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Anatomy Spring Block I Review
n/a
412
Anatomy
Graduate
02/03/2012

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Cards

Term
What are the boundaries of the perineum?
Definition
Pubic symphysis, ischiopubic rami, ischial tuberosities, sacrotuberous ligaments, tip of coccyx
Term
What makes up the roof of the perineum?
Definition
Pelvic diaphragm
Term
What divides the perineum into an anterior urogenital triangle and a posterior anal triangle?
Definition
An invisible line connecting the two ischial tuberosities
Term
The superficial perineal space lies between what structures?
Definition
Inferior fascia of the urogenital diaphragm (perineal membrane) and membranous layer of the superficial perineal fascia (Colles's fascia)
Term
What are the contents of the superficial perineal space?
Definition
Superficial transverse perineal muscle, ischiocavernosus muscles, crus of the penis/clitoris, bulbospongiosus muscles, bulb of the penis or vestibular bulbs, central tendon of the perineum, greater vestibular bulbs (in females), branches of the internal pudendal vessels, perineal nerve and its branches
Term
The deep membranous layer of the superficial perineal fascia that forms the inferior boundary of the superficial perineal pouch is known as what?
Definition
Colles's fascia
Term
Colles's fascia is continuous with what?
Definition
Dartos fascia, superficial fascia of the penis, and Scarpa's fascia
Term
Extravasated urine may result from a rupture of the bulbous portion of the spongy urethra and may pass into where?
Definition
Superficial perineal space and inferiorly into scrotum
Term
The inferior fascia of the urogenital diaphragm that divides the superficial and deep perineal pouch is known as what?
Definition
Perineal membrane
Term
What forms the crus of the penis or clitoris?
Definition
Corpus cavernosum
Term
What muscle inserts into the corpus cavernosum?
Definition
Ischiocavernosus muscle
Term
What role does the ischiocavernosus play during penile erection?
Definition
Compresses the crus and the deep dorsal vein of the penis
Term
What innervates the ischiocavernosus muscle?
Definition
Perineal branch of the pudendal nerve (S2-4)
Term
What muscle inserts into the corpus spongiosum?
Definition
Bulbospongiosus muscle
Term
What innervates the bulbospongiosus muscle?
Definition
Perineal branch of the pudendal nerve (S2-4)
Term
What muscle stabilizes the central tendon/perineal body by inserting into it?
Definition
Superficial transverse perineal muscle
Term
What innervates the superficial transverse perineal muscle?
Definition
Perineal branch of the pudendal nerve (S2-4)
Term
What fibromuscular mass lies in the center of the perineum between the anal canal and the vagina/bulb of the penis?
Definition
Perineal body/central tendon of the perineum
Term
The perineal body/central tendon of the perineum serves as an attachment site for what structures?
Definition
Superficial and deep transverse perineal muscles, bulbospongiosus, levator ani, and external anal sphincter muscles
Term
What is the function of the greater vestibular (Barotholin's) glands?
Definition
Lubricates vagina during coitus
Term
What are the contents of the deep perineal space?
Definition
Deep transverse perineal muscle, urethral sphincters, membranous part of the urethra, bulbourethro (Cowper's) glands in males, branches of the internal pudendal vessels/nerve
Term
Which urethral sphincter is composed of smooth muscle and is involuntary?
Definition
Internal urethral sphincter
Term
Which urethral sphincter is composed of skeletal muscle and is voluntary?
Definition
External urethral sphincter
Term
What forms the urogenital diaphragm?
Definition
Deep transverse perineal muscle and urethral sphincters
Term
Ducts from the bulbourethral (Cowper's) glands in the deep perineal space open at what point?
Definition
Bulbous portion of the spongy penile urethra
Term
The potential space on either side of the anorectum separated from the pelvis by the levator ani is known as what?
Definition
Ischiorectal fossa
Term
What are the contents of the ischiorectal fossa?
Definition
Ischioanal fat, inferior rectal nerves/vessels, perineal branches of the posterior femoral cutaneous nerve, pudendal canal on its lateral wall
Term
What are the muscles of the anal triangle?
Definition
Obturator internus, external anal sphincter, levator ani, coccygeus
Term
What muscles directly support and raise the pelvic floor?
Definition
Levator ani and coccygeus
Term
The fascia of the penis that is a continuation of the deep perineal is known as what?
Definition
Buck's fascia (deep fascia of the penis)
Term
What is the name of the dense fibrous layer that envelopes both the corpora cavernosa and corpus spongiosum?
Definition
Tunica albuginea
Term
What serous sac of the peritoneum covers the front and sides of the testis and epididymis as well as forming the innermost layer of the scrotum?
Definition
Tunica vaginalis
Term
What structure forms the canal of Nuck and is related to both indirect inguinal hernias and hydrocele?
Definition
Processus vaginalis
Term
What fetal cord connects the fetal testis to the floor of the developing scrotum and helps testis descend during development?
Definition
Gubernaculum
Term
What does the gubernaculum become in females?
Definition
Ovarian ligament, round ligament of the uterus
Term
What makes up the scrotum?
Definition
Thin skin and underlying dartos?
Term
What retracts the scrotum?
Definition
Wrinkling is by the dartos, cremaster elevates the testis
*insert Seinfeld reference here*
Term
What innervates the scrotum?
Definition
Scrotal branch of the ilioinguinal, genital branch of genitofemoral, posterior scrotal branch of the perineal branch of the pudendal, perineal branch of the posterior femoral cutaneous
Term
An accumulation of fluid in the tunica vaginalis is known as what?
Definition
Hydrocele
Term
Hemorrhage into the cavity of the tunica vaginalis due to injury to the spermatic vessels is known as what?
Definition
Hematocele
Term
An enlargement of the pampiniform venous plexus of the spermatic cord is known as what?
Definition
Varicocele ("bag of worms")
Term
What composes the root of the penis?
Definition
Two crura and the bulb of the penis
Term
What makes up the body of the penis?
Definition
Single corpus spongiosum and paired corpora cavernosa
Term
What forms the glans penis?
Definition
Terminal part of the corpus spongiosum
Term
What forms the mons pubis?
Definition
Labia majora
Term
What forms the prepuce of the clitoris?
Definition
Upper part of the labia minora
Term
What forms the frenulum of the clitoris?
