Activities Flashcards
1
Q
Locate the adrenal glands on the model.
○ What substances do the adrenal glands produce?
A
Cortex = aldosterone , cortisol, testosterone
Medulla = adrenaline
2
Q
Locate the adrenal glands on the model.
○ How do they differ in shape from each other?
A
Right gland is more triangular and left is flatter due to presence of spleen
3
Q
What are the 3 arteries that supply the adrenal glands and where do they originate from?
A
Superior adrenal artery= inferior phrenic artery
Middle adrenal artery = abdominal aorta
Inferior adrenal artery= renal artery
4
Q
Which veins drain the adrenal gland? Where do they drain to? Is this the same on the le ft and right?
A
Left adrenal vein —> left renal vein
Right adrenal vein —> inferior vena cava
5
Q
Which ribs are overlying the kidneys when theyʼre in their anatomical position?
A
10, 11, 12
6
Q
Is the kidney intraperitoneal or retroperitoneal?
A
Retroperitoneal
7
Q
What are the names of the layers of tissue surrounding the kidney?
A
Perinephric fat
Renal fascia
Paranephric fat
8
Q
Why does the right kidney rest lower in the abdomen than the le ?
A
Presence of liver
9
Q
Which other veins drain into the left renal vein before it reaches the IVC
A
Left adrenal vein
Left testicular.vein
10
Q
Which parts of the nephron lie in the cortex, and which parts lie in the renal pyramid?
A
Cortex = glomerulus, PCT, DCT
Medulla = straight parts of PCT/DCT, collecting duct, loop of henle
11
Q
Where do the ureters enter the urinary bladder?
A
At the trigone on the posterior aspect
12
Q
Which organs are immediately anterior and posterior to the bladder?
A
Anterior = pubic symphysis
Posterior - vagina and rectum
13
Q
What is the name of the folds of tissue in the bladder wall?
○ What is their purpose?
○ Which other organ has these folds?
A
Rugae
- allow the bladder the expand when filling with urine
- stomach
14
Q
What is the name of the muscle inside the wall of the urinary bladder?
A
Detrusor
15
Q
Which nerve provides conscious control of the external urinary sphincter?
A
Pudendal nerve
16
Q
Which nervous system controls the detrusor and internal sphincter to allow the storage of urine?
A
Sympathetic - hypogastric nerve (T12-L2)
17
Q
Which nervous system controls the detrusor and internal sphincter to allow the expulsion of urine? Which nerve roots convey these impulses?
A
Parasympathetic
- pelvic splanchnic nerves (S2-S4)
18
Q
Which arteries supply the urinary bladder? Which artery are they branches of?
A
Vesical arteries —> internal iliac artery
19
Q
Identify the urethra.
○ How long is it in human adults?
○ How does this differ between sexes?
A
Females = 3-4cm
Males = 15-20cm
20
Q
Ureters
○ What structures do they pass over and under to reach the bladder?
A
Run anterior to psoas major on posterior abdominal wall and cross pelvic brim to enter the pelvis
21
Q
Ureters
○ Where are the narrowest parts of the ureter where stones may get stuck?
A
Where the ureters enter the bladder - rudimentary valve
22
Q
Aorta
○ At what thoracic levels do they transverse the diaphragm?
○ At what lumbar levels do they bifurcate? What do they bifurcate into?
A
T12
L4 - common iliac arteries
23
Q
IVC
○ At what thoracic levels do they transverse the diaphragm?
○ At what lumbar levels do they bifurcate? What do they bifurcate into?
A
T8
L5- common iliac veins
24
Q
Psoas muscles
○ What is their function?
A
- actions of psoas major are flexion and lateral rotation of the thigh at the hip. It also flexes the trunk at the hip and flexes the trunk laterally. Psoas major is also a postural muscle.
25
Which structures are found above the pelvic floor? What anatomical region lies below it?
Above = contents of pelvis
Below = perineum
26
What is the pelvic floor made of?
