ANATOMY 3 Flashcards

1
Q

nerves in pelvis (above levator ani)

A
visceral afferents (sensory)
autonomic (visceral motor)
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2
Q

nerves in perineum

A

somatic sensory and motor

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3
Q

what are the superior pelvic organs (touching peritoneum)

A

uterine tubes
uterus
ovaries

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4
Q

what do visceral afferents to superior pelvic organs run alongside

A

sympathetics

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5
Q

where is pain from superior pelvic organs felt

A

suprapubic pain (T11-L2)

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6
Q

what are inferior pelvic organs

A

cervix

superior vagina

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7
Q

what do visceral afferents to inferior pelvic organs run alongside

A

parasympathetics

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8
Q

where is pain from inferior pelvic organs felt

A

perineal pain (S2-S4)

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9
Q

what are the perineal organs

A

inferior vagina

perineal muscles, glands and skin

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10
Q

what nerve is sensory supply to perineum

A

pudendal nerve (S2-4)

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11
Q

where is spinal anaesthetic injected into

A

L3-L4 subarachnoid space

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12
Q

how is L4 process found

A

draw a straight line from most superior point of iliac crests (intercristal line)
L4 process is first palpable spinous process superiorly

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13
Q

onset of spinal anaesthesia and how long does it last

A

5 mins

wears off quickly

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14
Q

side effects of spinal and epidural

A

hypotension
decreased sweating
warm, flushed lower limbs

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15
Q

where is epidural anaesthetic injected into

A

L3-L4 epidural space

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16
Q

what does epidural space contain

A

fat and veins

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17
Q

onset of epidural and how long does it last

A

slower onset, lasts longer

18
Q

when is a pudendal nerve block used

A

anaesthetise perineum in epiostomy, forceps and stitching

19
Q

course of pudendal nerve

A

exits pelvis via greater sciatic foramen
passes posterior and lateral to sacrospinal ligament (next to ischial spines)
re-enters via lesser sciatic foramen
travels in pudendal canal through obturator membrane

20
Q

what is used as a landmark to administer pudendal nerve block

A

ischial spines (felt in vaginal exam)

21
Q

external oblique muscle attachments

A

ribs 5-12
iliac crest
pubic tubercle
linea alba

22
Q

internal oblique muscle attachments

A

ribs 10-12
thoracolumbar fascia
iliac crest
linea alba

23
Q

transversus abdominis attachments

A

7-10 costo-cartilages
thoracolumbar fascia
iliac crest
linea alba

24
Q

what are in rectus abdominis muscles

A

tendinous intersections

25
Q

what is rectus sheath

A

combined aponeuroses of anterolateral abdominal wall muscles
completely surrounds rectus abdominis muscles

26
Q

layer of lateral abdominal wall

A
external oblique 
internal oblique 
transversus abdominis 
transversalis fascia 
extra peritoneal fat 
parietal peritoneum
27
Q

what layer do cutaneous nerves to lateral abdominal wall run

A

between internal oblique and transversus abdominis

28
Q

blood supply of anterior abdominal wall

A

superor and inferior epigastric arteries

29
Q

what are superior epigastric arteries a continuation of

A

internal thoracic artery

30
Q

where do inferior epigastric arteries arise from

A

external iliac arteries

31
Q

what layer are anterior abdominal wall arteries immediately below

A

rectus abdominis

32
Q

what is arterial supply to lateral abdominal wall

A

intercostal and subcostal arteries (subcostal 7th-11th ribs)

33
Q

where do epigastric arteries anastomose

A

ubilicus

34
Q

course of inferior epigastric arteries and clinical relevance

A
start lateral  (medial to deep inguinal ring) and 
means middle has poor blood supply so worse wound healing
35
Q

what way should muscles be cut in an incision

A

same direction as their fibres

36
Q

why should rectus abdominis be cut transversely despite its fibres running longitudinally

A

creates another transverse band

37
Q

what is LSCS

A

lower segment caesarean section

38
Q

describe LSCS

A

rectus muscles not cut (linea alba is if laparotomy)

bikini line/supra pubic is most common

39
Q

complications of midline incision and why

A

poor wound healing - relatively bloodless area

40
Q

where is deep inguinal ring located

A

halfway between ASIS and pubic tubercle

41
Q

how to differentiate between uterine artery and ureter

A

ureter under artery (bridge over water)

ureter will vermiculate when touched