Term
Contents of which quadrant of the abdomen?
right lobe of liver, gallbaldder, pylorus of stomach, duodenem, head of pancreas, right suprarenal gland, right kidney, right colic flexure, superior ascending colon, right transverse colon |
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Definition
| right upper quadrant (RUQ) |
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Term
Which quadrant?
Right lobe of liver
gallbladder
pylorus
1st-3rd parts of duodenum
head of pancreas
right kidney and suprarenal gland
right colic flexure
superior part of ascending colon
right half of transverse colon |
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Definition
|
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Term
Which quadrant?
Left lobe of liver
spleen
stomach
jejunum
proximal ileum
body and tail of pancreas
left kidney and suprarenal gland
left colic flexur
left transverse colon
superior descending colon |
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Definition
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Term
WHich quadrant?
cecum
appendix
most of ileum
inferior ascending colon
right ovary
right uterine tube
right ureter
right spermatic cord
uterus
urinary bladder |
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Definition
|
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Term
Which quadrant?
Sigmoid colon
inferior descending colon
left ovary
left uterine tube
left ureter
left spermatic cord
uterus
urinary bladder |
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Definition
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Term
| Between which two layers of the abdominal wall is there a potential space? |
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Definition
| Scarpa's fascia and superficial investing fascia |
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Term
| What layer of the abdominal wall acts as a natural cleavage plane for separation of muscles during surgery? |
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Definition
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Term
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Definition
Origin: pubic symphysis and pubic crest
Insertion: Xiphoid process and 5-7th costal cartilages
Innervation: Thoracoabdominal nerves
Action: Flexes trunk and compresses abdominal viscera. stabilizes &controls tilt of pelvis (antilordosis) |
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Term
| Transverse Abdominal - Origin, Action, Insertion, Innervation |
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Definition
Origin: Internal surfaces of 7-12th costal cartilages, thoracolumbar fascia, iliac crest, laterla third of inguinal ligament
Insertion: linear alba with aponeurosis of ext oblique, pubic creast, pecten pubis via conjoint tendon
Innervation: Thoracoabdominal nerves
Action: Compresses and supports abdominal viscera |
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Term
|
Definition
Origin: Thoracolumbar fascia, anterior 2/3 of iliac crest, lateral half of inguinal ligament
Insertion: Inferior borders of 10-12th ribs, linea alba, pecten pubis via conjoint tendon
Innervation: Thoracoabdominal nerves
Action: Compress and support abdominal viscera, flex trunk
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Term
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Definition
origin: external surface of 5-12th ribs
Insertion: linea alba, pubic tubercle, anterior half of iliac crest
Innervation: thoracoabdominal nerves
Action: Pulls chest downward and compresses abodminal cavity |
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Term
| Blood vessels and nerves to the anterior abdominal wall run between the ___ and ___. |
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Definition
| Internal oblique and transversus abdominis |
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Term
Dermatomes of Abdomen
Xiphoid process
Umbilicus
Pubis |
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Definition
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Term
| Lymphatic drainage superior to umbilicus and inferior to umbilicus. Deep? |
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Definition
Superior - to axillary nodes
Inferior - to Inguinal nodes
Deep - accompany deep veins: external iliac, common iliac, lumbar lymph nodes |
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Term
| ___ is a condition of superficial venous dilation in the abdomen |
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Definition
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Term
| What vein, in particular, acts as a collateral pathway should other veins get blocked? |
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Definition
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Term
| Why is abdominal protuberance physiological in children? What causes it in adults? |
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Definition
Children: normal due to GI tract containing significant air, large liver, and enlarged abdominal cavities for organ development
Adults: Six F's: Food, fat, fluid, feces, flatus,fetus |
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Term
| What are two particularly high risk abdominal incisions? |
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Definition
Pararectus (lateral side of rectus abdominis) and Inguinal
These are both very close to nerves. Inguinal is close to ilioinguinal nerve |
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Term
| 5 umbilicalperitoneal folds and where they come from |
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Definition
Median umbilical fold - from remnant of urachus (joined apex of fetal bladder to umbilicus) - covers median umbilical ligament
two Medial umbilical folds - cover medial umbilical ligaments - formed by parts of the umbilical arteries
Two Lateral Umbilical folds - cover the inferior epigastric vessels and therefore bleed profusely if cut |
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Term
| The ___ fossae are impressions above the bladder that allow for abdominal wall stretching as the bladder fills. The ___ fossae (AKA ____) are important areas for direct herniation and are bounded by the epigastric artery, lateral umbilical fold, and rectus abdominis. The ___ fossae are lateral to the lateral umbilical folds and contain the deep inguinal rings and are thus potential sites for indirect inguinal hernias. |
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Definition
Supravesical fossae
Medial inguinal fossae (Hesselbach Triangles)
Lateral inguinal fossae |
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Term
| The ___ is the thick inrolled lower border of the ext oblique aponeurosis. It extends from ___ to ___. It's purpose is to give support to the ___ and ___, to keep them from being crushed when you sit down. |
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Definition
Inguinal ligament
From ASIS to pubic tubercle
Inguinal artery and vein |
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Term
Inguinal canal:
begins at ____, ends at ____.
Transmits ___ in males and ___ in females.
Created when testes & ovaries descend. |
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Definition
deep inguinal ring, ends at superficial inguinal ring
transmits spermatic cord and round ligament of uterus
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Term
Deep inguinal ring:
Located Superior to the middle of the ___, and lateral to the ___ artery. It is an evagination of the ___ fascia.
Superficial inguinal ring:
Located just superiolateral to the ____, where the lateral crus attaches. The medial crus attaches to the ____. |
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Definition
inguinal ligament, inferior epigastric artery, trasversalis fascia
Pubic tubercle, pubic crest |
|
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Term
| Two muscles in the testicles that contract to pull testicles upward in cold temperatures |
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Definition
|
|
Term
Internal structure of the testis:
Approximately (#) lobules, each one contains:
_-_ seminiferous tubules
About __ straight tubules
The mediastinum of the testis, called ____
__-__ efferent tubules
Epididymis |
|
Definition
300 lobules:
1-4
25 straight
rete testis
15-20 |
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Term
| If the porcesses vaginalis persists in females, it forms a small peritoneal pouch, known as the ____. Cysts can develop here, which can turn into indirect hernias. |
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Definition
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Term
| A ___ is the presence of excess fluid in a persistent processus vaginalis. It is a congenital anomaly. These can occur in what two places? |
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Definition
| Hydrocele - can happen in testis or spermatic cord |
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Term
| How do you tell the difference between a hydrocele and a hemocele in the testis? |
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Definition
| Transillumination - blood won't transilluminate. |
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Term
A ___ is a retention cyst (collection of milky fluid) in the epididymis, usually near the head. A ___ is a collection of fluid anywhere in the epididymis.
___ is an enlargement of pampiniform plexus that makes the testicle feel like a "bag of worms". Occurs 99% of the time in the __ testicle because it makes a 90 degree angle with the Left renal vein. |
|
Definition
Spermatocele, epididymal cyst
varicocele - left testicle |
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Term
| Cancer of the testis generally metastasizes to the ___ lymph nodes. Cancer of the scrotum generally metastazies to the ___ lymph nodes |
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Definition
lumbar.
superficial inguinal |
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Term
What muscle?
Origin: transvere process of Lumbar vertebrae, bodies of T12-L5
Insertion: lesser trochanter of femur
Innervation: lumbar plexus via L2-L4
Action: flexes thigh, flexes vertebral column laterally, balance trunk, flexes trunk when sitting |
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Definition
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Term
What muscle?
Origin: superior 2/3 of iliac fossa, ala of sacrum, anterior sacroiliac ligaments
Insertion: lesser trochanter of femur
Innervation: Femoral nerves L2-L4
Action: flexes thigh and stabilizes hip joint, acts with psoas major |
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Definition
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Term
What muscle?
