Anatómía abdomen og pelvis Flashcards
1
Q
Innihald rectus sheath (5):
A
- The rectus abdominis muscle
- The pyramidalis muscle
- The superior epigastric vessels
- The inferior epigastric vessels
- The ventral primary rami of T7-T12 nerves
2
Q
Hvaða tvö lög eru fyrir ofan rectus sheath?
A
- Camper’s fascia (anterior part of the superficial fascia)
- Scarpa’s fascia (posterior part of the superficial fascia)
3
Q
Hvaða 3 lög eru fyrir neðan rectus sheath?
A
- Transversalis fascia
- Extraperitoneal fat
- Parietal peritoneum
4
Q
Úr hverju er rectus sheath?
A
The rectus sheath is formed by the aponeurosis of the three flat muscles: transversus abdominis and the external and internal oblique muscles.
5
Q
Í hvaða 3 lög skiptist rectus sheath og úr hverju eru þau?
A
- An anterior layer consisting of the aponeurosis of the external oblique and internal oblique
- A posterior layer consisting of the fused aponeurosis of the internal oblique and transversus abdominis
- A cresenteric line of transition called the arcuate line between the tranversalis fascia and the aponeurotic posterior wall of the rectus sheath
6
Q
Í hvaða tvo hópa skiptast abdominal lymph nodes?
A
The abdominal lymph nodes can be broadly divided into pre-aortic and para-aortic groups, depending upon their relationship to the aort
7
Q
Hvar liggja pre-aortic hópur abdominal eitla?
A
The pre-aortic nodes lie anterior to the aorta and lie around the origins of the visceral (anterior) arteries.
8
Q
Hvað drenera pre-aortic abdominal eitlar?
A
- gastrointestinal tract
- and its accessory viscera (liver, spleen and pancreas).
9
Q
Pre-aortic eitlar eru annar hópur abdominal eitla. Í hvaða 3 undirhópa skiptast þeir svo?
A
- Coeliac lymph nodes
- Superior mesenteric lymph nodes
- Inferior mesenteric lymph nodes
10
Q
Hvert drenera pre-aortic eitlar í abdomen?
A
Í intestinal trunk, sem drenerar svo í cisterna chlyi.
11
Q
Hvað drenera Coeliac lymph nodes sem eru hluti af pre-aortic eitlum? (5)
A
- Stomach
- Most of the duodenum
- Liver and biliary tree
- Pancreas
- Spleen
12
Q
Hvað drenera superior mesenteric lymph nodes, sem eru hluti af pre-aortic eitlum? (5)
A
- Part of the duodenum
- Jejunum and ileum
- Caecum and appendix
- Ascending colon
- Transverse colon
13
Q
Hvað drenera inferior mesenteric lymph nodes, sem eru hluti af pre-aortic eitlum? (3)
A
- Descending colon
- Sigmoid colon
- Upper rectum
14
Q
Hvað heita ligamentin fjögur í symphysis pubis?
A
Anterior pubic ligament
Posterior pubic ligament
Superior pubic ligament
Inferior (arcuate) pubic ligament
15
Q
Hvaða tvö ligament í symphysis pubis eru sterkari en hin?
A
The anterior and posterior pubic ligaments are weaker than the superior and inferior pubic ligaments, which provide most of the joint’s stability.
16
Q
Hvaða ligament í symphysis pubis er stærst og þykkast og hvernig liggur það?
A
The inferior (arcuate) pubic ligament is the largest and thickest of the pubic ligaments. It is triangular in shape and connects the two pubic bones inferiorly, forming the upper border of the pubic arch. It attaches to the fibrocartilage superiorly and the inferior pubic ramus of the pubic bones laterally.
17
Q
Í hvaða 4 svæði skiptist maginn?
A
- The cardia – which is around the opening of the oesophagus
- The fundus – which is the dilated superior portion lying beneath the left dome of the diaphragm
- The body – which is the large central position lying between the fundus and the pylorus
- The pylorus – which is the lower portion that facilitates the emptying of its contents into the duodenum
18
Q
Hvaðan koma greater og lesser omentum?
A
Frá greater og lesser curvatures maga, respectively.
19
Q
Hvar er angular notch?
A
Á maga á lesser curvature - milli pylorus og body.
20
Q
Í hvaða hluta skiptist duodenum og hvernig liggja þeir?
A
- The superior (first) part:
This superior part is short (around 5 cm long) and lies anterior to the body of L1. It is connected to the liver by the hepatoduodenal ligament. The first 2 cm is mobile and is referred to as the duodenal cap. Duodenal ulcers are most likely to occur in this part of the duodenum.
- The superior (first) part:
- The descending (second) part:
This is the longest part (around 7-10 cm long) and descends long the right side of the L1-L3 vertebrae. This part curves inferiorly around the head of the pancreas.
- The descending (second) part:
- The inferior (third) part:
This part is around 6-8 cm long and passes laterally to the left crossing the body of L3. This part crosses anteriorly over the inferior vena cava and aorta and is located inferiorly to the pancreas.
- The inferior (third) part:
- The ascending (fourth) part:
The ascending part is short (around 5 cm long). It begins to the left of L3 and ascends to the level of the superior border of L2. During its ascent is curves anteriorly at a sharp turn referred to as the duodenojejunal flexure.
- The ascending (fourth) part:
21
Q
Hvaða hluti duodenum er tengdur við lifur með hepatoduodenal ligamenti?
A
Fyrsti hlutinn.
22
Q
Hvað er duodenal cap?
A
Fyrstu 2 cm í fyrsta hluta duodenum. Þetta er mobill partur duodenum.
23
Q
Hvaða partur duodenum er lengstur og fer inferiort kringum höfuð pancreas?
A
Annar partur.
24
Q
Hvaða partur duodenum fer anteriort yfir inferior vena cava?
A
Þriðji partur.
25
Hvaða líffæri sjáum við á T11 á CT?
Þind, lifur, aortu, milta, maga, hrygg.
26
Hvaða líffæri sjáum við í hæð við T12 á CT?
Þind, lifur, aortu, milta, maga, hrygg.
Bætist svo við vinstra nýra.
Inferior vena cava sást á T11 líka en betur hér.