Definition
Lower part of labia minora
Term
The space or cleft between the labia minora is known as what?
Definition
Vestibule of the vagina (urogenital sinus)
Term
What tissue forms the glans clitoris?
Definition
Corpus cavernosa
Term
What covers the bulbs of the vestibule?
Definition
Bulbospongiosus
Term
Where does the pudendal nerve (S2-4) leave the pelvis?
Definition
Greater sciatic foramen between the piriformis and coccygeus muscles
Term
What does the pudendal (S2-4) nerve cross as it enters the perineum?
Definition
Ischial spine
Term
What nerves does the pudendal nerve give off and where does it terminate?
Definition
Inferior rectal and perineal nerve, terminates as the dorsal nerve of the penis/clitoris
Term
How is a pudendal nerve block performed?
Definition
Inserting a needle through the posterolateral vaginal wall toward the ischial spine or subcutaneously through the buttock on the medial side of the ischial tuberosity
Term
What does the inferior rectal nerve innervate?
Definition
External anal sphincter, skin around the anus
Term
What are the branches of the perineal nerve?
Definition
Superficial branch (scrotum and labia majora) and deep branch (perineal muscles)
Term
The internal pudendal artery arises from what?
Definition
Internal iliac artery
Term
How does the internal pudendal artery leave the pelvis?
Definition
Greater sciatic foramen between the piriformis and coccygeus muscles
Term
How does the internal pudendal artery enter the perineum?
Definition
Via lesser sciatic foramen over the ischial spine
Term
What arteries are given off by the internal pudendal artery?
Definition
Inferior rectal, perineal, artery of the bulb, urethral artery, deep arteries of the penis/clitoris, dorsal artery of the penis/clitoris
Term
Deep arteries of the penis/clitoris run through what structure?
Definition
Corpus cavernosum
Term
What gives off the external pudendal artery?
Definition
Femoral artery
Term
How does the external pudendal artery enter the pelvis?
Definition
Through the saphenous ring, passes medially over the spermatic cord or round ligament of the uterus
Term
What does the external pudendal artery supply?
Definition
Skin above the pubis, penis, scrotum, or labium majus
Term
What does the deep dorsal vein of the penis drain to?
Definition
Prostatic and pelvic venous plexuses
Term
What does the superficial dorsal vein of the penis drain to?
Definition
Terminates in superficial pudendal veins which drain into the greater saphenous
Term
What drains lymph from most of the perineum?
Definition
Superficial inguinal lymph nodes to external iliac nodes
Term
What drains lymph from the glans penis/clitoris?
Definition
External iliac nodes
Term
What drains lymph from the uppermost part of the rectum?
Definition
Inferior mesenteric nodes to the aortic nodes
Term
What drains lymph from the testis/ovaries and epididymis?
Definition
Aortic nodes
Term
What are the contents of the broad ligament of the uterus?
Definition
Uterine tube, uterine vessels, round ligament of the uterus, ovarian ligament, lower part of ureter, uterovaginal nerve plexus, lymph vessels
Term
The mesovarium connects what structures?
Definition
Anterior surface of ovary with the posterior layer of the broad ligament
Term
What part of the broad ligament suspends the uterine tube?
Definition
Mesosalpinx
Term
What is the major part of the broad ligament found below the mesoalpinx and mesovarium?
Definition
Mesometrium
Term
The round ligament can be distinguished as it enters what structure?
Definition
Inguinal canal at the deep inguinal ring
Term
What fibromuscular cord extends from the ovary to the uterus below the uterine tube and runs within the broad ligament?
Definition
Ovarian ligament
Term
What band of peritoneum extends upward from the ovary to the pelvic wall and transmits ovarian vessels, nerves, and lymphatics?
Definition
Suspensory ligament of the ovary
Term
What fibromuscular condensation of pelvic fascia extends laterally below the base of the broad ligament, providing support to the uterus?
Definition
Transverse cervical ligament (Cardinal ligament) of the uterus
Term
What ligaments extend from the posterior surface of the pubis to the cervix of the uterus?
Definition
Pubocervical ligaments
Term
What ligament extends from the neck of the bladder or the prostate gland in males to pelvic bone?
Definition
Pubovesical (female) or puboprostatic (male) ligaments
Term
What sac or recess formed by a fold of peritoneum dips down between the rectum and the uterus?
Definition
Rectouterine pouch
Term
What is the peritoneal recess between the bladder and rectum in males?
Definition
Rectovesical pouch
Term
What is the pertioneal sac between the bladder and uterus in females?
Definition
Vesicouterine pouch
Term
What is clinically significant about the rectouterine pouch?
Definition
Lowest point of the peritoneal cavity, can accumulate fluid
Term
What are the three possible constriction points of the ureter?
Definition
Renal pelvis, pelvic brim, junction with the bladder
Term
What has an elevated chance of being injuring during a hysterectomy?
Definition
Ureter
Term
What are found at the corners of the trigone in the bladder?
Definition
Ureters enter the bladder the corners, internal urethral orifice bound by the internal sphincter is the exit
Term
The smooth muscle fibers of the urinary bladder are called what?
Definition
Detrusor muscle of the bladder
Term
What drains blood from the bladder?
Definition
Prostatic plexus
Term
What supplies blood to the bladder?
Definition
Superior vesical artery, inferior vesical (vaginal artery in females) artery
Term
What provides parasympathetic innervation to the bladder and what are its effects?
Definition
Pelvic splanchnic nerve (S2-4_ for detrusor muscle contraction, relaxation of the internal urethra sphincter
Term
What effect does sympathetic innervation have on the bladder?
Definition
Relaxes detrusor muscles and constricts the internal urethra sphincter
Term
What initiates the need to urinate?
Definition
Stretch receptors in the detrusor muscle of the bladder wall
Term
What structure functions in the maturation and storage of spermatozoa?
Definition
Epididymis
Term
A vasectomy is a surgical excision of what duct that transmits spermatozoa from the epididymis to the ejaculatory duct?
Definition
Ductus defernes/vas deferens
Term
What forms the ejaculatory duct?
Definition
Union of the ductus deferens with the ducts of the seminal vesicles
Term
Where does the ejaculatory duct open into the prostatic urethra?
Definition
Seminal colliculus lateral to the prostatic utricle
Term
Where does spermatozoa develop?
