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Anatomy > Abdomen, Pelvis and Perineum > Flashcards

Abdomen, Pelvis and Perineum Flashcards

1
Q

What structure forms the deep inguinal ring?

A

Outpouching of Transversal fascia

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2
Q

What muscle of the 3 layers of the anterior abdominal wall does not contribute to spermatic fascia/cord?

A

Transversus abdominis

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3
Q

What structures forms the external, middle and internal spermatic fascia of the spermatic cord?

A
  • external abdominal oblique (external)
  • internal abdominal oblique (middle)
  • transversalis fascia
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4
Q

What structure form the femoral canal?

A

Transversalis fascia ▶️ inferior extension ▶️ femoral sheath

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5
Q

Contents of inguinal canal in female

A
  • round ligament of the uterus

- ilioinguinal nerve (L1)

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6
Q

Contents of inguinal canal in male

A
  • Ilioinguinal nerve (L1),
  • espermatic cord: testicular artery, pampiniform venous plexus, vas deferens (ductus deferens and its artery), autonomic nerves, lymphatics
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7
Q

What is the fibrous gubernaculum during descent of testes?

A

Fibrous tissue that guides the testis descending to the deep inguinal ring

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8
Q

Where does penis and scrotum cancer metastasize, and the testicular cancer?

A
  • penis and scrotum: superficial inguinal lymph nodes

- testicular: aortic (lumbar) lymph nodes

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9
Q

What nerves are the responsible of the sensitive and motor response of the cremasteric reflex?

A
  • ilioinguinal nerve: sensory fibers (lightly touch of thigh)
  • genitofemoral nerve: motor fibers
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10
Q

What structure forms the superficial inguinal ring?

A

External abdominal oblique fascia

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11
Q

What is the result of a persistent process vaginalis?

A

Congenital indirect inguinal hernia

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12
Q

What happen if serous fluid collects in the tunica vaginalis?

A

Hydrocele ▶️ enlarged scrotum (doesn’t reduce in size when lying down)

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13
Q

Which the boundaries of inguinal “hasselbach’s” triangle? And what is its importance?

A

Lateral: inferior epigastric vessels
Medial: rectus abdominis muscle
Inferior: inguinal ligament
- site of direct inguinal hernia

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14
Q

Which layers cover the sac where bulges the indirect inguinal hernia?

A

The 3 layers of spermatic fascia

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15
Q

What is the difference or boundary between femoral and inguinal hernia?

A
  • femoral: pass below inguinal ligament

- inguinal: pass above inguinal ligament

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16
Q

What is the epiploic foramen (of Winslow) and its boundaries?

A

The only communication between the lesser sac and the greater sac of peritoneal cavity

  • Anteriorly: Hepatoduodenal ligament and the hepatic portal vein.
  • Posteriorly: Inferior vena cava.
  • Superiorly: Caudate lobe of the liver.
  • Inferiorly: First part of the duodenum
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17
Q

What structures undergo to secondary retroperitonealization? Why does it occur?

A 
Duodenum, 2nd and 3rd parts 
Head, neck, and body of pancreas
Ascending colon
Descending colon
Upper rectum
- they fuse with the body wall by way of fusion of visceral peritoneum with parietal peritoneum
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18
Q

What is annular pancreas and its mean feature?

A

Defect in rotation and fusion of ventral and dorsal buds of pancreas ▶️ constrict or obstruct duodenum ▶️ polyhydramnios

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19
Q

Where is located the portal triad, what is it?

A
  • hepatoduodenal ligament

- portal vein, hepatic artery, common bile duct

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20
Q

What clinical presentation commonly occur in head cancer pancreas?

A

Constrict main pancreatic duct and common bile duct, obstruction of it ▶️ jaundice

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21
Q

Innervation and function of internal anal sphincter

A
  • circular smooth muscle surround anal canal
  • sympathetic: lumbar splanchnic ⬆️ tone
  • parasympathetic: pelvic splanchnic ⬇️ tone relaxes (defecation)
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22
Q

Innervation and function of external anal sphincter

A
  • circular voluntary skeletal muscle surrounding the canal

- inferior rectal branch of pudendal nerve, relaxes during defecation

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23
Q

What is the cause of hirschsprung disease?

