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Inguinal Region, Suprarenal, Kidney, Ureter, Bladder
n/a
78
Anatomy
Professional
09/17/2011

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Cards

Term
Where is the inguinal region located?
Definition
Between the anterior superior iliac spine and the pubic tubercle
Term
The inguinal canal is formed by what process during development?
Definition
Relocation of the testes
Term
Define Deep/Internal Inguinal Ring
Definition

The hole in the transversalis fascia through which the spermatic cord (round ligament (f)) pass through

- deep aspect of the abdominal wall

Term
Define Superficial/External Inguinal Ring
Definition
The point at which the spermatic cord (round ligament) crosses the medial defect of the external oblique aponeurosis
Term
Boundaries of the Inguinal Canal
Definition

anterior: external oblique aponeurosis & internal oblique M (more lateral)

posterior: transversus abdominis M and transversali fascia

Superior: internal oblique M and transversus abdominis M and aponeurosis

Inferior: inguinal ligament and lacunar ligament

Term
[image]
Definition

 

  1. Anterior superior iliac spine
  2. Pubic symphysis
  3. Deep inguinal ring
  4. Superficial inguinal ring
  5. Inguinal canal
  6. Obturator foramen
Term
What is Poupart's Ligament?
Definition
Inguinal Ligament
Term
Describe the Inguinal Ligament
Definition

- comprised of inferior fibers of the external oblique aponeurosis

- streches from the ASIS to the pubic tubercle

- forms the inferior floor of the inguinal canal

Term
Cooper's Ligament is another name for what ligament?
Definition
Pectineal Ligament
Term
Describe the Pectineal Ligament
Definition

- lateral portion of the lacunar ligament

- fused to the pubic tubercle

- may include fibers from the transversus abdominis, iliopubic tract, internal oblique, and rectus abdominis

Term
Describe the Illiopubic Tract
Definition

- on deep side of inguinal ligament (looking from inside out)

- begins at ASIS and inserts into the pectineal lig.

- helps form the inferior margin of the deep (internal) inguinal ring

- continues as the anterior and medial border of the femoral canal

Term
Gimbernat's Ligament is also known as what?
Definition
Lacunar Ligament
Term
Describe the Lacunar Ligament
Definition

- triangular fanning out of the inguinal ligament as it joins the pubic tubercle

- lateral edge forms medial border of femoral canal

Term
What is another name for Conjoined Tendon?
Definition
Falx inguinalis
Term
Describe the Conjoined Tendon
Definition
- fusion of the inferior fibers of the internal oblique and transversus abdominis aponeurosis, where they insert on the pubic tubercle
Term

Describe the Deep (Internal) Inguinal Ring

 

Definition

- entrance to inguinal canal for spermatic cord (round ligament)

- entrance for genital branch of genitofemoral N

- lateral to the inferior epigastric A

- starts as an invagination of the transversalis fascia that forms an opening for the spermatic cord to enter the inguinal canal

- inferior border formed by iliopubic tract

Term

Describe the Superficial (external) inguinal ring

- Do things enter or exit?

- What goes through this ring?

-What is its position?

- what does it split to form?

Definition

- exit for the spermatic cord (round ligament), genitofemoral N, and ilioinguinal N from inguinal canal

- superior and lateral to pubic tubercle

- splits to form the medial and lateral crus (portion of the external oblique aponeurosis

Term
Define the Intercural Fibers
Definition

- formed from the superficial layer of deep fascia overlying the external oblique M and aponeurosis

- runs perpendicular to the fibers of the aponeurosis to help prevent the crura from opening

- runs perpendicular to the medial and lateral crus to prevent the opening of the superficial inguinal ring

Term

Describe the Gubernaculum

 

what does it do?

what does it become?