Origin: medial half of inferior border of 12th ribs and tips of lumbar transverse processes
Insertion: iliolumbar ligament and internal lip of iliac crest
Innervation: anterior branches of T12-L4 nerves
Action: Extends and laterally flexes vertebral column, fixes 12th rib during inspiraiton |
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Definition
|
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Term
| Retroperitoneal organs (8) |
|
Definition
Kidneys
Suprarenal glands
Ureters
Pancreas
Descending, horizontal, and some ascending duodenum
Ascending and descending colon
Some portions of cecum
Rectum to the sacral flexure |
|
|
Term
Parts of peritoneal cavity:
Greater sac
Lesser sac
Epiploic foramen (of winslow)
Supracolic compartment
Infracolic compartment
Paracolic gutters |
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Definition
1. Greater sac - everything that's not lesser
2. Lesser sac (omental bursa) - lies behind stomach
3. Epiploic Foramen - Between greater and lesser sacs, just above duodenum, between stomach, liver, inf vena cava, diaphragm, and lesser omental ligament
4. Supracolic compartment - above the transverse colon
5. Infracolic - below transverse colon
6. paracolic gutters - join supra and infracolic compartmets. can be site of pus/ascitis fluid accumulation and allow for migration between the two cavities. On sides of ascending and descending colons
** Supracolic and infracolic are divisions of the greater sac |
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Term
| There are no organs in the ___ cavity, it is a potential space used for fetal development in women (it is closed in men). How does the body prevent pathogens from entering in women? |
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Definition
peritoneal
has mucus plug to prevent pathogens from entering, but allows sperm to enter |
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Term
| Perforation of the posterior wall of the stomach results in the passage of stomach contents into the omental bursa. If the pancreas is inflamed, it's fluid can pass into the bursa, causing a ____. |
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Definition
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Term
___ covers organs and attaches them to the body wall. 2 types:
1. ____: peritoneum that connects convolutions of the jejunum and ileum with the dorsal wall of the abdomen.
2 ___: extends obliquely from the dudodenojejunal flexure at the left side of the 2nd lumbar vertebrae to the right sacroiliac articulation, where it attaches to the body wall.
In the intestines, it has two parts:
1. ____: covers sigmoid colon, attaches to the pelvic wall.
2. ____: Covers transverse colon and attaches to dorsal wall of abdomen. |
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Definition
mesentry
1. mesentry proper (The Mesentry)
2. Root of mesentry
1. sigmoid mesocolon
2. transverse mesocolon |
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Term
| Pleura that attaches between two organs (not to a body wall) is called? |
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Definition
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|
Term
| Differentiate between lesser and greater omentum |
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Definition
Greater (gastrocolic) - between transverse colon and greater curvature of stomach
Lesser (gastrohepatic) - between lesser curvature of stomach and inferior surface of liver |
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Term
Process of fluid removal in ascites is called ___.
___ is the infection and inflammation of the peritoneum. It often forms adhesions that limit the movements of the abdominal viscera and need to be removed via ____. |
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Definition
abdominal paracentesis
Peritonitis, adhesiotomy |
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Term
| List the 10 abdominal viscera |
|
Definition
abdominal aorta
esophagus
stomach
intestine
gallbladder
spleen
pancreas
suprarenal glands
Kidneys and ureters
|
|
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Term
| Branches of abdominal aorta: 3 ventral, 4 lateral, 2 dorsal |
|
Definition
ventral: celiac trunk, superior mesentric, inferior mesentric
- supply esophagus to rectum
Lateral: inferior phrenic, suprarenal, renal, testicular or ovarian
- supply GU tract
Dorsal: lumbar, median sacral
- supply body wall and diaphragm |
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Term
Esophagus:
Pierces diaphragm at __
Esophagogastric junction at ___
The ___ ligament makes a ring around the esophagus and permits independent movement of diaphragm and esophagus during respiration and swallowing
The ___ is a jagged line where mucosa abruptly changes from esophageal to gastric |
|
Definition
T10
T11
Phrenicoesophageal ligament
Z line |
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Term
The __ plexus supplies the esophagus and stomach. It is formed by the right and left ___ nerves.
The ___ supplies the anterior part of the esophagus and stomach, and is formed mainly by the left ___ nerve.
The ___ supplies the posterior part of the esophagus and stomach and is formed mainly by the right __ nerve. |
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Definition
esophageal plexus, vagus nerves
anterior vagal trunk, left vagus nerve
posterior vagal trunk, right vagus nerve |
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Term
___ are greatly enlarged submucosal veins in the esophagus that become distended and can rupture, causing life-threatening hemorrhage. They are commonly developed in alcoholics due to ___
___ is more commonly called heartburn, it is the result of regurgitaiton of small amounts of food or gastric fluid (acid) into the lower esophagus
___ is a weakening of the muscular part of the diaphragm caused by widening of the esophageal hiatus that results in abdominal visceral going through the diaphragm. In infants, this is more severe because it enters the space where the lungs should be forming and doesn't allow them room to do so. |
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Definition
Esophageal varices, due to portal hypertension
Pyrosis
Hiatal hernia |
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Term
| ___ are formed by the folding of the gastric mucosa, allowing the stomach to stretch. They are not present when your stomach is full |
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Definition
|
|
Term
| Why is gastric pain felt in epigastrium |
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Definition
| because stomach is supplied by T6-T10 nerves |
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Term
Carcinoma of the stomach usually occurs in the ___ or ___. However if it occurs in the second spot, it is very bad, why?
___ is surgical removal of part of the stomach
Gastric ulcers mainly occur in which part of the stomach?
Pyloric stenosis is more common in women or men?
___ is failure of smooth muscle fibers encircling the pylorus to relax, and thus causes food not to pass into the duodenum.
Acid secretion is controlled by the ___ nerve, surgical excision of this nerve is called a ___. |
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Definition
Carcinoma: body and pylorus. hard to remove pylorus bc it has so many lymph nodes
gastrectomy
lesser curvature
men
vagus, vagotomy |
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Term
Derivatives from which embryologic structure will result in epigastric pain when they are inflamed?
Which result in periumbilical pain?
Which result in hypogastric pain? |
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Definition
Foregut derivatives result in epigastric pain: esophagus, stomach, pancreas, duodenum, liver and biliary ducts
Midgut derivatives result in periumbilical pain: small intestine distal to bile duct, cecum, appendix, ascending colon, most of transverse colon
Hindgut derivatives result in hypogastric pain: distal transverse colon, descending colon, sigmoid colon, rectum |
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Term
| The jejunum and ileum are together 6-7m long, the ___ makes up the first 2/3, and the __ makes the second 1/3. |
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Definition
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Term
4 parts of the duodenum:
1st (superior) part is __cm long.
2nd part (descending) is __-__ cm long, and contains the ___, which enter through the posterior lateral wall
3rd part (horizontal)
4th part (ascending) - contains the ___ ligament, which holds it to the right crus of the diaphragm. Surgical landmark. |
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Definition
1st - 5cm
2nd - 7-10cm, hepatopancreatic ampulla (bile duct and pacreatic duct)
4th - suspensory ligament of Treitz
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Term
65% of duodenal ulcers occur in which part?
Potential complications of duodenal ulcers?
___ hernias occurs in the paraduodenal fold and fossa, which is a large recess to the left of the ascending duodenum. Loops of intestine can enter here and strangulate the duodenum. Branches of the ___, __, and ___ are associated with this area. |
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Definition
posterior wall of superior (1st) part
perforations caused by duodenal uclers can cause it's contents to enter the peritoneal cavity and lead to severe peritonitis
paraduodenal ulcers - inf mesenteric artery and vein, left colic artery |
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Term
Two sources of blood supply to the duodenum, above and below the entry of the bile duct:
1. Above the bile duct: ____ (artery)- branches to the right gastroduodenal, superior pancreatico duodenal artery and ___ (vein)
2. Below the bile duct: ___ (artery)- branches to the inferior pancreaticoduodenal artery, and ___ and ___ (veins) |
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Definition
Above: Celiac trunk, portal vein
Below: Superior mesenteric artery, superior mesentery vein and splenic vein |
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Term
| Blockage of the ____ by a gall stone can block both the biliary and pancreatic duct systems so neither juices can enter the duodenum. Bile can back up into the pancreatic duct and cause ____. |
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Definition
Hepatopancreatic ampulla
pancreatitis |
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Term
Which is the jejunum and which is the ileum?