27
Hvaða líffæri sjáum við í hæð við L1 á CT?
Þind, lifur, aortu, milta, maga, hrygg, bæði nýru, gallblöðru, oft pylorus og upphaf duodenum. Pancreas.
Upphaf superior mesenteric artery.
Portal vein.
28
Hvaða líffæri sjáum við í hæð við L2 á CT?
Þind, lifur, aortu, maga, hrygg, bæði nýru og nú nýrnaslagæðarnar, gallblöðru. Pancreas.
Superior mesenteric artery.
Portal vein.
Miltað horfið.
29
Hvaða líffæri sjáum við í hæð við L3 á CT?
Aortu, maga, hrygg, bæði nýru og nú nýrnaslagæðarnar, gallblöðru. Pancreas.
Superior mesenteric artery.
Portal vein.
Inferior mesenteric artery kemur inn.
Psoas vöðvinn.
30
Hvaða líffæri sjáum við í hæð við L4 á CT?
Aorta skiptist í hæ og vi common iliaca, maga, hrygg, neðri hlutann á nýrum. Pancreas.
Superior mesenteric artery.
Portal vein.
Inferior mesenteric artery.
Psoas vöðvinn.
31
Hvort nýrað er lægra?
Hægra, út af lifrinni þar fyrir ofan.
32
Coeliac artery og superior mesenteric artery eru greinar frá...
...aortu.
33
Í hæð við L3 ganga tvær æðar út frá aortu...
...hægri og vinstri nýrnaslagæðar
34
Rétt fyrir neðan nýrnaslagæðar gengur hvaða æð út frá aortu?
Testicular arteries (langar mjóar æðar sem fara niður)
35
Aorta skiptist í hæð við...
...L4
| Hægra megin við hana í svipaðri hæð renna iliaca æðarnar saman og mynda inferior vena cava.
36
Tveir þrengstu staðirnir í ureterum:
- Pelvic uritary junction
| - Þar sem ureter fara anteriort við iliaca æðarnar.
37
Meðallengd botnlangans:
11cm
38
Hvernig þekkjum við ristilinn á rtg?
Haustrae fara ekki alla leið yfir ristilinn.
39
Utan um nýrun eru 4 lög af fitu og fasciu. Telja þau upp í röð frá superficial til deepest:
1. Pararenal fat
This lies external to the renal fascia and is mostly located on the posterolateral aspect of the kidney.
2. Renal fascia
This encloses the kidney and sends bundles of collagen through the fat, which assist in holding the kidney in position. It ascends to envelop the adrenal glands superiorly.
3. Perirenal fat
This is continuous with the fat in the renal sinus at the hilum of the kidney.
4. Renal capsule
This is the tough fibrous capsule that surrounds the kidney. It provides a limited amount of protection against trauma and damage.
40
Hvers vegna eru fasciulögin kringum nýrun mikilvæg? Hvar festist renal fascian við kviðvegginn?
The attachments of the renal fascia are clinically important as they prevent the extension of perinephric abscess pus. The renal fascia is attached to the posterior abdominal wall inferiorly and to the renal vessels and ureter at the hilum. These attachments serve to prevent the extension of pus.
41
2 algengustu staðirnir fyrir sár í efri hluta meltingarvegar sem valda blæðingu og hvaða æðar eru þar?
The two most common sites of ulcers that cause haemorrhage are
- the posterior duodenum, eroding the gastroduodenal artery
- the lesser curvature of the stomach, eroding branches of the left gastric artery.
42
Small intestine mesentery: hvað er það, hvernig er það í laginu og hvar festist það?
- The small intestine mesentery is a large, broad, fan-shaped mesentery that is attached to the jejunum and ileum, connecting them to the posterior wall of the abdominal cavity.
- Superiorly the root of the mesentery is attached to the duodenojejunal junction just to the left of the L2 vertebra.
- It runs obliquely downwards, from left to right, to attach inferiorly to the ileocaecal junction close to the right sacroiliac joint.
43
7 lög kviðveggjarins, frá dýpsta að ysta:
- Parietal peritoneum (deepest)
- Extraperitoneal fat
- Transversalis fascia
- Aponeurosis of transverse abdominis and internal oblique
- Rectus abdominis muscle
- Aponeurosis of internal oblique and external oblique muscles
- Superficial fascia (most superficial)
44
Superficial fascian sem er yst í kviðveggnum skiptist í tvennt:
- Camper’s fascia (anterior part of the superficial fascia)
| - Scarpa’s fascia (posterior part of the superficial fascia)
45
Hvað og hvar er dentate línan (pectinate línan) og
The dentate line (pectinate line) is a line that divides the upper two-thirds and the lower third of the anal canal. It represents the line of division between the embryonic hindgut-proctodeum junction. As a general rule, the neurovascular supply and lymphatics of the anal canal differ above and below this line.
46
Ítaugun anal canal fyrir ofan dentate línu:
Above the dentate line, the anal canal has visceral innervation provided by the inferior hypogastric plexus and is, therefore, sensitive to stretch only.
47
Ítaugun anal canal fyrir neðan dentate línu:
Below the dentate line, the anal canal has somatic innervation provided by the inferior anal nerves (also referred to as the inferior rectal nerves), which are branches of the pudendal nerve. It is, therefore, sensitive to pain, touch, temperature and pressure.
48
Anal reflexinn: hvernig og hvaða taugarætur:
The anal reflex is the reflexive contraction of the external anal sphincter that occurs when the skin around the anus is stroked. The tactile stimulus of the skin triggers a reflex arc that is carried via the pudendal nerve to the S2-S4 spinal segments. This is often utilised in neurological assessment, and the absence of the reflex can indicate damage to the spinal cord.
49
Hvaða 3 lög af kviðveggnum eru fyrir neðan rectus sheath?
Transversalis fascia
Extraperitoneal fat
Parietal peritoneum
50
Hvaða 5 atriði eru inni í rectus sheath?
```
The rectus abdominis muscle
The pyramidalis muscle
The superior epigastric vessels
The inferior epigastric vessels
The ventral primary rami of T7-T12 nerves
```
51
Hver er algengasta ástæða pneumoperitoneum?
The most common cause of pneumoperitoneum is a perforated peptic ulcer, and the most frequent perforation site is the anterior wall of the first part of the duodenum.
