Anatomy Flashcards
(127 cards)
1
Q
What are the muscles of the posterior abdominal wall (from superficial to deep)?
A
1) Erector Spinae (& Latissimus Dorsi lateral)
2) Quadratus Lumborum
3) Psoas Major
2
Q
What are the muscles of the anterior abdominal wall (from superficial to deep)?
A
1) External oblique
2) Internal oblique
3) Transversus abdominis
3
Q
What are the muscles that form the hip-flexor muscle?
A
Psoas major and iliacus (form Ilio-psoas)
4
Q
What muscle in the abdomen is frequently absent?
A
Psoas minor
5
Q
What muscle is directly inferior to the Quadratus lumborum?
A
Iliacus
6
Q
What are the nerves in the posterior abdominal wall (root from superior to inferior)?
A
1) Subcostal (T12)
2) Iliohypogastric (L1)
3) Ilioinguinal (L1)
4) Genitofemoral (L1-2)
5) Lateral cutaneous nerve (L2/3)
6) Femoral (L2-4)
7
Q
What spinal segment does the subcostal nerve arise from?
A
T12
8
Q
What spinal segment does the Iliohypogastric nerve arise from?
A
L1
9
Q
What spinal segment does the Ilioinguinal nerve arise from?
A
L1
10
Q
What spinal segment does the Lateral Cutaneous nerve arise from?
A
L2/3
11
Q
What spinal segment does the Femoral nerve arise from?
A
L2-4
12
Q
What spinal segment does the Genitofemoral nerve arise from?
A
L1/2
13
Q
Which is deeper/outside the renal fascia? Perinephric or paranephric fat?
A
Paranephric
14
Q
The abdominal aorta is a continuation of the _________.
A
Descending aorta
15
Q
The abdominal aorta divides into the _______________.
A
R and left common iliac arteries
16
Q
What are the paired branches of the abdominal aorta (5)?
A
1) Phrenic
2) Middle suprarenal
3) Renal
4) Gonadal
5) 4 Lumbar arteries
17
Q
What are the unpaired branches of the abdominal aorta (4)?
A
1) Coeliac
2) Superior mesenteric
3) Inferior mesenteric
4) Median sacral
18
Q
What are the anterior branches of the abdominal aorta (5)?
A
1) Coeliac
2) Superior mesenteric
3) Inferior mesenteric
4) Gonadal
5) Phrenic
19
Q
The IVC is formed at the union of _________ at which spinal segment?
A
formed @ union of R and L common iliac veins at L5
20
Q
The IVC is located (right/left) of the midline and thus pierces of the (right/left) horn of the ______ of the diaphragm.
A
Right of midline
Pierces right horn of central tendon
21
Q
What veins drain into the IVC (5)?
A
1) R and L renal veins
2) R gonadal
3) R suprarenal
4) Median sacral
5) Hepatic
22
Q
How blood from the left gonad flow back into the heart?
A
Into the L renal vein then into the IVC → RA
(R gonadal vein drains directly into IVC)
23
Q
What are the posterior relations of the IVC in the abdomen(3)?
A
1) Lumbar vertebrae
2) R sympathetic trunk
3) R psoas muscles
24
Q
What are 4 functions of the kidney?
A
1) Excretion of organic wastes from blood (eg. urea, uric acid)
2) Homeostasis of blood pressure/volume (Renin: BP, EPO: RBC, Water loss via urine)
3) Homeostasis of plasma ion conc. (eg. Na, K, CL, Ca)
4) Homeostasis of blood pH (H+ secretion and HCO3- reabsorption
25
Where are the kidneys located?
Abdominal cavity
- against posterior abdominal wall
- retroperitoneal (outside of peritoneum)
- L kidney T12-L3 level
- R kidney lower (compressed by liver)
- directly inferior to adrenal glands
26
What structure is directly superior to the kidneys?
Adrenal glands
27
True or false: the kidneys lie within the abdominal and peritoneal cavity.
False. Kidneys are within the abdominal but outside of the peritoneal cavity (retroperitoneal)
28
Which kidney is normally higher than the other?
Left (right is compressed by liver)
29
What are 3 layers of connective tissue that stabilise, protect and cushion the kidneys (superficial to deep)?
1) Renal fascia
2) Perirenal fat
3) Renal capsule
30
Describe the flow of blood in renal circulation from the Aorta to the Right Atrium.
1) Aorta
2) Abdominal aorta
3) Renal arteries
4) Segmental arteries
5) Interlobar arteries
6) Arcuate arteries
7) Cortical radiate arteries
8) Afferent arterioles
9) Glomerulus
10) Efferent arterioles
11) Peritubular capillaries
12) Cortical radiate veins
13) Arcuate veins
14) Interlobar veins
15) Renal veins
16) IVC
17) Right atrium
31
What are the components of the renal corpuscle?