Definition
Seminiferous tubules of the testicle
Term
What produces the fructose and choline rich seminal fluid that is added to semen?
Definition
Seminal vesicles
Term
Where does the seminal vesicle join the ejaculatory duct?
Definition
Ampullae of the ductus deferens
Term
What are the different lobes of the prostate gland?
Definition
Anterior, middle, posterior, right and left lateral lobes
Term
What part of the prostate gland is prone to benign hypetrophy that may obstruct the internal urethral orifice?
Definition
Middle lobe
Term
What part of the prostate gland is prone to cancer?
Definition
Posterior lobe
Term
What part of the prostate gland forms the main mass of the gland?
Definition
Left and right lateral lobes
Term
What is the composition of the fluid the prostate contributes to semen?
Definition
Prostate-specific antigens, prostaglandins, citric acid, acid phosphatase, proteolytic enzymes
Term
Prostate gland ducts open into what structure? Where does it receive?
Definition
Prostatic sinus, receives ejaculatory duct which then opens intot he urethra on the seminal colliculus
Term
Erection depends on stimulation from what nerves?
Definition
Parasympathetic innervation from pelvic splanhnic nerves
Term
What type of innervation is required for ejaculation?
Definition
Sympathetic
Term
What drains blood from the ovary/testicles?
Definition
Testicular/ovarian veins, right goes to inferior vena cava, left goes to left renal vein
Term
Where does fertilization most often take place?
Definition
Ampulla of the uterine tube
Term
What is the normal position of the uterus?
Definition
Anteverted and anteflexed
Term
What are the three segments of the uterus ?
Definition
Internal os, cervical canal, external os
Term
What increases the chance of uterine prolapse?
Definition
Weakness of the muscles, ligaments, and fasciae of the pelvic floor, age, menopause
Term
What is endometriosis?
Definition
Benign disorder of the uterus where a mass of endometrial tissue occurs aberrantly in various locations, may form endometrial cancer
Term
What forms the recess between the cervix and the wall of the vagina?
Definition
Vaginal fornix
Term
What drains lymph from the vagina?
Definition
Upper 3/4 to the internal iliac nodes, lower 1/3 to the perineum and the superficial inguinal nodes
Term
What innervates the vagina?
Definition
Uterovaginal plexus for upper 3/4, deep perineal branch of the pudendal nerve for lower 1/4
Term
What is incised in a median epiostomy? Why would this be performed?
Definition
Posterior vaginal wall and central tendon in order to expand the birth canal
Term
What circular muscle layer in the rectum forms three transverse folds which support fecal mass?
Definition
Houston's valves
Term
What supplies blood to the rectum?
Definition
Superior, middle, inferior rectal arteries, middle sacral artery
Term
What drains blood from the rectum?
Definition
Superior rectal vein to the portal system, middle and inferior rectal veins to the inferior vena cava
Term
What provides parasympathetic innervation to the rectum?
Definition
Pelvic splanchnic nerve
Term
Where are anal columns found?
Definition
Upper half of the anal canal
Term
Which anal sphincter is composed of smooth muscle? Which is composed of skeletal muscle?
Definition
Internal and external anal sphincters respectively
Term
What line separates the visceral and somatic portions of the anal canal?
Definition
Pectinate line
Term
What drains lymph from the anal canal?
Definition
Internal iliac nodes above the pectinate line, superficial inguinal nodes below
Term
What innervates the anal canal below the pectinate line?
Definition
Inferior rectal nerve branch of the pudendal nerve
Term
What ventral rami form the saral plexus?
Definition
L4-5 and S1-4
Term
What is the continuation of the aortic plexus below the aortic bifurcation known as?
Definition
Superior hypogastric plexus
Term
What forms the inferior hypogastric plexus?
Definition
Hypogastric, pelvic splancnic, and sacral splanchnic nerves
Term
The sacral splanchnic nerves primarily consists of what types of fibers?
Definition
preganglionic sympathetic fibers
Term
What type of nerve fibers are carried by the pelvic splanchnic nerves (S2-4)?
Definition
Parasympathetic fibers (all other splanchnic nerves are sympathetic)
Term
The mesonepheric duct is the developmental origin of what structures?
Definition
Uteric bud which forms the ureter, renal pelvis, manjor and minor calyces, and collecting tubules, also the epididymal duct, vas deferens, ejaculatory duct, and seminal vesicles
Term
Which kidney lies lower in the abdomen and why?
Definition
Right due to liver
Term
What are the layers of coverings of the kidney from superficial to deep?
Definition
Pararenal fat, renal fascia, perirenal fat, renal capsule
Term
Where does the ureter and renal vessels enter or leave the kidney?
Definition
Hilum
Term
The kidneys lie on the vertebral wall at what vertebral levels?
Definition
T12-L3
Term
Where does the renal fascia fail to cover the kidney in fibrous connective tissue? What does this make kidneys susceptible to?
Definition
Inferior border of kidney, vulnerable to infection, dropped kidney (nephroptosis)
Term
What is the orientation of the contents of the hilum from anterior to posterior?
Definition
Vein, Artery, Ureter
Term
The medulla is made up an aggregation of what?
Definition
Renal pyramids
Term
The pale outer layer surrounding renal pyramids is known as what?
Definition
Renal cortex
Term
The striations extending from the base of the renal pyramids into the cortex are referred to as what?
Definition
Cortical labyrinths and medullary rays
Term
What extension of the cortex into the medulla lies in between renal pyramids as they extend into the medulla?
Definition
Renal columns
Term
Describe the subdivisions of the renal pelvis
Definition
Renal papilla form minor calyces which form major calyces which form the renal pelvis
Term
Apical projections of a renal pyramid that join to form a minor calyx is known as what?
Definition
Renal papilla
Term
What constitutes a kidney lobe?
Definition
A renal pyramid and surrounding cortical tissue, including renal columns
Term
What constitutes a kidney lobule?
Definition
Section of cortical and medulla tissue with a medullary ray in the middle
Term
What is the functional unit of the kidney?
Definition
Uriniferous tubule
Term
What are the parts that make up a uriniferous tubule?
Definition
Collecting tubule and its associated nephrons
Term
What functional parts are found within the renal cortex?