52
Í hvaða hæð hryggjarliða er nafli?
The umbilicus lies at L3/L4.
53
Hvar er lægsti punktur thoracic cage?
The subcostal plane (the lowest point of the thoracic cage) lies at L2.
54
Hvar er efsti punktur lifrarinnar?
The upper border of the liver lies at T6.
55
Í hvaða hæð er suprasternal notch?
The suprasternal notch lies at T2/T3.
56
Í hvaða 4 hluta skiptist þvagblaðran anatómískt:
- The apex – which is located superiorly and points towards the superior edge of the pubic symphysis
- The body – the large central portion located between the apex and the fundus
- The fundus (base) – which is triangular in shape and located posteroinferiorly
- The neck – which is the point where the fundus and inferolateral surfaces converge
57
Hvar eru inguinal lymph nodes og hvað eru þeir margir?
The inguinal lymph nodes are located in the upper aspect of the femoral triangle. There can be up to twenty of these lymph nodes present in this area.
58
Hvert fer lymphan úr testes og scrotum?
The lymph from the testes drains into the para-aortic lymph nodes, whilst that from the scrotum drains into the superficial inguinal lymph nodes.
59
Í hvaða tvo hluta skiptast inguinal lymph nodes og hvað drenera þeir?
1. The deep inguinal lymph nodes:
- These are located medial to the femoral vein and under the cribriform fascia. There are usually between three and five nodes in this area.
- The most superior of these nodes is called Cloquet’s node and is located under the inguinal ligament.
- They drain the deep parts of the lower limbs, the penis in the male, and the clitoris in the female.
- The deep inguinal lymph nodes drain superiorly into the external iliac lymph nodes, then to the pelvic and para-aortic lymph nodes.
2. The superficial inguinal lymph nodes:
- These form a chain immediately below the inguinal ligament and lie deep to Camper’s fascia. There are usually around ten nodes in this area.
- They drain into the deep inguinal nodes. There are broadly speaking three groups of superficial inguinal lymph nodes:
- Inferior: lie inferior to the saphenous opening and receive drainage from the lower legs
- Superolateral: lie on the side of the saphenous opening and receive drainage from the buttocks and the lower abdominal wall
- Superomedial: lie in the middle of the saphenous opening and receive drainage from the perineum, the outer genitalia (including the scrotum), and the anus below the pectinate line.
60
5 atriði sem þreifast anteriort í rectum hjá kk:
```
The prostate gland
The seminal vesicles
The rectovesical pouch
The bulbourethral glands
The full bladder
```
61
5 atriði sem þreifast anteriort per rectum hjá kvk:
```
The vagina
The cervix
The pouch of Douglas
The broad ligaments
The uterine tubes and ovaries
```
62
2 atriði sem þreifast lateralt og 3 sem þreifast posteriort í rectum:
Lateralt:
- The ischial tuberosity and spine
- The sacrotuberous ligament
Posteriort:
- The sacrum
- The coccyx
- anococcogyal ligament
63
Leiðin sem gallið fer frá lifur út gegnum sphincter of Oddi.
The biliary tract begins as the interlobular bile ducts form the right and left hepatic ducts. These two ducts merge to form the common hepatic duct, which is situated alongside the hepatic vein.
The common hepatic duct exits the liver and joins with the cystic duct from the gallbladder to form the common bile duct. The common bile duct is sometimes referred to as the ‘trunk of the biliary tree’ and, together with the hepatic artery and hepatic portal vein, forms the central axis of the portal triad.
The common bile duct passes downwards posteriorly to the proximal duodenum and joins with the pancreatic duct from the pancreas to form the ampulla of Vater. The ampulla of Vater opens into the duodenum, and the release of bile at this point is controlled by a muscular valve called the sphincter of Oddi.
64
3 atriði sem eru anteriort við ascending colon:
Anterior abdominal wall
Small intestine
Greater omentum
65
5 atriði sem eru posteriort við ascending colon:
```
Quadratus lumborum
Iliacus
Right kidney
Iliohypogastric nerve
Ilioinguinal nerve
```
66
2 atriði sem eru anteriort við transverse colon:
Anterior abdominal wall
| Greater omentum
67
4 atriði sem eru posteriort við transverse colon:
Duodenum
Jejunum
Ileum
Head of pancreas
68
3 anteriort við descending colon:
Anterior abdominal wall
Small intestine
Greater omentum
69
5 atriði sem eru posteriort við descending colon:
```
Quadratus lumborum
Iliacus
Left kidney
Iliohypogastric nerve
Ilioinguinal nerve
```
70
3 atriði sem eru anteriort við sigmoid colon:
Urinary bladder
Uterus (females)
Upper vagina (females)
71
2 atriði sem eru posteriort við sigmoid colon:
Rectum
| Sacrum
72
Hvernig liggur anterior hluti sacroiliac ligamentsins:
The anterior sacroiliac ligament consists of numerous thin bands that pass from the anterior surface of the lateral part of the sacrum to the margin of the auricular surface of the ilium.
73
Posterior sacroiliac ligamentið - hvar liggur það og hvernig liggja efri og neðri hlutar þess:
The posterior sacroiliac ligament is situated in the depression between the sacrum and the ilium. It is a strong ligament that forms the main bond of union between the two bones. It can be divided into an upper and a lower part:
- The upper part passes horizontally from the 1st and 2nd transverse tubercles on the back of the sacrum to the tuberosity of the ilium
- The lower part passes obliquely from the 3rd transverse tubercle on the back of the sacrum to the posterior superior iliac spine
74
HVernig liggur interosseous sacroiliac ligamentið?
The interosseous sacroiliac ligament lies deep to the posterior sacroiliac ligament and passes from the tuberosity of the sacrum to the tuberosity of the ilium.
75
Fyrir hvað stendur SAD PUCKER?
Minnisregla fyrir öll retroperitoneal líffærin!
```
S = Suprarenal (adrenal) glands
A = Aorta and inferior vena cava
D = Duodenum (apart from the first segment)
P = Pancreas (apart from the tail)
U = Ureters
C = Colon (ascending and descending parts)
K = Kidneys
E = (O)esophagus
R = Rectum
```
76
Hvenær er detrusor slakur vs krepptur?
