Lab 5: Radiology of the Abdomen & Pelvis, Urinary System, Reproductive System
Learning Objectives:
- Identify and describe the anatomical structures of the kidney.
- Identify the structures of the urinary system and its blood supply.
- Identify the anatomy of the female and male reproductive systems.
- Identify the structures of the pelvis using multiple imaging modalities.
Terms to Know
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Vasculature
Kidney
Urinary Tract
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Female Reproductive System
Male Reproductive System
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Introduction
In this lab, you will explore the organs of the urinary system and the male and female reproductive systems. You will also observe the abdominal aorta and the arteries that branch off of the aorta along its path through the abdominal cavity. As you are using the tools and specimens in the lab today, keep in mind that not all structures will be visible using all tools.
Lab Activity 1: Urinary and Reproductive Systems – Anatamage Navigator
The navigator model has female anatomy, so you will only explore female reproductive anatomy in this section. You can review the male reproductive anatomy with the cadaveric tissue, atlas images, and digital atlas. First, ensure that the Navigator is on the correct settings. You should be able to see all of the internal pelvic organs present in the 3D model. If this is not the case, click on the eye (view) icon on the toolbar and choose another preset. Be sure to view the structures in all three planes.
- Explore the kidneys, ureters, bladder, uterus, uterine tubes, and ovaries in the 3D printed model.
- Also, observe the renal arteries and veins that carry blood to each kidney. Notice that the ureters and vasculature all enter/exit the kidney in the same area. As in the lung, this region is called the hilum.
- Posterior to the bladder, observe the uterus, oviduct, and ovaries, which are structures of the female reproductive system. Though not visible in this model, the rectum would sit just posterior to the uterus. Notice the spaces between these structures. The vesicouterine pouch is located between the bladder and the uterus, while the rectouterine pouch is located between the uterus and the rectum. These pouches represent the most inferior portions of the abdominal cavity. Fluids and infections within the abdominal cavity can accumulate in these pouches, especially in the rectouterine pouch. The rectouterine pouch is also the preferred place for peritoneal dialysis, a form of dialysis used in end-stage renal (kidney) failure patients.
- Observe the kidneys in cross-section. These organs are located along the posterior abdominal wall. You can see the renal medulla/renal pyramids and the renal cortex in cross-section.
- Observe the bladder, uterus, and rectum in cross section, and view the vesicouterine and rectouterine pouches, particularly in the sagittal plane. You can also see the ovaries and uterine tubes, though they can be more difficult to discern in these cross-sections.
Lab Activity 2: Urinary and Reproductive Systems – Digital Atlas
- Open the Atlas app and go to the Digestive System Views. Click on 8. Stomach Vasculature. Click twice on veins in the column at the left to remove the veins and give you a better view of the arteries.
- Observe the aorta.
- Ascending aorta: the portion of the aorta that carries blood superiorly as it leaves the heart. This is difficult to see on these aortas, but it can be seen in the hearts.
- Arch of the aorta: the portion of the aorta the forms an arch between the ascending and descending aorta. Though the aorta has been cut open, you can generally still appreciate the arch of the aorta on this tissue.
- Descending aorta: the portion of the aorta carrying blood inferiorly. The portion of the descending aorta located in the thorax is called the thoracic aorta, while the portion located in the abdomen is called the abdominal aorta.
- Between the liver and stomach, click on the celiac trunk branching off of the descending aorta. It is a midline, unpaired artery.
- Three branches of the celiac trunk supply the digestive tract from the inferior esophagus through the first half of the duodenum of the small intestines and the spleen and liver: the common hepatic artery, splenic artery, and left gastric artery. You observed these branches in the previous lab, and you can see them in this view in the digital atlas.
- Hide the stomach, body of the pancreas, transverse colon, ileum, and jejunum. Click on the superior mesenteric artery, which branches from the aorta just inferior to the celiac trunk. Notice its branches that supply the second half of the duodenum of the small intestines to the first 2/3 of the transverse colon.
- Click on the inferior mesenteric artery, which branches from the aorta more inferiorly. Notice its branches supply the digestive tract from the distal 1/3 of the transverse colon to the rectum.
- Click on Arteries in the column at the left to show the rest of the arteries. The most inferior aspect of the aorta branches into the right and left common iliac arteries. The common iliac arteries then branch into the internal iliac artery, which supplies pelvic and gluteal structures, and the external iliac artery, which supplies the lower extremity.