Definition
Cortical labyrinth (renal corpuscles, proximal and distal convoluted tubules), medullary rays (collecting tubules)
Term
What are the functional parts of the renal medulla?
Definition
Renal pyramids (loops of Henle, lower collecting tubules, Bellini ducts), renal papilla
Term
What is the path of circulation to the kidneys starting from the abdominal aorta to efferent glomerular arterioles?
Definition
Abdominal aorta -> renal artery -> segmental artery -> interlobar artery -> arcuate arteries -> interlobular artries -> afferent glomerular arterioles -> glomeruli -> efferent glomerular arterioles
Term
What are the capillaries supplied by efferent glomerular arterioles that supply the cortex and both nephrons?
Definition
Peritubular capillaries
Term
What are the capillaries supplied by efferent glomerular arterioles that supply the medulla, loop of Henle, and most of the juxtamedullary nephron?
Definition
Vasa recta spuria
Term
What receives venous blood from peritubular capillaries and vasa recta?
Definition
Stellate veins and venulae recta respectively
Term
What is the route of venous return from the kidneys?
Definition
Interlobular veins -> arcuate veins -> interlobar veins -> renal vein -> inferior vena cava
Term
Renal cell carcinomas grow outward of kidney into fat and fascia and can also travel elsewhere in the body by spreading to what?
Definition
Inferior vena cava
Term
What supplies and drains blood from the upper end of the ureter?
Definition
Renal artery/renal vein
Term
What supplies and drains blood form the middle portion of the ureter?
Definition
Testicular or ovarian artery, abdominal aorta, common iliac artery/gonadal vein
Term
What supplies and drains blood form the distal third of the ureter?
Definition
Branches of internal iliac artery and vein
Term
Where does lymph from the kidneys drain to?
Definition
Lateral aortic or lumbar nodes
Term
The right suprarenal gland lies behind what structures?
Definition
Inferior vena cava, right lobe of liver
Term
The left suprarenal gland lies behind what structures?
Definition
Pancrease, lesser sac of stomach
Term
What are the three layers, external to internal, of the cortex of the suprarenal glands?
Definition
Zona glomerulosa, Zona fasciculata, Zona reticularis
Term
Adrenal insufficiency is characteristic of what disease?
Definition
Addison's disease
Term
Excessive cortisol production is characteristic of what disease?
Definition
Cushing's syndrome
Term
Tumors of the adrenal medulla are known as what?
Definition
Pheochromocytoma
Term
What are the arteries that supply blood to the suprarenal glands superiorly to inferiorly?
Definition
Inferior phrenic artery, abdominal aorta, renal artery
Term
What drains blood from the right suprarenal gland?
Definition
Right suprarenal vein to inferior vena cava
Term
What drains blood from the left suprarenal gland?
Definition
Left suprarenal vein to left renal vein
Term
Where do preganglionic sympathetic fibers that innervate the adrenal medulla for the secretion of catecholamines originate?
Definition
T10-12
Term
What is the developmental origin of the kidneys and ureters?
Definition
Intermediate mesoderm
Term
The bulge formed by the intermediate mesoderm during folding of the embryo that forms most of the urogenital system is known as what?
Definition
Urogenital ridge
Term
What are the names of the three overlapping kidneys that develop in cranial-caudal succession during gestation?
Definition
Pronephros, mesonephros, metanephros
Term
The pronepheros forms what?
Definition
Vestigial excretory tubules and the pronephric duct which becomes the mesonephric duct
Term
When does the pronepheros appear and disappear?
Definition
4th week
Term
When does the mesonephros appear and disappear?
Definition
Late in 4th week of gestation, disappears by 8th week
Term
When does the mesonephric duct form?
Definition
Late in 4th week of gestation, disappears by 8th week
Term
What does the mesonephric duct form?
Definition
Majority of bladder and ductus deferens (males only)
Term
When does the metanephros appear?
Definition
5th week
Term
When is the metanephros able to function in order to produce urine?
Definition
9th week
Term
What parts of intermediate mesodermal origin does the metanephros develop from?
Definition
Metanephric diverticulum (uretic bud) and metanephric mesoderm (metanephrogenic blastema)
Term
How does the metanephric diverticulum develop?
Definition
From mesonephric duct which becomes the metanephric blastema before becoming the collecting system of the kidney
Term
What develops from the metanephric mesoderm?
Definition
Nephrons w/Bowman's capsules, convoluted tubules, loop of Henle, and an opening into a collecting tubule
Term
How long does it take to form roughly 1 million nephrons?
Definition
40 weeks
Term
Ascent of the kidneys stops once they come in contact with what?
Definition
Suprarenal glands
Term
What is the primary remover of nitrogenous wastes from the fetus prior to birth when that function is resumed by the kidneys?
Definition
Placenta
Term
Absence of proper kidney development occurs as a result of what?
Definition
Metanephric diverticulum fails to develop or degenerates
Term
Individuals lack of kidneys at birth (fatal) exhibits flattening face, hypoplastic lungs, limb deformities, etc., which are symptoms collectively labeled as what?
Definition
Potter sequence
Term
A fused kidney is known as what?
Definition
Discoid or pancake kidney
Term
A fused kidney that continues to rise on one side, bringing the other along with it, is known as what?
Definition
Crossed renal ectopia
Term
A duplication of the urinary tract results from what?
Definition
Division of the metanephric diverticulum
Term
Fusion of the poles of kidneys during development results in what?
Definition
Horseshoe kidney
Term
Horseshoe kidneys are most frequent in what demographic?
Definition
Women with Turner syndrome
Term
Multiple cysts of varying size resulting in severe renal insufficiency is symptomatic of what disease?
Definition
Polycystic kidney disease
Term
The piriformis exits the pelvis at what point to insert where?
Definition
Great sciatic foramen, greater trochanter of the femur
Term
What is the action performed by the piriformis muscle?
Definition
Lateral rotation of hip and abduction of the thigh
Term
Where does the obturator internus leave the pelvis and where does it insert?
Definition
Lesser sciatic foramen, greater trochanter of the femur
Term
What action is performed by the obturator internus muscle?
Definition
Lateral rotation of the thigh
Term
What is the origin of the levator ani muscles?
Definition
Posterior aspect of the body of the pubis, tendinous arch, and ischial spine
Term
What forms the tendinous arch in the pelvic wall?
