36 Questions
What is the primary function of the oblique manner in which the ureters pierce the bladder wall?
To create a one-way valve and prevent back-flow of urine
Which of the following arteries supplies blood to the upper 1/3 of the ureter?
Renal arteries
What is the purpose of the ureteric vasculature?
To supply blood to the ureters
What is the most likely location of a pelvic kidney?
At the level of the common iliac artery
What is the primary investigation used to diagnose renal calculi?
CT scan of the kidneys, ureters and bladder (CT-KUB)
What is the main reason why renal calculi may become lodged in the ureter?
Due to the decreased width of the ureter
What is the significance of the ureteropelvic junction (UPJ)?
It is a site where renal calculi may become lodged
What is the congenital abnormality associated with recurrent infections?
Pelvic kidney
What is the widest part of the prostatic urethra?
3-4cm
What is the longitudinal midline ridge on the posterior wall of the prostatic urethra?
Urethral crest
Where do the ejaculatory ducts open?
On each side of the prostatic utricle
What characteristic is typical of the membranous part of the urethra?
It is the narrowest and least distensible part of the urethra
What is the function of the external urethral sphincter?
It is under voluntary control
What is characteristic of the spongy part of the urethra?
It is the most mobile part of the urethra
What is located in the glans of the penis?
The navicular fossa
How many bends does the urethra have?
2 bends
What is the typical colour of the kidneys?
Reddish-brown
Which of the following is NOT part of the upper urinary tract?
Prostate
What is the location of the kidneys in the body?
Posterior abdomen
What is the name of the tube that connects the kidneys to the bladder?
Ureter
What is the name of the part of the lower urinary tract that is associated with the male reproductive system?
Prostate
What is the shape of the kidneys?
Bilateral bean-shaped
What percentage of the prostate gland is made up of the peripheral zone?
65%
Which zone of the prostate gland is most prone to benign prostatic hyperplasia (BPH)?
Transition zone
Which artery is involved in the arterial supply of the prostate gland?
Inferior vesical artery
Where does the lymphatic drainage of the prostate gland drain into?
Internal iliac nodes
What is the function of the bulbourethral glands?
Aid with lubrication of the urethra
How is the prostate gland typically examined?
Through a digital rectal examination
What is the location of the central zone of the prostate gland?
Surrounds the ejaculatory ducts
What is the location of the bulbourethral glands?
Within the deep perineal pouch, lateral to the membranous urethra
What is the characteristic shape of kidneys that have not separated?
Horseshoe-shaped
What type of trauma can cause injuries to the kidneys and renal vasculature?
Stab wounds or penetrating trauma to the back
What is the characteristic pain pattern associated with renal calculi?
Loin-to-groin pain that keeps going down into the scrotum (males)/labia (females)
What is the purpose of the renal punch test?
To gently tap on the back of the patient to assess for kidney problems
What is the preferred imaging modality for renal calculi?
CT KUB
What is a common complication of renal calculi?
Infection
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
A quiz on the anatomy of the upper and lower urinary tract, covering the structural components and functions of the urinary system.
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