Levator ani: Puborectalis, pubococcygeus, iliococcygeus
Coccygeus
27
What are the main functions of the pelvic floor muscles?
Prevent herniation of the pelvic organs
Control continence
Increasing intra-abdominal pressure
28
What additional important function does puborectalis have?
Acts as a sling to control defecation and micturition
29
Which nerve innervates the pelvic floor muscles?
S4 nerve and pudendal nerve
30
Describe the location of the perineum - where is it?
Beneath the pelvic floor between the pubic symphysis and coccyx and medial surfaces of the thighs
31
On a bony pelvis, where would you draw a line to separate the urogenital triangle from the anal triangle?
Between the ischial tuberosities
32
Superior gluteal artery
artery exits the pelvis posteriorly to supply the gluteal region
33
Inferior gluteal artery
artery also exits the pelvis posteriorly (but more inferior to the superior gluteal artery) to supply the gluteal region
34
Obturator artery
artery runs along the superior pubic ramus to reach the obturator
foramen
35
Internal pudendal artery
one of the final and deepest branches on the model, it exits the pelvis inferiorly to reach the perineum
36
Inferior vesical artery
○ This is a branch of the internal iliac artery on the model.
○ Which organ does it supply?
Bladder
37
Sciatic nerve - this is the thickest peripheral nerve in the body. Branches of the internal iliac artery are seen on its surface in the model.
○ Which nerve roots contribute to the sciatic nerve?
L4-S3
38
Obturator nerve - this nerve runs along with the obturator artery to along the superior pubic ramus to reach the obturator foramen.
○ Which nerve roots contribute to the obturator nerve?
L2-L4
39
Pudendal nerve - this nerve is formed at the inferior aspect of the sacral plexus,
and it exits the pelvis inferiorly with the pudendal artery.
○ Which area does it supply somatic nerve fibres to?
○ Which nerve roots contribute to the pudendal nerve?
Urinary bladder and sphincters
S2-S4
40
Bulbospongiosus and Ischiocavernosus - these are small muscles that are located in the perineum.
○ Which layer of the urogenital triangle are they located in?
Superficial perineal pouch
41
Bulbospongiosus and Ischiocavernosus - these are small muscles that are locatedin the perineum.
○ Do you know what structures they cover?
Bulbospongiosum = corpus spongiosum
Ischiocavernosus- corpora cavernosa
42
Bulbospongiosus and Ischiocavernosus - these are small muscles that are located in the perineum.
○ What structure does bulbospongiosus attach to posteriorly?
Perineal body
43
The perineal body - what is its role? What are the consequences if it is damaged? How can this be prevented during childbirth?
Acts as an attachment for almost all the perineal and pelvic floor muscles
- incontinence or pelvic floor weakness
-episiotomy
44
Identify the male urethra - what are the four parts?
Pre-prostatic
Prostatic
Membranous
Penile
45
What is the main somatic nerve of the perineum? How does this nerve get from the pelvis into the perineum?
Pudendal nerve via lesser sciatic foramen
46
Obturator foramen
between the superior and inferior pubic rami
47
Ischial tuberosity
bulky protuberance on the posterior part of the
ischium
48
Ischial spine
an angular projection of bone from the ischium)
■ Above and below the ischial spine, there are two notches, the greater and lesser sciatic notches.
49
Sacrotuberous ligament
runs between the sacrum and the ischial tuberosity
50
Sacrospinous ligament
runs between the sacrum and the ischial spine
51
Greater sciatic notch
allows structures to pass between the pelvis and the gluteal region (e.g. gluteal nerves and vessels).
52
Lesser sciatic notch
allows structures to pass between the gluteal region and the perineum (e.g the internal pudendal artery and the pudendal nerve)
53
Which bony landmarks does the inguinal ligament attach to?
Anterior superior iliac spine
Pubic tubercle
54
Which bony landmarks can be palpated on a patient?