1) Glomerulus: capillary bed
2) Bowman's capsule: double walled sac
32
What are the vascular and tubular pole of the renal corpuscle?
Vascular pole: afferent and efferent (smaller) arterioles
Tubular pole: PCT
33
True or false: The bowman's capsule is continuous with the tubular epithelium of the PCT.
True
34
What are the parietal and visceral layers of the renal corpuscle?
Parietal:
- basement membrane
- squamous epithelium
Visceral:
- basement membrane
- podocytes
35
What is the order of ultrafiltration in the renal corpuscle?
1) Plasma in afferent arterioles
2) Fenestration in capillaries
3) Basement membrane
4) Filtration slits between pedicles of podocytes
5) Capsular space
6) PCT
36
The renal tubule starts at the _____ pole of the renal corpuscle and ends at the _________ (tip of renal ______)
Start: tubular pole
End: renal papilla (end of renal pyramid)
37
What are the morphological/histological features of the PCT?
1) Simple cuboidal epithelial cells with brush border ("hazy-looking" lumen → cilia)
2) Larger cells than DCT → less nuclei per cross section
3) Stronger stained cytoplasm (PCT > eosinophilic)
38
What is the main function of the PCT?
Reabsorption of water, ions, glucose, amino acids, plasma
(dysfunction → glycosuria)
39
What are the differences between the descending and ascending limbs of the loop of Henle?
Descending:
1) Thin
2) Squamous cells
3) More water reabsorption
Ascending:
1) Thick
2) Cuboidal cells
3) More solutes secreted via active transport
4) more mitochondria
40
What are the morphological/histological features of the DCT?
1) Cuboidal epithelium, no brush border/cilia
2) Large and clearly defined lumen
3) Smaller cells than PCT
4) Cells have pale stained cytoplasm (< eosinophilic than PCT)
41
What is the main function of the DCT?
Secretion of ions (eg. K, H, HCO3) and toxins
(site of action of aldosterone: ↑ Na+ reabsorption)
42
What are the morphological/histological features of the collecting duct?
Cuboidal cells:
1) Principle Cells
- light stained
2) Intercalated cells
- dark stained
43
What are differences between the types of cells in the collecting duct?
Principal cells:
- Light stained
- Reabsorb Na+, secrete K+
- Receptors for both ADH and aldosterone (Water retention)
Intercalated cells:
- Dark stained
- reabsorb HCO3-, secrete H+ (maintain plasma pH)
44
Outline the path urine takes in the Pelvicalyceal system.
1) Collecting duct
2) Renal papilla
3) Minor calyx
4) Major calyx
5) Renal pelvis
6) Ureter
45
The Juxtaglomerular Apparatus is a triangle zone formed by _______________ and 3 types of cells: ____________.
Triangle zone formed by DCT, Afferent and Efferent arterioles
3 types of cells:
1) Macula densa
2) Juxtaglomerular (JG) cells
3) Mesangial cells
46
What are the 2 main functions of the Juxtaglomerular Apparatus?
Maintain blood volume and pressure
47
What is function of mesangial cells?
Form a mesangial matrix to regulate blood flow through the glomerulus
48
What are JG cells?
Specialised smooth muscle cells in the walls of afferent and efferent arterioles.
49
What are the functions of JG cells?
1) Secrete renin in response to paracrine signaling from Macula Densa
2) Constrict/Dilate arterioles to regulate GFR
50
What is the Macula Densa?
Initial portion of DCT between the afferent and efferent arterioles
51
What are the functions of the Macula Densa?
1) Sense changes in [Na+]
2) Induce JG cells to produce renin via paracrine signalling
52
How long is a human ureter?
~25cm
53
Describe the position of the ureter.
- Retroperitoneal
- Attached to posterior abdominal wall
- enters pelvic cavity by crossing in front of sacroiliac joint
- in pelvis, runs inferiorly and posteriorly, lateral to the ischial spine
- turns anteriorly and medially to the base of the bladder where it enters obliquely
54
Where are the physiological constrictions of the ureter?
1) Ureteropelvic junction
2) Pelvic inlet (where it enters pelvic cavity)
3) Entrance to bladder
55
What is the clinical significance of constrictions in the ureter?
Most likely location for stones to be lodged
→ create backpressure on kidneys
→ hydronephrosis
56
What form of epithelium lines the ureter and bladder?
Urothelium/Transitional epithelium
57
What are the histological features of the urothelium?
Resemble stratified squamous epithelium but have intact visible nuclei throughout
(stratified squamous have squished long nuclei that can disappear on section towards lumen)
58
What are the 3 layers of the ureter (superficial to deep)?
1) Mucosa
- transitional epithelium
- lamina propria
2) Muscularis
- Inner longitudinal layer
- Circular outer layer
3) Adventitia
- Outer connective tissue layer
59
Where is the urinary bladder located?
