Genitourinary System 🤰🏽

What is the peritoneum

It is a serous membrane which lines the abdominal cavity

What is the mesothelium

This is the membrane which makes up the peritoneum

What are the two types of the mesothelium

Parietal

Visceral

List the features of parietal mesothelium

It lines the abdominopelvic wall

It has localised pain

It responds to pain, laceration, pressure, temperature

It is derived from the somatic mesoderm in embryo

It has a somatic nerve supply

List the features of visceral peritoneum

It lines the abdominal organs

It is derived from the sphlanchnic mesoderm in embryo

Pain is not localised

It responds to stretch and chemical irritation

Autonomic nerve supply

What organs are interperitoneal

Stomach

Spleen

Liver

What organs are retroperitoneal

Kidneys

Rectum

Oesophagus

What vertebrae do the kidneys lie at

T11-L3

ribs 11-12

What kidney is higher than the other and why

The right kidney is lower than the left and this is because the liver sits just above it

Define retroperitoneal organs

They do not sit within the peritoneum

What is the main functions of the kidneys

Filters waste and creates urine

Regulation - glucose, pH, osmolarity, ions

Production of calcitriol and erythropoietin

What are the two main regions of the kidney

Cortex and medulla

What is contained within the cortex

Bowman’s capsule

Glomerulus capillaries

Convoluted tubule

What is the function of the medulla

It filters urine into the renal pelvis

Afferent arterioles and filtration

Blood enters afferent arteriole and into the glomerular capillary

Filtration into the bowman’s capsule

Some ions can be reabsorbed into the peritubular capillaries

Some ions can be secreted into the peritubular capillaries which then form the venous system

Renal corpuscles

They contain the bowman capsule and glomerular capillaries

Renal tubules

Proximal and distal convoluted tubules

Loop of henle

What is the function for the loop of henle

concentration gradient for fluids and electrolytes

What are diuretics

They are used to promote urination

they are sodium linked

Increase excretion of water

How much reabsorption occurs at each stage of the renal tubule

PCT - 65%

LoH - 15%

DCT - 15%

Collecting duct - 5%

Renal pyramids, calyx, renal pelvis

The urine passes through the renal pyramid, into the minor calyx, into the major calyx, and then into the renal pelvis into the ureter

What is the hilum

Hilum is the gateway which allows renal arteries, veins, nerves, ureter to exit and enter the kidney

Outline the artery passage through the kidney

Abdominal aorta > renal artery > segmented artery > interlobular artery > arcuate blood vessels > cortical artery < afferent arteriole

Outline the venous passage of the kidney

Peritubular capillaries > arcuate blood vessels > interlobular veins > segmented veins > renal vein > inferior vena cava

Where is the renal vein located in comparison to the renal artery

Anteriorly

Where do the renal arteries and veins branch off of

Artery - abdominal aorta

Vein - inferior vena cava

What veins come off of the inferior vena cava and aorta

Renal

The gonadal

Mesenteric artery

Phrenic

Suprarenal

What happens when kidneys fuse

it creates a horse shoe kidney

What scan is used to identify blood in places it shouldn’t be

FAST scan

What can polycystic kidney disease cause

Renal failure due to an autosomal dominant mutation

What is the ureter

The transport of urine rom the kidney to the bladder

What is the name of the movement of urine in the ureter

peristalsis

What is the bladder

the bladder is a muscular organ which holds urine, the bladder can accommodate urine fluctuations by shrinking and expanding

What is the trigonal feature of the bladder called

The trigone

What are the layers of the bladder

Transitional epithelia

Lamina Propria

Submucosa

Detrusor muscle

What is the movement of sperm from production to the vas deferents

Seminiferous tubules for production

Straight tubules

Rete Testes

Efferent ductules

Epididymis

Vas deferents

What are the two protective layers of the tests

Tunica vaginalis

Tunica albuginea

Tunica vaginalis function

To line the tunica albuginea

Tunica albuginea function

To line the testes

Is male gonads internal or external

External

Where is immature and mature sperm found

Immature - seminiferous tubules

Mature - epididymis

What is the normal anatomical position of the uterus

Anteflexed

Anteverted

What is the role of the prostate

To break down proteins

Where does the prostate lie

Below the bladder but superior to the penis

What are the 3 regions of the male urinary tract

Prostatic

Membranous

Penile

What is the structure called that the vas deferents go into

The ejactulatory duct found in the prostatic region of the urethra

Urethral crest

Long fold in the posterior wall of urethra - stops passage of sperm into the bladder