1. greater vascularity supply, long vasa recta, a few large loops of arcades, less fat in mesentery
2. less vascularity, short vasa recta, many short loops of arcades, more fat in mesentery. |
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Definition
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Term
| In the jejunum and ileum, arteries come from the ____, and veins go to the ____ and ultimately the ___. |
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Definition
Superior mesenteric artery
superior mesenteric vein - portal vein
|
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Term
64% of appendices are located where?
Pain from appendicitis is located where? |
|
Definition
Lateral 1/3 of McBurney's point
Right lower quadrant, referred pain in umbilicus |
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Term
____ is inflammation of the colon or rectum. 2 common diseases of this are?
___ is evaginations of the mucosa of the colon. It happens most in middle aged and elderly people, and most in the sigmoid colon. Prevention is eating a diet high in fiber. |
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Definition
Colitis - ulcerative colitis, crohn's disease
Diverticulosis |
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Term
The __ is the pelvic part of the large intestine. The terminal part is dilated as the ___, a reservoir for stool.
The rectosigmoid junction lie anterior to which vertebrae?
The anal canal begins at the tip of the ___.
3 Lateral flexures of the rectum? |
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Definition
Rectum, ampulla
S3
Coccyx
Superior, inferior, intermediate |
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Term
| What structures can be felt during a rectal exam? |
|
Definition
Men: Prostate and seminal glands
Females: cervix |
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Term
| 2 sphincters of the anal canal |
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Definition
Internal - superior - constricted except during defecation - involuntary
External - inferior - voluntary - constricted when it's closed |
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Term
| Which rectal arteries form anastomoses? What is the importance of this? |
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Definition
| Middle rectal arteries form anastomoses between portal and systemic veonous systems |
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Term
A __ is a slit-like lesion in the anus, usually located in the posterior midline inferior to the anal valves. Very painful.
A __is an abnormal canal that opens into the anal canal and allows infection to get into canal.
___ are elarged and engorged blood vessels (varicosities) in or around the anus. These may be associated with pain, bleeding, itching, and feels as if a lump is hanging down. Are internal or external ones more painful? |
|
Definition
Anal fissure
Anal fistula
Hemorrhoids (piles). external are painful |
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Term
| The __ is the largest gland in the body, weighing appx ___ gm and making up __% of the adult body weight. It is located in which parts of the abdomen? It is enclosed by a thin fibrous capsule called the ____. |
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Definition
Liver
1500
2.5%
right hypochondrium, epigastrium, left hypochondrium
hepatic capsule (of Glisson) |
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Term
Liver:
Diaphragmatic surface is covered with ____
___ is the part of the diaphragmatic surface that is not covered
___ is the protrusion of the peritoneal cavity between liver and diaphragm
___ is the space between the liver and right kidney
____ contains the fossa for the gall bladder and portal triad, it is devoid of peritoneum |
|
Definition
peritoneum
bare area
subphrenic recess
hepatorenal recess/subhepatic space/hepatorenal pouch
visceral surface |
|
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Term
| If infection lodges in subphrenic recesses, a ___ may occur, such as with appendicitis or duodenal ulcers |
|
Definition
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|
Term
The bare area of the liver is formed by the 2 ___ ligaments, which unite to form the ___ ligament.
the ___ ligament holds the liver to the anterior body wall. |
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Definition
coronary -- triangular
falciform |
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Term
| Parts of the portal triad |
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Definition
hepatic artery
portal vein
bile duct |
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Term
| Explain the functional lobes of the liver |
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Definition
Right and left lobes are considered the functional lobes because they have separate biliary drainage and vacular supply (portal triad)
Quadrate lobe is part of left lobe because it receives the left portal triad
Caudate lobe is functionally part of left and right lobe - considered a third liver |
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Term
What serves as a guide between liver segments in a segmentectomy?
How many segments are there? |
|
Definition
intersegmental hepatic veins
8 |
|
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Term
The ___ forms during the 4th week of development as the head, tail, and lateral folds incorporate the ddorsal part of the umbilical vesicle into the embryo. It is closed at it's cranial end by the ____ membrane (____) and at its caudal end by the ___ membrane (___).
It is divided into three sections: __, __, and ___. |
|
Definition
primordial gut
oropharyngeal membrane (stomodeum) = primordial mouth
Cloacal membrane (proctodeum) = primordial anus
foregut, midgut, hindgut |
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Term
In the primordial gut, the endoderm gives rise to what 2 things?
The ectoderm gives rise to what 2 things? |
|
Definition
endoderm: epithelium and glands (liver, pancreas, gall bladder)
ectoderm: stomodeum and proctodeum (epithelium of cranial and caudal ends of the alimentary tract) |
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|
Term
|
Definition
| oral cavity, pharynx, tongue, tonsils, salivary glands, upper resp tract, lower resp tract, esophagus, stomach, proximal half of duodenum, liver, and pancreas, biliary apparatus |
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|
Term
| The ___ septum divides the forgut into esophagus and trachea |
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Definition
|
|
Term
The distal part of the foregut is initially a simple tubular structure. Around the middle of the fourth week, a slight dilation indicates the site of the primordium of the ____.
It is initially oriented in the ___ plane.
During the next two weeks, the dorsal border of this structure grows faster than the ventral border, which becomes the ____.
As it enlarges, it acquires its final shape. It rotates 90 deg in a clockwise direction along its longitudinal axis, which creates the ___.
The ___ gets it's C-shaped from the rotation described above and because of its located between the foregut and midgut. |
|
Definition
stomach
median
greater curvature of stomach
omental bursa (lesser peritoneal sac)
duodenum |
|
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Term
The pancreas develops from two outgrowths of the endodermal epithelium, the (a) and (b). during the rotation of the gut, these two come together to form a single pancreas.
The (b) forms the __ and __ of the pancreas, while the (b) forms the __, __, and __ of the pancreas. The ducts of (a) and (a) join together to form the ___, but the proximal part of the duct of the (a) may persist as an _____. |
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Definition
a = dorsal pancreatic bud
b = ventral pancreatic bud
ventral bud forms uncinate process and part of the head
dorsal bud forms head, body, and tail.
main pancreatic duct
accessory pancreatic duct |
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Term
The liver develops from endodermal cells that forms the (a). As it grows, the (a) divides into a cranial part, which forms the ___ of the liver, and a caudal part, which forms the ___ and ___.
The hemopoietic cells, kupffer cells, and connective tissue of the liver are derived from mesenchyme in the ____.
Blood formation (hemopoiesis) begins in the liver during the __ week of development, and bile formation begins in the ___ week. |
|
Definition
a = hepatic diverticulum
parenchyma
gall bladder, cystic duct
septum transversum
6th week, 12th week |
|
|
Term
What condition is described?
Overgrowth of the longitudinal muscle fibers of the pylorus creates a marked thickening of the pyloric region of the stomach. The resulting stenosis (Gk. severe narrowing) of the pyloric canal obstructs passage of food into the duodenum, and as a result after feeding the infant expels the contents of the stomach with considerable force (projectile vomiting). This condition affects approximately 1/150 male infants, but only 1/750 female infants. |
|
Definition
| Congenital hypertrophic pyloric stenosis |
|
|
Term
What condition is described?
During development, the ventral and dorsal pancreatic buds form a ring aroudn the duodeunum, thereby obstructing it. |
|
Definition
|
|
Term
The midgut communicates wtih the yolk sac via the ____.
As the midgut forms, it elongates into a U-shaped loop called the ____.
The cranial limb of the midgut elongates rapidly during development and forms the ___ and cranial portion of the ____.
The caudal limb forms the ___, ___, ___, ___, and ___. The caudal limb is easily recognized by the presence of the ____.
The midgut loop rotates 270 deg counter clockwise around the ____ artery as it retracts into the abdominal cavity during the tenth week of development. |
|
Definition
yolk stalk
midgut loop
jejunum and ileum
cecum, appendix, caudal part of ileum, proximal 2/3 of transverse colon
cecal diverticulum
superior mesenteric |
|
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Term
The hidgut is defined to begin where the blood supply changes from the ___ artery to the ___ artery at the distal 1/3 of the transverse colon.