In its relaxed state, the detrusor muscle allows the bladder to store urine. During micturition, the detrusor muscle contracts.
77
Ítaugun detrusor vöðvans:
It receives innervation from both the sympathetic and parasympathetic nervous system:
- Sympathetic innervation is via the hypogastric nerve (T12-L2). Sympathetic stimulation causes relaxation of the detrusor muscle and facilitates the retention of urine.
- Parasympathetic innervation is via the pelvic splanchnic nerves (S2-S4). Parasympathetic stimulation causes contraction of the detrusor muscle and stimulates micturition.
78
Hver er algengasti staðurinn fyrir diverticulitis?
Approximately 90% of cases of diverticulitis involve the sigmoid colon, and for this reason, it is most likely to present with left iliac fossa pain and tenderness.
79
3 atriði sem eru anteriort við prostötu:
Retropubic space
Prostatic venous plexuses
Puboprostatic ligament
80
2 atriði sem eru posteriort við prostötu:
```
Rectovesical fascia (Denonvillier’s fascia)
Ampulla of the rectum
```
81
2 atriði sem liggja lateralt við prostötu:
Pelvic floor
| Levator ani
82
2 atriði sem eru superiort við lifur:
Thoracic cavity
| Diaphragm
83
4 atriði sem eru anteriort við lifur:
Thoracic cage
Costal margins
Pleura and lungs
Anterior abdominal wall
84
5 atriði sem eru posteriort við lifur:
```
Oesophagus
Stomach
Gallbladder
1st part of duodenum
Inferior vena cava
```
85
Hvað hefur lifrin marga recessa og hvað heita þeir?
The liver has three hepatic recesses, which are spaces situated between itself and surrounding structures:
- The left and right subphrenic recesses – between the liver and diaphragm on either side of the falciform ligament
- The hepatorenal recess (Morison’s pouch) – between the right lobe of the liver and the right kidney
86
Hvað er það sem skiptir lifrinni í loba, hvað skiptist hún í marga loba og hvað heita þeir?
The liver is traditionally divided into two portions, the right and left lobes, by the attachment of the falciform ligament. There are two further ‘accessory lobes’ situated on the visceral surface of the liver:
- The caudate lobe – situated on the upper aspect of the right lobe of the liver between the inferior vena cava and a fossa produced by the ligamentum venosum.
- The quadrate lobe – situated on the lower aspect of the liver between the gallbladder and a fossa produced by the ligamentum teres.
87
Hvað er porta hepatis?
The porta hepatis (transverse fissure of the liver) is a short, deep fissure situated between the caudate and quadrate lobes. It is approximately 5 cm long and extends transversely beneath the left side of the right lobe.
88
6 atriði sem liggja í gegnum porta hepatis:
- Hepatic portal vein
- Hepatic artery
- Common hepatic duct
- Sympathetic nerves
- Hepatic branch of the vagus nerve
- Lymphatics
89
Hvað hefur lifrin mörg yfirborð og hvað heita þau?
The liver has two external surfaces, the diaphragmatic and visceral surfaces:
- The diaphragmatic surface – This is the anterosuperior surface of the liver. It is smooth and dome-shaped (convex) as it conforms to the concave inferior surface of the diaphragm. It is covered with peritoneum, except posteriorly in the large triangular ‘bare area’, which lies in direct contact with the diaphragm.
- The visceral surface – This is the posteroinferior surface of the liver. It is irregular in shape due to the impression formed by surrounding structures. It has impressions from the oesophagus, right kidney, right adrenal gland, right colic flexure, duodenum, gallbladder and stomach. It is covered with peritoneum, except at the gallbladder and porta hepatis.
90
3 strúktúrar sem mynda þakið á inguinal canal:
Transversalis fascia
Transversus abdominis
Internal oblique
91
2 strúktúrar sem mynda gólfið á inguinal canal:
Inguinal ligament
| Medial third of lacunar ligament
92
2 strúktúrar sem mynda anterior vegg inguinal canal:
Aponeurosis of external oblique
| Reinforced by internal oblique muscle laterally
93
2 strúktúrar sem mynda posterior vegg inguinal canal:
Transversalis fascia
| Reinforced by conjoint tendon medially
94
3 strúktúrar anteriort við thoracic esophagus:
Trachea
Left recurrent laryngeal nerve
Pericardium
95
2 strúktúrar anteriort við abdominal vélinda:
Left vagus nerve
| Posterior surface of the liver
96
4 strúktúrar posteriort við thoracic vélinda:
Thoracic vertebrae
Thoracic duct
Azygous veins
Descending aorta
97
2 strúktúrar posteriort við abdominal vélinda:
Right vagus nerve
| Left crus of diaphragm
98
2 strúktúrar til hægri við thoracic hluta vélinda:
Pleura
| Terminal part of azygous vein
99
1 atriði til hægri við abdominal hluta vélinda:
Lesser sac of peritoneum
100
4 atriði til vinstri við thoracic hluta vélinda:
Subclavian artery
Arch of the aorta
Thoracic duct
Pleura
101
1 atriði til vinstri við abdominal hluta vélinda:
Greater sac of peritoneum
102
Hvar er Hartmann´s pouch og hvers vegna er hann klínískt mikilvægur?
At the junction of the neck of the gallbladder and the cystic duct lies an outpouching of the gallbladder wall that forms a mucosal fold called Hartmann’s pouch. This is a common location for gallstones to become lodged and cause cholestasis.
103
Dæmi um taug sem liggur inni í spermatic cord:
The genital branch of the genitofemoral nerve
104
Innihald spermatic cord:
The classic description of the contents of the spermatic cord is that it contains the ‘four threes':
- Three fascial layers
- Three arteries: artery to vas deferens, testicular artery, cremasteric artery
- Three nerves: genital branch of the genitofemoral nerve, sympathetic and visceral afferent fibres, and the ilioinguinal nerve
- Three ‘other structures’: pampiniform plexus, vas deferens, testicular lymphatics (which drain to the para-aortic nodes)
The ilioinguinal nerve, despite being part of this description, does not actually lie within the spermatic cord. It is actually outside the spermatic cord and travels next to it.
