Abdomen and Pelvic Cavity Flashcards
what is the boundary where the abdominal cavity becomes the pelvic cavity
pubic symphysis, L5 level
what happens to urine production if there is a drop in blood pressure
it goes down to try to conserve water and therefore blood pressure
what three structures make up the lower urinary tract
ureters
bladder
urethra
what is the flow of urine
kidney
ureters
bladder
urethra
explain how kidneys regulate fluid and electrolyte balance
regulate osmolarity by either conserving or eliminating water and electrolytes (sodium, potassium, calcium)
explain how kidneys excrete metabolic wastes
they filter out CO2, phosphates, and nitrogenous wastes (urea, ammonia, uric acid, and creatinine)
eliminate them via urine
how is urea produced
it is a waste product made when your liver breaks down protein
how is uric acid produced
chemical created when the body breaks down purines
how is creatinine produced
waste product of creatine
explain how kidneys maintain acid-base balance
regulates blood pH by conserving or eliminating hydrogen and bicarbonate ions
what is the optimal pH range for the body
7.35-7.45
what happens to pH if you remove hydrogen ions
pH increases
what three “hormones” do kidneys secrete
renin
erythropoietin
*prostaglandins - not technically a hormone
what does renin do
converts angiotensinogen into angiotensin 1 in the RAAS system
eventually, vessels constrict which causes hypertension and an increase in blood pressure
helps to maintain blood pressure
what does erythropoietin do
regulates making of red blood cells (erythropoiesis)
can increase red blood cell formation to combat anemia
what are protaglandins and what do they do
lipids made at sites of infection/damage
regulate renal blood flow and glomerular filtration rate
what substances do the kidneys detoxify in the blood
heavy metals
excess salt
excess vitamin C
how do kidneys regulate vitamin D metabolism
convert inactive form of vitamin D into active form (calcitriol)
what is gluconeogenesis
making of new glucose
can be done by the kidneys
what 5 heavy metals should we only see trace amounts of in the blood
chromium
copper
iron
manganese
zinc
*too much of these in the blood could indicate that the kidneys are not functioning properly
what percentage of kidney failure will you have to be at to be symptomatic
75% failure
how is kidney failure determined
high creatinine levels
what happens when you have damaged kidneys
less buffering (pH maintenance) capacity
more phophate, less calcium (muscle twitching)
more sodium, water, and edema
more potassium, hyperkalemia, cardiac muscles affected
what is hyperkalemia
too much potassium in the blood
typically due to kidney failure
what are the four external layers of the kidney from superficial to deep
pararenal (paranephric) fat capsule
renal fascia (Gerota’s fascia)
adipose capsule (perirenal or perinephric fat capsule)
renal capsule
where would you find paranephric (pararenal) fat
on posterior region of kidney
what does the renal fascia (gerota’s fascia) do
anchors kidney to peritoneum and muscles of posterior abdominal wall (psoas major and quadratus)
what does the adipose capsule (perirenal or perinephric fat capsule) do
found within the renal fascia directly touching the kidney
keeps kidneys in place and shields them from physical shock
what does the renal capsule do
covers exterior of kidney
protects kidney from outside infection and physical trauma
invaginates to become outer layer of calyces and pelvis
how much does a kidney weigh in both males and females
female: 130 g
male: 160 g
how are the structures entering the hilum of the kidney from anterior to posterior
renal vein
renal artery
nerves
lymph vessels
ureters
what is the renal sinus and what does it do
made up of calyces, pelvis, and fat
anchors vessels in place
how is the kidney broken up
superior pole (at the end closest to the adrenal gland)
lateral border (opposite the hilum)
innferior pole (at the end farthest from the adrenal gland)
where is the right kidney located
slightly inferior due to the liver
where is the left kidney located
between T11-L2 vertebrae
higher than right kidney becuase no liver on that side
which ribs protect the kidneys
the floating ribs (11+12)
what structures do you find around the right kidney
liver
hepatic flexture
duodenum
IVC
psoas muscle
what structures do you find around the left kidney
descending colon
ligament of treitz
psoas muscle
what are kidneys like during utero
start with 8 lobes
start out in the pelvis then ascend to the abdomen
what are the three distinct regions of the internal kidney
