Where are the kidneys and proximal ureters?
Abdomen
Where are the distal ureters, bladder and proximal urethra?
Pelvis
Where is the distal urethra?
Perineum
Where do the ureters pass?
From the retroperitoneum, through the false pelvis and into the true pelvis
Where is the false pelvis?
The false pelvis is from the iliac crests to the pelvic inlet
The false pelvis is part of the abdominal cavity
Where is the true pelvis?
From the pelvic inlet to the pelvic floor
Where is the bladder?
Pelvic cavity
Pelvic floor muscles?
Levator ani
Urethra passes through where?
Through the pelvic floor and into the perineum
Where do the ureters pass in relation to the common iliac vessels?
The ureters pass anterior to the common iliac vessels to enter the pelvis
At what level to the ureters turn medially to enter the posterior aspect of the bladder?
The ureters turn medially at the level of the ischial spine to enter the posterior aspect of the bladder
In which direction do the ureters enter the posterior bladder wall?
The ureters enter the posterior bladder wall in an inferomedial direction
-helps prevent reflux of urine back into the ureters when the bladder contracts
Most inferior part of the male peritoneal cavity?
Rectovesicle pouch
Most inferior par of the female pertioneal cavity?
Rectouterine puch
What is the vesico-uterine pouch?
The pouch between the bladder and the uterus
The ureter in reference to the vas deferens?
The ureter runs inferiorly to the vas deferens
“water under the bridge”
In females, the ureter enters the bladder by passing UNDER the uterine artery
Uterine artery is a branch of what?
The uterine artery is a branch of the internal iliac
What gives branches to the pelvic organs, gluteal region and perinuem?
The internal iliac gives branches to the pelvic organs, gluteal region and perineum
Arteries to the bladder?
Vesical arteries
-the postatic arteries are often branches from the vesical arteries
Middle rectal artery is a branch of which artery?
The internal iliac
Bladder wall formed by which muscle?
Detrusor muscle
In the male bladder, which muscle also forms the internal urethral sphincter muscle and what is the function of this sphincter?
The detrusor muscle forms the internal urethral sphincter muscle and this contracts during ejaculation to prevent retrograde ejaculation
An empty bladder? where does it lie?
An empty bladder lies within the pelvis
The peritoneum covers its superior surface only
A full bladder can extend out of where?
-Where does the superior part lie?
A full bladder can extend out of the pelvis
- The superior part lies superior to the pubic bone
- peritoneum still only covers the superior surface
2 routes of catheterising a patient?
Urethral (more common)
Suprapubic (through anterior abdominal wall, avoiding peritoneal cavity)
Roughly how long is the female urethra?
The female urethra is approximately 4cm long
How long is the male urethra?
20cm long
Where is the spongy urethra?
Within the corpus spngiosum
What type of muscle makes the external urethral sphincter?
Skeletal muscle
Where is the spongy urethra?
Within the corpus spongiosum
What travels through the spermatic cord?
Testicular artery Testicular vein Vas deferens Lymphatic vessels Nerves (autonomic--> vas deferens, somatic --> cremaster muscle)
Nerve supply to vas deferens
Autonomic
Nerve supply to cremaster muscle?
Somatic
The sac that the testis sit within?
The tunica vaginalis
Excess fluid within the tunica vaginalis?
Hydrocele
Where can the epididymis be palpated?
Epididymis can be palpated at posterior aspect of testis
Where can the vas deferens be palpated?
The vas deferens can be palpated within the spermatic cord
-in scrotum, superior to testis
The route of sperm?
Vas deferens passes superiorly in spermatic cord, to deep inguinal rung
- at deep inguinal ring, the vas deferens turns medially into the pelvis
- it then travels posterior to bladder
Through which ducts do the glandular secretions from the prostate drain into the prostatic urethra?
Prostatic ducts
Ejaculatory duct
Combined duct of the vas deferens and the duct from the seminal gland
Most cancers arise from which part of the prostate gland?
Most cancers arise from the peripheral zone of the postate gland
How can you feel the peripheral part of the prostate gland?
You can feel the peripheral zone of the porstate on rectal examination
Where does the root of the penis attach to?
The ischium of pelvis
What does the corpus cavernosum transmit?
The deep arteries of the penis
What does the corpus spongiosum transmit?
The spongy urethra