Abdomen, Pelvis and Perineum 3 Flashcards

1
Q

What is the function of the kidneys? (2)

A

filter the blood and create urine

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2
Q

Where do the kidneys sit? (3)

A

Behind the peritoneum on either side of the lumbar vertebrae at T12 to L3

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3
Q

Which kidney sits lower and why?

A

Right kidney, liver is above

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4
Q

What are the four layers covering each kidney, from outermost to innermost?

A
  1. Paranephric fat
  2. Renal fascia
  3. Perinephric fat
  4. Renal capsule
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5
Q

Which structures lie anterior to the left kidney? (6)

A
  • Left adrenal gland
  • Spleen
  • Stomach
  • Pancreas (body and tail)
  • Left colic flexure
  • Jejunum
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6
Q

Which structures lie posterior to the left kidney? (5)

A
  • Diaphragm
  • 11th and 12th ribs
  • Psoas major
  • Quadratus lumborum
  • Transversus abdominis
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7
Q

Which structures lie anterior to the right kindey? (4)

A
  • Right adrenal gland
  • Liver
  • Duodenum
  • Right colic flexure
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8
Q

Which structures lie posterior to the right kidney? (5)

A
  • Diaphragm
  • 12th rib
  • Psoas major
  • Quadratus lumborum
  • Transversus abdominis
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9
Q

What does the hilum of the kidney lead into?

A

The renal sinus

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10
Q

What lies inside the renal sinus? (4)

A
  • calices
  • renal pelvis
  • renal blood vessels
  • fat
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11
Q

What are the two main parts of the kidney?

A

Outer cotex and inner medulla

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12
Q

What does the medulla contain?

A

Renal pyramids

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13
Q

What are renal papillae?

A

Apices of the renal pyramids which project into the renal sinus

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14
Q

Where is urine from the renal papillae collected?

A

The minor calices which unite to form the major calices

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15
Q

What is the renal pelvis?

A

Fusion of the major calices, continuous with the ureter

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16
Q

Why is there asymmetery between the blood supply of each kidney?

A

The abdominal aorta is on the left side of the abdomen and the IVC is on the right

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17
Q

Which renal artery is longer?

A

Right renal artery

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18
Q

Which renal vein is longer?

A

Left renal vein

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19
Q

What is the blood supply of the kidneys?

A

Left and right renal arteries respectively, branches of the abdominal aorta

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20
Q

What do the kidneys drain into?

A

Left and right renal veins respectively, branches of the inferior vena cava

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21
Q

Which lies anterior to the other: renal arteries and renal veins?

A

The renal veins both lie anterior to the renal arteries

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22
Q

Where do the adrenal glands lie?

A

Right above each kidney, enclosed in the renal fascia

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23
Q

What shape is the right adrenal gland?

A

Pyramid

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24
Q

What shape is the left adrenal gland?

A

Semilunar

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25
Q

Which adrenal gland is larger?

A

Left

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26
Q

What is the blood supply for the adrenal glands?

A

Superior, middle and inferior adrenal arteries

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27
Q

What is the origin of the superior adrenal arteries?

A

Inferior phrenic artery

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28
Q

What is the origin of the middle adrenal arteries?

A

Abdominal aorta

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29
Q

What is the origin of the inferior adrenal arteries?

A

Renal artery

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30
Q

What is the venous drainage of the adrenal glands?

A

Left and right adrenal veins

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31
Q

Which adrenal vein is shorter?

A

Right, drains almost immediately into the IVC

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32
Q

What are the ureters?

A

Smooth muscular tubes that transport urine from the kidneys to the bladder

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33
Q

How do the ureters project urine?

A

Peristalsis

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34
Q

What are the three restriction zones of the ureter?

A
  1. the uteropelvic junction
  2. the pelvic brim
  3. the vesicouteric junction
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35
Q

What can happen at the restriction zones?

