1
Q
Where is the retroperitoneal space?
A
- found behind the peritoneal sac
- only covered by paritetal peritoneum on the anterior surface
- retroperitoneal organs are immobile
- secured to the posterior body wall
2
Q
Is the urinary system retroperitoneal structure or intraperitoneal?
A
retroperitoneal
2
Q
What is the function of the urinary system?
A
- it functions to filter our lood and detoxify the blood
- removing waste
- maintaining balance with water and ions in the blood that control and regulate blood pressure and keep it within normal ranges or increase it it needed or decreases if needed
2
Q
What are the structures of the urinary system?
A
- Kindey’s, Urters, Urinary bladder, Urethra, Adrenal glands
- we have a right and a left kidney, the two year ureters that bring the urine toward the urinary bladder that’s in the pelvis
- uretha which is the most distal part of the urinary system
- it allows us to excrete the urine into the external environment
2
Q
What is the difference between the deep and outer muscles and deep muscles?
A
Outer muscles = anterior abdominal wall (in front of the peritoneal cavity)
- external oblique, internal oblique rectus abdominis, transversus abdominis
Deep muscles = Retroperitoneal (behind the organs and peritoneum)
- travsversus abdominis, quadratus lumborum, psoas major, iliacus
2
Q
What are the retroperitoneal muscles?
A
Transversus abdomis (horizontal fibers coming from posteriorly and wraps all th way anteriorly), quadratus lumborum (vertical fibers, psoas major , ilacus
3
Q
What direction does the transversus abdominis?
A
horizontal fibers coming from posteriorly and wraps all the way anteriorly
3
Q
Which way does Quadratus Lumborum muscle go?
A
- vertical fibers
4
Q
What is iliopsoas?
A
Iliacus and Psoas major
4
Q
Where is the renal vein located at the hilum?
A
Most anteriorly, carries deoxygenated blood that has been detoxified by the kidney
- away from the kidney back towards to the heart
4
Q
Where is the renal artery?
A
Found posterior to the renal artery
- carry oxygenated blood that has to be detoxified towards the kidney
4
Q
Where are the ureters found?
A
Posterior to the kidneys
- bring urine away from the kidney down towards the urinary bladder
4
Q
What is the renal capsule for?
A
specifically for the kidney
- connective tissue that kind of keep all of the kidney tissue together
4
Q
What happens at the acetabulum?
A
Ilium, Ischium and Pubis join
4
Q
What is the renal vein?
A
- drain the kidney
- lost it’s oxygen, deoxygenated, high in carbon dioxide
- bring blood back to the kidney
4
Q
What is the location of the right abdominal renal artery?
A
Behind the IVC posterior
5
Q
What is the location of the left renal vein?
A
Under the superior mesenteric artery
- the left renal vein is longer than the right renal vein
5
Q
Where do the gonadal arteries?
A
- Gonadal arteries are paired branches from the abdominal aorta, they are just below the superior mesenteric artery
- terticlar arteries and ovarian arteries inside or below the pelvis
5
Q
What is the order of the arteries in the kidneys?
A
- Renal arteries
- Segmental arteries
- Interlobar arteries (between the lobes of the kidneys, between renal pyramids)
- Arcuate artery (turn and between cortex and medulla)
- Cortical Radiate arteries (supplying the cortex)
- Peritubular capillaries or vasa recta (supply the inner kidney, the medulla and help with reabsorption)
5
Q
What is the order of the veins?
A
- Cortical rediate vein (in the cortex, draining)
- arcuate veins (found between the cortex and medulla)
- Interlobar vein (found between each pyramid)
- Segmental vein
- Renal vein (deoxygenated blood that has been detoxified by the kidneys, goes back towards the heart)
5
Q
Blood filteration vessel filteration start?
A
In the renal corpuscle
5
Q
How is the filteration happening?
A
- Blood enters the glomerulus at high pressure
- the walls of the glomeruslus are slightly leaky
- this allows water, waste, and small molecules to filter out of the blood into the Bowman’s Capsule
- the filtered fluid then flows into tiny tubes (renal tubules) to form urine
5
Q
What gets picked up in the renal capsule?
A
Water and molecules because the glomercular are leaky
- blood don’t come out
- water and waste products are called filterate which eventually becomes urine
5
Q
How are concentration gradients maintained?
A
- water and ions are being exchanged to help to make concentration gradient
- maintain blood volume back into the bloodstream and that will concentrate the filterate to make it as concentrated as possible
5
What do the peritubular capillaries do?