The (a) is the expanded terminal part of the hindgut.
The ___ membrane separates the (a) from the proctodeum.
During develoment, a sheet of mesenchyme called the ___ develops to divide the (a) into a ventral and dorsal portion called the ___ and ___.
By week seven, the urorectal septum reaches the cloacal membrane, dividing it into the ___ and ___ membranes (ventral and dorsal portions). |
|
Definition
SMA and IMA
cloaca
cloacal membrane
urorectal septum, urogenital sinus, anorectal canal
urogenital membrane, anal membrane |
|
|
Term
The epithelium of the superior 2/3 of the anal canal is derived from the endodermal _____. The inferior 1/3 is from the ectodermal ____.
The junction of these two epithelia is indicated by the ____, which also indicates the approximate former site of the anal membrane that normally ruptures during the 8th weeks of development. |
|
Definition
hindgut, proctodeum
pectinate line |
|
|
Term
What condition?
A remnant of the proximal part of the yolk stalk that fails to degenerate during the early fetal period results in a finger-like blind pouch that projects from the ileum. While this condition occurs in about 1/50 people, it is usually asymptomic and only occasionally leads to abdominal pain and/or rectal bleeding. |
|
Definition
| Ileal diverticulum (Meckel's Diverticulum) |
|
|
Term
What disorder?
The anal membrane fails to break down before birth. The anus must be reconstructed surgically, with severity depending on the thickness of the intervening tissue. |
|
Definition
|
|
Term
| What is a subhepatic cecum and appendix and why does it matter clinically? |
|
Definition
| During the fetal period, the cecum and appendix adhere to the inf surface of the liver and are thus carried upward with it. May result in difficulty diagnosing appendicitis bc it is not where it should be anatomically |
|
|
Term
| Failure of recanalization of ileum during the solid stage of development leads to narrowing or complete obstruction of the intestinal lumen. Can be caused by an infarction of fetal bowel, owing to imairment of its blood supply |
|
Definition
| Stenosis & atresia of the small intestine |
|
|
Term
| How does hepatomegaly occur and what are some common causes? |
|
Definition
The IVC and hepatic veins lack valvces, so any rise in central venous pressure is directly transmitted to the liver.
Causes: CHF, bacterial and viral diseases (hepatitis), tumor |
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Term
Situation: broken rib, abdominal hemorrhage, right upper quadrant pain.
Possible cause? |
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Definition
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Term
Cirrhosis of the LIver:
Progressive destruction of hepatocytes, which are replaced by ___ and ___, creating a "hobnail" appearance.
May be caused by ____ or ____ (most common cause)
Creates ____, impeding the circulation of blood vessels and biliary ducts. |
|
Definition
fat and fibrous tissue
industrial solvents (carbon tetrachloride) or alcoholism
portal hypertension |
|
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Term
| In a liver biopsy, where is the needle usually inserted? |
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Definition
| 10th ICS in the midaxillary line. Done on full inspiration to reduce costodiaphragmatic recess and lessen possibility of injuring the lung. |
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Term
Variations in hepatic arteries:
In __% the right hepatic artery runs posterior to the common hepatic duct
in __%, the right hepatic artery runs anterior to the common hepatic duct
In __%, the right hepatic artery arises from the SMA and does not cross the hepatic duct
In __%, the right hepatic artery runs anterior to the portal vein
In __%, the right hepatic artery passes posterior to the portal vein
Why is it important to know these variation? |
|
Definition
64
24
12
91
9
Important to know because these arteries could be damaged during surgeries like cholecystectomy, fundoscopy, or laparoscopy |
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Term
A common variety of right hepatic artery is that it may be replaced by an accessory artery arising from the ____
The most common replacement of the left hepatic artery is the ____. |
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Definition
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Term
The ___ is the major lymph-producing organ
Superficial lymphatics of the liver: __ and __ nodes, where do they drain?
Deep lymphatics of the liver: ___ nodes to the ___. |
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Definition
liver
phrenic to mediastinal nodes
hepatic to celiac nodes to chyle cistern
Deep lymphatics surround portal triad: hepatic nodes to chyle cistern
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Term
Gall bladder:
6-10 cm long, 45ml capacity. Pear-shaped lying on the inferior surface of the liver in a fossa between the __ and __ lobes.
What are it's functions?
3 parts?
The neck gives rise to the ___ duct with ___ valves, and it may contain a pundulous sacculation called _____, or the ampulla of the gallbladder. |
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Definition
between right and quadrate lobes
Fxns: receives bile, concentrates it, release it during digestion
3 parts: fundus, body, neck
Neck: cystic duct with spiral (Heister's) valves.
Hartmann's pouch = ampulla |
|
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Term
| The ___ is 3-4 cm long and connects the neck of the gall bladder to the common hepatic duct. |
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Definition
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Term
Gall stones:
More common in women or men?
What percent are "silent" (asymptomatic)?
Where do they tend to collect? (3 places)
Blockage of the ___ can cause cholecystitis because of bile accumulation in the gallbladder. Pain starts in the ___ and moves to the ____. Also produces thoracic wall & right shoulder pain due to diaphragm irritation. If bile cannot leave gallbaldder, it enters the blood and ___ results.
What two other places outside the gallbladder can gallstones collect? |
|
Definition
women
50%
infundibulum, hepatic and cystic ducts
cystic duct, epigastrium --> hypochondrium, jaundice
superior duodenum & transverse colon |
|
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Term
Gall bladder arterial supply:
right hepatic artery --> cystic artery --> gallbladder
The right hepatic artery arises from the cystohepatic triangle (Triangle of Calot). What are the borders of this triangle? |
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Definition
Superior border: visceral surface of the liver
Inferior border: cystic duct
Medial border: common hepatic duct |
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Term
Hepatic portal vein:
Formed by the convergence of the ___ and ___, posterior to the neck of the pancreas at the level of ___.
conveys all venous blood and bloodborne nutrients from the __ to the ___.
After the liver, the blood drains to the ___. |
|
Definition
SMA and Splenic vein at L2
from GI tract to Liver
IVC |
|
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Term
| 3 portal-systemic anastomoses |
|
Definition
1. submucosa of inf esophagus
2. submucosa of anal canal
3. Paraumbilical region |
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Term
Cirrhosis causes scarring and fibrosis which can obstruct the _____ in the liver, this causes a pressure rise in the portal system, resulting in ____.
Large volumes of blood flow from the portal system to the systemic system at anastomose sites can cause ____, especially in the lower esophagus, called ____.
In severe portal obstruction, veins in anterior abdominal wall anastomose wtih paraumbilical veins and may become ___ and look like small snakes around the umbilicus, called ____. |
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Definition
Portal vein, portal hypertension
varicose veins, esophageal varices
varicose, caput medusae |
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Term
___ are a common method for reducing portal hypertension.
They create communication between the ____ and the ___ and thus divert blood away from the portal system to the systemic venous system. |
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Definition
| Portosystemic shunts, portal vein to IVC |
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Term
Pancreas:
Accessory digestive gland, lies retroperitoneally and transversely across the posterior abdominal wall, posterior to the stomach between the ___ on the right and the ___ on the left.
Exocrine secretion: ___ through acinar cells, which enter the duodenum through ____ ducts
Endocrine secretion: __ & __ by islets of Langerhans. enters blood. |
|
Definition
between duodenum and spleen
exocrine: pancreatic juice, main accessory pancreatic ducts
Endocrine: glucagon and insulin |
|
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Term
What might cause rupture of the pancreas and what are some possible effects?
____ is the most common type of pancreatic cancer (90% of cases). Why is it so deadly?
___ is removal of most of the pancreas. It is sometimes performed in what condition? The head of the pancreas is impossible to remove, why? |
|
Definition
Pancreatic rupture is rare due to its central placement in the body. Rupture require sudden, severe, forceful compression of the abdomen and it usually tears the duct system, resulting in leakage of pancreatic juice, which can digest surrounding tissues.
Ductal adenocarcinoma. Surgical resection is useless and it metastasizes quickly via the portal vein
Pacreatectomy - chronic pancreatitis. head is impossible to remove bc the blood supply, bile duct, and duodenum are all in it |
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Term
Spleen:
Largest lymphatic organ
Located in what quadrant? Associated with what ribs?