105
Hvað heita 5 flexúrurnar á rectum?
- The sacral flexure – concave anteriorly (formed by the sacrum and coccyx)
- The anorectal flexure – convex anteriorly (formed by the puborectalis muscle)
- Three lateral flexures – superior, intermediate and inferior (formed by transverse folds of the internal rectal wall)
106
Hvaða flexúra á rectum skiptir mestu máli til að halda hægðum?
The anorectal flexure is mainly responsible for producing the angle of the rectum that maintains faecal continence. The tone of the puborectalis muscle forms this flexure, and relaxation of the muscle allows the angle to be reduced and defaecation to occur.
107
Í hæð við hvaða hryggjarbol liggur fyrsti hluti duodenum?
L1
108
Í hvaða 4 parta skiptist þvagrás karla?
- Pre-prostatic part
- Prostatic part
- Membranous part
- Spongy part
109
Hvar í typpinu eru Cowper´s glands staðsettir?
The spongy part contains the opening of bulbourethral glands (Cowper’s glands) posteriorly.
110
Hvað er Meckel´s diverticulum, hversu algengt er það og hvort er það algengara í kk eða kvk?
A Meckel’s diverticulum is a vestigial remnant of the vitellointestinal duct. It is the commonest malformation of the gastrointestinal tract, being present in around 2% of the population. They are twice as common in men as women.
111
Hvar er algengast að Meckel´s diverticulum sé staðsett? Hversu stórt er það ca?
When present, a Meckel’s diverticulum is located in the distal ileum, usually within 60-100 cm (2 feet) of the ileocaecal valve. They are usually 3-6 cm (approx. 2 inches) long and may have a greater lumen than that of the ileum.
112
Hvaða fær Meckel´s diverticulum blóðflæði sitt og hvers konar vefur er oftast í því?
Meckel’s diverticula run antimesenterically but receive their blood supply from the mesentery of the ileum, and a typical feeding vessel called the vitelline artery can be identified. They are typically lined with ileal mucosa but frequently contain ectopic mucosa, the two commonest types being gastric (50%) and pancreatic (5%).
113
Í hvaða tvö lög af "pulp" skiptist miltað og hvaða frumur eru í hvoru lagi?
The spleen is comprised of red and white pulp. The white pulp of the spleen is composed of nodules called Malpighian corpuscles. These are composed of lymphoid follicles, which are rich in B-lymphocytes, and periarteriolar lymphoid sheaths (PALS), which are rich in T-lymphocytes. B-lymphocytes are far more abundant than T-lymphocytes within the white pulp.
The red pulp of the spleen is comprised of sinuses, which are filled with red blood cells, platelets, granulocytes, and splenic cords or reticular fibres. There is also a marginal zone, which borders the white pulp.
114
Hvað er í hvíta "pulp" laginu í miltanu og hvaða frumur koma þar við sögu?
The white pulp of the spleen is composed of nodules called Malpighian corpuscles. These are composed of lymphoid follicles, which are rich in B-lymphocytes, and periarteriolar lymphoid sheaths (PALS), which are rich in T-lymphocytes. B-lymphocytes are far more abundant than T-lymphocytes within the white pulp.
115
Hvað er að finna í rauða "pulp" laginu í milta og hvaða frumur koma þar við sögu?
The red pulp of the spleen is comprised of sinuses, which are filled with red blood cells, platelets, granulocytes, and splenic cords or reticular fibres. There is also a marginal zone, which borders the white pulp.
116
Superior pancreaticoduodenal artery er grein frá hvaða æð og hvaða 2 líffæri nærir hún?
The superior pancreaticoduodenal artery is a branch of the gastroduodenal artery, which most commonly arises from the common hepatic artery of the coeliac trunk. It supplies blood to the duodenum and pancreas.
117
Inferior pancreaticoduodenal slagæð er grein frá hvaða æð og hvað nærir hún?
The inferior pancreaticoduodenal artery branches either directly from the superior mesenteric artery or from its first intestinal branch, opposite the upper border of the inferior part of the duodenum. It supplies blood to the head of the pancreas and the descending and inferior parts of the duodenum.
118
Ef superior mesenteric artería lokast, fá pancreas og duodenum samt blóðflæði vegna þess að:
The superior and inferior pancreaticoduodenal arteries anastomose with each other, allowing blood to perfuse the pancreas and duodenum through multiple channels.
119
Hvar liggur endi botnlangans í 64% tilfella?
Ascending retrocaecal
120
Hvað heitir mesentery-ið sem botnlanginn hangir á og hvar tengist hann við ristilinn?
It has a short triangular mesentery called the mesoappendix that suspends it from the mesentery of the terminal ileum.
121
Hvað er "greater omentum" og úr hverju er það?
| Hvar festist það uppi (2) og niðri (1)?
The greater omentum is a large, fat-laden fold of visceral peritoneum that hangs like an apron from the greater curvature of the stomach and the inferior border of the proximal half of the first part of the duodenum. It consists of a double sheet of peritoneum, folded back in on itself so that it has four layers. It descends downwards to attach to the anterosuperior aspect of the transverse colon.
122
Í hvaða 3 ligament skiptist greater omentum?
- Gastrophrenic ligament – extends to the underside of the left dome of the diaphragm
- Gastrocolic ligament – extends to the transverse colon (main attachment)
- Gastrosplenic ligament – extends to the spleen
123
Hvaða tilgangi gegnir "the greater omentum"?
The greater omentum prevents the visceral peritoneum from adhering to the parietal peritoneum lining the abdominal wall. It has considerable mobility enabling it to migrate throughout the peritoneal cavity. It is sometimes referred to as the ‘policeman of the abdomen‘ because of its rich vascular supply. In cases of intra-abdominal infection or inflammation, it can migrate to the affected area and wrap itself around the inflamed organ to ‘wall it off’ and protect other viscera. Because of its rich vascular supply, it can also provide leukocytes to fight the infection.
124
Hvað er porta hepatis? (sami strúktúr og tranverse fissure)
The porta hepatis is the central intraperitoneal fissure of the liver that separates the caudate and the quadrate lobes. It is the entrance and the exit for several important structures.
125
Hvaða 6 atriði liggja í porta hepatis?