- supply oxygen to kidney tissues so they can function
- after dropping off oxygen, they take waste carbon dioxide from kidney tissues
- after this exchange, the blood become low in oxygen and is carried away by the renal vein, which takes it back to the heart
5
What is the order of collecting urine?
Collecting duct (terminal end of the nephron)
Renal Papilla
Minor Calyx
Major Calyx
Renal Pelvis
Urether
5
What blood supply do the ureters get from?
Receive blood supply from branches of renal arteries, gonadal arteries, iliac arteries
5
What is the location of ureters?
The ureters descend, going to pass behind the gonadal artereis but over top of the external iliac arteries
- Ureter is passing deep or posterior to the gonadal artery but superficial or anterior to the external iliac
5
Where is the urinary pelvis found?
- In the pelvis
- infraperitoneal
- continuous plane with retroperitoneum
- anterior to the rectum
5
Where are the uterus and the vagina found?
Between the urinary bladder and rectum
5
What is the urinary bladder?
A muscular sack used for storing urine before it's excerete
- expands
- urine exits bladder via urethra
5
What is the blood supply to the urinary bladder?
superior and inferior vesicle arteries
5
How is the female and male bladder different?
We have the prostate gland associate at the inferior aspect of the male bladder
5
What are the muscles of the urinary bladder?
detrusor muscle, similar to the rugae of the muscle
- allow the bladder to expand as it fills ith urine
5
What is the trigone muscle for?
Trigone muscle
- posterior and inferior, smooth
- Trigone is smooth, so we don't see rugae (folds) in this area
5
What are Ureteric Orifices?
Two small opening at the back of the bladder where the ureter enter
- allow urine to flow from th ekidney sinto the bladder
5
What is the Urethral Orifice?
A single opening at the base of the bladder leading to the urethra
- allows urine to exit the blader and leave the body
5
Where is the internal urethral sphincter?
On top of the prostate
- involuntary
5
What is at the membranous urethra?
The external urethral sphincter
- Voluntary
5
What is the order of the urethra ?
Internal urethral sphincter (involutary)
Pre-prostatic urethra
Prostatic urethra
Membranous urethra (external urethral sphincter, voluntary)
Penile Urethra
5
What is the ejaculatory ducts for?
Seminal vesicle and prostatic gland secretions empty into the prostatic urethra
5
What is the bulbourethral gland for?
Secretions in penile urethra
5
What are the three main pelvic organs?
Baldder
Rectum
Uterus/Prostate Gland
5
Why i sthe female more prone to urinary tract infections?
Female urethra is shorter
5
What is the vestible of vulva?
Small area between the two inner folds of skin in the femal body
- a little space where imporant opening are located
5
What is the external urethral orifice?
Small opening at end of the urethra wheer the urine leaves the body
- located in the vestible
- tip of the penis
- below the clitoris and above the vaginal opening
5
What is the first step in the Micturition Process?
1. Stretch receptors sense bladder is full
5
What is the second step?
- The stretch repceptor that are sensing that's it's being stretched and filling up
- those send signals to the spinal cord and up to the brain, to a region called the Pontine Mictuition Center
- ot is going to coordinate the response
5
What is the third step?
-The activation of parasympathetic is going to detrusor muscle to contract to help force urine out
- in this time duration center is also inhibiting sympathetic
5
What is the fourth step?
- it inhibits the sympathetics that allows the internal urethral sphincter to relax and dilate
5
What is the fifth step?
- voluntary that is the conscious control of the external urethral sphincter causing it to relax
6
Kidney stones
- buildup of minerals, mineral deposits that get caught in the urinary tract
- areas in where are natural narrowing in urinary tract
6
Where are kidney stones most common?
Uteropelvic junction: where we go from the wide renal pelvic to the skinny ureter where the ureter crosses over teh external eliac to descend into the pelvis
- because the pelvis is in a different plant, it causes a natural kink
Uterovesical: wehre the ureter is entering the bladder,
6
How to clear Kidney Stones?
Drink lots of water to try and pass naturally, muscle relaxants
6
How to detect shockwave litotripsy?
Shockwave Lithotripsy: uses sound waves to break kidney or ureter stones into smaller pieces that pass naturally
Ureteroscopy: inserting a thin scope through the urinary tract to locate and remove stones or treat blockages
6
Pelvis Oseology
Hip Bones: pubis, ischium, ilium, sacrum
6
What is the pelvic inlet and pelvic outlet?