Most commonly injured abdominal organ.
It is entirely surrounded by peritoneum except for the ___.
Relations to the spleen:
Anterior to the spleen is the ____
Posterior is the ___, which separates it from the pleura, lung, and 9-11 ribs.
Inferior is the ____
Medial is the ___
____ is like a small lymph node found around the hilum. Found in __% of the population. |
|
Definition
Left hypochondrium, 9-11th ribs
hilum
anterior: stomach
posterior: diaphragm
Inferior: left colic flexure
Medial: left kidney
Accessory spleen, 10% of pop
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|
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Term
What are some common ways to rupture the spleen?
How do you treat a ruptured spleen?
Splenomegaly:
Normal spleen is how big?
Enlarged spleen can be how big?
If the lower border is palpable under the costal margin at the end of inspiration, it is about __x its normal size.
Causes of enlarged spleen? |
|
Definition
Rupture: severe left sided blow that fractures one of the 9-12th ribs, blunt trauma to abdomen. Results in intraperitoneal hemorrhage and shock. Treatment: total/partial splenectomy
Splenomegaly:
Normal: 7 oz, not palpable bc it's behind the ribs
Enlarged: can be 10x normal size and weigh 100g
3x
Causes: hypertension, granulocytic leukemia, certain anemias |
|
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Term
The kidney:
lies at the level of __-__
Which kidney lies lower than the other?
It is invested by ____ and surrounded by ___ fascia and ___ fat |
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Definition
T12-L3
Right lower than left
fibrous renal capsule, perirenal fascia, pararenal fat
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|
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Term
___ is AKA "dropped kidney"
What causes it?
What happens to the adrenal galnds?
What happens to ureters?
Pain? |
|
Definition
Nephrotosis
Caused by lack of inferior support of kidneys in fascia so they descend more than the normla 3cm when the person stands
adrenal glands stay in place
ureters coil and have kinks (insignificatn)
Pain is from stretch of renal vessles, releived by lying down |
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Term
Renal Transplantation:
When is it done? Where is the transplant site and why? |
|
Definition
Done for select cases of chronic renal failure
Transplant site is iliac fossa of greater pelvis bc there's more supprt, major blood vessels are near, easy access to bladder
The renal artery and vein are jointed to the external iliac artery and vein
The ureter is attached to the bladder |
|
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Term
| What is contained in the renal hilum? |
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Definition
| Anterior to posterior: renal vein, renal artery, renal pelvis (becomes ureter) |
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Term
| Nephron and collecting schema of the kidney (follow path of urine) |
|
Definition
Bowman's capsule -- proximal convoluted tuble -- loop of henle -- distal convoluted tubule -- collecting duct
distal convoluted tubule of each kidney empties into central collecting duct |
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Term
3 components of the renal cortex:
Renal cortex extends between renal pyramids as ____
Renal medulla consists of what 4 things? |
|
Definition
renal corpuscles, proximal convoluted tubules, distal convoluted tubules
Renal columns (of bertini)
medulla: 9-13 renal pyramds (of malpighi), straight tubules, loop of henle, collecting ducts |
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Term
What i the basic functional unit of the kidney?
Each ____ (apex of the renal pyramid) opens into a cup shaped end of a ____, from which the urine is excreted.
Collecting system:
a. ____: fuse together to form 2-4 ____.
b. ____ joint to form the funnel-shaped ____.
c. The ____ narrows to form the ureter. |
|
Definition
Fxn unit: renal pyramid
renal papillae, minor calyx
minor calyx, major calyx
major calyx, renal pelvis
renal pelvis, ureter |
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Term
| ___ is a major cause of renal failure. it is an autosomal dominant trait. symtpoms include enlarged kidenys, distorted by cysts up to 5cm. |
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Definition
| polycystic disease of the kidneys |
|
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Term
How are the right and left adrenal (suprarenal) gland shaped?
What do the different parts secrete? |
|
Definition
Right: pyramidal shaped
Left: crescent-shaped
Cortex: secretes androgens and corticosteroids
medulla: adrenaline and noradrenaline |
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Term
Renal arteries:
Arise from ____ at the __-__ IV level
The right/left is longer.
Divide into __ segmental arteries, which distribute into each renal segment and make them surgically resectible
Suprarenal arteries:
Superior suprarenal arteries (6-8) arise from?
Middle suprarenal arteries arise from?
Inferior suprarenal arteries arise from?
Renal vein drains to?
Reight suprarenal vein drains to?
Left suprarenal vein drains to? |
|
Definition
abdominal aorta at L1-L2
Right is longer
5 segments
superior: inferior phrenic
middle: abdominal aorta
Inf: renal arteries
IVC
IVC
Inferior phrenic to left renal vein |
|
|
Term
How long are the ureters?
3 physiologic constrictions
What is the purpose of the costriction? |
|
Definition
25-30 cm
junction of renal pelvis and abdominal part of ureter
at pelvic brim
where it enters the urinary bladder
significance: doesn't let urine return to kidney from bladder |
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Term
___ are vulnerable to injury when the ovarian vessels are ligated during an ovariectomy due to their close proximity to each other as they cross the pelvic brim
It is also in danger of being injured during a hysterectomy because it crosses inferiorly to the uterine artery, 2cm above the ischial spine. |
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Definition
|
|
Term
Arterial supply to ureters (venous drainage follows arterial supply)
Abdominal ureters: 4 arteries
Pelvic ureters: 3 arteries
Terminal ureters: 2 arteries |
|
Definition
Abdominal: renal, gonadal, abdominal, common iliac
Pelvic: common iliac, internal iliac, ovarian
Terminal: uterine, inferior vesicle |
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Term
Bladder:
Superior apex points toward the superior edge of the ____
The fundus lies ___ to the apex
The ___ is inferiorly placed and is funnel-shaped. The wall of it is made up by the ___ (smooth) muscle
Internall, the bladder is regose, except for a small posterior triangle, the ____.
(a) lie at the superior angles of the trigone, and the ____ is at its apex.
(a) are encircled by loops of detrusor muscle, which prevent reflux of urine into the ureters when the bladder contractss |
|
Definition
pubic symphysis
opposite
neck, detrusor
trigone
(a) = uteric orifices, internal urethral orifice
|
|
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Term
| 2 biggest differences between the female and male urinary bladder |
|
Definition
Involuntary, internal sphincter where the bladder meets the urethra: males have it, females don't
Ligments that secure the neck of the bladder:
females = pubovesical ligaments
males = puboprostatic ligaments |
|
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Term
| Arterial supply to the bladder, venous draina1ge |
|
Definition
Arterial supply: superior and inferior vesical, supplemented by obturator, inf gluteal, and vaginal artery (females)
venous: prostatic (male) or vesical (female) plexus empties into the internal iliac vein |
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Term
___ is a hernia of the bladder
Mainly happens in females, due to damage/prolapse of the ___ or their associated fascia during childbirth, which results in bladder herniation into vaginal wall
Rupture of the bladder may cause urine to escape intra or extraperitoneally, and often also tear the peritoneum |
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Definition
cystocele
peritoneal muscles |
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Term
___ is puncture of a distended bladder as it extends superiorly above the pubic symphysis into the loose areolar tissue between the peritonium and the anterior abdominal wall. done to remove cyst of foreign body from bladder
A ___ is used to examine the interior of the bladder and its three orifices. Done during a transurethral resection of a tumor where a high-frequency electrical current is used to remove the tumor in small fragments that are washed from the bladder with water. |
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Definition
suprapubic cystotomy
cystoscopy |
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Term
The urethra conveys urine from the ___ to the ___.
Female urethra: __cm long and only the proximal part is intra-pelvic. It lies anterior to and in the same axis as the vagina. The (a) opens anterior to the vagina. The ___ (homologous to the prostate) provides lubrication and open on each side of the (a). |
|
Definition
internal urethral orifice to the external urethral orifice
4, external urethral orifice (a), paraurethral glands |
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Term
Male urethra: coveys __ and __. Is __-__cm long.
