Anatomy Flashcards
False pelvis
Iliac crests to pelvic inlet
True pelvis
Pelvic inlet to pelvic floor
Perineum
Between pelvic floor and skin
Route of ureters
Anterior to common iliac vessels into pelvis
Turn medially at ischial spine
Enter bladder posteriorly/inferomedially
Posterior to uterine artery, medial to suspensory lig of ovary, over vas def
Subperitoneal
Round ligament of uterus
Attaches uterus to peritoneum via inguinal canal
Branches of internal iliac artery
Vesical arteries
Uterine and vaginal artery
Middle rectal artery
Neck of male bladder
Detrusor muscle thickens to form internal urethral sphincter (contracts during ejaculation)
Inside the scrotum the testes sit in a sac called:
tunica vaginalis
Excess fluid in tunica vaginalis
Hydrocele
Left gonadal vein drains to:
Left renal vein
How is ejaculatory duct formed?
Seminal duct + vas deferens
Most prostate cancers arise from what zone of prostate?
Peripheral zone
Root of penis laterally attached to:
Ischium
What part transmits deep arteries of penis?
Corpus cavernosum
What part expands to form glans?
Corpus spongiosum
Paraphimosis
Retraction of foreskin behind glans, swelling
Tx: squeeze out oedema, surgery/circumcision
Blood to penis
Deep artery of penis (from internal pudendal, off internal iliac)
Blood to scrotum
Internal pudendal (off internal iliac) and branches of external iliac
Lymph from scrotum and most of penis
Superficial inguinal nodes
Lymph from testes
Lumbar nodes
Level of bifurcation of aorta
L4
Level of kidneys
Left: T12-L2
Right:L1-3
Kidneys lie lateral and anterior to what muscles?
Lateral to psoas
Anterior to quadratus lumborum
Layers around kidneys
Capsule Perinephric fat Deep/Renal fascia Paranephric fat Superficial fascia/Visceral peritoneum
Deepest part of peritoneal cavity
Hepatorenal recess (part of greater sac)
Which are anterior, renal veins or arteries?
Renal veins
Which are anterior, iliac veins or arteries?
Iliac arteries
Ureteric blood supply
Renaly artery, abdo aorta, Common iliac, internal iliac, vesical artery
Lymph from kidneys
Lumbar nodes
Lymph from ureters
Lumbar and Iliac nodes
Cause of supra-renal AAA and renal artery stenosis
Occlusion of renal arteries
Cause of infrarenal AAA and renal artery stenosis
Atherosclerosis
How many pyramids in each medulla?
27
Connection between multiple kidney stones
Staghorn calculus
Filling defect suggests:
Stone
Hydronephrosis
Water in the kidney due to backpressure
Painful stretching of capsule and enlargement
5 types of nerve fibre
Somatic sensory Visceral afferent Somatic motor Parasympathetic Sympathetic
Where do sympathetic fibres leave the CNS?
Spinal nerves between T1-L2 (thoracolumbar outflow)
How do sympathetic fibres reach glands of body wall?
In spinal nerves
How do sympathetic fibres reach glands within body?
Splanchnic nerves (cardiopulmonary or abdominopelvic)
How do sympathetic fibres reach glands in the head?
Arteries
What type of nerve fibres do spinal nerves contain?
Somatic motor, sensory, sympathetic
How do sympathetic fibres get to kidneys, ureters and bladder?
Leave spinal cord at T10-L2
Enter symp chain but do not synapse
Leave chain in abdominopelvic splanchnic nerves
Synapse in ganglia around aorta and follow periarterial plexus
How do parasympathetic fibres leave the CNS?
III, VII, IX, X and sacrospinal nerves
What do parasympathetic fibres innervate?
Organs (NOT body wall)
How do para fibres reach glands of head?
CNs
How do para fibres reach the hindgut and pelvic organs?
Pelvic splanchnic nerves
Are para fibres carried in spinal nerves?
Only for short distance in sacral spinal nerves
How do para fibres get to kidneys, ureters and bladder?
Kidneys and ureter: CN X
Bladder: pelvic splanchnic nerves (S2-4)
Somatic motor supply to renal system
Perineum - urethra, ext anal sphincter, levator ani
S2-4
Innervation of detrusor
Pelvic splanchnic nerves (para) S2-4
Nerves to internal urethral sphincter
Symp = contraction Para = relaxation
Nerves to external anal sphincter
Pudendal nerve S2-4
Nerves to levator ani
S3-4
How do visceral afferents from kidneys and ureters get to CNS?
Enter symp fibres T11-L2
Dermatomal pain
How do visceral afferents from bladder get to CNS?
Part touching peritoneum: enter symp fibres T11-L2 = suprapubic
Rest of bladder: para fibres enter spinal cord S2-4
How do visceral afferents from urethra get to CNS?
Proximal urethra (above levator ani): para fibres enter spinal cord S2-4 = suprapubic Distal urethra: pudendal nerve S2-4 = localised
How do pain fibres get from testes to CNS?
Symp back to spinal cord T10-11 = suprpubic
Localised body wall L1
Lumbosacral plexus
L1-S4
- Sciatic nerve L4-S3
- Pudendal nerve S2-4
Lumbar plexus
Iliohypogastric L1 Ilioinguinal L1 Lateral cutaneous nerve of thigh L2-3 Genitofemoral nerve L1-2 Femoral L2-4 Obturator L2-4