A

Mutations affect the migration of neural crest cells into the Gut ▶️ deficiency of terminal ganglion cells in Auberbach’s plexus

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24
Q

What is the cause of pain in gastrointestinal tract?

A

Excessive contraction and or distention of smooth muscle

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25
Q

What alteration in gastrointestinal motility results in Hirschsprung disease?

A

Particularly in rectum ▶️ peristalsis is not effective ▶️ constipation

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26
Q

What results in Vit B12 deficiency?

A
  • pernicious anemia

- disruption of peripheral and central nervous system myelin (subacute combined degeneration)

27
Q

How does histamine increases the HCl secretion by parietal cells?

A
  • H2 receptor ⬆️ potentiate gastrin and Ach

* inhibitor: cimetidine and H2 antagonist

28
Q

How can you differentiate the three portions of the small intestine?

A
  • duodenum: brunner’s glands in submucosa
  • jejunum: no brunner’s or peyer’s patch
  • ileum: peyer’s patch in lamina propia
29
Q

In case of constipation what system would you like to activate?

A

Parasympathetic system ▶️ 🔛 peristalsis

*dopaminergic of cholinergic agents (metoclopramide)

30
Q

What is the function of a paneth cell?

A
  • apical acidophilic granules ▶️ lysozymes and defensins (cryptins) ▶️ protect against pathogens
31
Q

Main functions of salivary glands

A
  • initial triglycerides digestion (lipases)
  • initial starch digestion (amylases)
  • lubrication
32
Q

What is the effect of parasympathetic and sympathetic innervation on salivary glands?

A
  • sympathetic: ⬆️ serous production by B-adrenergic receptors
  • parasympathetic: ⬆️ mucous production by muscarinic receptor (anticholinergic ▶️ dry mouth)
33
Q

What is the function of Ito cells? Where are they?

A
  • contain fat, storage of fat-soluble vitamins, Vit A mainly

- space of Disse

34
Q

What zone of the hepatic acinus is more susceptible to hypoxia and ischemia?

A

zone 3

35
Q

What induce the contraction and empty of the gallbladder? Where is it produced?

A
  • cholecystokinin

- enteroendocrine cells of the duodenum when meal (lipid) arrive

36
Q

Besides excretion and aid to absorption of fat, what is the other function of the bile?

A

Transport of IgA

37
Q

What pathological process does the Ito cell contribute?

A

Scarring of the liver
*stimulated during liver injury ▶️ release collagen type I and other matrix components into space of Disse (cirrhosis due to etanol)

38
Q

Which are the three branches that can suffer erosion by penetrating ulcer of the wall of the stomach?

A
  • splenic
  • left gastric
  • gastroduodenal
39
Q

Where is the most common site of bowel ischemia?

A

The splenic flexure

40
Q

What anastomoses represents the junction between foregut and midgut, midgut and hindgut?

A
  • pancreoticoduodenal, superior (foregut) and inferior (midgut) arteries, branches from celiac and SMA respectively
  • marginal artery interconnection of the branches of SMA and IMA to the colon (midgut and hindgut)
41
Q

What structure most commonly be compressed by an aneurism of the superior mesenteric artery? What symptoms or signs can you get?

A
  • left renal vein when crosses anterior to the aorta

- renal and adrenal hypertension on left, in males ▶️ varicocele on the left

42
Q

Which are the sites where portal system anastomoses with caval system?

A
  • esophageal veins
  • rectal veins
  • thoracoepigastric veins
  • if portal hypertension exists (obstruction) these veins may enlarge (retrograde blood flow) ▶️ esophageal varices, internal hemorrhoids, and a caput medusae
43
Q

What is the cause of spastic bladder?

A

Lesion of spinal cord above the sacral spinal cord levels
*loss inhibition of the parasympathetic nerve that innervates detrusor muscle during filling stage ▶️ urge incontinence (activate destructor with minimum stretch)

44
Q

Atonic bladder is the result of what lesion?

