Abdomen Lecture Notes Pt. 4 Flashcards
Runs in the transverse cervical ligament and passes OVER the ureter
Uterine artery
The uterine artery spirals around the side of the uterus so that it can supply the uterus when the uterus is
Stretched during pregnancy
Ectopic implantation typically occurs in the
Ampulla
Passes under the ureters
Vaginal artery
Crosses over the ureter at the pelvic brim
Ovarian artery
The suspensitory ligament is also known as the
Infundibulopelvic (IP) ligament
Appendicular pain may be seen close to
Ovarian pain
Results when the pericervical ring is weakened
Uterine prolapse
Surgical removal of uterus
Hysterectomy
What are the three types of hysterectomy?
- ) Partial (only uterus)
- ) Total (uterus and cervix)
- ) Radical (uterus, cervix, and vagina)
Typically a radical hysterectomy is only seen in
Cancer
The rectosigmoid junction is located at
S3
Has smoother mucosa than the rest of the colon, with no tenia coli, haustra, or omental appendices
Rectum
The upper 1/3 of the rectum is covered by
-NO mesentary
Peritoneum
What are the three arteries supplying the rectum?
- ) Superior rectal (Portal)
- ) Middle rectal (Caval)
- ) Inferior rectal (Caval)
Rectal innervation is from the
-another name for inferior hypogastric
Rectal plexus
Creates an angle where the rectum projects anteriorly and the anal canal projects posteriorly
-prevents fecal incontinence
Puborectal sling
The Vas (ductus) deferens and seminal vesicles are derived from the
Mesonephric ducts
The internal urethral sphincter is located in the
Prostatic urethra
Provide most of the semen and contian fructose
Seminal vesicles
Receives blood from erectile tissue
Prostatic venous plexus
The prostate receives PARASYMPATHETIC innervation from
Pelvic splanchnics (secremotor function)
The prostate receives SYMPATHETIC innervation that functions to
Contract smooth muscles during ejaculation
Located around the prostatic urethra and makes up 5% of the prostate volume
- Site of BPH
- 10% of prostatic cancers here
Transitional zone
Located around the ejaculatory ducts and urethra and makes up 25% of prostatic volume
-where 5% of prostatic cancers occur
Central zone
Makes up 70% of prostatic volume and is where 80% of prostatic cancers occue
Peripheral zone
Caused by an increase in the number of cells in the transitional zone
Benign Prostatic Hyperplasia (BPH)
BPH compresses the urethra and presents with
Lower Urinary Tract Symptoms (LUTS)
Irritation of the prostatic urethra seen in BPH makes you feel like you constantly have to
Urinate
Prostate cancer is an
Adenocarcinoma
Protate cancer shows symptoms similar to BPH and can be detected with which two tests?
- ) DRE (firm prostate = positive test)
2. ) Prostate specific androgen (looking for large increase above 4ng/mL)
Prostate cancer metastasizes to
Bone, Liver, and Lungs
What are the three entry points for a prostatectomy?
- ) Retropubic
- ) Transurethral
- ) Suprapubic
When removing the prostate, you must be careful not to damage the nerves responsible for
Erections
The puborectalis changes the direction of the
Rectum
Unlike the rest of the colon, which has teniae coli, the rectum has
External Longitudinal Muscle
Folds of rectal mucosa formed by underlyin blood vessels
-where we see internal hemorrhoids
Anal columns
The base of the anal columns is the
Pectinate/dentate line
If we cut ourselves above the pectinate line, would we feel it?