- On the floor of the pelvic cavity
- Inferior to the peritoneum
- Posterior to the pubic symphysis
M: btwn pubic symphysis and rectum;
F: btwn pubic symphysis, uterus (superior) and vagina (posterior)
60
Where does the bladder expand into when full?
Superiorly into the abdomen
61
What are the layers of the urinary bladder (4) (superficial to deep)?
1) Mucosa
- Urothelium
- Rugae ("waves" of bladder)
2) Submucosa
- Fibroelastic connective tissue
3) Detrusor: Smooth muscles
- Inner longitudinal
- Middle circular
- Outer longitudinal
4) Adventitia
- External connective tissue
- Arteries, veins, lymphatics, and nerves (stretch receptors)
62
Where is the trigone area of the urinary bladder?
Between the 2 urethral openings and the internal urethral orifice
63
How is the trigone area different from the rest of the urinary bladder wall?
It has no rugae
64
What are the 2 sphincters of the bladder and how are they different?
Internal: involuntary smooth muscle
External: Voluntary skeletal muscle
65
How are the male and female urethra different?
Male is 15-20cm, Female 3-4cm
Female is short, straight and larger in diameter
Female is more susceptible to infection
66
What are the 3 segments of the male urethra?
1) Prostatic
- passes through the prostate gland
- prostate secretion during ejaculation
2) Membranous
- passes through the urogenital diaphragm
- external sphincter (where micturition is voluntarily controlled)
3) Spongy (penile)
- longest segment
- passes through the penis to the external urethral orifice
67
What are the components of the hip bone (3)?
1) Ilium
2) Ischium
3) Pubis
68
What is the joint that connects the spine to the hip bone?
Sacroiliac joint
69
Where does the femur connect to the hip bone to form the hip joint?
At the acetabulum (socket in hip bone @ junction of all 3 parts: ilium, pubis, ischium)
70
What the joint formed between the 2 symmetrical halves of hip bones?
Pubic symphysis (between both pubis bones)
71
The ischium has a protrusion on its _______ surface known as the _________________.
Interior surface
Ischial spine
72
The hole bounded by the pubis and ischium is known as?
Obturator foramen
73
What muscle covers the obturator foramen?
Obturator internus
74
What muscles form the pelvic floor/diaphragm?
Coccygeus and Levartor Ani
75
What are the 2 major function of the muscles of the pelvic floor?
1) Provide support and prevent prolapse
2) Continence mechanisms to urethral, anal, and vaginal orifices (in females)
76
What muscle lies posterior to the obturator internus, originates from the sacrum and attaches to the trochanter of the femur?
Piriformis
77
What are the muscles of the pelvic wall (4)?
1) Piriformis
2) Obturator internus
3) Coccygeus
4) Levartor Ani
78
Are the external genital organs are located within the pelvic cavity or perineum?
Perineum
79
What structure separates the pelvic cavity and the perineum?
Urogenital diaphragm
80
What is the order of structures in the pelvis in a male from anterior to posterior?
1) Pubic bone
2) Urinary bladder
3) Rectovesical pouch of the pelvic cavity
4) Rectum
5) Sacrum
81
What structure lies inferior to the urinary bladder in males?
Prostate
82
What is the order of structures in the pelvis in a female from anterior to posterior?
1) Pubic bone
2) Urinary bladder
3) Vagina/cervix/uterus (with vesico-uterine pouch of pelvic cavity anterior and superior to bladder)
4) Rectouterine pouch of pelvic cavity
5) Rectum
6) Sacrum
83
What is the embryological origin of the peritoneum?
Intraembryonic coelom
84
What are the anatomical pouches of the peritoneum/pelvic cavity?
Male:
- Rectovesical (btwn bladder and rectum)
Female:
- Vesico-uterine (shallower; superior to bladder and anterior to uterus)
- Rectouterine (deeper; between uterus and rectum)
85
What occupies the anatomical pouches of the peritoneum/pelvic cavity?
Small intestine and peritoneal fluid
86
The neck of the bladder is formed by the convergence of which 2 surfaces?
The base/fundus and the inferolateral surfaces.
87
Embryologically, the trigone of the bladder is derived from _____________, while the rest of the bladder is __________.
Trigone: mesodermal
Rest of bladder: endodermal
88
What forms the upper boundary of the trigone?
The inter-ureteric crest (elevated region of tissue located between both ureteric apertures)
89
How do the internal and external urethral sphincter differ?
Internal: smooth muscle (autonomic control)
External: skeletal muscle (somatic: S2-4 Pudendal nerve)
Internal: In males, prevent retrograde ejaculation
90
What are the posterior relations of the male urinary bladder (5)?
1) Ureters
2) Vas deferens
3) Seminal vesicles
4) Recto-vesical pouch
5) Rectum
91
What are the anterior relations of the female urinary bladder?
