4-Internal Pelvic Organs And Male Pelvic Organs

Front 1

Are the ureters retroperitoneal or intraperitoneal?

Back 1

retroperitoneal

Front 2

Where do the ureters enter the pelvis?

Back 2

near where they cross the bifurcation of the iliac into external and internal arteries

Front 3

What is the name of the junction of the ureter with the bladder?

Back 3

uterovesical junction

Front 4

What is the significance of the ureter entering the bladder at an oblique angle?

Back 4

it tends to form a natural one-way valve, letting urine into the bladder but not transferring pressure or urine back up the ureters

Front 5

Are the ureters medial or lateral to the ductus deferens?

Back 5

ureters are lateral

Front 6

Describe the relationship of the ureters, uterine artery and vaginal arteries in females.

Back 6

ureters pass inferior to uterine artery, but superior to vaginal arteries

Front 7

What is ureter pain carried by? Where is ureteral pain usually refered to?

Back 7

visceral afferent fibers that return to the spinal cord along sympathetic nerves to T11-L1
-ipsilateral lower quadrant of abdomen, esp groin

Front 8

What are the most common places that a kidney stone may lodge?

Back 8

-junction of renal pelvis w/ ureter
-where ureters cross pelvic brim (where crossing iliac vessels)
-ureters passing obliquely into bladder

Front 9

Is the bladder deep or superficial to the peritoneal membrane?

Back 9

deep

Front 10

What is anterior to the bladder?

Back 10

symphysis pubis

Front 11

What is posterior to the bladder in males? females?

Back 11

rectum in males, uterus and part of vagina in females

Front 12

What is inferior to the bladder in males? females?

Back 12

prostate gland in maes, pelvic diaphragm in females

Front 13

Name the parts of the bladder and what each corresponds with.

Back 13

fundus-posterior and inferior portion
superior-cranial portion
neck-inferior portion at junction w/ urethra
apex-anterior just posterosuperior to pubis symphysis

Front 14

What is the smooth muscle of the wall of the bladder called?

Back 14

detrusor muscle

Front 15

The inner surface of the mucosa of the bladder is thrown into folds except which area?

Back 15

trigone-area between the two ureters openings and the internal urethral opening

Front 16

What is the detrusor muscle innervated by? What does this cause?

Back 16

PSNS
contraction of bladder=increase internal P or causing micturation if the urethral sphincters are open

Front 17

What normally keeps the internal urethral sphincter closed if the bladder has less than 250mL of urine?

Back 17

smooth muscle fibers and elastic fibers

Front 18

What is the shape of a newborn babies empty bladder? Where does the newborns bladder extend?

Back 18

fusiform shape
extends into abdominal cavity up to umbilicus

Front 19

Where is the bladder located by the age of 6? by puberty?

Back 19

greater pelvis
true pelvis

Front 20

As the bladder recedes into the pelvis what does it leave behind?

Back 20

median umbilical fold over the urachus connected to the umbilicus

Front 21

What could be a cause for dribbling of urine from the umbilicus?

Back 21

urachus re-canalization

Front 22

What is the blood supply to the ureters and bladder that both males and females share? What does this artery branch from?

Back 22

superior vesicle arteries
off internal iliac

Front 23

Name the additional artery that supplies the bladder in males? What part does it supply?

Back 23

males-inferior vesicular arteries supply fundus and neck

Front 24

Name the additional artery that supplies the bladder in females? What part does it supply?

Back 24

vaginal arteries supply lower portion of bladder

Front 25

Name the veins that drain the bladder.

Back 25

vesicular venous plexus which drains into the internal iliac veins

Front 26

In males, what is the vesicular venous plexus continuous with?

Back 26

prostatic venous plexus

Front 27

What are the levels of the spinal cord that provide PSNS innervation to the bladder? What are these nerves called?

Back 27

S2,3,4
pelvic splanchnic N

Front 28

What is the main PSNS innervation of the bladder? Via what plexus?