Sphincter urethrae

The muscles which control the opening of the bladder into the urethra

Prostatic utricle

Represents the origin of where the vagina and uterus would have been

What is secreted by the membranous urethra

glycoproteins in mucous during sexual arousal

What is the function of the mucous produced in sexual arousal

Lubricates the urethra and penis

Removes debris and pathogens

Neutralises acidity

Are the gonads of the female internal or external

Internal

What differs between the male and female reproductive and urinary tracts

The males have a shared reproductive and urinary tract

Females have different reproductive and urinary tracts

Outline the reproductive anatomy of a female

The urinary tract lies anterior to the reproductive tract

The bladder lies superior to the uterus

What is the round ligament

Maintains anteflexion of uterus

What is the broad ligament

Has a minor role in keeping the uterus forward

Fundus

the top of the uterus which is rounded

Fimbriae

the region of the uterine tube which will catch the eggs

Suspensory ligament

Not a functioning ligament but contains blood supply of the ovaries - it connects to the anterior abdominal wall

Ovarian ligament

connects ovary and lateral aspect of the uterus

Rectourine pouch

Double fold of peritoneum between rectum and back wall of uterus

What are the 3 main stages of life before birth

Week 1 - pre implantation

Week 2-8 - embryonic stage so the connection is made between the embryo and the mother and the development of organs and placenta

Week 9-38 - Foetal stage, lots of growth and development

What is the placenta

The supporting organ in pregnancy

What is ovulation

Where an egg is released from the ovary and if sperm is present then it can fertilise the egg to create a zygote

What does a zygote contain

Both paternal and maternal genetic material

What happens to the zygote once it has formed

It undergoes cleavage

What is cleavage

Cleavage is cell division so the zygote now becomes a bundle of cells

Where does cleavage occur

All the way down the uterine tube until the embryo makes it way to the uterus

What should begin to occur around day 7 of life before birth

The embryo should be in the uterus and ready for implantation

What happens to the cell during cleavage

It divides but the size of the embryo will stage the same, this means the individual cells get smaller but the number gets larger

Why does the size of the embryo in week 1 have to stay the same size

This is to allow the zygote to move through the uterine tube easily without getting stuck

What is the narrowest part of the uterine tube called

Isthmus

Zona pellucida

This is a glycoprotein coat which coats the zygote

Role of the zona pellucida

To prevent premature implantation

Prevent embryo enlargement

What is the morula formation

Around day 4 of fertilisation, the cells clump together using tight junctions and this can increase cell communication

This allows the zygote to enter the uterus and implant

When cells become damaged and die, how does this not cause an impact in the early developing zygote

This is due to all of the cells in the zygote having the same function, so when a cell is damaged or dies then the other cells can compensate.

When the embryo becomes a zygote what happens to the function of the cells

They will decide whether they will be an embryo cell or a placenta cell

If they are going to be a placenta cell then they need to decide what function of embryo cell they will have

When does blastocyst formation occur

Day 5/6

What are the key features of a blastocyst

Cells clumped together called inner mass cell

Cells clumped together around the outside called the trophoblast

Blastoseal - cavity filled with fluid, this will enlarge as the blastocysts develop to allow for blastocyst hatching

What will the inner mass cell form

Embryological tissue and extra embryonic structures

What will the trophoblast cells form

The placenta

How does the blastocyst implant into the uterus

The blastocyst will fill up with fluid called a blastoseal, this will then burst and remove the zona pellucida from the embryo and the cells can now become bound to the uterine wall

Define implantation

The interaction between the embryo and the endometrial wall of the uterus

What cell is a key part of week 2 development

Trophoblasts

What is the process called when the blastocyst makes contact with the endometrium of the uterus

Decidualisation

Where does decidualisation occur

The stroma cells of the uterus

What will the stromal cells of the uterus form

Th maternal component of the placenta

What does decidualisation cause

Several changes to the endometrium to prepare it for pregnancy

What does decidualisation trigger

Production of several molecules and promotes trophoblasts to be invasive

What do the closest inside of the embryo become

Cytotrophoblast - a single layer of cells

What is the outer invasive layer of an implanting trophoblast

Syncytiotrophoblast

What cells to the trophoblast cells become

Cytotrophoblast

Syncytiotrophoblast

What layers do the inner cell mass become

Epiblast

Hypoblast

What does the epiblast and hypoblast make up

The bilaminar disc

What hormone is produced by the syncytiotrophoblast cells

Human chorionic gonadotrophic hCG

What is the clinical relevance of hCG

This is what is detected by a pregnancy test

What is the role of the syncytiotrophoblast

Communicate to the maternal side of the placenta and they can establish a connection in order to allow for nutrient, gas exchange, via a blood supply

What can occur when implantation occurs in the wrong place

AN ectopic pregnancy

What can cause ectopic pregnancy

Slow transit through uterine tube, premature implantation

What are the 4 extra embryonic membranes

Amnion

Chorion

Yolk sac

Allantois