renal cortex
renal medulla
renal pelvis
what is the renal cortex
rim of reddish-brown tissue around the inside of the kidney
holds 95% of all kidneys blood vessels
what is the renal medulla
Inner portion of kidney deep to the cortex
includes several renal pyramids and the columns between them
darkened due to lack of blood vessels
what are renal columns (of Bertin)
invaginations of the renal cortex between renal pyramids
has branches of the renal artery going to the outer cortex
what are nephrons and where are they found
filtering apparatus made of renal corpuscle and renal tubule
found within the cortex with extensions into the medulla
what do the renal corpuscles do
made of glomerulus and its capsule
filters blood
what are renal tubules and what do they do
made of proximal tubule, loop henle, and distal tubule
collect and modify filtrate
what are the two types of nephrons
cortical and juxtamedullary
what are some features of the cortical nephrons
make up 80% of nephrons
found primarily in renal cortex and have small nephron loops
what are some features of juxtamedullary nephrons
nephrons whose loop extends deep into the renal pyramid
what are the three portions of the collecting duct from cortex to minor calyx
cortical (within cortext)
medullary (within pyramid)
papillary (bottom of pyramid)
what is the papilla
bottom portion of renal pyramid
what makes up a major calyx
3-4 minor calyces
what makes the renal pelvis
2-3 major calyx
what is the ureteropelvic junction
constriction at the junction of the renal pelvis and ureter
what is a bifid renal pelvis
more than one renal pelvis
invasion of what two structures halves the survival rate of kidney cancer
renal vein or renal capsule
explain transitional cell cancer
cancer of the transitional epithelial cells
can occur in the pelvis, top of ureter, and bladder
treated by removing entire kidney and ureter
explain renal cell cancer
tumor of lining of small tubes in kidney
treated by removing kidney and a small portion of ureter
symptoms don’t present until it’s severe
most common in older men
explain nephrolithiasis
kidney stones
caused by dehydration, obesity, salt, etc.
pain radiates medially and inferiorly from lumbar region to pubic region
diagnosed through CT scan or intravenous pylogram
what is the arterial blood flow of the kidney
abdominal aorta
R + L renal arteries
segmental artery
interlobar artery
arcuate artery
interlobular (cortical radiate artery)
afferent arterioles
glomerulus
efferent arteriole
peritubular capillaries
what are peritubular capillaries and what do they do
branches from neighboring cortical nephrons (mixed)
supply blood to loops of cortical nephrons
what is the vasa recta and what does it do
ladder-like network of capillaries that arise from efferent arterioles (mixed)
allows juxtamedullary nephrons to control volume and concentration of urine
why is the renal medulla (pyramids) vulnerable to ischemia
because they are relatively avascular and have low hematocrit value
where do the capillary beds (peritubular capillaries or vasa recta) drain into
interlobular veins
what is the venous flow of the kidney
interlobular veins
arcuate veins
interlobar vein
renal vein
IVC
how long and wide is the adult ureter
length: 25-30 cm
diameter: 3-4 mm
at which vertebral level do the ureters originate
L2
what are the three layers of the ureter from superficial to deep
adventitia
muscularis
mucosa
what is the mucosa layer of the ureters made of and what does it do
made of transitional epithelium
capable of expanding and contracting 5 times/minute
what is unique about how the ureters enter the bladder
enter at an oblique angle
function as a valve
how does the parasympathetic division effect the ureter
increases peristalsis
(contracts up to 5x/minute)
how does the sympathetic division effect the ureter
decreases peristalsis
how much urine can the bladder hold
700-800 mL
what is the trigone of the bladder
triangular region on the bladder’s floor
made of both ureter openings and internal urethral orifice
smooth, no folds
what two things hold the bladder in place
parietal peritoneum and median umbilical ligament
what is the median umbilical ligament and what does it do
remnant of urachus
attaches the apex of bladder to umbilicus
what was the urachus
remnant of a channel between bladder and umbilicus where urine drains in the fetus during the 1st trimester
turns into median umbilical ligament
where is the neck region of the bladder
around the opening to the urethra
where is the apex region of the bladder
where the median umbilical ligament is located
