Abdomen, Pelvis and Perineum 3 Flashcards
What is the function of the kidneys? (2)
filter the blood and create urine
Where do the kidneys sit? (3)
Behind the peritoneum on either side of the lumbar vertebrae at T12 to L3
Which kidney sits lower and why?
Right kidney, liver is above
What are the four layers covering each kidney, from outermost to innermost?
- Paranephric fat
- Renal fascia
- Perinephric fat
- Renal capsule
Which structures lie anterior to the left kidney? (6)
- Left adrenal gland
- Spleen
- Stomach
- Pancreas (body and tail)
- Left colic flexure
- Jejunum
Which structures lie posterior to the left kidney? (5)
- Diaphragm
- 11th and 12th ribs
- Psoas major
- Quadratus lumborum
- Transversus abdominis
Which structures lie anterior to the right kindey? (4)
- Right adrenal gland
- Liver
- Duodenum
- Right colic flexure
Which structures lie posterior to the right kidney? (5)
- Diaphragm
- 12th rib
- Psoas major
- Quadratus lumborum
- Transversus abdominis
What does the hilum of the kidney lead into?
The renal sinus
What lies inside the renal sinus? (4)
- calices
- renal pelvis
- renal blood vessels
- fat
What are the two main parts of the kidney?
Outer cotex and inner medulla
What does the medulla contain?
Renal pyramids
What are renal papillae?
Apices of the renal pyramids which project into the renal sinus
Where is urine from the renal papillae collected?
The minor calices which unite to form the major calices
What is the renal pelvis?
Fusion of the major calices, continuous with the ureter
Why is there asymmetery between the blood supply of each kidney?
The abdominal aorta is on the left side of the abdomen and the IVC is on the right
Which renal artery is longer?
Right renal artery
Which renal vein is longer?
Left renal vein
What is the blood supply of the kidneys?
Left and right renal arteries respectively, branches of the abdominal aorta
What do the kidneys drain into?
Left and right renal veins respectively, branches of the inferior vena cava
Which lies anterior to the other: renal arteries and renal veins?
The renal veins both lie anterior to the renal arteries
Where do the adrenal glands lie?
Right above each kidney, enclosed in the renal fascia
What shape is the right adrenal gland?
Pyramid
What shape is the left adrenal gland?
Semilunar
Which adrenal gland is larger?
Left
What is the blood supply for the adrenal glands?
Superior, middle and inferior adrenal arteries
What is the origin of the superior adrenal arteries?
Inferior phrenic artery
What is the origin of the middle adrenal arteries?
Abdominal aorta
What is the origin of the inferior adrenal arteries?
Renal artery
What is the venous drainage of the adrenal glands?
Left and right adrenal veins
Which adrenal vein is shorter?
Right, drains almost immediately into the IVC
What are the ureters?
Smooth muscular tubes that transport urine from the kidneys to the bladder
How do the ureters project urine?
Peristalsis
What are the three restriction zones of the ureter?
- the uteropelvic junction
- the pelvic brim
- the vesicouteric junction
What can happen at the restriction zones?
Renal stones become stuck
What do the ureters pass over?
the tips of the transverse processes of the lumbare vertebrae
What do the ureter pass under once in the pelvic cavity?
The ductus deferens in men and uterine artery in women
Where do the ureters end?
The base of the bladder as they enter the trigone
Where is the bladder located?
Directly posterior to the pubic symphysis
What is the role of the bladder?
to store up to 500ml of urine at any one time and to carry out micturition
What is the difference between an empty and full bladder?
Empty = lies entirely in the pelvic cavity
Full = extends up to the suprapubic region of the abdomen
What are the relations of the bladder in women? (3)
- anterior to the vagina and rectum
- anteroinferior to the uterus
What are the relations of the bladder in men? (2)
- anterior to the rectum
- superior to the prostate
What is the blood supply to the ureters? (4)
Multiple small arteries branched from the renal arteries, abdominal aorta, gonadal vessels and iliac arteries
What is the uterus?
a hollow muscular organ that functions to nourish a fertilized egg until birth
Where is the uterus located?
The midline between the bladder and rectum
What is the superior surface of the uterus covered by?
the broad ligament perioteum
What are the vesicouterine and rectouterine pouches?
