, Ureters, Urinary Bladder, Urethra

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What is the function of the ureters?

1. Muscular tube that conveys urine form pelvis of the kidney to urinary bladder
2. muscular wall is expandable and contractible: peristalitic waves convey urine along the tube.

The ureter is the continuation of what?, and it ends at what viscera?

pelvis of the kidney and ends to urinary bladder

What is the structure of the ureter?

a. inner wall:lumen lined with mucosa, has series of folds.

b. describe muscular wall: has both circular and longitudinal layers of smooth muscle

d. outer layer of adventitia(serosa) is composed of some adipose cells and connective tissue throughout.

What structures are located in the outer layer?

the numerous small branches of arteries, venules and nerve fibers

What is the positional relationship of the ureters to the peritoneum?

directly external to periteneum

The ureter descends on what muscle of the posterior abdominal wall?

ureter descends through the abdomen and pelvis anterior to medial border of psoas major mm

What vessels are close to the right ureter?

IVC
Gonadal
Lumbar lymph nodes

What vessels are close to the left ureter?

Left gonadal artery and vein
Left inferior meseneinteric artery and v

Where does each ureter enter the true pelvis (where does it cross the pelvic brim)?

at the level of bifurcation of common iliac arteries into external and internal iliac arteries

In the pelvis, what wall of the pelvis does the ureter descend upon?

lateral pelvic wall arteries

The ureter enters the urinary bladder. In the male, it enters the bladder near (adjacent to) what reproductive structures?

Vas deferens
Seminal Vescicle

Which of these structures is medial to ureter entering urinary bladder, and which of these structures is lateral?

medial: seminal vesicle and lateral: vas deferens

Does the vas deferens cross superior or inferior to the ureter?

superior

In the female, what blood vessel crosses close to the entrance of the ureter to the urinary bladder?

uterine arterie superior to ureter at level of ischial spine

What wall of the urinary bladder does the ureter enter?

posterior wall

The ureter gets its arterial supply from blood vessels in the abdomen and pelvis. Name the arteries that have small branches that supply the ureter: In the abdomen, they are all of the "obvious" arteries you learned for the posterior abdominal wall.

ureter in abdomen:aorta, renal and gonadal arteries, other branches arise from common or internal iliac arteries

In the pelvis, think of which artery and its branches are the arterial sources to the pelvis:

main sources are from common and internal iliac arteries.
Male: vesical arteries(ureter and urinary bladder)
Female: Uterine arterie (some branches to ureter)

Is the venous drainage ultimately to the portal system of veins, or to the IVC?

Abdominal: to gonadal Veins to renal vv to IVC
Pelvic: uterine vv to internal iliac vein to common iliac vv. to IVC

Innervation to the ureters (and most pelvic structures are by preganglionic sympathetic neuron cell bodies located in what spinal cord levels?

preganglionic T12, L1-L2
postganglionic: superior and inferior hypogastric plexus

Where are the preganglionic parasympathetic neuron cell bodies located (again, for most pelvic structures)?

S2-S4

What is the function of the urinary bladder?

Store urine until is convenient to release it to the exterior

Describe the structure of the urinary bladder:

It is a hollow , distensible, muscular organ

What are the basic layers that form the structure of the urinary bladder?

1.Mucosa(numerous folds)
2.Muscular layer( has 3 distinctives layers of smooth muscle)
Serosa superiorly (outermost layer)

The trigone is part of which of the above three layers?

Mucosa

does the trigone differ from the remainder of this layer of the bladder? 1

Yes

What is the trigone of the urinary bladder?

smooth triangular region

What wall of the urinary bladder is trigone part of?

fundus or base (posterior wall of the bladder)

structures are located at the lateral angles of the trigone?

internal uteric orifices (uteres opening)

So, through which wall of the urinary bladder, and exactly where do the ureters open (in relation to the trigone) into the urinary bladder?

downward directed at lateral angles of trigone, prevent reflec of urine back to the bladder

What are the muscular layers of the bladder called?

