones that promote growth and reproduction) and mineralocorticoids (aldosterone - regulates bp)

Question 9

Sympathetic innervation of bladder and sphincters

Answer 9

Innervates the internal sphincter and bladder wall
L1,2

Question 10

Parasympathetic innervation of the bladder/spincters

Answer 10

Innervates the bladder wall
S2,3,4

Question 11

Somatic innervation of the bladder/spincters

Answer 11

S2,3,4
Sensory and motor to the external sphincter

Question 12

Through which nerve do the afferents from bladder wall run

Answer 12

Hypogastric nerve and enter the cord in the upper lumbar roots

Question 13

Where are the locations of the 3 afferents

Answer 13

Bladder wall stretch
Sensors in the urethra
Skeletal muscle sensors in the external sphincter

Question 14

What are the 3 efferents

Answer 14

External sphincter via somatic
Internal sphincter via the sympathetic
Detrusor via the parasympathetic

Question 15

Parasympathetic/sympathetic during storage phase

Answer 15

Sympathetic

Question 16

Parasympathetic/sympathetic during voiding phase

Answer 16

Parasympathetic

Question 17

Hypogastric nerve

Answer 17

This nerve surpasses the contraction of the detrusor muscle in the storage phase

Question 18

Pudenal nerve

Answer 18

This nerve controls the external sphincter in the storage phase

Question 19

Pelvic splanchnic nerve

Answer 19

Causes detrusor to contract in the voiding phase

Question 20

Neurogenic bladder

Answer 20

Bladder wall contractions start at lower volumes, therefore people will have sudden urge to pee even though their bladders remain fairly empty

Question 21

Atonic bladder

Answer 21

Bladder fills with little sensation of this happening - too compliant. Person will find it difficult to empty bladder and therefore may require catheter.

Question 22

What is the site of structural abnormality of the prostrate in older men

Answer 22

Transitional zone of the prostate gland

Question 23

Layers of tissue that envelope the kidneys from innermost to outermost

Answer 23

Capsule -> Perirenal fat -> Renal fascia -> Pararenal fat

Question 24

What vertebral level are the kidneys

Answer 24

T12-L3

Question 25

Blood supply to the adrenal gland

Answer 25

Superior adrenal artery from the inferior phrenic, middle adrenal artery from abdominal aorta and inferior adrenal artery from renal artery.

Question 26

Difference between retroperitoneal and intraperitoneal

Answer 26

Retroperitoneal usually means fixed to posterior abdominal wall Intraperitoneal usually means mobile

Question 27

Examples of retroperitoneal organs

Answer 27

SAD PUCKER S- suprarenal (adrenal gland) A - Aorta and inferior vena cava D - duodenum (2nd and 3rd segments) P - pancreas U - ureters C - colon (ascending and descending) K - kidney E - oesophagus R - rectum

Question 28

Length of ureter

Answer 28

25cm

Question 29

Anatomical parts of ureter

Answer 29

Abdominal and pelvic region

Question 30

In what motion does urine move down the ureter

Answer 30

Peristalsis

Question 31

3 areas where kidney stones may cause blockage

Answer 31

Pelvouretic brim Trigone Pelvic brim

Question 32

3 areas where ureter is most narrow

Answer 32

Pelvic brim Point where ureter meets bladder Uteropelvic junction

Question 33

Upper two thirds of ureter is...

Answer 33

2 layers - Smooth muscle - inner longitudinal and outer circular

Question 34

Lower third of ureter is...

Answer 34

3 layers - Smooth muscle - inner longitudinal, middle circular and outer longitudinal

Question 35

What is different about submocosa of the ureter

Answer 35

There is no submucosa

Question 36

Why is ureter highly folded

Answer 36

To prevent reflux of urine when bladder becomes full

Question 37

What are the 3 main regions of the male urethra

Answer 37

Prostatic urethra Membranous urethra Spongy/penile urethra

Question 38

What are the 2 main regions of the female urethra

Answer 38

Proximal and distal urethra

Question 39

What is the trigone region formed by

Answer 39

The two ureters and the urethra

Question 40

bladder capacity

Answer 40

300-500ml

Question 41

Blood supply of the urinary bladder

Answer 41

Internal iliac vessels

Question 42

When relaxed what is the appearance of the transitional epithelium of the bladder

Answer 42

Cuboidal/columnar lower cells and cuboidal apical cells

Question 43

When distended what is the appearance of the transitional epithelium of the bladder

Answer 43

Superficial cells become squamous in appearance

Question 44

Difference between the L+R gonadal veins

Answer 44

L gonadal vein drains into the renal vein whereas R gonadal vein drains directly into the inferior vena cava

Question 45

If there is kidney pathology, how might this be shown in the left testicle

Answer 45

Increases pressure in left renal vein and causes varicocele of the pampiform venous plexus

Question 46

In what anatomical direction does the left renal vein cross the aorta

Answer 46

Posteriorly

Question 47

What constitutes the spermatic cord

Answer 47

Vas deferens and surrounding tissue

Question 48

What is the serosal covering of the spermatic cord typically called

Answer 48

Tunica vaginalis

Question 49

3 layers that make up the spermatic cord

Answer 49

External spermatic fascia Cremasteric muscle Internal spermatic fascia