Definition
Thickening of the pelvic fascia covering the obturator internus muscle
Term
The tendinous arch is incomplete anteriorly to allow passage for what?
Definition
Urethra, vagina in females
Term
What muscles form the levator ani muscles?
Definition
Iliococcygeus, pubococcygeus, puborectalis, levator prostate/sphincter vaginae
Term
What innervates the levator ani muscles and what are its nerve roots?
Definition
Perineal branches of S4
Term
Which U-shaped sling muscle that makes up part of the levator ani muscles is responsible for the anorectal flexure and plays a major role in maintaining fecal continence?
Definition
Puborectalis muscle
Term
What pelvic ligaments are unique to females?
Definition
Pubocervical, uterosacral, transverse cervical ligament (cardinal ligament)
Term
What pelvic ligament is unique to males?
Definition
Puboprostatic ligament supporting the urinary bladder
Term
The uterine artery anastomoses with what other arteries?
Definition
Vaginal and ovarian arteries
Term
What internal iliac artery branch is absent in females?
Definition
Inferior vesical artery
Term
Sacral and coccygeal nerve plexuses are located where?
Definition
On anterior surface of the piriformis
Term
Where does the sacral and coccygeal nerve plexuses leave the pelvis?
Definition
Greater sciatic foramen
Term
Sympathetic ganglia connect to sacral spinal nerves by what?
Definition
Gray rami communicantes carrying postganglionic sympathetic fibers
Term
What plexuses are included in the inferior hypogastric plexus (pelvic plexuses)
Definition
Rectal, vesical, uterovaginal, prostatic plexuses
Term
What connects superior and inferior hypogastric plexuses
Definition
Right and left hypogastric nerves
Term
The terminal branches of the inferior hypogastric plexus penetrate the pelvic floor to innervate what?
Definition
The erectile tissues of the penis and the clitoris in the perineum (cavernous nerves)
Term
What divides the pelvis into a greater (false) pelvis and a lesser (true) pelvis?
Definition
Pelvic brim/inlet
Term
What makes up the linea terminalis?
Definition
Iliopectineal line and the sacral promotory
Term
What makes up the pelvic inlet/brim?
Definition
Pubic crest (anteriorly), iliopectineal line (laterally), sacral alae and sacral promontory (posteriorly)
Term
Where does the psoas major insert?
Definition
Lesser trochanter
Term
What innervates psoas major?
Definition
L1-3
Term
What is the origin of iliacus?
Definition
Iliac fossa of hip bone
Term
Where does iliacus insert?
Definition
Lesser trochanter
Term
What innervates iliacus?
Definition
Femoral nerve, L2-4
Term
What is the origin of quadratus lumborum?
Definition
Iliolumbar ligament, iliac crest
Term
Where does quadratus lumborum insert?
Definition
12th rib and transverse process of lumbar vertebrae
Term
What innervates quadratus lumborum?
Definition
T12 and L1-4
Term
What are the actions of quadratus lumborum?
Definition
Depression and stabilization of 12th rib, lateral bending of trunk, extension of trunk
Term
Where does the diaphragm insert?
Definition
Trifoliate central tendon
Term
What innervates the diaphragm?
Definition
Phrenic nerve, lower 6 thoracic nerves
Term
What are the roots of the phrenic nerve?
Definition
C3-5
Term
What are the larger diaphragmatic apertures?
Definition
Aortic, oesophageal, and venacaval
Term
What vertebral level is the venacaval aperture located?
Definition
T8
Term
What is the vertebral layer of the oesophageal aperture?
Definition
T10
Term
What is the vertebral level of the aortic aperture?
Definition
T12
Term
Which diaphragmatic aperture tendinous?
Definition
Venacaval
Term
Which diaphragmatic aperture is muscular?
Definition
Oesophageal
Term
Which diaphragmatic aperture is osseo-aponeurotic?
Definition
Aortic
Term
What passes through the venacaval aperture?
Definition
Inferior vena cava, right phrenic nerve, and pericardiophrenic vessels
Term
What passes through the oesophageal aperture?
Definition
Oesophagus, gastric nerves, branches of the left gastric vessels and lymphatics
Term
What passes through the aortic aperture (hiatus)?
Definition
Aorta, thoracic duct, lumbar azygos vein
Term
What passes through the smaller diaphragmatic aperture at sternal and costal origins?
Definition
Superior epigastric vessels
Term
What passes through the smaller diaphragmatic aperture deep to the lateral arcuate ligament?
Definition
Subcostal nerve and vessels
Term
What passes through the smaller diaphragmatic aperture piercing the crus of the diaphragm?
Definition
Greater and lesser splanchnic nerve
Term
What passes through the smaller diaphragmatic aperture piercing the left dome of the diaphragm?
Definition
Left phrenic nerve and percardiphrenic vein
Term
What veins drain from the superior surface of the diaphragm?
Definition
Pericardiphrenic, musculophrenic, and superior phrenic
Term
What veins drain from the inferior surface of the diaphragm?
Definition
Right and left inferior phrenic veins
Term
The thoracic surface of the diaphragm drains lymphatics to where?
Definition
Anterior and posterior diaphragmatic lymph nodes and then to parasternal and posterior medistatinal lymph nodes
Term
The abdominal surface of the diaphragm drains lymphatics to where?
Definition
Anterior diaphragmatic phrenic and superior lumbar lymph nodes
Term
What is the developmental precursor to the diaphragm?
Definition
Septum transversum, muscular in growth from body wall, dorsal mesentary oesophagus, and pleuro-peritoneal membrane membrane folds
Term
What are the branches of the lumbar plexus?
Definition
Ilio hypogastric, ilio inguinal, genito femoral, lateral cutaneous, femoral, obturator, muscular
Term
What is the only abdominal wall artery that is not a branch of the abdominal aorta?
Definition
Subcostal arteries
Term
A collective of all the vertebral foramina form what?
Definition
Vertebral canal
Term
What forms the vertebral arch?
Definition
Two pedicles and two laminae
Term
Intervertebral foramen are formed between what structures?
Definition
Inferior and superior vertebral notches of adjacent vertebra
Term
Where do spinal nerves exit the vertebral canal?
Definition
Intervertebral foramen
Term
What are the names of the the process projections from each vertebral arch?