Definition

- fibrous tract connecting the primordial testes to the anterolateral abdominal wall at the site of the deep inguinal ring

- fibrous cord connecting the ovary and uterus to the developing labium majus

- becomes ovarian ligament and the round ligament

Term
Define Processus Vaginalis
Definition
- the peritoneal diverticulum (outpouching) that crosses the developing inguinal canal carrying the muscular and fascial layers of the anterolateral abdominal wall into the scrotum
Term
Describe the Myopectineal Orifice [image]
Definition

-passageway for the great vessels to the lower extremity, and for the testicle to reach the scrotum

- Site for many different hernias to occur


Borders

Superior: arch of the int. oblique M and transversus abdominis M

Lateral: iliopsoas M

Medial: lateral edge of the rectus abdominis and pubic pectin

- Iliopubic tract divides orifice into superior portion (spermatic cord) and inferior portion (iliac vessels)

Term
Define Triangle of Pain
Definition

- space bordered by iliopubic tract (superior) and gonadal vessels (lateral)

- contains lateral femoral cutaneous N, femoral branch of the genitofemoral N, and femoral N

[image]

 

Term

Define Triangle of Doom

- borders

- what runs through it

Definition

- space bordered by vas deferens and spermatic cord vessels

- contains external iliacs, deep circumflex iliac V, femoral N, genital branch of genitofemoral N

- cut thru the vessels in this region and pt can bleed to death

[image]

Term
Define the Circle of Death
Definition
- vascular continuation formed by the common iliac, internal iliac, obturator, inferior epigastric, and external iliacs
Term
Compare direct and indirect hernias
Definition
  • Direct Hernias
    • go through the Hesselbach triangle
    • protrude medial to the inferior epigastrics
  • Indirect Hernias 
    • DO NOT go through Hesselbach's triangle
    • protrude laterally to inferior epigastrics

 

Term

Define Hesselbach's Triangle

- borders

Definition

- superior/lateral border: inferior epigastrics

- medial border: lateral edge of rectus abdominis

- inferior border: inguinal ligament

Term
What is the scrotal ligament a remenant of?
Definition
Gubernaculum
Term

What forms the Tunica Vaginalis?

and what does it cover?

 

Definition

- distal part of the processus vaginalis (the stalk degenerates)

- covers the testis and epididymis

Term
In females, how does the Gubernaculum function?
Definition
- the gubernaculum is a fibrous cord that connects the ovary and the primordial uterus to the developing labium majus
Term

Do the ovaries descend into the inguinal region?

How about the round ligament?

Definition

- No, the ovaries do not descend into the inguinal region because the ovarian ligament holds the ovaries up

- The round ligament however does enter the inguinal region

Term
What does the spermatic cord contain? (11 items)
Definition

vas deferens A/V

cremasteric A/V

testicular A/V

vas deferens

pampiniform venous plexus

genital branch of genitofemoral N

sympathetic N

lymphatic vessels

 

Term

What are the 3 fascial layers of the spermatic cord?

- include the layers origin

Definition

- external spermatic fascia - external oblique aponeurosis

- cremaster fascia - internal oblique M

- internal spermatic fascia - transversalis fascia

Term
What are the layers of the scrotum?
Definition
2 layers - skin and dartos fascia
Term
Describe Dartos Fascia
Definition

- layer of smooth muscle fibers responsible for wrinkled appearance of scrotum

- superior dartos fascia has no fat

- continuous anteriorly with Scarpa's fascia

-continous posteriorly with Colle's fascia

- attaches to skin and causes scrotum to contract and bring testis closer to abdominal cavity to keep warm and sperm alive

Term
Describe the Epididymis
Definition

- lies on posterior surface of the testis

- is covered by tunica vaginalis

- has 3 parts head, body, tail

Term
Explain the relationship between the efferent ductules, rete testis, and epididymis
Definition

- the rete testis = network of canals at the termination of the seminiferous tubules

- the efferent ductules transport sperm from the rete testis to the epididymis where sperm is stored

 

- seminiferous tubules in testes -> rete testis -> efferent ductules -> epididymis

Term

Name the layers covering the Testis

(from most superficial to deep)

Definition

Outer to Inner layers

- skin

- dartos fascia

- external spermatic fascia

- cremaster fascia

- internal spermatic fascia

- tunica vaginalis (parietal layer)

- tunica vaginalis (visceral layer)

- tunica albuginea

Term
Describe the Vas Deferens
Definition

- aka ductus deferens

- continuation of the tail of the epididymis

- muscular tube that conveys sperm from the epididymis to the ejaculatory duct

- meets with seminal vesicle duct to form ejaculatory duct

Term

Describe the Seminal Vesicles

- where is located

- what does it do


Definition

- located in between the fundus of the bladder and rectum

- DOES NOT STORE SPERM

- secretes thick alkaline fluid that mixes with sperm as they pass into the ejaculatory ducts and urethra

Term
Describe the Iliohypogastric N
Definition

- superior terminal branch of the anterior ramus (L1)

-pierces transversus abdominis to course b/t 2nd and 3rd layers of abdominal M (in between transversus abdominis and internal oblique M)

- branches into lateral and anterior cut. branches, pierce internal and external oblique M above superficial inguinal ring 

- innervates skin overlying iliac crest, upper inguinal and hypogastric regions, internal oblique, and transversus abdominis M

 

Term
Describe the Ilioinguinal N
Definition

- inferior terminal branch of anterior ramus of L1

- passes between 2nd and 3rd layer of abdominal M.