A

Renal stones become stuck

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36
Q

What do the ureters pass over?

A

the tips of the transverse processes of the lumbare vertebrae

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37
Q

What do the ureter pass under once in the pelvic cavity?

A

The ductus deferens in men and uterine artery in women

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38
Q

Where do the ureters end?

A

The base of the bladder as they enter the trigone

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39
Q

Where is the bladder located?

A

Directly posterior to the pubic symphysis

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40
Q

What is the role of the bladder?

A

to store up to 500ml of urine at any one time and to carry out micturition

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41
Q

What is the difference between an empty and full bladder?

A

Empty = lies entirely in the pelvic cavity
Full = extends up to the suprapubic region of the abdomen

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42
Q

What are the relations of the bladder in women? (3)

A
  • anterior to the vagina and rectum
  • anteroinferior to the uterus
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43
Q

What are the relations of the bladder in men? (2)

A
  • anterior to the rectum
  • superior to the prostate
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44
Q

What is the blood supply to the ureters? (4)

A

Multiple small arteries branched from the renal arteries, abdominal aorta, gonadal vessels and iliac arteries

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45
Q

What is the uterus?

A

a hollow muscular organ that functions to nourish a fertilized egg until birth

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46
Q

Where is the uterus located?

A

The midline between the bladder and rectum

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47
Q

What covers the superior surface of the uterus covered by?

A

the broad ligament perioteum

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48
Q

What are the vesicouterine and rectouterine pouches?

A

Pouches of peritoneum which hang in spaces between the uterus and bladder or rectum respectively

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49
Q

What is the cervix?

A

the neck of the uterus, a narrow canal with a superficial and deep opening

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50
Q

What is the internal os?

A

Superficial opening of the cervix which opens into the uterine cavity

51
Q

What is the external os?

A

Deep opening of the cervix which opens into the vaginal cavity

52
Q

What are the ovaries?

A

endocrine glands that responsible for releasing oestrogen and progesterone to control the menstrual cycle and releasing gametes

53
Q

Where are eggs from the ovaries released into?

A

the infundibulum of the uterine tube via the fimbriae

54
Q

What are fimbriae?

A

Finger-like projections which rim the infundibulum

55
Q

Where does fertilisation of the egg normally occur?

A

The ampulla

56
Q

What does the infundibulum expand to?

A

The ampulla

57
Q

What does the ampulla narrow into?

A

The isthmus

58
Q

What does the isthmus join to?

A

The body of the uterus

59
Q

What is the anterior vaginal wall related to?

A
  • the base of the bladder
  • urethra (embedded in the anterior vaginal wall)
60
Q

What is the posterior vaginal wall related to?

A

The rectum

61
Q

What is the inferior vaginal wall related to?

A

The vestibule of the perineum

62
Q

What is the vaginal fornix?

A

The recess formed between the margin of the cervix and the vaginal wall

63
Q

What is the fornix divided into?

A
  • 1 anterior fornix
  • 1 posterior fornix
  • 2 lateral fornices (left and right)
64
Q

Which ligaments stabilise the uterus and ovaries?

A
  • broad ligament
  • round ligament
  • ovarian ligament
  • suspensory ligament of the ovaries
65
Q

What are the testes and where are they found?

A
  • endocrine glands which produce sperm and testosterone
  • in the scrotum
66
Q

What happens to sperm during ejaculation?

A

They are transported into the ductus deferens via the epididymis by ciliated epithelium

67
Q

What is the ductus deferens?

A

Tubes which connect the external testes to the internal ejaculatory ducts

68
Q

What is the route of the ductus deferens?

A
  • 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
69
Q

What happens to the end of the ductus deferens?

A

joins the duct of the seminal vesicle to form the ejaculatory duct

70
Q

What are the seminal vesicles?

A

produce 70% of the ejaculatory fluid which nourishes the sperm cells

71
Q

Where are the seminal vesicles located?