Definition
Transverse and spinous processes
Term
The laminal between the superior and inferior articular processes from adjacent vertebra form what?
Definition
Pars interacticularis (interarticular part), creates zygapophysial joints
Term
Zygapophysial joints are particularly susceptible to what disease?
Definition
Osteoarthritis
Term
What is a distinguishing characteristic of typical cervical vertebra (C3-6)?
Definition
Short, often bifid spinous process, may have uncinate process extending superiorly from the edge of its body on each side
Term
What joint is formed between uncinate processes and the body of vertebra above in cervical vertebra?
Definition
Unconvertebral joints
Term
What are the atypical cervical vertebra?
Definition
Atlas (C1), axis (C2), vertebra prominens (C7)
Term
The articulation between the atlas and the skull creates what joint?
Definition
Atlanto-occipital joint
Term
What joint is formed between the atlas and the axis?
Definition
One median and two lateral atlantoaxial joints
Term
The transverse ligament of the atlas at the median atlantoaxial joint may be absent in individuals with what disease?
Definition
Down syndrome
Term
What is unique to C7 among cervical vertebra?
Definition
Small or absent transverse foramina lacking a verterbal artery, long spinous process
Term
An enlarged costal process know as a cervical rib may form on C7 which may potentially compress what?
Definition
Subclavian and/or lower part of the brachial plexus (thoracic outlet syndrome)
Term
Typical thoracic vertebra have what defining features?
Definition
Costal facets on each side of the body for articulation with the heads of ribs, long and slender spinous process directed inferiorly
Term
Lumbar vertebra typically have what defining characteristics?
Definition
Large body, hatchet shaped spinous process, mammilary processes on the posterior surface of each superior articular process
Term
What attaches to the mammilary processes on lumbar vertebra?
Definition
Multifidus muscle
Term
A "scottie dog sign" is the appearance of a dog head in an oblique x-ray of the lumbar spine and aids in the diagnosis of what?
Definition
Spondylolysis
Term
What part of the sacrum is used in caudal epidural anesthesia during surgery or childbirth?
Definition
Sacral hiatus
Term
The sacral hiatus is located by palpation of what landmarks on either side?
Definition
Sacral cornua
Term
The lateral joint formed between the sacrum and the hip bone and the point where weight is transferred from the axial skeleton to the lower extremity is known as what?
Definition
Sacroiliac joint
Term
What are the primary curvatures of the spine that are concave anteriorly and face the same direction as the original fetal curvature?
Definition
Thoracic and sacral regions
Term
Abnormal increase in the thoracic curvature is known as what?
Definition
Kyphosis
Term
An increase in lumbar curvature is known as what?
Definition
Lordosis
Term
What would make a case of scoliosis structural and irreversible?
Definition
Hemivertebra between vertebra
Term
What is the most common form of scoliosis?
Definition
Idiopathic structural scoliosis
Term
Lateral curvature of structural scoliosis is accompanied by rotation of the vertebra towards what side? What visible sign does this produce?
Definition
Side of convexity, rib hump
Term
The partial forward dislocation of a vertebra over the vertebra below it is known as what?
Definition
Spondylolisthesis
Term
What is the most common cause of spondylolisthesis?
Definition
Spondylolysis causing L5 to slip on S1
Term
Bilateral fractures of the pars interarticularis of the vertebral laminae is know as what?
Definition
Spondylolysis
Term
What is the only ligament that helps to limit extension of the vertebral column?
Definition
Anterior longitudinal ligament
Term
Where is the anterior longitudinal ligament located?
Definition
Along the anterior aspect of the vertebral bodies
Term
Where is the posterior longitudinal ligament located?
Definition
Along the posterior aspect of the vertebral bodies
Term
What is the function of the posterior longitudinal ligament?
Definition
Limits flexion
Term
What joints the laminae of adjacent vertebra and helps limit flexion while assisting with extension of the flexed column?
Definition
Ligamenta flava
Term
What is the name of the ligaments between adjacent spinous processes?
Definition
Interspinous ligaments
Term
What connects the tips of spinous processes of C7 to the sacrum?
Definition
Supraspinous ligament
Term
The expansion of the supraspinous ligament in the cervical region is called what?
Definition
Nuchal ligament (ligamentum nuchae)
Term
What is the function of the nuchal ligament?
Definition
Muscle attachment in place of longer spinous processes in the cervical region
Term
What lies between bodies of adjacent vertebra?
Definition
Intervertebral discs
Term
What are the components that makes up intervertebral discs?
Definition
Central gelatinous nucleus pulposus enclosed by fibrocartilaginous anulus fibrosus which is thinner posteriorly
Term
What is the function of intervertebral discs?
Definition
Shock absorption
Term
Where do intevertebral discs most commonly herniate? What do they most commonly compress during herniation?
Definition
L4/5 or L5/S1, compresses the nerve root traversing to exit at the intervertebral foramen below
Term
Where do intervertebral disc herniations most commonly occur in cervical vertebra and what is in danger of compression in such cases?
Definition
C5-6 and C6-7, may compress the nerve root exiting at that same level
Term
Though posterior intervertebral disc herniation is very rare, what may be the outcome in such instances?
Definition
Paralysis at that below that verterbal level due to compression of the spinal cord
Term
What are the contents of the vertebral canal?
Definition
Meninges, cerebrospinal fluid, spinal cord, spinal nerve roots, internal vertebral venous plexus, and epidural fat
Term
What anchors the dura matter at S2?
Definition
Filum terminale externum (coccygeal ligament)
Term
What specialization of the pia mater that helps anchor the spinal chord continues inferiorly from the conus medullaris and is enclosed by the coccygeal ligament below S2?
Definition
Filum terminale/filum terminale internum
Term
What specialization of the pia mater that helps anchor the spinal chord is shaped as lateral bands with tooth-like processes that attach to the dura mater for fixation?
Definition
Denticulate ligaments
Term
What connects arachnoid mater and pia mater within the subarachnoid space?
Definition
Arachnoid trabeculae
Term
The subarachnoid space is enlarged caudal to the lower end of the spinal cord to form what?
Definition
Lumbar cistern
Term
What is contained within the lumbar cistern?
Definition
Cauda equina and filum terminale
Term
Why is the lumbar cistern an important landmark?
