Abdomen, pelvis and perineum Flashcards
1
Q
Wall layers of the anterior abdomen (8)
A
Skin
Superficial fascia (camper-fatty; and Scarpa-fibrous)
External oblique
Internal oblique
Transversus abdominis
Trasnversalis fascia
Extraperitoneal connective tissue
Parietal peritoneum
2
Q
three flat abdominal muscles (superficial to deepest)
A
External abdominal oblique muscle
Internal abdominal oblique muscle
Transversus abdominis muscle
3
Q
from which abdominal layer comes the gonad?
A
Extraperitoneal connective tissue
4
Q
Layers of spermatic fasciae (external to deepest)
A
External spermatic fascia
Cremaster muscle and fascia
Internal spermatic fascia
5
Q
External spermatic fascia comes from
A
External oblique fascia
6
Q
Cremaster muscle and fascia come from
A
Internal oblique fascia
7
Q
Internal spermatic fascia
A
Transversalis fascia
8
Q
Innervation of the anterior abdominal wall
A
ventral primary rami of the Lower 6 thoracic spinal nerves + iliphfpogastric + ilioinguinal branches of L1
9
Q
Arterial blood supply of the anterior wall
A
superior epigastric branch of the internal thoracic artery + inferior epigastric + deep circumflex iliac branches
10
Q
The testicular artery is branch of the..
A
Abdominal aorta
11
Q
What assists in the regulation of the temperature of the testis?
A
Pampiniform venus plexus
12
Q
3 fascial components that surround the spermatic cord
A
- External spermatic fascia (external oblique)
- Middle or cremasteric muscle and fascia (internal oblique)
- Internal spermatic fascia (trasversali fascia)
13
Q
Which muscle helps regulate the thermal environment of the testis?
A
Cremasteric muscle
14
Q
Lymphatic drainage of the testis
A
aortic nodes
15
Q
Superior border of inguinal canal
A
External abdominal oblique muscle +
Transversus abdominis muscle
16
Q
anterior border of inguinal canal
A
Aponeurosis of the external abdominal oblique + internal oblique
17
Q
Inferior border of inguinal canal
A
Inguinal ligament + lacunar ligament
18
Q
Posterior border of inguinal canal
A
Trasversalis fascia + conjoint tendon
19
Q
Hernia lateral to the inferior epigastric vessels
A
Indirect
20
Q
Hernia medial to the inferior epigastric vessels
A
Direct
21
Q
Hernia found within the spermatic cord
A
Indirect
22
Q
Hernia found on the surface of spermatic cord
A
direct
23
Q
layers of the indirect hernia
A
3 spermatic layers (external, cremaster, and internal)
24
Q
layers of the direct hernia
A
external layer of the spermatic fascia
25
Components of the Inguinal Triangle (Hesselbach)
1. Inguinal ligament (inferior border)
2. Rectus abdominis muscle (medial border)
3. Inferior epigastric vessels (lateral border)
26
What causes a congenital indirect inguinal hernia?
Persistent process vaginalis
27
What causes hydrocele in a new born?
A persistent process vaginalis - liquid from the perineum enters the scrotum
28
Lymphatic nodes of the penis and scrotum
Superficial Inguinal lymph nodes
29
What causes varicocele?
Blood collects in the pampiniform venous plexus
30
Which one disappears when the patient lays down? Varicocele or hydrocele?
