Glossary of 4-Internal Pelvic Organs and Male Pelvic Organs
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- Are the ureters retroperitoneal or intraperitoneal?
- Where do the ureters enter the pelvis?
- near where they cross the bifurcation of the iliac into external and internal arteries
- What is the name of the junction of the ureter with the bladder?
- uterovesical junction
- What is the significance of the ureter entering the bladder at an oblique angle?
- it tends to form a natural one-way valve, letting urine into the bladder but not transferring pressure or urine back up the ureters
- Are the ureters medial or lateral to the ductus deferens?
- ureters are lateral
- Describe the relationship of the ureters, uterine artery and vaginal arteries in females.
- ureters pass inferior to uterine artery, but superior to vaginal arteries
- What is ureter pain carried by? Where is ureteral pain usually refered to?
- visceral afferent fibers that return to the spinal cord along sympathetic nerves to T11-L1
-ipsilateral lower quadrant of abdomen, esp groin
- What are the most common places that a kidney stone may lodge?
- -junction of renal pelvis w/ ureter
-where ureters cross pelvic brim (where crossing iliac vessels)
-ureters passing obliquely into bladder
- Is the bladder deep or superficial to the peritoneal membrane?
- What is anterior to the bladder?
- symphysis pubis
- What is posterior to the bladder in males? females?
- rectum in males, uterus and part of vagina in females
- What is inferior to the bladder in males? females?
- prostate gland in maes, pelvic diaphragm in females
- Name the parts of the bladder and what each corresponds with.
- fundus-posterior and inferior portion
neck-inferior portion at junction w/ urethra
apex-anterior just posterosuperior to pubis symphysis
- What is the smooth muscle of the wall of the bladder called?
- detrusor muscle
- The inner surface of the mucosa of the bladder is thrown into folds except which area?
- trigone-area between the two ureters openings and the internal urethral opening
- What is the detrusor muscle innervated by? What does this cause?
contraction of bladder=increase internal P or causing micturation if the urethral sphincters are open
- What normally keeps the internal urethral sphincter closed if the bladder has less than 250mL of urine?
- smooth muscle fibers and elastic fibers
- What is the shape of a newborn babies empty bladder? Where does the newborns bladder extend?
- fusiform shape
extends into abdominal cavity up to umbilicus
- Where is the bladder located by the age of 6? by puberty?
- greater pelvis
- As the bladder recedes into the pelvis what does it leave behind?
- median umbilical fold over the urachus connected to the umbilicus
- What could be a cause for dribbling of urine from the umbilicus?
- urachus re-canalization
- What is the blood supply to the ureters and bladder that both males and females share? What does this artery branch from?
- superior vesicle arteries
off internal iliac
- Name the additional artery that supplies the bladder in males? What part does it supply?
- males-inferior vesicular arteries supply fundus and neck
- Name the additional artery that supplies the bladder in females? What part does it supply?
- vaginal arteries supply lower portion of bladder
- Name the veins that drain the bladder.
- vesicular venous plexus which drains into the internal iliac veins
- In males, what is the vesicular venous plexus continuous with?
- prostatic venous plexus
- What are the levels of the spinal cord that provide PSNS innervation to the bladder? What are these nerves called?
pelvic splanchnic N
- What is the main PSNS innervation of the bladder? Via what plexus?
- detrusor muscle, via inferior hypogastric plexus
- Which spinal cord levels supply the sympathetic innervation to the bladder? What are these nerves called?
- T11, L1,2
vesicle nerve plexus
- What is the main innervation of the bladder by the SNS? Via which plexus?
- urethrhal (vesicle) sphincter, via superior hypogastric plexus
- What is the function of the internal urethral sphincter? What is its additional in males?
- keeps urine in the bladder
prevents retroejaculation of sperm into the bladder
- What forms the external urethral sphincter? What is the additional component in females?
- compressor urethra muscle
urethrovaginal sphincter muscle
- What are the compressor urethra muscle and urethrovaginal sphincter muscles innervated by?
- pudendal nerve
- When do most adults begin to feel fullness of the bladder? Describe what occurs with micturition.
stretch receptors return infor via both SNS and PSNS as the bladder fills, stretch receptors stimulate a spinal reflex arch causing PSNS firing leading to contraction of the bladder
- What is one of the most frequent causes of urinary retention in men?
- benign prostatic hyperplasia
- Describe the automatic reflex bladder. What might be an abnormal cause for this
- it is the same bladder response found in infants, if PSNS are intact the bladder will empty every 1-4hr
-lumbosacral spinal cord lesion
- What is an autonomous bladder?
- when the reflex arc is lost, bladder simply overfills and urine continually dribbles out
- What is the name of the extraperitoneal space behind the pubic bones typically filled w/ fat?
- retropubic space
- What is the name of the peritoneal space between the bladder and uterus in females?
- vesicouterine pouch
- What is the name of the peritoneal space behind the uterine/vaginal junction and anterior to the rectum?
- rectuterine pouch (of Douglas)
- What is the lowest point in the pelvic cavity in females?
- rectouterine pouch
- What is a way for materials in the rectouterine pouch of Douglas to be biopsied?
- via a transvaginal approach through the posterior fornix
- What is the aspiration of fluid from the dul-du-sac of Douglas by puncturing the posterior, superior wall of the vagina?
- What is the name of the peritoneal space between the bladder and the rectum?
- retrovesical fossa
- What is the name of the peritoneal reflection on each side of the bladder?
- paravesical fossa
- What is the name of the peritoneal reflection on each side of the rectum?
- pararectal fossa
- What is the lowest point in the pelvic cavity in males?
- retrovesical fossa
- In females, what are both the internal sphincter at the bladder and the external sphincter at the urogenital membrance composed of?
- compressor urethra muscle
external urethral sphincter muscle
urethrovaginal sphincter muscle
- Describe the path of the ductus deferens. What do they eventually form?
- begins at the tail of the epididymis, ascends the spermatic cord, passes through the inguinal canal, crosses the external iliac vessels, passes along the lateral pelvic wall, moves medially, stays extraperitoneal, widens into an ampulla which lies superior to the seminal vesicles, then joins seminal vesicles and forms common ejaculatory ducts
- Which part of the nervous system stimulates expulsion of sperm?
- Where do seminal vesicles lie with respect to the bladder rectum and prostate?
- posterior to fundus of bladder and anterior to rectum, superior to prostate
- What do seminal vesicles help form?
- ejaculatory ducts
- What is responsible for most of the volume of ejaculate?
- seminal vesicles
- What type of gland is the prostate?
- Describe the capsule around the prostate gland? Is it retro or interperitoneal?
- does not have a true CT capsule
it is retro(extra)peritoneal
- What is responsible for producing the last portion of ejaculate?
- prostate gland
- What can benign prostate hypertrophy cause?
- obstructs th epassage of urine, leading to increased retetion and infections
- What are some means of detection for carcinoma of the prostate?
- rectal examination and PSA
- What may be some risk factors for carcinoma of the prostate?
- men greater that age 45, androgens and high dietary fat consumption
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