Definition
Used for lumbar spinal punctures to withdraw cerebrospinal fluid or for spinal blocks
Term
What is the distribution of the 31 spinal nerves?
Definition
8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal
Term
The tapered inferior end of the spinal cord is referred to as what?
Definition
Conus medullaris
Term
The collection of obliquely descending anterior and posterior nerve roots below the inferior end of the spinal cord is known as what?
Definition
Cauda equina
Term
The filum terminale represents the tract of regression of the spinal cord and helps anchor the spinal cord after what month of fetal development?
Definition
3rd month
Term
Nerve roots from C1-7 are named according to what?
Definition
Vertebra below of the same number
Term
Where is nerve C8 located?
Definition
Above T1
Term
Nerve roots T1 to Co1 are names according to what?
Definition
Vertebra above of the same number
Term
What supplies blood to the spinal cord?
Definition
Single anterior and two posterior spinal arteries
Term
The anterior and posterior spinal arteries receive supplemental blood supply from what?
Definition
Segmental medullary arteries
Term
What artery is especially important for the blood supply of the lower 2/3 of the spinal cord?
Definition
Great anterior segmental medullary artery
Term
What does the great anterior segmental medullary artery arise from?
Definition
Lower intercostal or upper lumbar artery
Term
How is blood drained from the spinal cord?
Definition
Internal vertebral venous plexus which communicates with the external venous plexus
Term
Why is the communication between the vertebral venous plexuses and the thoracic, abdominal, and pelvic veins clinically important?
Definition
Potential pathway for the metastasis of cancer cells to the vertebral column, spinal cord, and brain
Term
Why are intervertebral discs most likely to herniate posteriolaterally?
Definition
Annulus fibrosus is thinner posteriorly but the posterior longitudinal ligament reinforces the spinal cord immediately posterior, forcing herniation to be posterior and lateral.
Term
What constitutes the superficial perineal fascia of the urogenital triangle?
Definition
A fatty layer continuous with Camper's fascia and a membranous layer known as Colle's fascia that is continuous with Darto's fascia of the male genitals, Scarpa's fascia, and attaches to fascia lata distal tot he inguinal ligament
Term
The expanded head of the corpus spongiosum over the distal ends of the corpora cavernosa is known as what?
Definition
Glans penis
Term
What artery is found within each corpus cavernosum?
Definition
Deep artery of the penis
Term
The primary structure found within the corpus spongiosum is what?
Definition
Spongy urethra
Term
The deep fascia of the body of the penis is known as what?
Definition
Buck's fascia
Term
What vein is found in the superficial fascia of the body of the penis?
Definition
Superficial dorsal vein of the penis
Term
What artery, vein, and nerve is found deep to the deep fascia of the penis?
Definition
Deep dorsal vein, dorsal artery, dorsal nerve of the penis
Term
What muscle covers the crura of the penis?
Definition
Ischiocavernosus muscle
Term
What muscle covers the bulb of the penis and the proximal corpus spongiosum?
Definition
Bulbospongiosus muscle
Term
What forms a sling around the digestive tube that pulls it forward at the anorectal junction?
Definition
Puborectalis portion of the levator ani muscle
Term
Enlarged submucosal rectal veins with potential for rectal bleeding are known as what?
Definition
Hemorrhoids
Term
What are the consequences of prolapse of a hemorrhoid through the the anal aperture?
Definition
Strangulation and ulceration via anal sphincters
Term
Though hemorrhoids may result from pregnancy, constipation, or straining at the stool, it may also be a sign of what circulatory dysfunction?
Definition
Portal hypertension
Term
A pudendal block provides anesthesia over what parts of the body?
Definition
S2-4 dermatomes, lower 1/4 of vagina
Term
Pelvic sympathetic innervation contracts what muscle to prevent emptying of the urinary bladder and reflex of semen into the bladder during ejaculation?
Definition
Internal urethral sphincter
Term
What prevents reflux of urine into the ureter
Definition
Pressure from a filling bladder due to oblique entry of ureter into bladder and detrusor muscle contraction
Term
Passage of a kidney stone produces pain in what regions?
Definition
Loin to groin
Term
What autonomic fibers carry innervation for the ureters?
Definition
T11-L2
Term
The superior vesical artery is a branch off of what artery?
Definition
Umbilical artery
Term
In males, the vesical venous plexus is continuous with what other plexus?
Definition
Prostatic venous plexus
Term
What are the roots for the sympathetic fibers that innervate the bladder?
Definition
T11-L2
Term
What are the roots for the parasympathetic fibers that innervate the bladder?
Definition
S2-4 via inferior hypogastric plexus
Term
What fibromuscular band attaches to the caudal pole of the testes and guides their descent to the future scrotum during development?
Definition
Gubnaculum testes
Term
What suspends the testes in the scrotum?
Definition
Spermatic cords
Term
How is hydrocoele within the cavity of the tunica vaginalis detectable?
Definition
Reddish glow upon transillumination
Term
A sperm filled cyst near the head of the epididymis is known as what/
Definition
Spermatocoele
Term
Why is prostatic fluid alkaline?
Definition
Helps neutralize the acidity of the vagina
Term
Lymphatic drainage of the prostate is mainly via what nodes?
Definition
Internal iliac nodes
Term
What is a potential risk in undergoing a prostatectomy?
Definition
Damage to the parasympathetic prostatic nerve plexus may cause impotency
Term
What defines the "environment" for a developing embryo/fetus?
Definition
Everything outside his/her own skin including the mother's body
Term
What is the definition of teratology?
Definition
The study of the causes, mechanisms, and manifestations of developmental defects of a structural and/or functional nature
Term
An abnormal number of chromosomes other than an exact multiple of the haploid number is known as what?
Definition
Aneuploidy
Term
An abnormal number of chromosomes that is an exact multiple of the haploid number is known as what?
Definition
Polyploidy
Term
What is the most common trisomies of autosomes?
Definition
Trisomy 21 (Down syndrome), Trisomy 18, Trisomy 13
Term
Turner syndrome (45,X) is an example of what type of numerical chromosomal abnormality?
Definition
Monosomy of sex chromosomes
Term
Why does the incidence of down syndrome increase dramatically with maternal age?
Definition
Increased incidence of meiotic nondisjunction
Term
What is the karotype of Klinefelter syndrome?