- Click on Veins in the column at the left to show the veins again. Observe the inferior vena cavaascending next to the aorta. This vessel carries blood from the legs and abdomen back to the heart.
- Observe the aorta.
- Go to the Urinary System Views click on 10 or 11. Renal Vasculature. From this view, you will be able to identify the following structures to know for this lab; Renal Pyramids, Renal Pelvis, Ureter, Renal Arteries, Renal Veins, Inferior Vena Cava, Descending Aorta. You will not be able to see all of the structures from the list of structures under Kidney. You will have to rotate the figure around, zoom, zoom out, and tap on the structures to find exactly what you are looking for. As with all of the structures, feel free to click on the book icon to read a little further on the function of the structure.
- Back to the systems view, open the Urinary System View again, and click on 18 or 19. Bladder Section (M or F). From this view, you will identify the following Urinary Tract structures; Ureters, Urinary Bladder, Urethra (Male only – Prostatic Urethra, Membranous Urethra, Spongy Urethra), Prostate Gland, Testes, Epididymis, (Vas) Ductus Deferens. (***NOTE, to see the different parts of the male urethra, you will have to hide the muscles of the penis; ischiocavernosus, corpus cavernosum, and bulbospongiosus). You will have to rotate the figure around, zoom, zoom out, and tap on the structures to find exactly what you are looking for. As with all of the structures, feel free to click on the book icon to read a little further on the function of the structure.
- Back to the systems view, open the Reproductive System View and click on 2. Pelvic Region (M). From this view, you can identify most of the male reproductive system structures: Testes, Epididymis, (Vas) Ductus Deferens, Prostate Gland, and Penis. (**To see the Glans, Corpus Cavernosum, Corpus Spongiosum, Testicular Artery, and Pampiniform Plexus, you will have to hide the fascial layers of the penis and testes twice, then these structures will be visible.) Again, you will have to rotate the figure around, zoom, zoom out and tap on the structures to find exactly what you are looking for. As with all of the structures, feel free to click on the book icon to read a little further on the function of the structure.
- Back to the systems view, open the Reproductive System View again, and click on 18. Location of Organs (F). From this view, you will appreciate where the female reproductive organs are in relation to the pelvis. You will be able to see the following structures; Ovaries, (Fallopian) Uterine Tubes, Uterus, Vagina, Labia Majora, and Minora, as well as the Clitoris. Again, you will have to rotate the figure around, zoom, zoom out, and tap on the structures to find exactly what you are looking for. As with all of the structures, feel free to click on the book icon to read a little further on the function of the structure.
- Back to the systems view, open the Reproductive System View again and click on 3. Internal Genitalia (M), 9. External Genitalia (M), 17. Internal Genitalia (F) and 22. External Genitalia (F). These views will allow you to see the internal and external genitalia and allow you to remove surrounding structures and layers to see more anatomy of the region. As with all of the structures, feel free to click on the book icon to read a little further on the function of the structure.
Lab activity 3: Full Cadaver Tissue and additional donor tissue
Observe the structures of the urinary system and reproductive system on the full cadaver. Begin by observing the kidneys. Both have evidence of renal cysts or fluid-filled sacs, with more on the left kidney. The kidneys remove waste products from the blood and work to control fluid and electrolytes in the body. The latter function allows them to play a role in blood pressure regulation as well. Observe the renal artery and renal veins supplying and draining blood from the kidneys, respectively. Also observe the ureter leaving each kidney and traveling inferiorly to the posterior wall of the bladder.
Also examine the donor tissue kidney, which has been opened. Comparing these structures to an atlas image, observe the following features:
- Renal cortex
- Renal pyramids
- Renal medulla (Darker area made up of the renal pyramids)
- Major calyx
- Minor calyx
- Renal pelvis
- Renal column
Examine the hilum of the kidney. This is where the renal arteries enter the kidneys, and the renal veins and ureters exit the kidneys.