towards the superior edge of the pubic symphysis
where is the fundus region of the bladder located
opposite to the apex
what is the detrusor muscle and what is it innervated by
smooth muscle of the bladder wall
innervated by the sympathetic trunk (causes relaxation of bladder during fight or flight)
explain pyelonephritis
inflammation of kidney due to bacteria in blood or ureters
causes flank, groin, or back pain
must be treated with antibiotics or can cause renal failure
explain nephrosclerosis
usually seen in older people with high blood pressure
arterionephrosclerosis (artery thickening) and arteriolonephrosclerosis (hardening of kidney)
explain bladder cancer
most common in trigone
can be cured if caught early
patients present with blood in urine
what is the internal urethral sphincter and what is it innervated by
smooth muscle opening of urethra within the bladder
innervated by parasympathetic division
what is the external urethral sphincter and what is it innervated by
skeletal muscle opening
formed by levator ani muscles
voluntarily innervated by cerebral cortex
what are the differences between the female and male urethra
male: 20 cm long and serves both a urinary and reproductive purpose
female: 4 cm long and serves only a urinary purpose
what are the three sections of the male urethra from superior to inferior
prostatic
membranous (intermediate)
spongy (cavernous)
what are some features of the prostatic urethra
3 cm long
runs from the neck of the bladder to the urogenital diaphragm
what are some features of the membranous (intermediate) urethra
1-2 cm long
found on pelvic floor
runs from bottom of prostate to start of shaft
surrounded by external urethral sphincter
what are some features of the spongy (cavernous) urethra
15 cm long
starts near cowper’s gland opening and extends through penis
terminates at external urethral orifice
what are cowper’s glands
bulbourethral glands
what are the 5 sequential stages of external genitalia development
genetic
gonadal
hormonal
phenotypic
psychological
at which stage do the internal and external genitalia develop into male or female structures
phenotypic stage (6-7 weeks)
what happens during the phenotypic stage
both: paramesonpehric (mullerian) ducts develop then mesonephric (wolffian) ducts develop
male: mesonephric (wolffian) duct differentiates into epididymis, vas deferns, and seminal vesicle between weeks 8-12; paramesonephric (mullerian) duct degenerates around week 7
female: paramesonephric (mullerian) duct differentiates into fallopian tubes, uterus, and upper part of vagina between weeks 10-13; mesonephric (wolffian) duct degenerates around week 10
where do the paramesonephric (mullerian) and the mesonephric (wolffian) ducts develop
on the surface of the mesonephric kidneys
what is SRY
sex determining region of y chromosome that is a transcription factor
what is AMH and what does it do
anti-mullerian hormone
causes regression of mullerian ducts in males
released by sertoli cells
what is DHT and what does it do
dihydrotesterone hormone
responsible for formation of male primary sex characteristics during embryonic life
what are the female sex chromosomes
XX
what are the male sex chromosomes
XY
what is the testis homologous with
ovary
what is the glans penis homologous with
glans clitoris
what is the shaft of penis homologous with
body of clitoris
what is the scrotum homologous with
labia majora
what is the appendix testis homologous with
fimbriated end of fallopian tube
what is the lower end of the uterus and vagina homologous with
prostatic utricle
what is the prostatic utricle
remnant of the paramesonephric (mullerian) duct in males
what is the corpus spongiosum homologous with
vestibular bulb
what is the round and ovarian ligament homologous with
gubernaculum
what are the bulbourethral (cowper’s) glands homologous with
bartholin’s glands
what are the boundaries of the perineum
pubic symphysis and coccyx
what is the urogenital triangle
pubic symphysis half of your obturator foramen
includes external urinary and reproductive structures
what is the anal triangle
coccyx side half of your obturator foramen
contains the anus
what runs through the inguinal canal
spermatic cord (round ligament), blood and lymphatic vessels, nerves
where is the superficial (external) inguinal ring
anterior opening of inguinal canal
where is the deep (internal) inguinal ring
posterior opening to inguinal canal
where does the inguinal ligament/canal run
between your anterior superior iliac spine and pubic tubercle
what forms the anterior wall of the inguinal canal
