Anatomy of Urinary Tract

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Questions and Answers

What is the primary function of the oblique manner in which the ureters pierce the bladder wall?

To facilitate the back-flow of urine

To decrease the diameter of the ureters

To increase intramural pressure

To create a one-way valve and prevent back-flow of urine (correct)

Which of the following arteries supplies blood to the upper 1/3 of the ureter?

Common iliac arteries

Abdominal aorta

Renal arteries (correct)

Internal iliac arteries

What is the purpose of the ureteric vasculature?

To facilitate the flow of urine

To create a one-way valve

To supply blood to the ureters (correct)

To increase intramural pressure

What is the most likely location of a pelvic kidney?

At the level of the common iliac artery Signup and view all the answers

What is the primary investigation used to diagnose renal calculi?

CT scan of the kidneys, ureters and bladder (CT-KUB) Signup and view all the answers

What is the main reason why renal calculi may become lodged in the ureter?

Due to the decreased width of the ureter Signup and view all the answers

What is the significance of the ureteropelvic junction (UPJ)?

It is a site where renal calculi may become lodged Signup and view all the answers

What is the congenital abnormality associated with recurrent infections?

Pelvic kidney Signup and view all the answers

What is the widest part of the prostatic urethra?

3-4cm Signup and view all the answers

What is the longitudinal midline ridge on the posterior wall of the prostatic urethra?

Urethral crest Signup and view all the answers

Where do the ejaculatory ducts open?

On each side of the prostatic utricle Signup and view all the answers

What characteristic is typical of the membranous part of the urethra?

It is the narrowest and least distensible part of the urethra Signup and view all the answers

What is the function of the external urethral sphincter?

It is under voluntary control Signup and view all the answers

What is characteristic of the spongy part of the urethra?

It is the most mobile part of the urethra Signup and view all the answers

What is located in the glans of the penis?

The navicular fossa Signup and view all the answers

How many bends does the urethra have?

2 bends Signup and view all the answers

What is the typical colour of the kidneys?

Reddish-brown Signup and view all the answers

Which of the following is NOT part of the upper urinary tract?

Prostate Signup and view all the answers

What is the location of the kidneys in the body?

Posterior abdomen Signup and view all the answers

What is the name of the tube that connects the kidneys to the bladder?

Ureter Signup and view all the answers

What is the name of the part of the lower urinary tract that is associated with the male reproductive system?

Prostate Signup and view all the answers

What is the shape of the kidneys?

Bilateral bean-shaped Signup and view all the answers

What percentage of the prostate gland is made up of the peripheral zone?

65% Signup and view all the answers

Which zone of the prostate gland is most prone to benign prostatic hyperplasia (BPH)?

Transition zone Signup and view all the answers

Which artery is involved in the arterial supply of the prostate gland?

Inferior vesical artery Signup and view all the answers

Where does the lymphatic drainage of the prostate gland drain into?

Internal iliac nodes Signup and view all the answers

What is the function of the bulbourethral glands?

Aid with lubrication of the urethra Signup and view all the answers

How is the prostate gland typically examined?

Through a digital rectal examination Signup and view all the answers

What is the location of the central zone of the prostate gland?

Surrounds the ejaculatory ducts Signup and view all the answers

What is the location of the bulbourethral glands?

Within the deep perineal pouch, lateral to the membranous urethra Signup and view all the answers

What is the characteristic shape of kidneys that have not separated?

Horseshoe-shaped Signup and view all the answers

What type of trauma can cause injuries to the kidneys and renal vasculature?

Stab wounds or penetrating trauma to the back Signup and view all the answers

What is the characteristic pain pattern associated with renal calculi?

Loin-to-groin pain that keeps going down into the scrotum (males)/labia (females) Signup and view all the answers

What is the purpose of the renal punch test?

To gently tap on the back of the patient to assess for kidney problems Signup and view all the answers

What is the preferred imaging modality for renal calculi?

CT KUB Signup and view all the answers

What is a common complication of renal calculi?

Infection Signup and view all the answers

Study Notes

The Kidneys

Bilateral, bean-shaped organs, reddish-brown in color, located in the posterior abdomen
Enter the base of the bladder in the upper outer aspect
Ureters pierce the bladder wall in an oblique manner, creating a one-way valve
High intramural pressure collapses the ureters, preventing back-flow of urine

Ureteric Vasculature

Upper 1/3: renal arteries (close to kidneys)
Middle 1/3: abdominal aorta, testicular/ovarian arteries, common iliac arteries
Lower 1/3: internal iliac arteries

Uterine Constrictions

Regions along the ureters become narrower:
- Ureteropelvic junction (UPJ)
- Pelvic inlet
- Ureterovesicular junction (UVJ)
Sites where renal calculi (renal stones) may become lodged due to decreased width
Investigation: CT scan of the kidneys, ureters, and bladder (CT-KUB)

Clinical Correlations

Recurrent infections: associated with congenital abnormalities
Development of kidneys: ascend and carry vasculature
Investigations necessary
Pelvic kidney: kidneys develop in the pelvic region and ascend to the lumbar retroperitoneal area
Horseshoe kidneys: kidneys have not separated, remain fused into a single horseshoe-shaped structure

Trauma to the Back

Stab wounds/penetrating trauma to the back can cause injuries to the kidneys and renal vasculature
Blunt trauma following a motor vehicle accident (MVA)

Urinary Tract Stones - Renal Calculi

Referred pain from the kidney
Loin-to-groin pain, keeps going down into the scrotum (males)/labia (females) associated with renal calculi
Can be familial and recurrent

Complications and Imaging

Complications: infection, obstruction
Imaging: CT KUB - kidney-urinary-bladder
Renal stones show up as white; vertebra appear white in a CT
X-ray shows radio-opaque areas (not the preferred imaging modality)

Prostate

Widest part: 3-4cm
Urethral crest: longitudinal midline ridge on posterior wall
Depression on either side: prostatic sinus
Dome-like elevation: seminal colliculus - important landmark in biopsy
Ejaculatory ducts open on each side of the prostatic utricle

Parts of the Urethra

Membranous part: narrow and least distensible, passes through the deep perineal pouch
Spongy part/penile urethra: most mobile, longest, surrounded by corpus spongiosum of penis
Openings of bulbourethral glands present
Easy to characterize
In the glans (head) of the penis, the urethra dilates to form the navicular fossa
2 bends - important in catheterisation

Prostate Zones

Peripheral zone: main body of the gland (65%), located posteriorly
Central zone: middle lobe, surrounds ejaculatory ducts
Transition zone: located centrally, surrounds the urethra
Anterior zone: fibromuscular stroma, merges with the tissue of the urogenital diaphragm

Prostate Vascular Supply, Venous Drainage, and Innervation

Arterial supply: inferior vesical artery, middle rectal artery
Venous drainage: prostatic venous plexus → interior iliac vein
Receives deep dorsal vein of penis and vesical veins
Lymphatics: drain into internal iliac nodes
Innervation: inferior hypogastric plexus, sympathetic stimulation stimulates smooth muscle of prostate during ejaculation

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Description

A quiz on the anatomy of the upper and lower urinary tract, covering the structural components and functions of the urinary system.