- Hepatic portal vein
- Hepatic artery
- Common hepatic duct
- Sympathetic nerves
- Hepatic branch of the vagus nerve
- Lymphatics
126
Hvert drenerast lympha frá pancreas?
- The majority of them drain into the pancreaticosplenic nodes that lie along the splenic artery.
- A small number of the vessels also drain into the pyloric lymph nodes.
Lymph from these nodes drains into coeliac, hepatic and superior mesenteric lymph nodes and then drain, either directly or indirectly, into the thoracic duct.
127
Hvað er renal tubule?
The renal tubule is the part of the nephron into which the glomerular filtrate passes after it has reached the Bowman’s capsule.
128
Hvað heitir fyrsti hluti renal tubule, hvar liggur hann í nýranu og hvað gerist þar?
The first part of the renal tubule is the proximal convoluted tubule (PCT). The PCT lies in the renal cortex and is where the majority of solute reabsorption occurs. This reabsorption is driven by ATP-dependant transporters.
129
Hvernig eru frumurnar í proximal convoluted tubule?
Cells are cuboidal with abundant mitochondria to provide energy and multiple microvilli (a brush border) to increase surface area.
130
Hvert fer innihaldið úr proximal convoluted tubule?
The water and solutes that have passed through the PCT then enter the loop of Henle. The loop of Henle has a hairpin-like shape and lies within the renal medulla.
131
Hvernig eru frumurnar í descending vs. ascending loop of Henle og hvað gerist í þeim?
- The descending loop of Henle has flat cells with few microvilli and few mitochondria, reflecting that in this segment, there is the movement of water by osmosis and no solute transport.
- The ascending thick loop of Henle has cuboidal cells, which are impermeable to water and contain plentiful mitochondria providing energy to Na.K.2Cl transporters. These measures contribute to the formation of the medullary concentration gradient and countercurrent multiplication.
132
Hvert fer innihald ascending loop of Henle og hvað gerist þar?
When the fluid leaves the ascending loop of Henle and re-enters the renal cortex, it passes into the distal convoluted tubule (DCT). The distal convoluted tubule allows variable resorption and secretion to fine-control urine composition. Mitochondria provide energy for membrane transporters. There are few microvilli.
133
Hverjir eru eiginleikar frumnanna í distal convoluted tubule?
The distal convoluted tubule allows variable resorption and secretion to fine-control urine composition. Mitochondria provide energy for membrane transporters. There are few microvilli.
134
Hvert fer innihaldið úr distal convoluting tubule? Hvað gerist þar?
The DCTs of many kidney nephrons converge into a single collecting duct. The collecting duct allows the final adjustments in urine concentration. The upper collecting duct is lined by columnar epithelium, which transitions into urothelium in the lower duct. Aquaporin channels are present in the cell membranes to allow the transcellular movement of water. The number of aquaporin channels is controlled by ADH.
135
Hvernig eru frumurnar í collecting ducts í nýrum og hvers vegna?
The upper collecting duct is lined by columnar epithelium, which transitions into urothelium in the lower duct. Aquaporin channels are present in the cell membranes to allow the transcellular movement of water. The number of aquaporin channels is controlled by ADH.
136
Hvað stýrir fjölda aquaporin ganga í collecting duct í nýrum?
The number of aquaporin channels is controlled by ADH.
137
Margir collecting ducts renna saman og mynda ___?
| Hvert fer svo þvagið þaðan?
Many collecting ducts join together to form several hundred papillary ducts. There are typically around 30 papillary ducts per renal papilla. The contents of the papillary duct drain into the minor calyx at the renal papilla. Several minor calyces combine to form a major calyx. Urine drains from the minor calyces into the major calyx and empties into the funnel-shaped renal pelvis. Urine then drains from the renal pelvis into the ureter.
138
Í hæð við hvaða hryggjarlið eru mótin milli rectum og sigmoid colon?
The rectum commences at the point where it connects with the sigmoid colon. This occurs at the S3 vertebral level.
139
Hvaða tvö atriði aðstoða nýrað við að hreyfast þegar við öndum?
Movements of the kidney during respiration are assisted by the perirenal and pararenal fat.
140
Í hvaða 4 lög skiptast renal fascia og fitan (talið að utan og inn):
1. Pararenal fat
This lies external to the renal fascia and is mostly located on the posterolateral aspect of the kidney.
2. Renal fascia
This encloses the kidney and sends bundles of collagen through the fat, which assist in holding the kidney in position. It ascends to envelop the adrenal glands superiorly.
3. Perirenal fat
This is continuous with the fat in the renal sinus at the hilum of the kidney.
4. Renal capsule
This is the tough fibrous capsule that surrounds the kidney. It provides a limited amount of protection against trauma and damage.
141
Hvar tengist renal fascian?
The attachments of the renal fascia are clinically important as they prevent the extension of perinephric abscess pus. The renal fascia is attached to the posterior abdominal wall inferiorly and to the renal vessels and ureter at the hilum. These attachments serve to prevent the extension of pus.
142
Hvar er gallsteinninn í biliary colic? (2 möguleikar)
Biliary colic occurs when a gallstone transiently obstructs either the cystic duct or Hartmann’s pouch, and the gallbladder contracts as a consequence. The obstruction is relieved by the stone falling back into the gallbladder or being passed along the duct.
143
Hvar er algengast að gallsteinar festist í biliary colic?
At the junction of the neck of the gallbladder and the cystic duct lies an outpouching of the gallbladder wall that forms a mucosal fold called Hartmann’s pouch. This is the commonest location for gallstones to become lodged and cause cholestasis.
144
Hvert leiðir verkurinn oft í biliary colic?
Aftur í hægra herðablað
145
Hvaða 5 liðbönd styðja við sacroiliac liðina?
- There are three sacroiliac ligaments that help to support the sacroiliac joints. -- sacrotuberous and sacrospinous ligaments.
146
Í hve marga hluta skiptist sacroiliac ligamentið og hvað heita þeir?
3 hluta - ant, post og interosseous
147
Hvernig liggur anterior sacroiliac ligamentið?
The anterior sacroiliac ligament consists of numerous thin bands that pass from the anterior surface of the lateral part of the sacrum to the margin of the auricular surface of the ilium.