Varicocele
31
Artery from the foregut
Celiac
32
Artery from the midgut
Superior mesenteric
33
Artery from the hindgut
inferior mesenteric
34
Parasympatic innervation of the foregut
Vagus nerves
35
Parasympathetic innervation of midgut
Vagus Nerves
36
Parasympathetic innervation of hindgut
Pelvic splanchnic nerves
37
sympathetic innervation of the foregut
Preganglionic: thoracic splanchnic nerves t5-t9
Postanglionic : celiac ganglion
38
sympathetic innervation of the midgut
Preganglionic: thoracic splanchnic nerves t9-t12
Postganglionic: superior mesenteric ganglion
39
sympathetic innervation of the hindgut
Preganglionic: Lumbar splanchnic nerves L1-L2
Postganglionic: inferior mesenteric ganglion
40
Referred pain of the foregut
Epigastrium
41
Referred pain of the midgut
Umbilical
42
Referred pain of the hindgut
Hypogastrium
43
The esophagus comes from which division of the primitive gut tube
foregut
44
The stomach comes from which division of the primitive gut tube
foregut
45
The duodenum (first and second parts) comes from which division of the primitive gut tube
foregut
46
The liver comes from which division of the primitive gut tube
foregut
47
The pancreas comes from which division of the primitive gut tube
foregut
48
The Biliary apparatus comes from which division of the primitive gut tube
foregut
49
The gallbladder comes from which division of the primitive gut tube
foregut
50
The duodenum (second, third and fourth parts) comes from which division of the primitive gut tube
midgut
51
The jejunum comes from which division of the primitive gut tube
midgut
52
The ileum comes from which division of the primitive gut tube
midgut
53
The cecum comes from which division of the primitive gut tube
midgut
54
The appendix comes from which division of the primitive gut tube
midgut
55
The ascending colon comes from which division of the primitive gut tube
midgut
56
The transverse colon (proximal two thirds) comes from which division of the primitive gut tube
midgut
57
The transverse colon (distal third) comes from which division of the primitive gut tube
hindgut
58
The descending colon comes from which division of the primitive gut tube
hindgut
59
The sigmoid colon comes from which division of the primitive gut tube
hindgut
60
The rectum comes from which division of the primitive gut tube
hindgut
61
The anal canal (above pectinate line) comes from which division of the primitive gut tube
hindgut
62
Is the stomach major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major intraperitoneal organ
63
Are the liver and gallbladder major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major intraperitoneal organs
64
Is the duodenum (1st part) major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major intraperitoneal organ
65
Is the spleen major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major intraperitoneal organ
66
Is the tail of pancreas major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major intraperitoneal organ
67
Is the jejunum major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major intraperitoneal organ
68
Is the ileum major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major intraperitoneal organ
69
Is the appendix major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major intraperitoneal organ
70
Is the transverse colon major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major intraperitoneal organ
71
Is the sigmoid colon major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major intraperitoneal organ
72
Is the duodenum (2nd and 3rd parts) major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major secondary retroperitoneal organ
73
Is the head, neck and body of the pancreas major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major secondary retroperitoneal organ
74
Is the ascending colon major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major secondary retroperitoneal organ
75
Is the descending colon major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major secondary retroperitoneal organ
76
Is the upper rectum major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major secondary retroperitoneal organ
77
are the kidneys major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major primary retroperitoneal organ
78
are the **adrenal glands major** inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major primary retroperitoneal organ
79
are the ureters major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major primary retroperitoneal organ
80
Is the aorta major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major primary retroperitoneal organ
81
Is the inferior vena cava major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major primary retroperitoneal organ
82
Is the Lower rectum major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major primary retroperitoneal organ
83
Is the anal canal major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?
major primary retroperitoneal organ
84
Is the lesser omentum between the liver and the gut tube, or between the liver and the ventral body wall?
between the liver and the gut tube
85
Is the falciform ligament between the liver and the gut tube, or between the liver and the ventral body wall?
between the liver and the ventral body wall
86
Parts of the pancreas that develop from the ventral bud
Head and major pancreatic duct
87
Parts of the pancreas that develop from the dorsal bud
Neck, body, tail, and minor pancreatic duct
88
Congenital abnormality of gut tube:
The musculares externa hypertrophies (narrow pyloric lumen) + polyhydramnios + non bilious vomiting
hypertrophic pyloric stenosis
89
Congenital abnormality of gut tube:
Lumen of the biliary ducts is occluded + jaundice + white-colored stool + dark-colored urine
Extrahepatic biliary atresia
