1st Year Med > Genitourinary System > Flashcards

Genitourinary System Flashcards

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1
Q

describe the peritoneum characteristics

A

serous membrane lining abdominal cavity
2 layers of mesothelium
peritoneal space inbetween 2 layers

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2
Q

where does the parietal peritoneum line and what is it derived from?

A

lines internal surface of the abdominal-pelvic cavity
derived from somatic mesoderm

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3
Q

what does the visceral peritoneum line?

A

invaginates and lines abdominal organs

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4
Q

what is the difference between pain in the visceral and parietal peritoneum?

A

visceral - poorly localised
parietal - well localised

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5
Q

what are the 3 intraperitoneal organs?

A

stomach, liver, spleen

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6
Q

what are the 3 main retroperitoneal organs and how are they covered by the peritoneum?

A

oesophagus, rectum, kidneys
peritoneum only covers anteriorly

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7
Q

what are the functions of the kidney?

A

filter waste (urine production)
regulates blood (BP/ions/pH/osmolarity/volume/glucose levels)
hormone production such as calcitrol (active vitamin D) or erythropoetin

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8
Q

what are the 3 structures found in the hilum?

A

renal artery, renal vein, ureter (forms at renal pelvis)

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9
Q

what does the cortex of the kidney contain and what is its function?

A

provides supporting tissue
contains glomeruli, bowman’s capsule and convoluted tubules

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10
Q

what is the function of the kidney’s medulla and how is it organised?

A

function - main site of filtration
organised into renal/medullary pyramids

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11
Q

what are the functioning units of the kidneys?

A

nephrons and collecting tubules

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12
Q

what 2 structures make up the renal corpuscle?

A

glomerulus and bowmans capsule

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13
Q

what are nephron collecting tubules comprised of?

A

renal corpuscle and renal tubules

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14
Q

what are the 4 basic steps of the nephron collecting tubules function?

A

filtration, reabsorption, secretion, excretion

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15
Q

what are renal tubules comprised of?

A

PCT, LoH, DCT, diuretics (Na linked)

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16
Q

what 3 blood vessels are located in the kidney and where do they supply?

A

interlobal - lobes
cortical - cortex
arcuate - between cortex/medulla

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17
Q

explain the calyx system

A

papillas link medulla pyramids to the minor calyx which drains the pyramid into a major calyx, which all connects to the renal pelvis which transports the urine to the bladder

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18
Q

what muscle near the kidneys is important for hip flexion?

A

psoas major

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19
Q

name the arteries that supply the area around the kidneys with blood

A

R/L suprarenal arteries
R/L inferior phrenic arteries
R/L renal arteries
R/L testicular/ovarian arteries
inf/sup mesenteric arteries

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20
Q

name the veins around the renal system responsible for blood drainage

A

R/L renal veins
L inferior phrenic vein
R/L testicular/ovarian veins

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21
Q

what is the function of the ureters?

A

transports urine to urinary bladder

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22
Q

what is a common problem of the ureters?

A

highly sensetive and can be blocked by kidney stones

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23
Q

what are the 3 main areas where kidney stones can block the ureter?

