5 Pelvis, Urinary System, Reproductive System | Radiology of the Pelvis
Learning Objectives:
By the end of this lab, students will be able to:
- 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.
Lab Activities
Activity 1: Urinary System
Watch the videos on Canvas exploring the kidneys, ureters, and bladder. Also, observe the structures of the urinary system in the Abrahams’ and Netter’s (kidney & bladder) atlases.
- Examine the kidneys. The kidneys function to filter our blood, keeping nutrients and fluids in the blood while removing waste products from the blood. Observe the following features:
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- Renal cortex
- Renal pyramids
- Renal medulla (Darker area made up of the renal pyramids)
- Major calyx
- Minor calyx
- Renal pelvis
- Renal column
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- Examine the hilum of the kidney. This is where the renal arteries enter the kidneys, and the renal veins and ureters exit the kidneys. Also, observe the renal arteries branching from the abdominal aorta and the renal veins draining into the inferior vena cava.
- Observe the ureters leaving the kidney and traveling inferiorly. The ureters enter the inferior posterior aspect of 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 female urethra is much shorter and is positioned anterior to the vagina.
Activity 2: female and male reproductive systems
Watch the videos on Canvas exploring the female reproductive system and identify these structures in the Abrahams’ and Netter’s atlases.
- Observe the muscular uterus. It has been cut in the coronal plane (roughly) and opened in the tissue video. The uterus houses the embryo/fetus as it develops during the 40 weeks of pregnancy. You can also see the cervix in cross-section and follow it inferiorly to observe the opening to the vagina.
- Observe the uterine (fallopian) tubes and ovaries. Follow the uterine tubes and observe the fimbriae near the ovary. These finger-like projections function to gently sweep the oocyte from the ovary into the uterine tube, as these two structures are not connected.
- In the atlas images, observe the external genitalia of the female reproductive system, including the labia majora, labia minora, and clitoris.
- In sagittal cross-sectional images, you can observe the vesicouterine pouch anterior to the uterus, between the uterus and the bladder, and the rectouterine pouch posterior to the uterus, between the uterus and the rectum. 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.
- Using the 3D image below, can you identify the ovaries, uterine tubes, uterus, vagina, labia majora, labia minora, and clitoris? (not all structures have annotations, and there are more annotations than you need to know)
Watch the videos on Canvas exploring the male reproductive system and identify these structures in the Abrahams’ and Netter’s atlases.
- Observe the gland just inferior to the bladder. This is the prostate gland. Observe the tube-like structures coming from the area of the prostate gland. These are the right and left ductus (vas) deferens. The ductus deferens carries sperm from the epididymis in the testes to the ejaculatory duct.
- Follow the ductus deferens towards the bladder and notice that it is increasing in size as it reaches its end. This is called the ampulla. The ampulla then meets the seminal vesicle, which you can observe next to the ampulla, to form the short ejaculatory duct. Then the contents of the ejaculatory duct enter the prostatic urethra. The prostatic urethra is surrounded by the prostate gland.
- Observe the spermatic cord. The spermatic cord contains the ductus (vas) deferens, as well as the testicular artery and pampiniform plexus of veins.
- Observe the testes. Notice the epididymis as well as the origin of the ductus deferens.
- Observe the anatomy of the penis, including the glans, external urethral orifice, corpora cavernosa, and corpus spongiosum.
- Using the 3D image below, can you identify the spermatic cord (housing the testicular artery, pampiniform plexus, and ductus (vas) defferens), testes, epididymis, ductus deferens, ampulla, seminal vesicles, prostate gland, penis, glans, corpora cavernosa, and corpus spongiosum?
Activity 3: Aorta and its branches in the abdominopelvic cavity
Watch the videos on Canvas exploring the aorta and its branches. Also, observe these structures in this image from the Netter’s atlas.
- Observe the aorta. In the tissue videos, the aorta has been opened.
- 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 that is located in the thorax is called the thoracic aorta, while the portion located in the abdomen is called the abdominal aorta.
- In the superior abdominal region of the descending aorta, you will observe two midline arteries branching, one just superior to the other. These are the celiac trunk (superior) and the superior mesenteric artery (inferior). These are usually located just superior to where the renal arteries (going to the kidneys) branch. 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, as well as the spleen and liver: the common hepatic artery, splenic artery, and left gastric artery. You observed these branches in the previous lab. The superior mesenteric artery supplies the second half of the duodenum of the small intestines to the first 2/3 of the transverse colon. The superior mesenteric artery angles slightly downward, while the celiac trunk branches are roughly perpendicular to the aorta.
- Move inferiorly and observe the inferior mesenteric artery. This artery branches at an angle downward (inferiorly). The inferior mesenteric artery supplies the digestive tract from the distal 1/3 of the transverse colon to the rectum.
- At the most inferior aspect of the aorta, observe how it 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.
- Also, observe the inferior vena cava ascending next to the aorta. Its walls are much thinner than the aorta. This vessel carries blood from the legs and abdomen back to the heart.
- Using the 3D image below, can you identify the descending aorta and associated branches. The 3D image is unique because it is a case of an aneurism in the aorta just proximal to the split into the common iliac arteries. You will also notice the inferior mesenteric artery is displaced due to the aneurism.
Activity 4: Cross-sectional Anatomy of the urinary and reproductive systems
Watch the video on Canvas that reviews the cross-sectional anatomy of the urinary and reproductive systems. Like the organs of the digestive system in the abdominal cavity, we often view these organs in cross-section via CT or MRI images. If you can understand the cross-sectional anatomy in the color images in the video, it will be easier to understand what you see in the radiology images.
Activity 5: Pelvic Radiology (uRINARY AND REPRODUCTIVE SYSTEMS)
View the radiology video in Canvas presenting on the radiology of the pelvic cavity, specifically the urinary and reproductive organs. You will also see the anatomy of the kidneys through radiology images in the abdominal cavity. The slides will also be posted as a study tool. Observe the following structures in the radiology images.
- Kidneys
- Bladder
- Ureters
- Uterus
- Fallopian Tubes
- Renal Arteries
- Descending Aorta
- Common Iliac Artery
WRAP UP AND Clinical Connection
For today’s clinical connection, we will discuss the clinical evaluation of the abdomen – utilizing palpation, auscultation, and percussion. Auscultation is performed by listening to the abdominal cavity with a stethoscope for altered bowel sounds (auscultation means listening to the sounds made by various body structures). Percussion is performed by tapping on the surface of the abdomen and listening to hear a dull or resonant sound. Palpation is the physical touching of the abdomen to evaluate for areas of rigidity, softness, and pain/rebound tenderness. Watch this video to learn more about how a clinician performs a physical exam of the abdomen.