Male donor
Follow the ureters and observe how the ureters enter the inferior posterior aspect of the bladder. The ureters carry urine to the bladder, where the urine is stored until it is expelled through the urethra. They enter the bladder at an angle. As the bladder fills with urine, the pressure on the ureters within the wall of the bladder increases and prevents the backflow of urine into the ureters. Note the size of the ureters and imagine passing a kidney stone through these structures. The ureters are highly innervated, and passing kidney stones are excruciating. If the stone is too large, it cannot pass through these narrow structures and remains in the kidney. In atlas images, observe the urethra. The male urethra has three parts: the prostatic urethra, membranous urethra, and spongy urethra. The prostatic urethra is surrounded by the prostate gland. The female urethra is much shorter and is positioned anterior to the vagina.
Posterior to the bladder, view the ductus deferens. This structure travels from the testicle through the spermatic cord and inguinal canal into the pelvic cavity. The inguinal canal has been surgically repaired on the right side, while the left side shows evidence of an inguinal hernia. The rest of its pathway is not visible in the cadaver. Now notice the artery traveling from the aorta into the spermatic cord. This is the testicular artery that supplies the testicle with blood. It is traveling through the abdominal cavity with the testicular vein. You can observe some of the pampiniform plexus of veins around the testicular artery in the spermatic cord, especially on the right where the cord is still bound by fascia.
Observe the testes and the epididymis. The left testicle has been cut in cross section. Observe the difference in the internal structure of the epididymis compared to the testicle.
Now observe the penis. It has also been sectioned to show the internal anatomy of the corpora cavernosa superiorly and the corpus spongiosum inferiorly. The glans and external urethral orifice are both visible distally.
Gently move the abdominal organs to the side to view the abdominal aorta. Also observe the celiac trunk and superior mesenteric artery near each branching from the aorta just inferior to the diaphragm. These arteries supply the majority of the digestive organs. They are single, midline arteries. Just inferior to the superior mesenteric artery, the renal arteries branch from the aorta to supply the kidneys. The inferior mesenteric artery is a single midline artery branching from the aorta just before it ends in the inferior abdomen. It supplies the last 1/3 of the transverse colon through the end of the digestive tract.
Female Donor
Gently move the intestines superiorly to observe female reproductive organs. You will see the uterus deep in the pelvis. It is about the size of a fist, if not a bit smaller. That is, in part, because our donor was in her mid 70s, many years post-menopause. The uterus and ovaries become smaller in size with more time post-menopause. These organs would be larger in a female of reproductive age. Observe the uterine tubes travelling laterally from the superior corners of the uterus. At the lateral end of the uterine tubes you can see the fimbriae, or short finger-like projections from the widened ampulla of the uterine tube. The fimbriae function to help sweep the oocyte into the uterine tube after ovulation. Also observe the ovaries. The ovaries appear somewhat granular and extend posteriorly and inferiorly in our donor, posterior to the uterine tubes.
You can also observe ligaments that we discuss in lecture. The ovarian ligament extends off of the ovary. The broad ligament is the tissue overlying the reproductive structures. Most of this ligament has been removed to show the uterus. You can also observe the round ligament travelling laterally from the uterus and towards the inguinal canal. You will not be asked to identify these ligaments in the lab course. However, observing them here may provide context to what you previously learned or will learn in lecture.
Lastly, observe the vesicouterine pouch anterior to the uterus and the rectouterine pouch posterior to the uterus. The bladder is covered by peritoneum in this case, but you can observe the intraperitoneal vesicouterine pouch between the uterus and bladder here. You can also observe the rectouterine pouch between the uterus and rectum.
Lab activity 4: Pelvic Radiology
View the imaging presentation of the pelvis on the lab computers. You will have the opportunity to see X-Ray imaging, CT imaging, and a fluoroscopic study of the pelvis. As you are watching the images, we would like you to identify the anatomical structures presented to you. You may not be able to see all of the structures from each view. (An HSG is a fluoroscopic image where dye is injected into the uterus to evaluate for blockages of the uterine tubes.)
X-Ray
- Lumbar vertebrae
- Inter-vertebral Space (what fits here?)
- Ribs (which ones can you see and what vertebrae do they originate from?)
- Liver
- Colon
- Bladder
- HSG
- Uterus
- Fallopian Tubes
CT
- Lungs
- Liver
- Spleen
- Kidneys
- Renal Arteries
- Stomach
- Small intestine
- Large intestine
- Descending Aorta
- Common Iliac Artery
- Hepatic Portal Vein
- Bladder