A

pelvoureteric junction
pelvic brim
trigone

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24
Q

name the layers of the urinary bladder from superficial to deep

A

detrusor muscle
submucosa
lamina propria
transitional epithelium

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25
where do the ureters enter the bladder?
the ureteric meatus'
26
what is the trigone?
a triangular area from the orifices of the ureter openings and the urethra
27
what does the vas deferens connect?
testes to urethra
28
name the layers of the testes from superficial to deep
scrotum skin superficial fascia external spermatic fascia crewmaster muscle (+ fascia) internal spermatic fascia parietal tunica vaginalis visceral tunica vaginalis tunica albuginea of testis
29
what are the exocrine and endocrine functions of the testes?
exocrine - sperm cells endocrine - testosterone
30
what structures in the testes does the tunica albuginea form?
200-300 lobules
31
what does each singular lobule contain?
1-4 seminiferous tubules
32
what 5 structures (in order) does sperm travel through?
seminiferous tubules straight tubules (tubulus rectus) rete testes efferent ductules epididymus
33
where are sperm cells produced and matured?
produced - seminiferous tubules (as spermatozoa) matured - epididymus
34
what are the 3 parts of the urethra?
prostatic, membranous, pendulous
35
what is the urethral crest and what is its function?
long fold in posterior urethra wall stopping sperm entering the bladder
36
what is the function of the sphincter urethrae muscles?
controls urine expulsion
37
what is the function of bulbourethral (cowper's) glands?
glycoprotein secretion in mucous during arousal lubricates urethra/penis, controls acidity and removes dead cells
38
what is the function of the prostate?
produces enzymes to break down proteins, stop clotting and maintain semen in a fluid state
39
what are the 4 uterine positions?
anteverted and anteflexed retroflexed retroverted retroverted and retroflexed
40
what ligaments hold the uterus in place?
round ligament - maintains forward orientation (anteflexus) broad ligament - acts as a mesentery
41
what does the ovarian ligament connect?
ovary and lateral uterus
42
what does the suspensory ligament do?
contains blood supply to the ovarian artery/vein and connects to anterior abdominal wall
43
what is the rectouterine pouch?
a double fold of peritoneum between the rectum and the back wall of the uterus
44
what can occur if uterine tubes or the ampulla become blocked?
ectopic pregnancy
45
what can happen if water/electrolyte homeostasis isn't maintained?
haemorrhage, dehydration, unusual eating/drinking behaviour
46
what is the typical water intake/output per day?
2.5 litres
47
what is the sequence of blood vessels in the kidneys?
afferent arteriole -> glomerular capillaries -> efferent arteriole -> tubular capillaries -> venule
48
name the 2 nephron types and state which one has more effective water reabsorption
superficial juxtamedullary (more water reabsorption)
49
what are the 4 sections of the nephron?
PCT LoH DCT collecting duct
50
what is nephron reabsorption?
the active pumping of filtrate into tubules in substances being retained (water/glucose)
51
what is nephron secretion?
the active pumping of filtrate into tubules for substances being eliminated (ammonia/uric acid)
52
what is ultrafiltration driven by?
BP in glomerular capillaries
53
what are the components of a glomerulus?
afferent/efferent arterioles glomerular tuft glomerular capillary
54
what composes the filtration barrier of the glomerular capillary?
podocyte foot processes fenestrated endothelial cells glomerular BM slit diaphragm
55
what occurs in glomerulus ultrafiltration?
high glomerular capillary pressure (55mmHg) water and small molecules filter through slits between podocytes at a normal filtration rate of 90-140ml/min
56
explain what occurs in proximal CT active reabsorption
in the brush border: Na, K, AAs and glucose reabsorbed through co-transporters and membrame pumps substantial water reabsorption and complete glucose/AA reabsorption filtrate volume reduced by 2/3
57
what differences does the wall of the LoH have at different points?
thinner during descent into medulla thicker during ascent from medulla
58
explain the counter current mechanism of the loop of henle
solute is actively pumped up ascending tube solute diffuses into descending tube this recycles the solute
59
what is the function and characteristics of the DCT?
function - solute absorption and secretion less intense electrolyte/water reabsorption than PCT ion pumping controlled by aldosterone (hormone that 'fine tunes' Na/K exchange)
60
what does AVP do?
decreases water loss by increasing uptake of water reabsorption in collective duct
61
how does ADH work?
promotes water reabsorption in DCT and collecting duct
62
what is the collecting duct permeability set by?
ADH and AVP
63
what occurs in collecting ducts permeable to water?
water moves out of the duct to concentrate filtrate
64
explain the function of aquaporins
they are inserted into luminal membrane to allow water movement when ADH or AVP is present
65
what is blood/plasma osmolarity?
a measure of the chemical components of the blood concentration
66
what is a normal value for blood osmolarity?
300 mOsm
67
what happens when water intake is restricted?
plasma osmolarity decreases more ADH/AVP is secreted by the hypothalamus to reabsorb more water and concentrate urine
68
what is the maximum concentration of urine?
1200 mOsm
69
what is the minimum and maximum accepted urine output?
minimum - 1ml/min maximum - 20ml/min
70
what is the second stage of filtration pressure and BP control in the kidney?
renin splits angiotensinogen into angiotensin 1 which is converted to angiotensin 2 (powerful vasoconstrictor)
71
what controls the salt balance in kidneys when electrolytes fall?
aldosterone promotes reabsorption of Na/Cl ions and promotes K secretion
72
what signals volume in the bladder?
stretch receptors
73
what maintains bladder continence? (holding it in)
sphincter activity (can be unconcious or concious)
74
what measures bladder behaviour and compliance?
cystometrogram
75
what is the detrusor muscle affected by?
reflexes wall stretching triggers contractions which produce additional force and pressure
76
what sphincter is present at the bottom of the urinary tract and how does it differ in M and F?
external sphincter in males it is stronger with more skeletal muscle
77
what is notable about bladder pressure in the beginning of the storage phase?
no bladder sensations due to stretchy bladder walls, pressure remains fairly constant
78
what happens to the external sphincter when sensation is felt?
contraction
79
what is voiding?
the emptying of the bladder
80
what occurs straight after voluntary voiding?
bladder wall contracts internal/external sphincters begin to relax
81
how can voiding be halted voluntarily?
contractions of both sphincters causing spike in bladder pressure
82
why does bladder pressure not immediately decrease during voiding?
to keep pushing the urine past the sphincters to empty the bladder
83
explain urine flow in terms of bladder and sphincter pressure
urine will flow out and void when bladder pressure exceeds sphincter pressure
84
what makes the coordination between the bladder and sphincters complex?
the external sphincter is skeletal muscle which changes force faster than the urethra (smooth muscle)
85
what sympathetic innervation does L1/L2 supply?
bladder and internal sphincter
86
what parasympathetic inervation does S2/3/4 supply?
bladder wall
87
what somatic innervations do S2/3/4 supply?
external sphincter
88
describe the afferent bladder control pathways
sensory fibres sense bladder wall stretching (through hypogastric nerve entering cord in upper lumar roots) urethra sensors sense urine flow skeletal muscle sensors sense external sphincter
89
describe the efferent bladder control pathways
parasympathetic to detrusor sympathetic to internal sphincter
90
what causes contraction and relaxation of the detrusor?
contraction - pelvic splanchric nerve fibres relaxation - hypogastric nerve fibres
91
what effects dominate the storage and voiding phases?
storage - sympathetic voiding - parasympathetic
92
name the sensations accompanied with bladder filling in order
first fullness sense -> fullness -> desire to micturate -> discomfort -> pain
93
what nerve fibres provide sensation to the bladder?
large myleinated fibres - intense sensation small unmyleinated fibres - less intense sensation
94
what is the general maximum bladder capacity?
400-600ml
95
what is the maximum micturition and detrusor pressure in the bladder?
micturition - 75-90cmH2O detrusor - 55-75cmH2O
96
what are the 3 volume-pressure relationships?
normal - fills slowly to 375ml then reflex contractions start, then stop neurogenic bladder - reflexes overactive and stiff bladder, higher pressures at lower volumes atonic bladder - reflexes underactive and small
97
what is the problem of prostate hypertrophy?
urethra compression, slowing urine flow
98
what is the first stage of controlling filtration pressure and BP in kidneys?
hypofiltration initiates renin secretion by the juxtoglomerular apparatus
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