A

on the base of the bladder in close relation to the ureters and the ductus deferens

72
Q

What are the ejaculatory ducts?

A

Short tubes which drain sperm and ejaculatory fluid from the ductus deferens and seminal vesicles into the prostatic urethra

73
Q

What is the prostate gland?

A

an exocrine gland which produces an alkaline fluid to secrete into the ejaculatory fluid

74
Q

Where is the prostate gland located?

A

surrounds the prostatic part of the urethra and secretes its secretions here

75
Q

What is the epididymis?

A

A tube in which spermatozoa acquire the ability to move and fertilise eggs as well as where they are stored until ejaculation

76
Q

What are the parts of the epididymis?

A
  • the efferent ductules which form the head
  • the true epididymis which forms the body and tail
77
Q

What are the seminiferous tubules?

A

Coiled tubes where sperm is produced in the testes

78
Q

What is the rectum?

A

the most posterior element of the pelvic viscera

79
Q

What are the two parts of the rectum and which blood vessels supply them?

A
  1. Superior (abdominal) - inferior mesenteric artery
  2. Inferior (pelvic) - internal iliac artery
80
Q

What is the anorectal flexure?

A

Where the pubortectalis muscle wraps around the front of the rectum and contracts to create an angle in the rectum

81
Q

What is the purpose of the anorectual flexure?

A

Helps to maintain faecal continence

82
Q

What does the rectum sit posterior to in women?

A
  • Rectouterine pouch
  • Sigmoid colon
  • Ileum
  • Vagina
  • Cervix
83
Q

What sits posterior to the rectum?

A
  • Sacrum
  • Coccyx
  • Coccygeus muscle
  • Levator ani muscle
84
Q

Where do the pelvic viscera sit?

A

The pelvic cavity

85
Q

What is the pelvic floor?

A

The inferior lining of the pelvic cavity

86
Q

What do the pelvic floor muscles do?

A

Separate the pelvic viscera from the perineum

87
Q

What are the two holes in the pelvic floor muscles?

A

Urogenital and rectal hiatuses

88
Q

What is the fucntion of the pelvic floor muscles?

A
  • 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
89
Q

Which muscles make up the pelvic floor?

A
  • levator ani group (puborectalis, pubococcygeus, iliococcygeus)
  • coccygeus
90
Q

What is the main nerve which supplies the pelvic floor muscles?

A

Pudendal nerve, a branch of the saccral plexus S2-S4

91
Q

What is the vascular supply of the pelvic structures excluding the testes and ovaries?

A

Left and right internal iliac arteries and veins

92
Q

What is the vascular supply of the testes?

A

The testicular arteries and veins

93
Q

What is the vascular supply of the ovaries?

A

The ovarian arteries and veins

94
Q

What do the testicular and ovarian arteries branch off from?

A

The abdominal aorta

95
Q

What do the testicular and ovarian veins branch off from?

A

The inferior vena cava

96
Q

What are the common iliac arteries?

A

The bifurcation of the abdominal aorta at L4

97
Q

What do the common iliac arteries branch into?

A
  • the external iliac artery (lower limb)
  • the internal iliac artery (pelvis and gluteal region)
98
Q

Where do the common iliac arteries branch?

A

The pelvic brim

99
Q

What does the internal iliac artery branch into?

A

The anterior and posterior trunk

100
Q

What does the anterior trunk if the internal iliac artery supply?

A

The pelvic organs and perineum

101
Q

What are the branches of the anterior trunk? (6)

A
  • umbilical artery
  • inferior vesicular artery
  • vaginal artery
  • uterine artery
  • middle rectal artery
  • internal pudendal artery
102
Q

What does the umbilical artery supply?

A

The superior aspect of the bladder (also takes deoxygenated blood from the foetus to placenta in utero)

103
Q

What does the inferior vesicular artery supply?

