Anatomy (1) Flashcards
What two structures are in the retroperitoneum?
- Kidneys
2. Proximal ureters
What three structures are in the pelvis?
- Distal ureters
- Bladder
- Proximal urethra
What structure is in the perineum?
Distal urethra
At what vertebral level does the abdominal aorta bifurcate?
L4
From the visceral peritoneum - what structures are found deep until the kidney is reached?
- Visceral peritoneum
- Paranephric fat
- Renal deep fascia
- Perinephric fat
- Renal capsule
What muscle is the kidney lateral to?
Psoas major
What muscle is the kidney anterior to?
Quadratus lumborum
What are the three structures of the renal hilum?
- Renal artery
- Renal vein
- Ureter
Name a muscle of the right side of the posterior abdominal wall?
Quadratus lumborum
What level is the right kidney at?
L1-L3
What level is the left kidney at?
T12-L2
What ribs are posteriorly related to the kidenys?
11 and 12
The right kidney is posterior to the liver and what other space?
Hepatorenal recess
Name four structures the left kidney is posterior to?
- Stomach
- Tail of the pancreas
- Hilum of the spleen
- Splenic vessels
What are more anterior - renal veins or arteries?
Veins
What nodes does lymph from kidneys drain to?
Lumbar nodes - located around AA and IVC
What nodes do lymph from the ureters drain to?
Lumbar nodes and iliac nodes
How many pyramids are in the human medulla?
27
What does each pyramid contain?
50000 nephrons
What structure of the nephron does ultrafiltration of the blood arriving via branches of renal artery?
Glomerulus
What structure comes after glomerulus?
Proximal convuloted tubule
Where does the collecting duct drain modified filtrate into after it has passed through the pyramid?
MInor calyx
How does urine drain from the kidney?
- Minor calyx
- Major calyx
- Renal pelvis
- Ureter
What are the three sites of ureteric constriction?
- Pelviureteric junction
- Ureter crossing anterior aspect of common iliac artery
- Ureteric orifice
What is hydronephrosis?
Water in the kidney
Where is the false pelvis?
From iliac crest to pelvic inlet - part of abdominal acivty
Where is true pelvis?
From pelvic inlet to pelvic floor - pelvic cavity
Where is the bladder found?
In the pelvic cavity
Name the pelvic floor muscle?
Levator ani
What does the urethra pass through the pelvic floor to reach>
Perineum
What do the ureters pass anterior to to enter the pelvis?
Common iliac vessels
At what level do the ureters turn medially to enter the posterior aspect of the bladder?
Level of ischial spine
What is the most inferior part of male peritoneal cavity?
Rectovesicle pouch
In females - what is lateral to the right ureter?
Right suspensory ligament
Where does the right uterine tube terminate?
In right ovary
What does the round ligament of the uterus do?
Attaches uterus to the perineum via the inguinal canal
What is the most inferior part of female peritoneal cavity?
Rectouterine pouch - of Douglas!
In females - what does the ureter run inferiorly to?
Uterine tubes and uterine artery - water under the bridge
In males whast does the ureter run inferiorly to?
Vas deferns
What are the arteries entering the pelvis mainly from?
Interal iliac artery
In females - what are the four arteries leaving the internal iliac artery to supply the pelvis?
- Vesical artery
- Uterine artery
- Middle rectal artery
- Vaginal artery
What three things form the traingle shape of the trigone in the bladder?
2 ureteric orifices and internal urethral orifice
What is the muscle that forms the main bulk of the bladder wall?
Detrusor
Around the neck of the male bladder - what does the detrusor muscle form?
Internal urethral sphincter muscle which contracts during ejaculation to prevent retrograde ejaculation
What is the most anterior organ in the pelvis?
Bladder - posterior to pubic bone
In females where does the body of the uterus lie?
Superior to the bladder - seperated by uterovesical pouch
In males what lies inferior to the bladder and ?
Prostate
What covers the superior surface of the bladder only?
Peritoneum
Is the epididimys anterior or posterior?
Posterior
What does the vas deferens and seminal gland form?
Ejaculatory duct
Where did testis ebryologically develop?
In posterior abdomen - travel through inguinal canal
Inside the scrotum - what does the testis sit in?
Sac called tunica vaginalis
What are the two layers of the tunica vaginalis?