external oblique aponeurosis
what forms the posterior wall of inguinal canal
transversalis fascia, medial internal oblique, and transversus abdominus aponeurosis
what forms the roof of the inguinal canal
external oblique
internal oblique
transversalis fascia
transversus abdominis
inguinal triangle (hesselbach’s traingle)
what are the three boundaries of Hesselbach’s triangle
inferior epigastric artery and vein
inguinal ligament
linea semilunaris (found on lateral edges of rectus abdominis muscle)
what forms the floor of the inguinal canal
iliopubic tract
inguinal ligament
lacunar ligament
femoral triangle
what is the femoral triangle made of
inguinal ligament
adductor longus
sartorius
what runs through the femoral triangle
femoral artery, vein, and nerve
femoral canal
what is a inguinal hernia
protrusion of parietal peritoneum and visceral
two types: indirect and direct
explain an indirect (congenital) hernia
most common - occurs during gestation
opening of processus vaginalis (canal that things travel through) - never fuses
spans entire inguinal canal (ring)
explain a direct (acquired) hernia
weakness in inguinal (hesselback’s) triangle
tissue can tear and pass around or through medial 1/3rd (back) of inguinal canal
explain a femoral hernia
caused by a weakening in the femoral canal
causes a bulge below inguinal ligament
can cause strangulation of intestine
explain an abdominal (ventral) hernia
occurs along midline of abdominal wall
three types:
epigastric: fat comes through the linea alba
umbilical: near belly button
incisional: at a scar
where are the testis found before they descend
within the abdominal cavity, behind the peritoneum
what are the two functions of the testes
sperm production and secretion of androgen hormones like testosterone
how much does one testicle weigh
20 g
where does testicular cancer spread to
peri-aortic nodes
what is the pampiniform venous plexus
converges with testicular veins after draining blood from testes
right: drains into IVC
left: drains into renal vein then IVC
innervated by ANS
what is the tunica vaginalis
closed peritoneal sac around testi
parietal and visceral layer with fluid between them
what is appendix testis (hydatid of morgagni)
small remnant of mullerian duct
found on the testis around the head of the epididymis
what is the scrotal ligament
remnant of gubernaculum
found on the inferior portion of the testis
secures testies to south pole
what is the tunica albuginea
tough fibrous surface that surrounds the testi (innermost layer)
thickens in the middle to form septa
what is the sperm flow
seminiferous tubules
single straight tubule
rete testis
efferent ductules
epididymis
ductus deferens
what is the rete testis and what does it do
network of tubules in posterior testis
transports sperm to efferent ductules
allows more access to vascular openings for tumors
what is semen
secretions from accessory structures which provide nourishment and support to the sperm
what are the four portions of the duct system
epididymis
ductus deferens
ejaculatory duct
urethra
what is the site of sperm maturation and storage
epididymis
what is the appendix epididymis
modified efferent duct
attached to head of epididymis
remnant of wolffian duct
where do the ductus deferens run
tail of epididymis
up the spermatic cord
through inguinal canal
into pelvic cavity
lateral side of bladder
over ureter
posterior side of bladder
terminates in ampulla
ejaculatory duct
what are the three layers of the ductus deferens
inner mucosa (pseudostratified)
muscularis
adventitia
what are the three layers of the muscularis of the ductus deferens
inner and outer longitudinal muscle
middle circular muscle
where does the ejaculatory duct run
begins at the junction of ductus deferens ampulla and seminal vesicle
dumps into prostatic urethra
which artery supplies the penile skin, fascia, and corpus spongiosum
dorsal arteries
which artery supplies the corpora cavernosa
deep arteries
what is the parasympathetic and sympathetic innveration for the penis
parasympathetic: pudendal nerve
sympathetic: hypogastric nerve
what does the pudendal nerve do
innervates the parasympathetic divison of the penis
controls micturition, defecation, erection, and ejaculation
what is signficant about the urethral mucosa
has mucous glands
secreted mucous combines with semen
where is the root of the penis located and what is it made of
membranous urethral area
made of crus and bulb of penis
what is the body of the penis composed of
2 corpora cavernosa
1 corpus spongiosum
what is glans penis composed of
prepuce (foreskin)
external urethral orifice