- enters the inguinal canal b/t the internal and external oblique M

- exits through the superficial inguinal ring

- innervates the skin of lower inguinal region, upper and medial thigh, inferiormost internal oblique M, transversus abdominis M, penis and upper scrotum (males), mons pubis and labium majus (female)

Term
Describe the Genitofemoral N
Definition

- arises from L1-2

- emerges on the ant. aspect of the psoas

- divides into the genital and femoral branches

- genital branch remains ventral to the iliac vessels and the iliopubic tract, as it enters the superficial inguinal canal (just lateral to inferior epigastric vessels)

- supplies the scrotum and cremaster M (males)

- supplies mons pubic and labia majora (females)

- femoral branch courses along the femoral sheath

Term
Describe the Lateral Femoral Cut. N
Definition

- arises from L2-3, emerges from lateral border of psoas M at level of L4

- crosses iliacus M obliquely

- passes inferiorly to the inguinal ligament where it divides to supply the lateral aspect of the thigh

Term
Name the different types of hernias (9)
Definition

- Femoral : found in the femoral canal

- Obturator: protrude through obturator canal, more common in elderly women, present w/ Howship-Romberg sign

- Umbilical: protrude thru' umbilical ring

- Spigelian: abdominal wall hernia thru' transversus abdominis aponeurosis, b/t semilunar line and the semicircular line at the lateral edge of the rectus M

- Lumbar (Petit): protrudes thru' inferior lumbar triangle (posterior)

- Grynfelt: protrudes thru' superior lumbar triangle (posterior and superior)

- Sliding: portion of hernia sac contains an intrabdominal organ

- Pantaloon: has both direct and indirect hernia ocurring simultaneously

- Epigastric: due to congenital or acquired weakness of the linea alba above the umbilicus

Term

Suprarenal Glands

-where are they located

- what are the measurements?

- name the fascia covering them

- describe the differences b/t the rt and lt gland

Definition

- located superiorly and medial to the kidneys at level of rib 11

- measures 5 x 3 x 1 and weights 4-5g

-Gerota's fascia covers the adrenal glands

- rt gland is more pyramid shaped, lt is more semilunar shape

- rt gland is close to liver and IVC

-lt gland is associated with aorta, spleen, and tail of pancreas

Term

Suprarenal Cortex

- what are the 3 zones? and what do they produce?

Definition

- Glomerulosa: mineralocorticoids

- Fasciculata: glucocorticoids

- Reticularis: androgens

Term

Suprarenal Medulla

- what % of the gland does it make up?

- Is it endodermal, mesodermal or ectodermal in nature?

- what does it produce?

Definition

- 20% of the gland (cortex makes up 80%)

- it is ectodermal in nature

- produces norepinephrine and epinephrine

Term

Describe the blood supply to the Suprarenal Glands

(include where the A branched from)

Definition

- Suprior adrenal A : from inferior phrenic A

- Middle adrenal A: from aorta

- Inferior adrenal A: from renal A

Term
Describe the different b/t the Rt and Lt Adrenal V
Definition

- the Rt adrenal V is shorter b/c IVC is on the right

- rt. adrenal V drains into IVC

- the left adrenal V is longer b/c it has to travel farther

-**the left adrenal V joins the inferior phrenic V and empties into the left renal V

Term
Which zones of the suprarenal cortex are present at birth and which one is not present until 3 years of age?
Definition

- at birth: glomerularis and fasciculata

- 3yo : reticularis

Term

Fetal adrenals are 10-20 times larger than adult glands due to extensive size of the cortex.