4 parts:
1. ___
2. ____: bears the urethral crest. The ___ is the roudned eminence at the middle of the urethral crest. The crest has the orifice of the prostatic utricle. Paired ___ ducts open laterla to the utricle. Two grooves on the sides of the urethral crest are the two prostatic sinuses.
3. ___: located behind the pubic symphysis, is the least dilatable part. ___ glands lie on each side.
4. ____: penile part of the urethra. Is __cm long. 2 dilations? |
|
Definition
urine and semen
18-22cm
1. pre-prostatic
2. prostatic: seminal colliculus, ejaculatory ducts
3. intermediate: bublourethral glands
4. spongy: 15cm, commencement of intrabulbular fossa, within glands penis to form the navicular fossa |
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Term
Arterial supply and venous drainage of male and female urethra:
Male: pre-prostatic and prostatic parts: prostatic branches of inferior vesical and middle rectal arteries
Intermediate and spongy parts: branches of dorsal artery of the penis
Veins follow arteries
Female:
Internal pudendal and vaginal arteries
Veins follow arteries |
|
Definition
|
|
Term
3 purposes of catheterization
Where is it likely that perforation could occur during catheterization?
What is a urethral stricutre? |
|
Definition
inability to micturate, irrigate bladder, collect uncontaminated urine
intermediate urethra of male
stricture: external trauma or infection, causing stenosis |
|
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Term
| Autonomic innervation of the abdomen and pelvis |
|
Definition
Autonomic innervation supplies viscera
Parasympathetic: vagus nerve - supply stomach to ascending colon, S2-S4 (pelvic splanchnic nerves) - supply descending colon to genitalia
Sympathetic: Sympathetic trunk (C8-L2) branches to supply viscera, thoracic, lumbar, and sacral splanchnic nerves, prevertebral sympathetic ganglia, abdominal aortic plexus and periarterial plexus |
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Term
Abdominaopelvic autonomic plexuses
1. ___ plexus
PS fibers from right and left vagus nerves
Symp fibers from greater and lesser splanchnic
2. ___ plexus
Branch of (1.)
lesser and least splanchnic nerves
Sometimes first lumbar ganglion of ST
3. ___ plexus
from the intermesenteric plexus
Lumbar ganglia of sympathetic trunks
4. ___ plexus
continuous with the intermesenteric plexus an dinferior mesenteric plexus
5. ___ plexus
from superior sacral sympathetic ganglia and pelvic parasympathetic splanchnic nerves
The right and left ___ nerves join the superior hypogastric plexus to the inferior hypogastric plexus |
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Definition
1. celiac plexus
2. superior mesenteric plexus
3. inferior mesenteric plexus
4. superior hypogastric
5. inferior hypogastric
hypogastric nerves |
|
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Term
Subplexuses of the celiac ganglionic plexus
Subplexuses of mesenteric plexus
subplexuses of inferior mesenteric plexus
Subplexuses of superior hypogastric plexus
Subplexuses of inferior hypogastric plexus
Subplexuses of suprarenal and renal plexus |
|
Definition
Hepatic, gastric, splenic, pancreatic
Superior mesenteric: no subplexuses
Inferior mesenteric: superior rectal plexus
Superior hypogastric: branches to ureter and genital organs
Inferior hypogastric: middle and inferior rectal, prostatic, deferential, uterovaginal, vesical, ureteral
Suprarenal and renal - ureteral |
|
|
Term
Parasympathetic innervation:
Vagus nerves supply...
Pelvic splanchnic nerves supply... |
|
Definition
Vagus: abdominal viscera to left colic flexure
Pelvic splanchnic: pelvic viscera
|
|
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Term
Sensory innervation of abdomen/pelvis:
Proximal to middle of sigmoid colon:
Afferent fibers convey pain sensation to ___ sesnory ganglia
Afferent fibers conveying reflex info to ___ |
|
Definition
Proximal to sigmoid colon:
Pain: thoracolumbar spinal sensory ganglia
Reflex: vagal sensory ganglia
Distal to sigmoid colon:
Pain & sensory impulse: S2-S4 soensory ganglia and spinal cord levels |
|
|
Term
| The ____ plexus is formed from the ventral rami of nerves L1-L3, L4, and some fibers from T12. Forms what 6 nerves? |
|
Definition
Lumbar plexus
iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, femoral nerve, obturator nerve |
|
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Term
What do the ilioinguinal and iliohypogastric nerves are formed from what vertebrae? what do they innervate?
Genitofemoral nerve is formed from which vertebrae? innervate what? |
|
Definition
iliohypogastric and ilioinguinal: From L1, often parts of T12. Abdominal muscles and skin of the inguinal and pubic regions
genitofemoral: L1, L2. Sensory for skin of upper medial thigh |
|
|
Term
| The __ is made up of the right and left hip bones (coxa or pelvic bones) and the sacrum. In anatomical position, the ASIS's and the ___ lie in the same plane. |
|
Definition
pelvic girdle (bony pelvis)
ASIS and pubic symphysis in same plane |
|
|
Term
The pelvic brim is created by what 5 things?
The pelvic brim encloses a space called the ____ that divides the pelvis into greater and lesser pelvis.
The ____ is an incomplete boundary that is closed by the pelvic diaphragm. |
|
Definition
Brim: sacral promontory, sacral alae, arcuate lines, pectineal lines, pubic crests
Pelvic inlet (superior pelvic aperture)
Pelvic outlet
Greater pelvis (false pelvis)
Lesser pelvis (true pelvis)
|
|
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Term
| Major differences between male and female bony pelvis |
|
Definition
Pelvic outlet: smaller in men than women
Pubic arch and subpubic angle: narrow in men, wide in women |
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Term
THe ___ pelvis shape is the normal female type. It's pelvic inlet typically has a rounded oval shape and a wide transverse diameter.
The ___ (masculine/funnel-shaped) pelvis in a woman may present hazards to successful vaginal delivery of a fetus |
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Definition
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|
Term
Crucial obstetric diameters:
The ___ diameter from the middle of the sacral promontory to the posterosuperior margin of the pubic symphysis. it is the narrowest fixed distances through which the baby's head must pass in a vaginal delivery.
The ___ diameter is from the sacral promontory to the level of the inferior margin of the pubic symphysis> it must be at least __ cm.
The ___ diameter is normally the narrowest part of the pelvic canal. Must be three fingers side by side. |
|
Definition
true conjugate diameter
diagonal conjugate - 11 cm
interspinuse |
|
|
Term
Weak places where pelvis fractures may occur (4)
What are common causes of pelvic fractures? |
|
Definition
pubic rami
acetabulum
Si joints
alae of ilium
Direct trauma as in a car accident
Forces transmitted to bones from lower limbs during falls on feet |
|
|
Term
| The pubic symphysis is a cartilaginous joint between the pubic bones with an intervening ____, which is thickest in women. What 2 ligaments stabilize this joint? |
|
Definition
interpubic disc, superior pubic and inferior arcuate pubic ligaments
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|
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Term
___ and ___ joints stabilize the pelvic girdle.
The ___ closes the obturator foramen except for a superior slit, the obturator canal, that transmits the ____. |
|
Definition
lumbosacral (L5 and Si) and sacrococcygeal (S5 and Co1)
obturator membrane, obturator canal |
|
|
Term
Relaxation of pelvic ligaments during pregnancy:
During the latter half of pregnancy, ___ causes increased flexibility of pubic symphysis, sacroiliac joints, and coccyx
The transverse diameter increases __-__%
What happens to the true diameter?
Why does it matter that relaxation is systemic? |
|
Definition
relaxin
transverse diameter
true diameter is unaffected
systemic relaxation increases possibility of joint dislocation |
|
|
Term
Muscles of pelvic floor and wall:
Obturator internus: Origin, insertion, innervation
Piriformis: origin, insertion, innervation
Coccygeous (Ischiococcygeous): origin, insertion, innervation |
|
Definition
Obturator internus:
O: ischium, ileum, obturator membrane
I: femur
I: nerve to obturator internus and superior gemellus
Piriformis:
O: sacrum, rim of greater sciatic notch, sacrotuberous ligament.