Anterior superior iliac spine
55
Which muscles and fascial layers would a surgeon have to cut through to enter the peritoneal cavity?
Rectus sheath
External oblique
Internal oblique
Transversus abdominis
Rectus abdominis
Transversalis fascia
56
Where are the superficial and deep inguinal rings located? They form holes in which layers of the abdominal wall?
Superficial = external oblique aponeurosis - lies superior to pubic tubercle
Deep= transversalis fascia - found above midpoint of inguinal ligament
57
Which structures pass through the inguinal canal in females?
Genital branch of genitofemoral nerve
Ilioinguinal nerve
Round ligament
58
Which structures are found within the spermatic cord?
2 nerves:
- genital branch of genitofemoral nerve
- sympathetic fibres
3 fascias:
-external spermatic fascia
-cremaster fascia and muscle
-internal spermatic fascia
3 arteries:
- testicular artery
-artery to vas deferens
- cremaster artery
4 other structures:
- vas deferens
-pampiniform venous plexus
- processus vaginalis
- lymphatics
59
Processus vaginalis
projection of peritoneum that forms the pathway of descent for the testes during embryonic development. In the adult, it is fused shut.
60
What is the difference between a direct and an indirect inguinal hernia?
Direct= only goes through superficial ring
Indirect = floes through deep ring and superficial ring
61
Which structures descend into the scrotum from the abdomen, through the inguinal canal, during foetal development?
Testis
62
What is contained within each half of the scrotum?
Testis
Epididymis
External spermatic fascia
63
What are the key functions of the testes?
○ What is the advantage of the testes being in the scrotum, rather than inside the abdominal cavity?
Produce sperm and testosterone
- sperm cannot be produced at body temperature (too high)
64
○ What problems can arise if the testes donʼt descend into the scrotum?
Unable to produce functioning sperm
More likely to have testicular cancer and not as easy to diagnose
65
Which arteries supply the testes? Where do they branch from?
Testicular arteries
Abdominal aorta
66
Which veins drain the testes? How does the course of these veins differ on the le ft and right sides?
Testicular veins
- right drains directly into IVC
- left drains first into left renal vein
67
What is the name of the tube that carries sperm from the epididymis to be ejaculated via the urethra? How does this structure reach the urethra?
Vas deferens - passes through seminal vesicle and then joins urethra in prostate
68
Name the columns of erectile tissue that make up the penis.
Corpora cavernosa
Corpus spongiosum
69
Which structure passes through the ventral erectile tissue?
Corpus spongiosum
70
Identify the glans penis - which erectile tissue forms this part of the penis?
Corpus spongiosum
71
What are the erectile tissues attached to proximally?
Perineal membrane
72
The bulb and crura are covered by thin muscles - what are they called?
Bulb= bulbospongiosum
Crura - ischiocavernosus
73
How do the erectile tissues work to cause the penis to become erect?
Corpora cavernosa = increase size and rigidity of penis as corpora becomes engorged with blood
Corpus spongiosum = also engorged with blood to a lesser extent- prevent urethra becoming compressed which would prevent ejaculation
74
In which surgical procedure are the vasa deferentia ligated (tied-off)? What is the purpose of this procedure?
Vasectomy- birth control
75
What is the role of the prostate?
Secretions of the prostate are added to the seminal fluid during ejaculation
76
Where does the prostate lie relative to the bladder?
Neck of the bladdef
77
What structure passes through the prostate?
Urethra
Ejaculatory duct
78
What may be the consequence of enlargement of the prostate?
Compression of the urethra - unable to urinate
79
Identify the seminal vesicles. What is their function?
Produce the seminal fluid (alkaline)
80
Which artery supplies the prostate and seminal vesicle?
Internal iliac arteries
81
The male urethra can be divided into 4 sections, what are these sections called?
Pre-prostatic
Prostatic
Membranous
Penile
82
Which part of the penis does the penile urethra pass through?