Pelvic Inlet: upper opening of the pelvis, superiorly
Pelvic Outlet: lower opening of the pelvis,
6
What is the difference between true pelvis and false pelvis?
- False pelvis is everything over the inlet line
- True pelvis is everything between the inlet line and the outlet line
6
Label these bones?
Orange - pubis
Blue - Ischium
Green - Ilium
6
What is the pink?
Sacroiliac Joint
- Between the sacrum and the ilium, one on each side
- synovial plane joint
6
What is the green?
The Pubic Symphysis
- fairly invisible
6
What is the blue?
Hip Joint
-
6
Where is the inferior pubic ramus?
7
Where is the ischial Ramus?
7
Where is the Ischial Tuberosity?
Sitting bone
- diggining into chair
7
Where is the Ischial Spine?
- just above the ischial tuberosity
7
Where is the lesser notch?
7
Where is the iliac fossa?
anterior surface, concave part, contributes to the false pelvis
8
Where is the iliac crest?
The top, superior border of the bone
8
What is the red pointer pointing to?
Little Protuberance called the anterior superior iliac spine
8
What is the red?
The greater sciatic notch, that sits above the lesser sciatic notch
- contributions from the ilium and the Ischium
8
What is the pink?
The sacroiliac joint
- synovial plane joint
8
What is the acetabulum?
- where all three bones come together
9
What is the pink?
Sacrospinous Ligament (Vertebro-elvic Ligament)
- it's going from the sacrum to the Ischial spine
9
What is the green?
Sacrotuberous ligament (Vertebro-Pelvic Ligament)
- larger than the sacrospinous ligament
9
What is the orange?
Anterior/Posterior Sacroiliac ligament
9
What is the Purple?
Inguinal Ligament
- coming from the ilium to the pubic tubercle
9
What is the blue?
Obturator Membrane
9
What is the top hole?
Greater Sciatic Foramen
- made of the greater sciatic notch
- sacrospinous ligament and sacrotuberous ligament create this
9
What is the bottom hole?
Lesser Sciatic Foramen
- sacrospinous ligament and sacrotuberous ligament create this
9
What is the difference between males and female pelvis?
Males are narrow and deeper
- coccyx is protruding into that opening, anteriorly
- small puic angle
- Female pelvises are much wider
- females ahve an anterior tilt
- females ahave a wider pubic angle
9
What is the Pelvic Wall?
- Cover the lateral borders of the pelvis
- Originate inside the pelvis
- Travel to the gluteal region
9
Which one is the blue one?
Piriformis
- Travels through the greater sciatic foramen
9
Which one is the Orange one?
Obturator Internus
- Travels through the lesser sciatic foramen
9
What is the pink line?
Thickening of the obturator Fascia also called the arch of levator ani
- origin from those
9
What are the muscles that support the pelvic organs inferiorly called?
- The Pelvic Floor Muscles
- The Pelvic Diaphragm Muscles
9
What are the Pink Muscles of the Pelvic Wall (Pelvic Diaphragm)?
Levator Ani Muscle group
9
What are the muscles in the Levator Ani Muscle Group?
- Leavator ani muscle group: puborectalis, pubcoccygeus, Iliococcygeus
9
What is the green?
Ischiococcygeus (coccygeus)
9
What makes up most of the pelvic floor?
Levator Ani Muscle group
- Puborectalis
- Pubococcygeus
- Iliococcygeus
10
What is the green?
Ischiococcygeus (coccygeus)
11
What is the red?
Puborectalis
- part of the levator ani muscles
11
What is the yellow one?
Pubococcygeus
- inserts on the coccyx and comes back around
11
What is the blue one?
Iliococcygeus
11
What are the holes in the puborectalis?
- The top is the rectal hiatus
- The bottom is the urogenital hiatus
11
What muscle is around the rectum?
Puborectalis
11
What is the perineum?
A small area of skin and muscle between your private parts and anus
- inferior to the pelvic floor
- between skin and pelvic floor
- contains external genitalia and anus
12
What is the Lithotomy View?
Flex and Abduct the hip to move them out of the way so we can get a good view
12
What is the blue?
The superior border of the perineum
- pubic symphysis
13
What the pink?
The Ischiopubic Ramus
- combination of the inferior pubic ramus, superior pubic ramus and ischial ramus
13
What is the green?
Ischial Tuberosity
13
What is the purple?
Sacrotuberous ligament
13
What is the orange?
Coccyx
13
What are the planes due to the orientation of the pelvis?
Urogenital triangle is more horizontal whereas anal triangle is more vertical tilt
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Anatomy Course : )
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