I: exits greater sciatic foramen to insert on femur
I: nerve to piriformis
Is used to locate sciatic nerve
Coccygeous:
O: ischial spine
I: inferior sacrum
I: nerve to lavator ani
Forms posteiror pelvic diaphragm
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|
|
Term
Muscles of Levator Ani:
Puborectalis: Arises from ___ and unites with its counterpart posterior to the ___. It forms the ____. Function?
Pubococcygeous: origin, insertion, action
Iliococcygeus: Arises fromt he ___ and ___ and meets its counterpart posteriorly to form the ____.
The ___ and ___ muscles encircle and support the urethra, bvagina, and anal canal.
All levator ani muscles form the ____> They are all innervated by the ___ |
|
Definition
puborectalis: arises from pubic bone, unites posteterior to anorectal jxn, forms puborectal sling. Maintains fecal continence
Pubococcygeous:
O: posterior aspect of pubic bones and anterior tendinous arch.
I: coccyx + turns fibrous to form the midline anococcygeal body (levator plate)
iliococcygeous: Arises from posterior tendious arch and the ischial spine and meets its counterpart posteriorly to form the anococcygeal body
pubococcygeus and puborectalis
form pelvic diaphragm
innervated by nerve to levator ani |
|
|
Term
What two muscles are most often torn during childbirth?
What problems might that cause? |
|
Definition
pubococcygeus and puborectalis
may cause urinary stress incontinence (dribbling of urine when intraabdominal pressure is raised) |
|
|
Term
| Only the ___ and ___ are intraperitoneal, all other pelvic viscera are not completely ensheathed by the peritoneum, but peritoneum is reflected and goes over the rest of the organs (but doesn't ensheath them) |
|
Definition
| ovaries and uterine tubes |
|
|
Term
Pelvic puches and fossae
1. The ___ is formed by peritoneum reflecting onto the superior surface of the bladder.
2. Peritoneum covers the convex superior surface of the bladder and slopes down the sides of the roof to ascend the lateral wall of the pelvis, creating the ____.
3. Peritoneum reflects from bladder and seminal glands onto rectum, forming the ____ (men only - uterus is here in women)
4. (3) extends laterally and posterioraly to form a ___ on each side of the rectum |
|
Definition
1. supravesical fossa
2. paravesical fossa
3. rectovesical pouch
4. pararectal fossa |
|
|
Term
| Anterior divisions of the Internal iliac |
|
Definition
umbilical - superior vesical
obturator
uterine - vaginal
middle rectal
internal pudendal
inferior gluteal |
|
|
Term
| posterior divisions of internal iliac |
|
Definition
superior gluteal
lateral sacral
iliolumbar |
|
|
Term
|
Definition
internal iliac vein
superior rectal to IMA to hepatic portal
lateral sacral to internal vertebral |
|
|
Term
Lymphatic drainage of pelvis:
1. superior parts of middle to anterior pelvic organs
2. inferior pelvic viscera, deep perineum, and gluteal regions - drain into common iliacs
3. posteroinferior pelvic viscera and drain into either internal or common iliacs |
|
Definition
external iliac nodes
internal iliac nodes
sacral nodes |
|
|
Term
Sacral plexus:
Includes ventral rami of spinal nerves __ - ___
Major nerves of the sacral plexus include the ___ and ___.
The ___ is the main nerve of the perineum and the chief sensory nerve of the external genitalia. It leaves the pelvis through the ___ and then hooks around the ischial spine and enters the perineum through the ____. |
|
Definition
L4-S4
pudendal nerve, sciatic nerve
pudendal nerve
greater sciatic foramen, lesser sciatic foramen |
|
|
Term
Coccygeal plexus:
anterior rami of __ and __ and the coccygeal nerves
Supplies what two muscles and one joint?
The ___ nerves supply a small area of skin between the tip of the coccyx and the anus.
How are the pelvic nerves most commonly injured? |
|
Definition
S4-S5
coccygeus muscle, part of levator ani, sacrococcygeal joint
anococcygeal nerves
fetal head can compres sacral plexus, esp obturator nerve |
|
|
Term
what is the normal uterine position?
In what position would prolapse be most likely? |
|
Definition
normal: anteverted, anteflexed
retroverted - most likely to prolapse |
|
|
Term
|
Definition
birth canal
conduit for menstrual flow
copulatory organ |
|
|
Term
| Supports of vagina - upper, middle, and lower thirds |
|
Definition
upper: levator ani & transverse cervical, pubocervial, and sacrocervical ligaments
middle: UG diaphragm
Lower: perineal body |
|
|
Term
|
Definition
| softening of uterine isthmus - early sign of pregnancy |
|
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Term
| How does the vagina distend during birth? How does that affect the fetus? |
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Definition
Vagina distends mainly in AP direction.
Lateral distension is limited by ischial spines and sacrospinous ligaments.
This causes fetus' shoulders to rotate into the AP plane during delivery |
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Term
| A ___ is an abnormal passage that connects the vagina to other pelvic organs such as the bladder, urethra, rectum, or perineum, resulting in leakage of urine or feces into vagina |
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Definition
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Term
2 tests for patency of uterine tubes:
1. ____: water-coluble radiopaque material is injected into the uterus and the path is traced
2. ___: thin fiberoptic telescope is inserted through the cervix. visualization of the uterus and fallopian tube is viewed |
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Definition
hysterosalpingography
hysteroscopy |
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Term
____ - an endoscopic examination of the female pelvic viscera by means of an endoscope introduced into the pelvic cavity through posterior vaginal fornix. Used to identify what?
___ - extraction of fluid from the rectouterine pouch posterior to the vagina through a needle. Used to identify what? |
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Definition
culdoscopy - tubal pregnancy
culdocentesis - pelvic abscess, ruptured ectopic pregnancy, suspected ovarian cyst |
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Term
Uterus:
Main arterial supply?
Collateral arterial supply?
Venous drainage?
Vagina:
superior, middle, and inferior arterial supply?
venous drainage? |
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Definition
uterus: uterine arteries and ovarian arteries
uterine vein - drains to internal iliac
vagina: superior: uterine arteries, middle & inf: vaginal and internal pudendal arteries
uterovaginal veinous plexus - drains to uterine vein, then internal iliac |
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Term
| Where are sperm produced? |
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Definition
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Term
| The two ___ glands lie posteroloateral to the intermediate part of the urethra. the ducts open through minute apertures into the proximal part of the spongy urethra. their mucus-like secretions enter the urethra during sexual arousa |
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Definition
| bulbourethral (cowper) glands |
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Term
____ is a smooth muscle tube that conveys seminal fluid. It dilates at the ___ and ends by joining the duct of the seminal gland to form the ____.
What is in seminal fluid?
____: paired, elongated, sacculated glands are obliquely placed superior to the prostate. secrete thick, alkaline fluid with fructose (energy source for sperm) and a coagulating agent.
___: paired ducts, each formed by the union of the ampula of the vas and the seminal gland duct. opens in prostatic part of urethra. |
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Definition
ductus deferens, ampulla, ejaculatory duct
seminal glands/vesicles
ejaculatory ducts |
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Term
| The prostatic ducts open into the ___, on either side of the ____. They carry ____, a thin milky fluid that adds 20% of the volume of semen to the ejaculate |
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Definition
| prostatic sinus, seminal colliculus, prostatic fluid |
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Term
Boundaries of the perineum:
Anterior:
Anterolateral:
lateral:
posterolateral:
posterior: |
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Definition
Anterior: pubic symphysis
Anterolateral: inferior pubic rami and ischial rami
lateral: ischial tuberosities
posterolateral: sacrotuberous ligametns
Posterior: inferiormost sacrum and coccyx |
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Term
The urogenital triangle is closed by the ___ membrane.
The ___ is a fibromuscular mass located in the median plane. Important in females because it is the final support of the pelvic viscera.