Parietal and visceral
What is a hydrocele?
Excess fluid within the tunica vaginalis
What does the right spermatic cord contain?
Vas deferenss, testicular arteru and pampiniform plexus
What do the testicular arteries branch from?
Aorta
Where does right testicular vein drain to?
IVC
Where does left testicular vein drain to?
Left renal vein
Where is sperm produced?
Seminiferous tubules
What size is the prostate gland?
Walnut sized
What is inferior aspect of prostate gland in contact with?
Levator ani muscle
What part of prostate is felt on rectal exam and is the malignant part?
PEROPHERAL ZONE
What structures in the penis transmit the deep arteries of the penis?
Right and left corpus cavernosum
What is the root of penis attached laterally to?
Ischium of pelvis
Describe blood supply to the penis?
From deep arteries of penis; branches from internal pudendal artery (from internal iliac)
Describe blood supply to scrotum?
Via internal pudendal and branches from external iliac artery
Where does lymph from the scrotum and most of penis (not glans) drain to?
Superficial inguinal lymph nodes - found in superficial fascia in groin
Where does lymph from the testis drain to?
Lumbar nodes around abdominal aorta
What are sensations from body wall conveyed to the CNS by?
Somatic sensory nerve fibres
What are sensations from our organs conveyed to the CNS by?
Visceral afferent nerve fibres
What is pain from pelvic urethra conveyed by?
Visceral afferent
What is pain from urethra in perinuem conveyed by?
Somatic sensory
How many pairs of spinal nerves are there?
31 pairs
What spinal cord levels do sympathetic nerve fibres leave the CNS within?
T1 - L2
At what level fo sympathetic fibres leave the CNS to get to the kidneys, ureters and bladder?
T10 and L2
wHAT DO SYMPATHETIC fibres from CNS leave the chain in to reach the kidneys, ureters and bladder?
Abdominosplanchnic nerves
Where are the abdominal sympathetic ganglia located?
Around abdominal aorta
What cranial nerves carry parasympathetic fibres?
3, 7, 9 and 10
What nerve carries parasympathetic fibres to innervate the kidneys and ureter?
Vagus nerve
What nerve carries parasympathetic fibres to innervate the bladder?
Plevic splanchnic nerves
What level of spinal nerves make up the pelvic splanchnic nerves?
S2, 3 and 4
What structure of the perineum is innervated by somatic motor nerve fibres?
Distal to pelvic floor urethra and external urethral sphincter and levator ani
What nerve supplies the external urethral sphincter?
Pudendal nerve
What nerves stimulate the bladder to contract?
Parasympathetic from S2-4 via pelvic splanchnic nerves stimualte detrusor muscle to contract
What fibres stimulate levator ani to contract?
S3 and S4
Where is pain from the kidney felt?
In posterior aspect of flank region
Where is pain from a calculus obstructing the ureter be felt?
Rdiating from loin to groin
At what level to visceral afferents from the kidneys enter?
T11 to L1
At what level do visceral afferents from ureters enter spinal cord between?
T11 and L2
What do visceral afferents carrying pain from superior part of bladder (which touches peritoneum) run alongside?
Sympathetic fibres - enter at T11 - L2
What do visceral afferents carrying pain from rest of bladder run alongside?
Parasympathetic nerbe fibres - enter at S2-4
What do visceral afferents carrying pain from testis run alongside?
Sympathetic fibres to enter at T10 to 11
What nerve fibres are key in control of micturition?
S2-S4
What fibres do pelvic splanmchnic nerves carry (S2-4)?
Parasympathetic
What fibres do pudendal nerve carry (S2-S4)?
Somatic motor nerves
What nerve roots make up sciatic nerve?
L4 - S3
What nerve root is iliohypogastric?
L1
What nerve root is ilioinguinal?
L1
What nerve root is lateral cutaneous nerbe of thigh?
L2 L3
What nerve root is genitofemoral nerve?
L1 and L2
What nerve roots are femoral and obturator?
L2 - L4
What nerve supplies sensation to plantar aspect of foot?
Tibial
What nerve supplies 1st web space of toe?
Deep fibular
What nerve supplies sensation to lateral aspect of foot?
Sural nerve (from tibial and common fibular nerve)