148
Hvernig liggur posterior sacroiliac ligamentið?
The posterior sacroiliac ligament is situated in the depression between the sacrum and the ilium. It is a strong ligament that forms the main bond of union between the two bones. It can be divided into an upper and a lower part:
- The upper part passes horizontally from the 1st and 2nd transverse tubercles on the back of the sacrum to the tuberosity of the ilium
- The lower part passes obliquely from the 3rd transverse tubercle on the back of the sacrum to the posterior superior iliac spine
149
Hvernig liggur interosseous sacroiliac ligamentið?
The interosseous sacroiliac ligament lies deep to the posterior sacroiliac ligament and passes from the tuberosity of the sacrum to the tuberosity of the ilium.
150
Hvað heitir æðin sem er í miðjunni á öllum "liver lobules" og hvert tengist hún?
Central vein í miðjunni og þær renna svo saman í hepatic veins.
Á hornunum á hverju liver lobule eru portal veins.
151
Hvert drenerast lympha frá prostötu?
The lymphatic drainage of the prostate gland is mainly into the obturator and the internal iliac lymph nodes. Some drainage can also pass into the external iliac, presacral and para-aortic lymph nodes.
152
Hvernig liggja gallgangarnir?
The biliary tract begins as the interlobular bile ducts form the right and left hepatic ducts. These two ducts merge to form the common hepatic duct, which is situated alongside the hepatic vein.
The common hepatic duct exits the liver and joins with the cystic duct from the gallbladder to form the common bile duct. The common bile duct is sometimes referred to as the ‘trunk of the biliary tree’ and, together with the hepatic artery and hepatic portal vein, forms the central axis of the portal triad.
The common bile duct passes downwards posteriorly to the proximal duodenum and joins with the pancreatic duct from the pancreas to form the ampulla of Vater. The ampulla of Vater opens into the duodenum, and the release of bile at this point is controlled by a muscular valve called the sphincter of Oddi.
153
Hvernig er ítaugun til rectum? (3)
The rectum receives sympathetic, parasympathetic and sensory innervation:
- Sympathetic innervation is via the lumbar splanchnic nerves and the superior and inferior hypogastric plexuses
- Parasympathetic innervation is via the pelvic splanchnic nerves and the inferior hypogastric plexus
- Sensory innervation is also via the pelvic splanchnic nerves and the inferior hypogastric plexus
154
Hvað er rót penis? (radix)
| Hvaða 4 vöðvar eru þar?
This is the most proximal, fixed part of the penis. It is located within the superficial perineal pouch of the pelvic floor and is not visible externally. It consists of the bulb of the penis centrally and two crura of the penis, one on either side of the bulb. It also contains four muscles, two ischiocavernosi and two bulbospongiosi.
155
Hvað er corpus/body á penis og af hverju samanstendur það?
This is the free part of the penis, located between the root and the glans. It is composed of three cylinders of erectile tissue, two corpus cavernosa and one corpus spongiosum. It is suspended from the pubic symphysis and has two surfaces, the dorsal surface (posterosuperior in the erect penis) and the ventral surface (facing downwards and backwards in the flaccid penis). The ventral surface is marked by a groove in the lateral direction.
156
Anatómía nýrans:
The parenchyma of the kidney is divided into two major structures:
The outer renal cortex and;
The inner renal medulla
The renal cortex extends into the medulla and divides it into triangular-shaped areas referred to as the renal pyramids. Each renal pyramid combines with the renal cortex above it to form a renal lobe. Between the renal pyramids are projections of renal cortex referred to as the renal columns.
The functional unit of the kidney is the nephron. These are responsible for the production of urine and span the cortex and medulla. The initial filtering portion of the nephron is the renal corpuscle, which is located in the cortex. This is followed by the renal tubule that extends into the renal pyramids. Within the renal cortex lies the medullary ray, which is a collection of renal tubules that drains into a single collecting duct.
At the apex of each renal pyramid is the renal papilla. This empties urine into the minor calyx. Several minor calyces combine to form a major calyx. Urine drains from the minor calyces into the major calyx and then empties into the funnel-shaped renal pelvis. Urine then drains from the renal pelvis into the ureter.
157
Hvaða vöðvi liggur undir internal oblique vöðvanum?
Transverse abdominis
158
Hvaðan kemur og hvert tengist transverse abdominis vöðvinn?
It arises from the internal surfaces of the 7th to the 12th costal cartilages, the thoracolumbar fascia, the iliac crest, and the lateral third of the inguinal ligament. It inserts into the xiphoid process, the linea alba, the pubic crest and the pecten pubis via the conjoint tendon.
159
Ítaugun transverse abdominis?
The transversus abdominis is innervated by the thoracoabdominal nerves (T7-11), the subcostal nerve (T12), the iliohypogastric nerve (L1), and the ilioinguinal nerve (L1).
160
Hvert er hlutverk transversus abdominis vöðvans?
The main action of the transversus abdominis is to compress and support the abdominal viscera.
161
Hvað gerir hepatic portal vein?
The hepatic portal vein is the major vein of the hepatic portal venous system and carries blood from the gastrointestinal tract and spleen to the liver.
162
Á hvaða 4 stöðum kommúnikerar hepatic portal venukerfið við systemic venukerfið?
The hepatic portal venous system communicates with the systemic venous system in the following locations:
- Oesophageal veins
- Para-umbilical veins
- Retroperitoneal veins
- Rectal veins
163
Hvað liggur að baki portal háþrýstings og hversu hár þarf þrýstingurinn að vera til að teljast háþrýstingur?
When blood flow through the portal system is obstructed, for example, due to cirrhosis, thrombosis or the presence of a tumour, pressure rises within the portal system. In these circumstances, portal hypertension develops (a portal venous pressure of >20 mmHg), and these anastomoses (fjórir staðir þar sem portal venukerfið kommunikerar við system venukerfið) become congested and form venous dilatations.
164
Við hvaða bláæð í system bláæðakerfinu kommunikerar left gastric vein og hvaða klíníska teikn kemur fram tengt þessum æðum þegar portal háþrýstingur er til staðar?