Pubic bone + anterior pelvic muscles
92
What are the posterior relations of the female urinary bladder (3)?
1) Uterus
2) Cervix
3) Rectum
93
What are the superior relations of the female urinary bladder (4)?
1) Peritoneum
2) Vesico-uterine pouch
3) Small intestine
4) Uterus
94
The abdominal aorta bifurcates into the L and R common iliac arteries at L4. From which, both common iliac arteries bifurcate into the ___________ at the level of ________.
Internal and external iliac arteries
at level of sacroiliac joint
95
The internal iliac artery is the primary artery which supplies the ______________.
Internal pelvic structures (eg. pelvic wall, pelvic viscera)
96
What do the external iliac arteries supply?
The lower limbs
97
What are the common and differing blood vessels that supply the bladder in males and females?
Both: superior vesical, obturator
Male: inferior vesical
Female: Uterine arteries
98
Where does lymph from the bladder flow to?
Mostly into internal iliac nodes, few from superolateral surface drain into external iliac nodes
99
True or false: the veins of the bladder follow the arteries.
False, they form a plexus that converges on the vesico-prostate plexus
100
Where is the vesico-prostate plexus?
In the groove between the bladder and the prostate
101
Where do the veins of the bladder drain to?
Backwards across the pelvic floor into the internal iliac veins.
102
Describe the nervous supply of the bladder.
Sympathetic – hypogastric nerve (T12 – L2). It causes relaxation of the detrusor muscle, promoting urine retention.
Parasympathetic – pelvic nerve (S2-S4). Increased signals from this nerve causes contraction of the detrusor muscle, stimulating micturition.
Sympathetic (from trunk hypogastric nerve) + Parasympathetic (from pelvic splanchic nerve) = inferior hypogastric plexus
Somatic – pudendal nerve (S2-4). It innervates the external urethral sphincter, providing voluntary control over micturition.
103
What is the effect of parasympathetic stimulation on the bladder?
Contracts detrusor muscle and relaxes internal urethral sphincter
104
What is the effect of sympathetic stimulation on the bladder?
Relaxes detrusor muscles and contracts internal urethral sphincter
105
How is retrograde ejaculation prevented in males?
Sympathetic activation
→ contraction of internal urethral sphincter
→ prevent reflux into bladder
106
How does micturition differ from infants and adults?
Both: Stretch receptors on bladder wall → S2-4
Infants: (Immature cerebral cortex: Primitive spinal reflex)
- Interneurons → parasympathetic efferent → micturition
Adults: (Mature CNS: voluntary control)
- ascends spinal cord
- pontine micturition center → communicate with cerebral cortex
- lift inhibition if deemed appropriate → micturition
107
True or false. The bladder is in the pelvis throughout a person's lifetime.
False. Only descends completely from abdomen until puberty.
108
How is the position of the bladder different when it is empty and full?
Empty: entirely within pelvis, posterior to pubic symphysis
Full: extends upward into abdominal cavity, pushing the peritoneum superiorly
109
Why are females more prone to UTIs?
1) Shorter urethra
2) Proximity to anus
110
How does damage to the spine above T12 affect the bladder?
Reflex/autonomic bladder:
- spinal reflex arc
- micturition w/o conscious control or awareness
111
How does damage to the spine below T12 affect the bladder?
Flaccid/atonic bladder:
- damage to parasympathetic outflow to the bladder
- detrusor muscle paralysed
- non-functional spinal reflex
- bladder fill uncontrollably → abnormally distended until overflow incontinence occurs
112
True or false: The apex of the bladder points towards the pubic symphysis.
True
113
True or false: The peritoneum covers the superior surface of the bladder.
True
114
True or false: The bladder wall is thicker at the neck.
True
115
True or false: The internal urethral sphincter is under voluntary control.
False. Involuntary control
116
True or false: The parasympathetic supply to the bladder is via pelvic splanchnic nerves.
True
117
True or false: The bladder mucosa is lined by urothelium.
True
118
True or false: The detrusor muscles is in the submucosa of the bladder.
False: Muscular layer (deep to submucosa)
119
True or false: The female urethra is longer than the male urethra.
False
120
True or false: Micturition is primarily controlled by the PNS.
True
121
True or false: The external urethral sphincter is formed of skeletal muscle.
True
122
True or false: The pontine micturition center in the brainstem plays a critical role in coordinating micturition throughout life.
False. Only in adults
123
True or false: Micturition can occur without involvement of higher brain centers.
True
124
True or false: The trigone is located on the posterior wall of the bladder.
True
125
True or false: The trigone is derived from the endoderm.
False: Mesoderm
126
True or false: The external iliac artery is the primary supply of the pelvis and perineal structure.
False: Internal
127
True or false: The vesical venous plexus drains into the internal iliac veins
True