A

the inferior aspect of the bladder, as well as the prostate and seminal vesicles in men

104
Q

What does the vaginal artery supply

A

VAGINA

105
Q

What does the uterine artery supply?

A

The uterus and uterine tubes

106
Q

What does the middle rectal artery supply?

A

the rectum

107
Q

What does the internal pudendal artery supply?

A

the perineum

108
Q

What is the function of the internal iliac vein?

A

Drains the pelvic viscera

109
Q

Where is the internal iliac vein formed?

A

The greater sciatic foramen

110
Q

Label 3-7

A
  1. Left renal vein
  2. Right sympathetic trunk and ganglion
  3. Left suprarenal (adrenal) gland
  4. Left renal artery
  5. Left ureter
111
Q

Label 1-7

A
  1. Fibrous capsule of kidney
  2. Renal pyramid; terminates in renal papilla
  3. Major renal calyx
  4. Renal artery
  5. Renal pelvis
  6. Renal cortex
  7. Medulla of kidney
112
Q

Label 1-7

A
  1. Right renal vein
  2. Iliohypogastric or ilioinguinal nerve (L1)
  3. Genitofemoral nerve (L1 and L2)
  4. Ductus deferens
  5. Testis and epididymis
  6. Inferior mesenteric artery
  7. Ureter
113
Q

Label 1-5

A
  1. Pampiniform plexus of veins
  2. Testicular artery
  3. Ductus deferens
  4. Body of epididymis
  5. Parietal layer of tunica vaginalis
114
Q

Label 1-7

A
  1. Right kidney
  2. Right ureter
  3. Inferior vena cava
  4. Uterus
  5. Round ligament of the uterus
  6. Urinary bladder
  7. Abdominal aorta
115
Q

Label 1-10

A
  1. Urinary bladder
  2. Seminal vesicle
  3. Ejaculatory duct (proximal portion)
  4. Prostate
  5. Bulbourethral gland (Cowper’s gland)
  6. Ductus deferens
  7. Ureter
  8. Levator ani muscle
  9. Obturator internus muscle
  10. Bulb of penis
116
Q

Label 1-7

A
  1. Median umbilical fold with urachus
  2. Urinary bladder
  3. Uterus
  4. Uterine tube
  5. Rectum
  6. Ovary
  7. Fimbriae of uterine tube
117
Q

Label 1-8

A
  1. Common iliac vein
  2. Genitofemoral nerve
  3. Round ligament of uterus
  4. Urinary bladder
  5. Ureter
  6. Superior hypogastric plexus
  7. Rectouterine pouch (of Douglas)
  8. Vesicouterine pouch
118
Q

Label 1-7

A
  1. Uterus
  2. Vesicouterine pouch
  3. Urinary bladder (collapsed)
  4. Sacral promontory
  5. Rectum
  6. Cervix of uterus
  7. Vaginal canal
119
Q

Label 1-8

A
  1. Internal iliac artery
  2. Internal pudendal artery
  3. Ureter
  4. Inferior hypogastric plexus (pelvic plexus)
  5. Lumbosacral trunk
  6. Pelvic splanchnic nerves (nervi erigentes)
  7. Prostate gland
  8. Rectum
120
Q

Label 1-6

A
  1. Ovary
  2. Uterine tube
  3. Urinary bladder
  4. Small intestine
  5. Uterus
  6. Urethra
121
Q

Label 1-5

A
  1. Urinary bladder
  2. Prostate
  3. Bulb of penis
  4. Obturator internus muscle
  5. Prostatic urethra
122
Q

Label 1-7

A
  1. Central tendon of diaphragm
  2. Ureter
  3. Right gonadal vein
  4. Splenic artery
  5. Suprarenal (adrenal) gland
  6. Left suprarenal vein
  7. Left gonadal vein
123
Q

What does the rectum sit anterior to in men?

A
  • Rectovesical pouch
  • Sigmoid colon
  • leum
  • Bladder
  • Prostate
  • Seminal vesicles