90
Congenital abnormality of gut tube:
Ventral and dorsal pancreatic buds form a ring around the duodenum
Annular pancreas
91
Congenital abnormality of gut tube:
lumen of the duodenum occluded + polyhydramnios + bile-containing vomitus + distended stomach
Duodenal atresia
92
Congenital abnormality of gut tube:
viscera herniate through the umbilical ring contained in a shiny sac
Omphalocele
93
Congenital abnormality of gut tube:
viscera herniate through the body wall not enclosed in a sac
gastroschisis
94
Congenital abnormality of gut tube:
Remnant of the vitelline duct forming a blind pounch on the anti mesenteric borer of the ileum
Ileal - Meckel - diverticulum
95
Rule of 2 of the Meckel diverticulum
2 feet from the ileocecal junction
2 inches long
in 2% of the population
96
Congenital abnormality of gut tube:
Loss of peristalsis + immobility of the hindgut + fecal retention + abdominal distention of the transverse colon (megacolon)
Colonic aganglionosis - Hirschsprung disease
97
Blood supply to the liver
arterial blood: hepatic artery
venous blood: portal vein
98
Structures of the portal triad
common bile duct
hepatic artery
hepatic portal vein (returns to the IVC)
99
location of the portal triad
hepatoduodenal ligament - the right border of the lesser omentum
100
Structures of the common bile duct
Cystic duct + common hepatic duct
101
Common bile duct information
Descends in the hepatoduodenal ligament, passes posterior to the 1st part of the duodenum and penetrates the head of the pancreas
102
Structures of the hepatopancreatic ampulla
Common bile duct + main pancreatic duct
103
hepatopancreatic ampulla drains into
2nd part of the duodenum, at the major duodenal papilla - sphincter of oddi
104
only part of the pancreas that is intraperitoneal
tail
105
Blood supply of the head of the pancreas
Superior and inferior pancreatic duodenal branches of the gastroduodenal and superior mesenteric arteries
106
Where does commonly carcinoma occurs
Head of the pancreas, constructing the main pancreatic dict and common bile duct, causing jaundice
107
Blood supply of the neck, body and tail of the pancreas
Splenic artery
108
Blood supply of the liver and how they reach the liver
splenic artery and vein by the splenorenal ligament
109
Internal anal sphincter
circular smooth muscle
Sympathetics: lumbar splanchnics - increase tone
Parasympathetic: pelvic splanchnics - relax tone during defecation
110
External anal sphincter
voluntary skeletal muscle controled by rectal branches of the pudendal nerve
111
layers of the GI system
1. Mucosa (inner) -
2. Submucosa
3. Muscularis externa
4. Serosa
112
In which GI layer are larger vessels
submucosa
113
Muscle type of the muscularis externa
Striated in the upper third of the esophagus and smooth elsewhere
114
serous cells secrete..
proteins and enzymes
115
mucous cells secrete
glycosylated mucins
116
Which salivary gland is?
* Lies on the master muscles in the lateral face
* Entirely serous
* Drain inside each cheek through Stensen's duct
* Contribute to 25% of the saliva
Parotid glands
117
Which salivary gland is?
* Lies inside the lower edge of the mandible
* Mixed serous and mucus - predominante serous
* Drain in the floor of the tongue through Wharton's ducts
* Contribute to 70% of the saliva
Submandibular glands
118
Which salivary gland is?
* Lies at the base og the tongue
* Mixed serous and mucus - predominante mucus
* Drain into the mouth through small ducts
* Contribute to 5% of the saliva
Sublingual glands
119
What are Ito Cells
liver cells involved in storage of fat-soluble vitamins (mainly vitamin A)
120
histological layers of gallbladder
1. Mucosa
2. Tunica muscularis
3. Serosa
121
Level of the aortic hiatus in the diaphragm
T12
122
where does the abdominal aorta bifurcates
L4
123
Branches of the abdominal aorta
3 unpaired visceral branches,
3 paired visceral branches
Several parietal branches
124
Unpaired visceral branches of the abdominal aorta
Celiac
Superior mesenteric
Inferior mesenteric
125
Paired visceral branches of the abdominal aorta
middle suprarenals
Renals
Gonads
126
Unpaired parietal branches of the abdominal aorta
medial sacral
127
**Paired parietal branches** of the abdominal aorta
Inferior phrenic
Lumbars
Common iliac
128
Branches of the celiac artery (trunk)
1. Left gastric artery
2. Splenic Artery
3. Common hepatic artery
129
Most common site for an abdominal aneurysm
between renal arteries and the bifurcation of the abdominal aorta
130
Most common site of atherosclerotic plaque
Bifurcation of the abdominal aorta
131
Branches of the **common hepatic artery**
* Proper hepatic artery
* Gastroduodenal artery
132
Branches of the **gastroduodenal artery**
* Right gastroepiploic artery
* Superior pancreaticduodenal arteries
133
Branches of the **superior mesenteryc artery**
* Inferior pancreaticduodenal arteries
* Intestinal arteries
* Ileocolic artery
* Right colic artery
* Middle colic artery
134
The intestinal arteries supply...
jejunum and ileum
135
The ileocolic arteries supply
distal ileum and cecum
136
Right colic arteries
ascending colon
137
The middle arteries supply
Proximal two-thirds of the transverse colon
138
most common site for bowel ischemia
splenic flexure
139
Branches of the **inferior mesenteric artery**
* Left colic artery
* Sigmoid arteries
* Superior rectar arteries
140
The left colic artery supplies..
distarl third of the transverse colon and the descending colon
141
Location of the caval hiatus
T8
142
the ureorectal septum divides the hindgut into
anorectal canal and urogenital sinus
143
Potter sequence (3)
Clubbed feet
Pulomonary hypoplasia
Craniofacial anomalies
144
Horseshoe kidney
fusion of both kidneys at their ends
145
Location of the kidneys
T12 - L3
146
Ureters are are retroperitoneal o peritoneal?