Back 28

detrusor muscle, via inferior hypogastric plexus

Front 29

Which spinal cord levels supply the sympathetic innervation to the bladder? What are these nerves called?

Back 29

T11, L1,2
vesicle nerve plexus

Front 30

What is the main innervation of the bladder by the SNS? Via which plexus?

Back 30

urethrhal (vesicle) sphincter, via superior hypogastric plexus

Front 31

What is the function of the internal urethral sphincter? What is its additional in males?

Back 31

keeps urine in the bladder
prevents retroejaculation of sperm into the bladder

Front 32

What forms the external urethral sphincter? What is the additional component in females?

Back 32

compressor urethra muscle
urethrovaginal sphincter muscle

Front 33

What are the compressor urethra muscle and urethrovaginal sphincter muscles innervated by?

Back 33

pudendal nerve

Front 34

When do most adults begin to feel fullness of the bladder? Describe what occurs with micturition.

Back 34

300mL
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

Front 35

What is one of the most frequent causes of urinary retention in men?

Back 35

benign prostatic hyperplasia

Front 36

Describe the automatic reflex bladder. What might be an abnormal cause for this

Back 36

it is the same bladder response found in infants, if PSNS are intact the bladder will empty every 1-4hr
-lumbosacral spinal cord lesion

Front 37

What is an autonomous bladder?

Back 37

when the reflex arc is lost, bladder simply overfills and urine continually dribbles out

Front 38

What is the name of the extraperitoneal space behind the pubic bones typically filled w/ fat?

Back 38

retropubic space

Front 39

What is the name of the peritoneal space between the bladder and uterus in females?

Back 39

vesicouterine pouch

Front 40

What is the name of the peritoneal space behind the uterine/vaginal junction and anterior to the rectum?

Back 40

rectuterine pouch (of Douglas)

Front 41

What is the lowest point in the pelvic cavity in females?

Back 41

rectouterine pouch

Front 42

What is a way for materials in the rectouterine pouch of Douglas to be biopsied?

Back 42

via a transvaginal approach through the posterior fornix

Front 43

What is the aspiration of fluid from the dul-du-sac of Douglas by puncturing the posterior, superior wall of the vagina?

Back 43

culdocentesis

Front 44

What is the name of the peritoneal space between the bladder and the rectum?

Back 44

retrovesical fossa

Front 45

What is the name of the peritoneal reflection on each side of the bladder?

Back 45

paravesical fossa

Front 46

What is the name of the peritoneal reflection on each side of the rectum?

Back 46

pararectal fossa

Front 47

What is the lowest point in the pelvic cavity in males?

Back 47

retrovesical fossa

Front 48

In females, what are both the internal sphincter at the bladder and the external sphincter at the urogenital membrance composed of?

Back 48

compressor urethra muscle
external urethral sphincter muscle
urethrovaginal sphincter muscle

Front 49

Describe the path of the ductus deferens. What do they eventually form?

Back 49

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

Front 50

Which part of the nervous system stimulates expulsion of sperm?

Back 50

sympathetic

Front 51

Where do seminal vesicles lie with respect to the bladder rectum and prostate?

Back 51

posterior to fundus of bladder and anterior to rectum, superior to prostate

Front 52

What do seminal vesicles help form?

Back 52

ejaculatory ducts

Front 53

What is responsible for most of the volume of ejaculate?

Back 53

seminal vesicles

Front 54

What type of gland is the prostate?

Back 54

exocrine

Front 55

Describe the capsule around the prostate gland? Is it retro or interperitoneal?

Back 55

does not have a true CT capsule
it is retro(extra)peritoneal

Front 56

What is responsible for producing the last portion of ejaculate?

Back 56

prostate gland

Front 57

What can benign prostate hypertrophy cause?

Back 57

obstructs th epassage of urine, leading to increased retetion and infections

Front 58

What are some means of detection for carcinoma of the prostate?

Back 58

rectal examination and PSA

Front 59

What may be some risk factors for carcinoma of the prostate?

Back 59

men greater that age 45, androgens and high dietary fat consumption