Azygous vein
Sjáum Oesophageal varices
165
Við hvaða bláæð í system bláæðakerfinu kommunikera para-umbilical veins og hvaða klíníska teikn kemur fram tengt þessum æðum þegar portal háþrýstingur er til staðar?
Inferior epigastric vein
Sjáum caput medusae
166
Við hvaða bláæð í system bláæðakerfinu kommunikerar superior rectal vein og hvaða klíníska teikn kemur fram tengt þessum æðum þegar portal háþrýstingur er til staðar?
Middle and inferior rectal veins
Sjáum haemorrhoids
167
Ítaugun external oblique kviðvöðvans?
The external oblique muscle is innervated by the thoracoabdominal nerves (T7-11) and the subcostal nerve (T12).
168
Hvaða kviðvöðvi er stærstur og mest superficial af þremur "flötu" vöðvunum anterolateralt á kviðnum?
The external oblique muscle is the largest and most superficial of the three flat muscles of the lateral anterior abdomen.
169
Hvernig liggur external oblique kviðvöðvinn?
It arises from the external surfaces of the 5th to the 12th ribs and inserts into the linea alba, the pubic tubercle and the anterior half of the iliac crest.
170
Hvaða funksjón hefur external oblique kviðvöðvinn og hvaða áhrif hefur það á intra abdominal þrýsting?
The external oblique muscle acts to pull the chest downwards, compressing and supporting the abdominal cavity. This increases the intra-abdominal pressure as in the Valsalva manoeuvre. It also assists with flexion and rotation of the trunk.
171
Hvað heitir fyrsti partur ristilsins, hvar liggur hann og hversu langur er hann?
Ascending colon. This is the first part of the colon and is retroperitoneal. It ascends upwards from the caecum before turning right at a 90-degree angle at the right colic flexure (hepatic flexure) to become the transverse colon. It is approximately 20 cm long.
172
Hvað heitir annar partur ristilsins, hvar liggur hann og hversu langur er hann?
Transverse colon. This is the second part of the colon and is intraperitoneal. It extends transversely across the abdomen from the right colic flexure until it reaches the left colic flexure (splenic flexure) close to the spleen. Here it turns another 90 degrees inferiorly to become the descending colon. The transverse colon is the least fixed part of the colon. It is approximately 50 cm long.
173
Hvað heitir þriðji partur ristilsins, hvar liggur hann og hversu langur er hann?
Descending colon:
This is the third part of the colon and is retroperitoneal in the majority of people. It extends inferiorly down the abdomen from the left colic flexure passing over the lateral border of the left kidney. At the point that it turns medially, it becomes the sigmoid colon. It is approximately 30 cm long.
174
Hvað heitir fjórði partur ristilsins, hvar liggur hann og hversu langur er hann?
Sigmoid colon:
This is the final part of the colon and is intraperitoneal. It extends downwards in an ‘S’ shape from the left iliac fossa to the level of the S3 vertebra. It is approximately 50 cm long.
175
Hvers konar syndrome sést í þvagblöðrustarfsemi þegar mænuskaði verður ofan við T12?
Spinal cord injury above T12 causes a spastic (reflex) bladder.
The sensory (afferent) nerves in the bladder wall are no longer able to signal to the brain when the bladder is stretched and full. The patient will therefore have no awareness of bladder filling.
There is also no descending control over the external urethral sphincter, and hence there is no voluntary control over micturition. The external urethral sphincter is therefore constantly relaxed.
The bladder stretch reflex, where the parasympathetic efferents (via the pelvic splanchnic nerves) initiate detrusor contraction in response to bladder wall stretch, remains intact. The bladder, therefore, automatically empties as it fills.
176
Hvers konar syndrome sést í þvagblöðrustarfsemi þegar mænuskaði verður neðan við T12?
Spinal cord injury below T12 (in the cauda equina area of the spinal cord) causes a flaccid bladder.
In the case of spinal cord transection below the T12 level, the parasympathetic efferents are damaged. As a consequence, the detrusor muscle will be paralysed and unable to contract, and the bladder stretch reflex is lost.
This can result in the bladder being overstretched, and in extreme cases, the bladder can rupture. Overstretching of the bladder can cause damage to the bladder wall and predispose to infection.
If the flaccid bladder is not emptied (e.g. via catheterisation) and is left to overflow constantly, the pressure within the bladder can rise, and reflux nephropathy can occur.
177
Hluti af hvaða líffæri er caecum og milli hvaða tveggja strúktúra er það staðsett?
The caecum is the most proximal part of the large intestine and is located between the ileum and the ascending colon. It acts as a reservoir for chyme received from the ileum.
178
Hvar er hægt að þreifa caecum ef það er stækkað og hvort er það retro eða intraperitoneal?
It is located just inferior to the ileocaecal junction within the right iliac fossa and can be palpated here if enlarged. It is an intraperitoneal structure.
179
Hvar festist appendix? Hvað heitir mesentery-ið hans?
The appendix is a narrow, worm-shaped, blind-ended tube that is attached to the posteromedial end of the caecum. It has a short triangular mesentery called the mesoappendix that suspends it from the mesentery of the terminal ileum.
180
Hvaða 3 æðar sjá um slagæðanæringu penis?
The penis receives its blood supply from three branches of the internal pudendal artery (which itself is a branch of the internal iliac artery):
- Dorsal arteries of the penis
- Deep arteries of the penis
- Bulbourethral artery
181
Internal pudendal artery er grein hvaða æðar?
Internal iliac artery
182
Eitlum í kvið má skipta í tvennt:
The abdominal lymph nodes can be broadly divided into pre-aortic and para-aortic groups, depending upon their relationship to the aorta.
The para-aortic lymph nodes lie laterally on either side of the aorta, anterior to the medial margins of psoas major, the diaphragmatic crura and the sympathetic trunks.
183
Hvert drenerast lympha frá para-aortic eitlum?
All of the efferent lymphatics from the para-aortic nodes drain into the lumbar trunk, which in turn drains into the cisterna chyli.
184
Para-aortic eitlar í kvið taka við lymphu frá hvaða stöðum og þessum 5 líffærum:
They receive lymph directly from the deeper tissues of the posterior abdominal wall and a number of other structures:
- Kidneys
- Upper parts of ureters
- Gonads
- Fallopian tubes
- Uterus