Detrusor muscle

All muscle layers converge at what region of the bladder?

neck of the bladder

The sphincter in the neck region is called the

involuntary internal sphincter of the bladder

In what region of the body is the urinary bladder located (after the age of six years)?

located within the true pelvis

The bladder is located directly posterior to what bone?

pubic bone

A very full bladder can rise to what level in the adult?

umbilicus

In infants the urinary bladder is located in what region of the bladder?

within abdomen

What are the peritoneal pouches that relate to the urinary bladder called:
a. in the male:

b. in the female:

Male rectovesical pouch
Female: vesicouterine pouch

Apex(bladder)

antero- superior "point"

Fundus(bladder)

posterior wall
Male: fundus is adjacent to seminal vesicle and ampulla of vas deferens
the upper part adjacent with the rectum

Body(bladder)

between apex and fundus

neck(bladder)

the fundus ans inferolateral surfaces converge to the neck of bladder

Name the blood vessels that supply the urinary bladder in the male, and in the female (and what arteries are they direct branches of?)

direct or secondary branches of internal iliac a.a
Male: superior vesicle aa(branch umbilical a.a) inferior vesicle a.a ( internal iliac a.a)
Females: branches of vaginal or uterine a.a

Preganglionic sympathetic neuron cell bodies are located at what levels of spinal cord?

T12, L1-L2

What is the function of the sympathetic innervation to the urinary bladder?

closes the internal sphincter, prevents voiding ( urinate)

Preganglionic parasympathetic urinary bladder neuron cell bodies are located where?

S2-S4

What is the function of the parasympathetic innervation to the urinary bladder?

Contracts the detrusor muscle and relaxes the internal sphincter, causing voiding

What are the functions of the urethra in the female, and in the male?

muscular tube conveys urine from bladder to the exterior
male: urethra conveys semen which has sperm

What is the external opening of the urethra called?

external urethral orifice

three segments of the male urethra and what structure each segment passes through:
Where does this segment begin?Is this part of the urethra wide or narrow?

A. Prostatic urethra: Begins at the internal urethral orifice, passes through the prostate glan, ends at urogenital diaphragm.
Widest and most dilatable part of urethra

Name and describe the three segments of the male urethra and what structure each segment passes through:
b.What muscle surrounds the urethra in this region?
Is this part of the urethra wide or narrow?

Membranous urethra
Passes throug urogenital diaphragm where it is sorrounded by sphincter urethra muscle
Second narrowest part of male urethra

Name and describe the three segments of the male urethra and what structure each segment passes through:
This part of the urethra ends as what?

Spongy or Penile Urethra
Longest porth the corpus spongiosion of the urethra, passes trhrough bulb of the penis. Ends as external urethral orifice(narrowest)

The female urethra is short and straight, and its segments lack names, but correspond (sort of) to which segments of the male urethra?

prostatic (superior)and membranous part (inferior)

The female urethra and male urethra pass through what structure?

a. and each is surrounded by what specific muscle?

urogenital diaphragm and surrounden by sphinter urethra muscle

Inferiorly, the female urethra is associated with the anterior wall of what reproductive structure in the female?

anterior wall of vagina

The external urethral orifice ends within what specific region of the female perineum?

vestibule of the vagina

The female urethra DOES NOT pass through what female genital structure?

clitoris

In the male, however, the urethra DOES pass through what male genital structure?

penis

Name the arteries that supply the urethra:
a. In the male:

b. In the female

Male: branches of internal iliac a.a
(inferior vesical a.a, middle rectal and internal pudendar a.a)
Female: branches of internal iliac a.a and internal pudendal a.a.

Most of the arteries that supply the bladder and urethra are branches of what artery of the pelvis?

intenal pudendal a.a

Is the innervation primarily sympathetic or parasympathetic to urethra?

parasympathetic S2-S4

What is urinary incontinance

inability to control voluntary urination

Damage to what nerves or to what spinal cord levels may cause urinary incontinence?

pudendal nerves (s2-S4)

What muscle is usually not functioning when pudendal nerves are damaged?

sphincter urethraae m.m

What is stress incontinence?

sudden increase in intra-adbominal pressure

Why does stress incontinence occur in the female and not in the male?

urethra is shorter

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