 

T/F

Definition
True - adrenals become smaller as ther cortex regresses during 1st year of life
Term
Name the 2 layers of fat and the fascia covering the kidneys
Definition

- Renal fascia (Gerota's fascia)

- Perirenal fat (inside the renal fascia)

Pararenal fat (outside renal fascia)

 

pararenal fat ->renal fascia -> perirenal fat

Term

Kidneys

 

- Measurements of kidneys

- Heavier in M or F?

Definition

- length: 10-14cm

- width: 5-6cm

-thickness: 2.5-3cm

- heavier in males

Term
What are the surfaces, borders, and poles of the kidneys?
Definition

surface : ant and post

borders: lateral and medial

poles: superior and inferior

Term

Kidneys have anastomotic arterial flow and are not prone to infarction when vessels are interrupted

 

True or False

Definition
False : Kidneys DO NOT have anastomotic flow --> prone to infarction when renal vessels interrupted
Term

Name the parts

[image]

Definition
[image]
Term
Describe the pathway of urine starting from nephron to ureter
Definition
bowman's capsule -> proximal convoluted tubule -> descending loop of henle -> ascending loop of henle -> distal convoluted tubule -> macula densa -> collecting ducts (located in renal papilla) -> minor calyces -> major calyces -> renal pelvis -> ureter
Term
Compare the rt and lt renal A
Definition

- Left renal A is  shorter than right, since aorta is on left side

- Rt renal A passes posterior to IVC

Term
Describe renal A pathway/branching
Definition
Renal A -> segmental A -> interlobar A -> arcuate A -> afferent arterioles
Term

Renal Veins

- describe the differences

- location

 

Definition

- renal V drain into IVC

- rt renal V is shorter than lt

- lt renal V passes anteriorly to aorta, but posteriorly to SMA (can be compressed)

- Lt renal V passes ant. to lt renal A

- Lt renal V is in continuity with the lt gonadal V, lt inferior adrenal V, and lumbar V

Term
What are the 3 excretory organs in development?
Definition
pronephros, mesonephros, metanephros
Term

Mesonephric duct becomes the Wolffian duct --> form male reproductive system

 

T/F

Definition
True
Term
Which of the 3 excretory organs during development will become the adult kidney? Pronephros, mesonephros, metanephros ?
Definition

Metanephros - will become adult kidneys

- give rise to collecting tubules, minor and major calices, renal pelvis, and ureters

Term

During the kidneys ascent, they add segmental vessels cranially and lose them caudally as thye go up toward the suprarenal glands.

 

True or false

Definition
true
Term
Where are the ureters located in relation to the renal vessels?
Definition
posterior to the renal vessels
Term

The ureter crosses anteriorly to the obliterated umbilical A.

 

True or False

Definition
False, the obliterated umbilical A passes anterior to the ureter
Term

The left ureter passes behind the sigmoid colon.

 

True or False?

Definition
True
Term
What are the parts of the bladder?
Definition

- apex : anterior end that points toward pubic symphysis

- body: part b/t fundus and apex

- Fundus base of bladder formed by posterior wall

- Neck

- Uvula : slight projection of trigone

Term
Describe the Trigone of the bladder
Definition

- smooth area within the base of the bladder

- bounded by 3 orifices : right and left ureterovesical orifices and the internal urethral meatus

Term
Describe the position of the bladder as it relates to male and females
Definition

males - bladder is anterior to rectum

females - bladder is anterior to vagina and uterus (bladder -> uterus & vagina -> rectum)

Term
Define Median Umbilical Ligament
Definition
connects dome of bladder to the umbilicus
Term

Lateral ligament

 

Definition
connects lateral wall of the bladder to the tendinous arch of the pelvic fascia
Term
Define Puboprostatic ligament
Definition
connects the pelvic wall to the prostate gland
Term
Define Pubovesical ligament
Definition
connects the pelvic wall to bladder neck
Term
Define Paracolpium ligament
Definition
- lateral attachment of the vagina to the tendinous arch of the pelvic fascia
Term
Describe the Cloaca as it relates to development
Definition

- divided by the urorectal septum -> doral rectum and ventral urogenital sinus

- recieves the allantois and mesonephric ducts

Term
Name the 3 parts the urogenital sinus divides into
Definition
  1. Vesical (cranial) - forms most of the urinary bladder
  2. Pelvic (middle) - becomes urethra in the neck of the bladder and produces prostatic and membranous portions of the uretha in the male
  3. Phallic (caudal) - forms penile urethra in male and vestibule of the vagina in the female
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