Retroperitoneal
147
common sites of ureteral constriction to blockage by renal canulli
* Where the renal pelvis joins the ureter
* Where the ureter crosses the pelvic inlet
* Where the ureter enters the wall of the urinary bladder
148
Blood supply of the bladder
branches of the internal iliac arteries and umbilical arteries
149
the venus plexus of the bladder drains to
Internal iliac veins
150
Lymohatics of the bladder drains to
external and internal iliac nodes
151
Innervation of the bladder
Parasympathetic: S2, S3 and S4 -> preganglionic fibers travel in pelvic splanchnic nerves to reach the detrusor muscle
Sympathetic: L1 and L2 (lumbar splanchnics) -> supply the trigone muscle and the internal urethral sphincter
152
Bladder muscles
Detrusor muscle
Internal urethral sphincter
external urethral sphincter
153
smooth muscle that contracts during emptying of the bladder
Detrusor muscle
154
Internal urethral sphincter
Smooth muscle, activated during the filling phase to prevent leakage
155
External urethral sphincter
Voluntary skeletal muscle; relaxed during mucturition; innerved by perineal branches of the pudendal nerve
156
spastic bladder
lesions of spinal cord above the sacral spinal cord levels -> loss of inhibition of the parasympathetic of the detrusor muscle causing urge incontinence
157
Atonic bladder
lesions to the sacral spinal cord segments; loss of contraction of the detrusor muscle
158
renal cortex and medullary fibrous produce..?
erythropoietin
159
components of the renal corpuscle
Bowman's capsule + glommerullus
160
The uro rectarl septum divides the cloaca into
Anorectarl canal and urogenital sinus
161
which forms the permanent kidney: pronephros, mesonephros or metanephros
Metanephros
162
Mesangial cells of the kidney
Palkissen or Lacis cells
163
male and female differentiation of **gonads**
Female: ovary, follicle, rate ovary
Male: Testes, seminiferous tubules and rate testes (Testes-determining factor+)
164
male and female differentiation of **paramesonephric ducts**
Female: uterine tubes, uterus, cervix, upper vagina
Male: appendix of testes (MIF-)
165
male and female differentiation of **mesonephric ducts**
Female: duct of gartner
Male: Epididymis, ductus deferens, seminal vesicle, ejaculatory duct (testosterone+)
166
male and female differentiation of **genital tubercle**
Female: clitories
Nale: Glands and body of penis
167
male and female differentiation of **Urogenital folds**
Female: labia minora
Male: ventral aspect of penis
168
male and female differentiation of **labioscrotal swellings**
Female: labia mejora
Male: Scrotum
169
Most common cause of female pseudointersexuality
Congenital adrenal hyperplasia - excess of androgens
170
Congenital anomalie:
46 xx, ovarian (but no testicular) tissue and masculinization of the female external genitalia
Female pseudointersexuality
171
Congenital anomalie:
46 xx, testicular (but no ovarian) tissue and stunted development of the male external genitalia
Male pseudointersexuality
172
Most common cause of Male pseudointersexuality
inadequate productionn of dihydrotestosterone due to 5a-reductase deficiency
173
cause of hypospadias
urethral folds fail to fuse completely, resulting in the urethral orifice opening onto the ventral surface
174
Cause of epispadias
external urethral orifice opens onto the dorsal surface of the penis
175
pelvic diaphragm muscles
Levator ani and coccygeus
176
urogenital diaphragms muscles
sphincter urethrae and deep transverse perineus
177
support for pelvic viscera in females (6 ligaments)
* Ovarian ligament
* transverse cervical ligament
* Uterosacral ligament
* Suspesonsory ligament of ovary
* Borad ligament
* Round ligaments of uterus
178
Sensory and motor innervation of perineum
Pudendal nerve (S2-S4) of the sacral plexus
179
what does the SRY secretes?
* testosterone (leydig)
* MIF (sertoli)
180
Genital tubercle gives rise to
* Female: clitoris
* Male: penis
181
Urogenital folds give rise to
* Female: lamina minora
* Male: penile urethra
182
Urogenital swellings give rise to
* Female: labia mejora
* Male: scrotum
183
Paramesonephric ducts give rise to
Fallopian tubes, uterus, cervix, 1/3 upper vagina
184
What differentiates internal genitalia in female
Paramesonephric (mullerian) ducts
185
What differentiates internal genitalia in male
Testosterone
186
What differentiates external genitalia in male
DHT
187
Sertoli cells secrete..? to male differentiation
MIF
188
Leydig cells secrete..? to male differentiation
Testosterone
189
Components of the spermatic cord (5)
1. Testicular artery
2. Panpiniforme venus plexus
3. Vas deferens
4. Autonomic nerves
5. Lymphatics