Corpus spongiosum
83
Males are less prone to urinary tract infections than females - why is this?
Shorter urethra
84
What layers of tissue does the surgeon need to cut through to reach the testis?
Skin
Tunica vaginalis
Tunica albuginea
85
What is meant by the term ʻvulvaʼ?
The external genitalia of females
86
Clitoris - what is it made of?
2 corpora cavernosa
Glans clitoris
87
Urinary meatus - where is it in relation to the vaginal opening and clitoris?
Posterior to clitoris
Anterior to vaginal opening
88
Vestibule - which structures flank the vestibule?
Labia minora
89
Which nerves provide sensory innervation to the vulva?
Pudendal nerve
Ilioinguinal nerve
Genital branch of genitofemoral nerve
Posterior cutaneous nerve of thigh
90
Which nerve roots provide parasympathetic nerve supply to the erectile tissues?
S2-S4
91
What is the blood supply to the clitoris?
Internal pudendal arteries (branch of internal iliac arteries)
92
Name the bodies of erectile tissue found in the female perineum.
○ Which is most lateral and which is medial?
○ What are the erectile tissues attached to?
Corpora cavernosa = lateral
Corpus spongiosum - medial
Perineal membrqne
93
Identify the clitoris - which erectile tissues contribute to this?
○ Where is it located in relation to the labia minora and urethral opening?
Corpora cavernosa
- anterior to both
94
The bulb of the vestibule, which is the proximal part of the corpus
spongiosum. How is this orientation different in males?
In males, it is wrapped around the bulb of penis and corpus spongiosum, while in females it encircles the vaginal orifice.
95
The bulb and crura are covered by thin muscles - what are they called?
○ What are the functions of the two muscles? How do they contribute to clitoral erection?
Ischiocavernosus - forces blood the crura to the body of the clitoris
Bulbospongiosus - forces blood to the glans clitoris which helps to maintain clitoral erection and constricts around the vaginal orifice which helps expression of fluid from the greater vestibular glands
96
Identify the vagina. How is the vagina adapted for its functions?
Can stretch
97
Which glands lubricate the vagina and vaginal opening?
Lesser and greater vestibular glands
98
Identify the cervix. Is it part of the uterus, or part of the vagina?
Uterus
99
Where do most ectopic pregnancies occur?
Ampulla of uterine tube
100
Which artery supplies the ovary? Where does this artery originate?
Ovarian arteries
Abdominal aorta
101
What structure produces ova? How is an ovum excreted if it is not fertilised?
Ovaries
- menstrual cycle
102
Consider the passage of the sperm a er sexual intercourse - which structures does it need to pass through to reach an ovum?
Vagina
Cervix
Uterus
Uterine tube
103
What is the name of the space between the uterus and urinary bladder?
Vestibulouterine pouch
104
space between the uterus and the rectum - what is its name? Why is this space clinically important?
Rectouterine pouch - most deep point so common site for accumulation of Intraperitoneal fluid or pus
105
The uterine artery is tortuous, why is this important?
Can stretch when pregnant
106
The non-gravid uterus has a significant blood supply for a small organ, why does it need this?
Menstrual cycle- sheds blood monthly
107
Where do the uterine arteries arise from?
Internal iliac arteries
108
Where in the uterine tube is the most common site of fertilisation?
Ampulla
109
What is the name of the finger-like projections at the lateral end of the uterine tube? What is their function?
Fimbriae - to waft ova into the uterine tune
110
Identify the uterine tube in the superior part of the broad ligament. What structure does the tube make contact with laterally?
Ovaries
111
Broad ligament
sheet of peritoneum that is draped over the uterus and uterine tubes and connects them to the lateral wall of the pelvis.
112
How does the position of the fundus change during pregnancy?
The fundus grows in height
113
Luis, a retired government spy, has undergone a right nephrectomy. The surgeons divided the renal artery. At what level does the right renal artery branch off the abdominal aorta?
L2