Pouches of peritoneum which hang in spaces between the uterus and bladder or rectum respectively
What is the cervix?
the neck of the uterus, a narrow canal with a superficial and deep opening
What is the internal os?
Superficial opening of the cervix which opens into the uterine cavity
What is the external os?
Deep opening of the cervix which opens into the vaginal cavity
What are the ovaries?
endocrine glands that responsible for releasing oestrogen and progesterone to control the menstrual cycle and releasing gametes
Where are eggs from the ovaries released into?
the infundibulum of the uterine tube via the fimbriae
What are fimbriae?
Finger-like projections which rim the infundibulum
Where does fertilisation of the egg normally occur?
The ampulla
What does the infundibulum expand to?
The ampulla
What does the ampulla narrow into?
The isthmus
What does the isthmus join to?
The body of the uterus
What is the anterior vaginal wall related to?
- the base of the bladder
- urethra (embedded in the anterior vaginal wall)
What is the posterior vaginal wall related to?
The rectum
What is the inferior vaginal wall related to?
The vestibule of the perineum
What is the vaginal fornix?
The recess formed between the margin of the cervix and the vaginal wall
What is the fornix divided into?
- 1 anterior fornix
- 1 posterior fornix
- 2 lateral fornices (left and right)
Which ligaments stabilise the uterus and ovaries?
- broad ligament
- round ligament
- ovarian ligament
- suspensory ligament of the ovaries
What are the testes and where are they found?
- endocrine glands which produce sperm and testosterone
- in the scrotum
What happens to sperm during ejaculation?
They are transported into the ductus deferens via the epididymis by ciliated epithelium
What is the ductus deferens?
Tubes which connect the external testes to the internal ejaculatory ducts
What is the route of the ductus deferens?
- travels through the inguinal canal inside the spermatic cord, and out of the deep inguinal ring
- then moves towards the base of the bladder and crosses over the ureter
What happens to the end of the ductus deferens?
joins the duct of the seminal vesicle to form the ejaculatory duct
What are the seminal vesicles?
produce 70% of the ejaculatory fluid which nourishes the sperm cells
Where are the seminal vesicles located?
on the base of the bladder in close relation to the ureters and the ductus deferens
What are the ejaculatory ducts?
Short tubes which drain sperm and ejaculatory fluid from the ductus deferens and seminal vesicles into the prostatic urethra
What is the prostate gland?
an exocrine gland which produces an alkaline fluid to secrete into the ejaculatory fluid
Where is the prostate gland located?
surrounds the prostatic part of the urethra and secretes its secretions here
What is the epididymis?
A tube in which spermatozoa acquire the ability to move and fertilise eggs as well as where they are stored until ejaculation
What are the parts of the epididymis?
- the efferent ductules which form the head
- the true epididymis which forms the body and tail
What are the seminiferous tubules?
Coiled tubes where sperm is produced in the testes
What is the rectum?
the most posterior element of the pelvic viscera
What are the two parts of the rectum and which blood vessels supply them?
- Superior (abdominal) - inferior mesenteric artery
- Inferior (pelvic) - internal iliac artery
What is the anorectal flexure?
Where the puborectalis muscle wraps around the front of the rectum and contracts to create an angle in the rectum
What is the purpose of the anorectual flexure?
Helps to maintain faecal continence
What does the rectum sit posterior to in men?
- Rectovesical pouch
- Sigmoid colon
- Ileum
- Bladder
- Prostate
- Seminal vesicles
What does the rectum sit posterior to in women?
- Rectouterine pouch
- Sigmoid colon
- Ileum
- Vagina
- Cervix
What sits posterior to the rectum?
- Sacrum
- Coccyx
- Coccygeus muscle
- Levator ani muscle
Where do the pelvic viscera sit?
The pelvic cavity
What is the pelvic floor?
The inferior lining of the pelvic cavity
What do the pelvic floor muscles do?
Separate the pelvic viscera from the perineum
What are the two holes in the pelvic floor muscles?
Urogenital and rectal hiatuses
What is the fucntion of the pelvic floor muscles?
- to support the abdominal and pelvic organs
- to assist with increasing intra-abdominal and pelvic pressure
- to assist with micturition, defecation, and parturition
- provide continence
Which muscles make up the pelvic floor?
- levator ani group (puborectalis, pubococcygeus, iliococcygeus)
- coccygeus
What is the main nerve which supplies the pelvic floor muscles?