No, only ischemia and distension
Gap between the UG diaphragm and pelvic diaphragm that is used for surgical repair of pelvic organ prolapse
Anterior Recess
Subflooring of pelvic viscera
-Where UG structures pass through pelvic floor
Urogenital diaphragm
The levator ani is incomplete anteriorly which gives us the
-right behind pubic symphysis
Urogenital hiatus
Fills in the urogenital hiatus by stretching from one ischiopubic ramus to another
Urogenital diaphragm
The urogenital diaphragm contains the
Deep Perineal Pouch
Base of support for the external genitalia
Urogenital Diaphragm
In males, the membranous urethra is in the
Deep perineal pouch
In males the spongy urethra is in the
Superficial perineal pouch
In females, there are no glands in the
Deep perineal pouch
Attached to the UG diaphragm in the superficial perineal pouch
Erectile bodies
Erectile tissue that attaches to the UG membrane and ischiopubic ramus
-Merge together to form corpus cavernosa
Right and Left Crura of the Penis
Portion of erectile tissue that receives the urethra
Bulb of penis
Inside the bulb of the penis is the
Corpus spongeosum
Sandwiched between ddep peile fascia and tunica albuginea of corpus cavernosum
Deep dorsal vein of the penis
Only attaches attached portions of erectile bodies
Skeletal muscle
Functions during ejaculation to squeeze on the bulb of the penis and make sure all sperm passes through the urethra
Bulbospongeous
Also empties the urethra after urination
Bulbospongeous
Can happen as the result of a straddle injury
Urethral tear
If we tear the spongy urethra from the membranous urethra, urine and blood will fill up the space between the
Deep penile fascia and superficial perineal fascia
If we tear the membranous urethra from the prostatic urethra, all of the bleeding will be
ABOVE the pelvic floor in the subperitoneal space
The body of the clitoris is the
Corpus cavernosa
Commonly infected and can result in a cyst called a Bartolon’s cyst
-covered in skin so cyst is painful
Greater Vestibular (Bartolon’s) Gland
Attachment for bulbospongious, superficial and deep perineal, external anal sphincter, and pelvic diaphragm muscles
Perineal body (Central Tendon)
The perineal body (central tendon) is pyramidal in shape, where the apex projects up and attaches to the
Rectovaginal fascia
If you ask a patient to bear down, it should be firm. But if it is soft than there is a tear. This describes the
Perineal body
The blood supply for the perineum is primarily via the
Internal pudendal artery
Once in the superficial pouch, the internal pudendal artery sends branches to the
Erectile tissues
Gives off dorsal artery of the penis/clitoris
Internal pudendal artery
Somatic innervation of the perineum is via the
Pudendal nerve
Foreign bodies that are aspirated are more likely to end up in the
Right bronchus
Ridge at the tracheal bifurcation
Carina
Congenital deformation where the esophagus ends blindly and the stomach is attached to the trachea so it’s filled with air
-Results in polyhydramnios
Tracheoesophageal fistula
The horizontal fissure is located at the
4th Rib
The oblique fissure is located at the
6th rib
Between the ribs and diaphragm and is 2 intercostal spaces deep during quiet breathing
Costodiaphragmatic recess
Procedure performed at the midaxillary line to remove fluid from the pleural cavity
Thoracentesis
The head of the 7th rib articulates with the vertebral body of the
6th and 7th vertebrae
The tubercle of the 7th rib articulates with the
Transverse process of the 7th Vertebra
The negative intrapleural pressure is between the
Visceral and parietal pleura
Increases both superior-inferior and lateral dimensions of the thoracic cavity
Diaphragm
If we lose the right phrenic nerve, when the left side of the diaphragm moves down, what happens to the right side?
Moves up (paradoxical movement of the diaphragm)
Affects venous return to the heart via the great veins
Changes in intrathoracic pressure during ventilation
Increases intrathoracic pressure which decreases blood drainage from the head
Forced exhalations
The input for the cough reflex comes from the
Vagus nerve
Atmospheric pressure on the injured side will compress or increase pressure on the mediastinum, which will compress the healthy lung during inspiration. This describes an
Open pneumothorax
More dangerous because it results in positive intrapleural pressure
-Trachea deviates and patient can’t breathe
Tension pneumothorax
Blood in the pleural cavity (hemothorax) does not clot because of the
Smooth surfaces of pleural walls
Pairs with the right border of the sternum
-surrounds the heart
Coronary sulcus
Where the heart is on an xray
Mediastinal shadow
The heart is tilted towards the chest wall such that the part closes to the chest wall is the
Inferior part
Prevent a hole in the center of the semilunar valves where the three cusps meet
Semilunar nodules
Where would we hear a tricuspid regurgitation?
Right 5th intercostal space at sternal border