Contents of the anal triangle
Technically, the area below the pelvic diaphragm is the ____. |
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Definition
perineal membran
perineal body
anal canal and anus
perineum |
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Term
| contents of the pudendal canal |
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Definition
| pudendal nerve, internal pudendal vein and artery |
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Term
| 3 superficial muscles of UG region, 2 deep muscles |
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Definition
superficial: ischocavernosus, bulbospongiousus, superficial transversus perini
Deep: sphincter urethrae, deep transversus perinei |
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Term
| Female: what glands secrete mucus during arousal? |
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Definition
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Term
| Fxn of bulbospongiosus and ischiocavernosus muscles |
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Definition
sphincter of vagina and assists in erection of clitoris
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Term
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Definition
external genitalia, perineal muscles, anal canal
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Term
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Definition
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Term
3 erectile tissues in penis
The ___ covers the glans penis |
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Definition
2 corpora cavernosa
single corpus spongiosum - contains spongy urethra and glans penis
prepuce |
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Term
| The ___ is the voluntary sphincter muscle of the urethra |
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Definition
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Term
arteries of penis:
deep arteries supply ____
___ arteries wrap around corpus cavernosus
artery of the bulb supplies ____ |
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Definition
corpus cavernosus,
deep artery
corpus spongiosus |
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Term
| Inital distension of bulbospongiosus and transverse perineal muscles cause involunatry spasms of perivaginal and levator ani muscles. can cause dyspareunia (painful intercourse) and can prevent vaginal penetration. |
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Definition
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Term
___ is when the dorsal and ventral pancreatic buds (during development) form a ring around the duodenum, constricting it.
The caudal limb of the midgut is easily recognized during development becauseo f the presence of the ____.
The ___ is defined to begin where the blood supply changes from the __ to the ___.
The ___ is the expanded terminal part of the hindgut. |
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Definition
annular pancreas
cecal diverticulum
hindgut
cloaca |
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Term
| The epithelium of the superior 2/3 of the anal canal is derivd from the endodermal hindgut, the inferior 1/3 develops from the ectodermal protodeum. The junction of these two epithelia is indicated by the ____. |
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Definition
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Term
| Arterial supply to the foregut, midgut, and hindgut |
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Definition
foregut: celiac artery
midgut: SMA
Hindgut: IMA |
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Term
___ is a remnant of the proximal part of the yolk stalk that fails to degenerate during the early fetal period. It resultsin a finger=like blind pouch that projects from the ileum.
___ is when the anal membrane fails to break down before birth. the anus must be reconstructed surgivally. |
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Definition
ileal diverticulum (Meckel's diverticulum)
imperforate anus |
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Term
| During folding of the embryo in the horizontal plane, intermediate mesoderm is carried ventrally and loses its connection with the somites. A longitudinal elevation of mesoderm fors called the ____. The part of this structure giving rise to the urinary system is the ____. |
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Definition
Urogenital ridge
nephrogenic cord |
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Term
3 sets of kidneys develop sequentially in the embryo, called _____, ____ , and ____
Which ones remain as permanent adult kidneys?
Which ones remain as the wolffian duct? |
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Definition
pronephros
mesonephros - remain as wolffian duct
metanephros - remain as adult kidney
Adult kidney a combination of metanephros and uteric bud |
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Term
___ form when the inf poles of the kidneys fuse together. the combined kidney is not able to ascned to its adult physiological location bc it gets "hung up" on the IMA
A ___ is a kidney that has failed to migrate to it's adult physiologic position |
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Definition
horseshoe kidney
pelvic kidney |
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Term
Male and female morphologic characteristics do not develop until what week?
The early genital systems in the two sexes are similar, which is knows as the ___. |
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Definition
7
indifferent state of development |
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Term
In female embryos: the ___ ducts develop into most of the female genital tract
In males, the testes secrete ____ which inhibits development of these ducts. instead, the ___ ducts develop. |
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Definition
paramesonephric ducts/mullerian ducts
mullerian inhibiting substance, mesonephric |
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Term
| External genital develoment: A gential tubercle elongates into a ____. |
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Definition
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Term
___: incomplete fusion of the UG folds creates abnormal openings of the urethra on the ventral aspect of the penis.
___: failure of testes to descend into scrotum.
___: failure of one paramesonephric duct to develop. results in a single uterine tube and horn of the uterus. |
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Definition
hypospadias
cryptochordism
unicornuate uterus |
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Term
____: the transitional region betweent he trunk and free lower limb
___: extends from gluteal, abdominal, and perineal region proximally and knee distally. |
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Definition
gluteal region
Thigh/femoral region |
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Term
Angle of inclination:
125 degress is normal
106 degrees is ____
140 degrees is ____ |
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Definition
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Term
A femoral neck fx happens when you fall down on your feet .. the ___ artery can be occluded and cause necrosis of the femoral head
A femoral shaft fx happens in ____
Where do tibial/fibular fractures typically occur?
A ___ fx (stress fx) often occurs in runner
A ___ fx (boot top fx) can cause shortening of the leg due to overriding fracture fragments. It is through the fibula and tibia. |
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Definition
medial circumflex femoral artery
severe accident
middle and superior 1/3
march
bumper |
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Term
____ is when the tibial tuberosity is elongated and fragmented with overlying soft tissue swelling
Ankle fxs (distal tibia/fibula) are typically due to excessive ___ or ___ |
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Definition
osgood schlatter
eversion or inversion |
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Term
7 bones of the tarsus
How many metatarsals?
How many phalanges? |
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Definition
calcaneus
talus
navicular
cuboid
3 cuneiforms
5 metatarsals
14 phalanges |
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Term
3 arches in the foot:
___: made up of calcaneus, talus, navicular, 3 cuneiforms and 3 metatarsals
___: made up of calcaneus, cuboid, and 4-5th metatarsals
___: cuneiforms and cuboid
Flat foot doesn't have which of these arches? |
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Definition
medial longitudinal arch
lateral longitudinal arch
transverse arch
flat foot = no medial longitudinal arch
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Term
____: fascia that covers the thigh
Iliotibial tract: condensation of fascia formed by ____ and ____ that attaches to the gerdy tubercle and limits ___ (action) |
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Definition
fascia lata
IT tract: gluteus maximus and tensa fascia lata - limits hyperadduction |
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Term
At the ankle, the ___ fascia condenses to form retinacula for the extensor, flexor, and peroneal muscles
The fascia at the ankle/foot is called ___, which covers muscles and tendons
the ___ is the fascia at the ankle that forms the tarsal tunnel. |
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Definition
crural
retinaculum
flexor retinaculum |
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Term
| The ___ holds the parts of the foot together, helps protect the sole from injury, and helps support the longitudinal arches. |
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Definition
| plantar fascia/deep fascia/plantar aponeurosis |
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Term
| ___ is the chief flexor of the hip joint. |
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Definition
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Term
| Taylors Muscles: ___ & ___ - acting together, they cross the legs |
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Definition
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Term
| ___ is the longest muscle in the body |
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Definition
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Term
| The 4 quadriceps femoris muscles have differnet origins but a common insertion... |
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Definition
Rectus femoris: ASIS
Vastus Lateralis: lateral edge of the linea aspera
vastus medialis: medial edge of linea aspera
Vastus intermedius: anterior surface of femur
common insertion: all unite to form patellar ligament |
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Term
A person with paralyzed ___ muscles cannot extend the lef against resistance.
Weakness of the ___ or ____, resulting from arthritis or trauma to the knee joint can result in abnormal patellar moement and loss of joint stability |
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Definition
quadriceps
vastus medailis & vastus lateralis |
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Term
| ____: soreness and aching around or deep to patella + patellar instability. results from quadriceps imbalance. AKA runners knee. |
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Definition
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Term
Adductor longus and brevis both originate at the ___ and insert at the ___.
___ artery and ___ nerve run between these muscles |
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Definition
pubic bone
linea aspera
deep femoral artery & anterior branch of obturator nerve |
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Term
| ____: Ossification that sometimes occurs in adductor longus tendons in horseback riders |
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Definition
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Term
Adductor magnus, 2 parts:
Action together?
Actions separately? |
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Definition
together: adducts thigh
Adductor part: flexes thigh
Hamstring part: extends thigh |
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Term
| Because the ___ is a relatively weak member of the adductor group, it can be removed and transplanted wihout noticeable loss of action. |
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Definition
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Term
What muscle?
Origin: margin of obturator membrane
insertion: trochanteric fossa of femur
Action: laterally rotates theigh, steadies head of femur in acetabulum |
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Definition
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