A

Lesions to the sacral spinal cord segments or sacral espinal nerve roots
*loss pelvic splanchnic motor innervation ▶️ loss contraction of detrusor ▶️ full bladder with continuos dribble

45
Q

What situation allows the filtration in the glomerulus?

A

pressure remains high inside

46
Q

What protein is associated with complex protein between the diaphragm formed by foot processes of podocytes?

A

Actin

47
Q

What cells produces erythropoietin?

A

Fibroblast in cortex and medulla

48
Q

What is the role of MIF in embryology of reproductive system?

A

Inhibit paramesonephric duct (Müllerian duct) - lead in uterine tubes, uterus, cervix, upper vagina
*male - appendix of testes once inhibited

49
Q

What structures would you expect to find normal in 5-Alfa reductase deficiency?

A

Prostate gland, epididymis, ductus deferens, seminal vesicle, ejaculatory duct (need just testosterone)
*Those that don’t need DHT to develop

50
Q

What is the cause of complete androgen insensitivity? What is its presentation?

A
  • mutation in androgen receptor gene

- testes develop but external female genitalia (46XY)

51
Q

What structures form the pelvic diaphragm?

A
  • levator ani

- coccygeus

52
Q

What structures form the Urogenital diaphragm?

A
  • urethral sphincter

- deep transverse perineus

53
Q

What is the role of the internal urethral sphincter muscle during ejaculation reflex? What system mediates this reflex?

A
  • contract to avoid retrograde flow and urine pass

* sympathetic control - contraction others smooth muscles to impulse seminal fluid (ex, of the ductus deferens)

54
Q

What is call the “water under the bridge” and for what is it important?

A
  • Ureter passes inferior to the uterine artery, or uterine artery within cardinal ligament crosses over anterior surface of ureter
  • Must be identified during surgical procedures→avoid ureter injury
55
Q

Which are the contents of the superficial perineal pouch?

A
  • women: great vestibular (Bartholin) glands
  • crura of penis or clitoris
  • bulb of penis (contain urethra) and of vestibule in women
  • ischiocavernosus muscle: covers crura
  • bulbospongiosus muscle: covers bulb
  • crura continues as corpora cavernosa in penis and clitoris
  • bulb continues as corpus spongiosum in penis
56
Q

What is the blood-testis barrier? And its function.

A
  • network of Sertoli cells formed by their tight junctions which divides the seminiferous tubules into a basal and an adlumental compartment
  • basal receive material from blood, the adlumental doesn’t
57
Q

What can cause accumulation of fluid in the scrotum, penis, and anterolateral abdominal wall?

A

Laceration membranous or penile urethra (deep to scarpa fascia)

  • trauma perineal region (saddle injury)
  • laceration of the urethra during catheterization
58
Q

What structure could have been injured to cause extravasation of urine from urethra to superficial perineal space?

A

Injury to the bulb of the penis

59
Q

Where is the corpus luteum come from and its function?

A
  • wall of follicles collapses and infold once the oocyte has been delivered
  • granulosa and theca lutein cells ▶️ estrogen and progesterone, androstenedione and progesterone (prevent development of new follicles)
60
Q

Why women with kartagener syndrome (immotile cilia syndrome) have normal transport of the ovum at the oviduct?

A

Ciliary action is not essential, contraction of muscle layer transport the ovum or fertilized egg (zygote) to the uterus

61
Q

A woman develops a stenosis of the superior mesenteric artery at its origin from the aorta, which part of colon results in decreased blood supply? Which vessel provides collateral circulation to the affected part?

A
  • 2/3 proximal colon

- Left colic (normally 1/3 proximal colon)

62
Q

What level does the inferior mesenteric artery arise?

A

From the aorta at L3 between the gonadal arteries and the bifurcation of the aorta.

63
Q

What can cause a failure in fusion of the buds of the pancreas?

A

Polyhydramnios
*defect in the rotation and fusion of the ventral and dorsal buds ▶️ annular pancreas ▶️ constrict or obstruct the duodenum

Anatomy (22 decks)

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