Definition
47, XXY
Term
What are the symptoms of Klinefelter syndrome?
Definition
Tall stature, broad hips, testicular atrophy with hyalinized seminiferous tubules, gynecomastia, possible mental retardation
Term
40% of Klinefelter syndrome patients have gynecomastia, giving them an increased chance at developing what?
Definition
Breast cancer
Term
What is the most common type of polyploidy?
Definition
Triploidy (fatal)
Term
Deletion means what?
Definition
Loss of part of a chromosome
Term
What is the definition of translocation
Definition
Transfer of a piece of one chromosome to an nonhomologous chromosome
Term
Duplication means what?
Definition
Incorporation into a chromosome of a duplicated segment
Term
What defines inversion?
Definition
The reversal of a segment of chromosome, usually following a double break
Term
What is the definition of isochrosomes?
Definition
The transverse trather than longitudinal division of the centromere joining two chromatids
Term
What causes cri du chat syndrome?
Definition
Partial deletion from chromosome 5
Term
When is it possible for translocation to not be detrimental to development?
Definition
If exchange is reciprocal and breaks do not occur
Term
What is the most common cause of duplications?
Definition
Unequal cross over
Term
What causes mosaicism?
Definition
Mitotic nondisjunction of chromosomes
Term
What are some drugs that cause developmental defects?
Definition
Thalidomide (sleeping pill), alcohol, aminopterin, retinoic acid (vit A), phenytoin
Term
What kind of defects are caused by aminopterin?
Definition
Skeletal and CNS defects
Term
What causes fetal hydantoin syndrome?
Definition
The anticonvulsant, phenytoin
Term
What causes fetal Minamata disease?
Definition
The environmental chemical methylmercury
Term
What kinds of infectious agents can cause developmental anomalies?
Definition
Toxoplasma gondii (intracellular parasite), Rubella virus (German measles), cytomegalovirus
Term
What can cause a Toxoplasma gondii infection?
Definition
Eating raw or poorly cooked pork or lamb, close contact with infected cats, may result in hydrocephalus
Term
What kind of infection can cause cataracts and possibly glaucoma?
Definition
Rubella virus
Term
Cytomegalovirus may cause what kind of defect of infection is later in gestation?
Definition
Microphthalmia (eye that is too small)
Term
Vulnerability to teratogenesis depends on what?
Definition
Developmental stage at the time of exposure
Term
What position of the uterus is more prone to prolapse?
Definition
Retroverted
Term
The angle between the body of the uterus to the cervix is known as what?
Definition
Angle of anteflexion
Term
The angle between the axes of the cervix and the vagina is known as what?
Definition
Angle of anteversion
Term
What structure provides dynamic support for the uterus?
Definition
Pelvic diaphragm
Term
What structures provide passive support to the uterus?
Definition
Transverse cardinal ligament, uterosacral ligament, perineal body, relationship with bladder
Term
Where does endometriosis usually occur?
Definition
Ovaries
Term
What is used to definitively diagnose endometriosis?
Definition
Laparoscopy
Term
A papanicolaou exam (pap smear) involves what kinds of cervical cell samples for evaluation?
Definition
Ectocervical, endocervical
Term
Inflammation of the uterine tube is known as what?
Definition
Salpingitis
Term
How are ectopic pregnancies diagnosed?
Definition
Beta-HCG levels, ultrasound
Term
Obstetrical trauma to the vagina may result in what fistulas?
Definition
Urethrovaginal or vesicovaginal fistula
Term
Why is the relationship between the posterior fornix of the vagina and the rectouterine pouch so important?
Definition
Fluid can be aspirated from the rectouterine pouch (culdocentesis)
Term
What are the different portions of the central tendon of the diaphragm?
Definition
Sternal (xiphoid process), costal, lumbar
Term
What are the divisions of the lumbar portion of the central tendon?
Definition
Median arcuate, medial arcuate, lateral arcuate
Term
Which arcuate ligament unites the left and right crura?
Definition
Median arcuate ligament
Term
Which arcuate ligament acts as a thickening of thoracolumbar fascia over quadratus lumborum?
Definition
Lateral arcuate ligament
Term
True or false: The aortic hiatus pierces the diaphragm
Definition
False
Term
At what vertebral level is the esophageal hiatus located as a muscular part of the diaphragm?
Definition
T10
Term
At what vertebral level is the vena caval foramen located?
Definition
T8
Term
The right and left inferior phrenic veins drain blood from the diaphragm to what?
Definition
Inferior vena cava and left suprarenal vein respectively
Term
True or false: Superior and inferior lymphatics of the diaphragm communicate freely
Definition
True
Term
While the phrenic nerve provides sensory perception to the central part of the diaphragm, what allows for sensation of the diaphragms peripheral portions?
Definition
Lower six intercostal and subcostal nerves (T5-12)
Term
Congenital diaphragmatic hernias result due to what developmental abnormality?
Definition
Failure of pleuroperitoneal membranes to close
Term
Which form of congenital diaphragmatic hernia is posterolateral, left sided, and through the pleuroperitoneal canal (foramen of Bochdalek)
Definition
Bochdalek hernia
Term
Which form of congenital diaphragmatic hernia is anterior, right sided, and through the sternocostal hiatus?
Definition
Morgagni hernia (rare)
Term
A congenital diaphragmatic hernia through the esophageal hiatus is known as what?
Definition
Hiatal hernia
Term
What is the action of the quadratus lumborum?
Definition
Fixes/depresses 12th ribs during respiration, flexes trunk laterally
Term
What supplies innervation to the iliacus?
Definition
Femoral nerve from lumbar plexus
Term
Where does the abdominal aorta begin and where does it terminate?
Definition
T12 at aortic hiatus, terminates at L4 as it divides into left and right common iliac
Term
What are the roots of the lumbar plexus?
Definition
L1-4
Term
What are the roots of the iliohypogastric and ilioinguinal nerve?
Definition
L1
Term
What are the roots of the genitofemoral nerve?
Definition
L1-2
Term
What are the roots of the lateral femoral cutaneous nerve?
Definition
L2-3
Term
What are the roots of the femoral and obturator nerves?
Definition
L2-4
Term
What are the parasympathetic nerves within the abdomen?
Definition
Vagus (CNX) and pelvic splanchnics (S2-4)
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