Pudendal nerve, a branch of the saccral plexus S2-S4
What is the vascular supply of the pelvic structures excluding the testes and ovaries?
Left and right internal iliac arteries and veins
What is the vascular supply of the testes?
The testicular arteries and veins
What is the vascular supply of the ovaries?
The ovarian arteries and veins
What do the testicular and ovarian arteries branch off from?
The abdominal aorta
What do the testicular and ovarian veins branch off from?
The inferior vena cava
What are the common iliac arteries?
The bifurcation of the abdominal aorta at L4
What do the common iliac arteries branch into?
- the external iliac artery (lower limb)
- the internal iliac artery (pelvis and gluteal region)
Where do the common iliac arteries branch?
The pelvic brim
What does the internal iliac artery branch into?
The anterior and posterior trunk
What does the anterior trunk of the internal iliac artery supply?
The pelvic organs and perineum
What are the branches of the anterior trunk? (6)
- umbilical artery
- inferior vesicular artery
- vaginal artery
- uterine artery
- middle rectal artery
- internal pudendal artery
What does the umbilical artery supply?
The superior aspect of the bladder (also takes deoxygenated blood from the foetus to placenta in utero)
What does the inferior vesicular artery supply?
the inferior aspect of the bladder, as well as the prostate and seminal vesicles in men
What does the vaginal artery supply
VAGINA
What does the uterine artery supply?
The uterus and uterine tubes
What does the middle rectal artery supply?
the rectum
What does the internal pudendal artery supply?
the perineum
What is the function of the internal iliac vein?
Drains the pelvic viscera
Where is the internal iliac vein formed?
The greater sciatic foramen
Label 3-7
- Left renal vein
- Right sympathetic trunk and ganglion
- Left suprarenal (adrenal) gland
- Left renal artery
- Left ureter
Label 1-7
- Fibrous capsule of kidney
- Renal pyramid; terminates in renal papilla
- Major renal calyx
- Renal artery
- Renal pelvis
- Renal cortex
- Medulla of kidney
Label 1-7
- Right renal vein
- Iliohypogastric or ilioinguinal nerve (L1)
- Genitofemoral nerve (L1 and L2)
- Ductus deferens
- Testis and epididymis
- Inferior mesenteric artery
- Ureter
Label 1-5
- Pampiniform plexus of veins
- Testicular artery
- Ductus deferens
- Body of epididymis
- Parietal layer of tunica vaginalis
Label 1-7
- Right kidney
- Right ureter
- Inferior vena cava
- Uterus
- Round ligament of the uterus
- Urinary bladder
- Abdominal aorta
Label 1-10
- Urinary bladder
- Seminal vesicle
- Ejaculatory duct (proximal portion)
- Prostate
- Bulbourethral gland (Cowper’s gland)
- Ductus deferens
- Ureter
- Levator ani muscle
- Obturator internus muscle
- Bulb of penis
Label 1-7
- Median umbilical fold with urachus
- Urinary bladder
- Uterus
- Uterine tube
- Rectum
- Ovary
- Fimbriae of uterine tube
Label 1-8
- Common iliac vein
- Genitofemoral nerve
- Round ligament of uterus
- Urinary bladder
- Ureter
- Superior hypogastric plexus
- Rectouterine pouch (of Douglas)
- Vesicouterine pouch
Label 1-7
- Uterus
- Vesicouterine pouch
- Urinary bladder (collapsed)
- Sacral promontory
- Rectum
- Cervix of uterus
- Vaginal canal
Label 1-8
- Internal iliac artery
- Internal pudendal artery
- Ureter
- Inferior hypogastric plexus (pelvic plexus)
- Lumbosacral trunk
- Pelvic splanchnic nerves (nervi erigentes)
- Prostate gland
- Rectum
Label 1-6
- Ovary
- Uterine tube
- Urinary bladder
- Small intestine
- Uterus
- Urethra
Label 1-5
- Urinary bladder
- Prostate
- Bulb of penis
- Obturator internus muscle
- Prostatic urethra
Label 1-7
- Central tendon of diaphragm
- Ureter
- Right gonadal vein
- Splenic artery
- Suprarenal (adrenal) gland
- Left suprarenal vein
- Left gonadal vein
