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anatomy Flashcards

1
Q

gonadal - venous drainage

A

Left ovary/testis –> left gonadal vein –> left renal vein
–> IVC
Right ovary/testes –> right gonadal vein –> IVC

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2
Q

left vs right gonadal vein

A

Left –> left renal –> IVC

right –> IVC

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3
Q

gonadal vein - female vs male

A

female –> ovarian vein

male –> testicular vein (or spermatic vein)

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4
Q

clinical significance of speramatic vein

A

Because left spermatic vein enters the left renal vein at 90 degrees, flow flow is less laminar on left than right
–> more pressure on left vein –> varicocelle more common in left

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5
Q

varicocelle is more common in left or right side

A

left

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6
Q

Cervical, hilar, Mediastinal, Axillary lymph node cluster drains … (area)

A

cervical –> head and neck
hilar –> lungs
mediastinal –> Trachea and esophagus
axiallary –> Upper limb, breast, skin above umbilicus

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7
Q

Celiac lymph node cluster drains … (area)

A

liver, stomach, spleen, pancreas, upper duodenum

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8
Q

Superior mesenteric lymph node cluster drains … (area)

A

lower duodenum, jejunum, ilieum, colon to splenic fructure

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9
Q

Inferior mesenteric lymph node cluster drains … (area)

A

colon from splenic flexure to upper rectum

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10
Q

Para-aortic lymph node cluster drains … (area)

A
  1. Testes
  2. ovaries
  3. kidneys
  4. uterus
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11
Q

internal iliac nodes drain

A
  1. lower rectum to anal canal (above the line)
  2. cervix
  3. corpus carvenosum
  4. vagina (middle third)
  5. prostate
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12
Q

superficial inguinal drain

A
  1. anal canal (below the line)
  2. skin below umbilicus (except popliteal area)
  3. scrotum
  4. vulva
  5. vagina (lower third)
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13
Q

deep inguinal nodes

A

glans penis

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14
Q

external iliac nodes

A
  1. body of uterus
  2. cervix (and upper third of vagina)
  3. superior bladder
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15
Q

cervix lymph drainage

A

external and internal iliac nodes

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16
Q

uterus lymph drainage

A 
Para-aortic
external iliac (body)
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17
Q

lymph drainage - uterus, cervix, vagina

A

para-aortic uterus –> uterus
external iliac –> body of uterus, cervix, upper third vagina
internal iliac –> cervix, middle third vagina
superficial inguinal –> lower third vagina

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18
Q

Lymphatic drainage of the vagina is generally to the

A

external iliac nodes (upper third of the vagina), internal iliac nodes (middle third), and the superficial inguinal nodes (lower third).

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19
Q

Fenale reproductive system - ligaments

A
  1. infundibulopelvic ligament (suspensory ligament of the ovary)
  2. Cardinal ligament
  3. Round ligament of uterus
  4. Broad ligament
  5. Ovarian ligament
  6. uterosacral
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20
Q

Fenale reproductive system - ligaments an what they connect

A
  1. infundibulopelvic (suspensory ligament of the ovary) –> ovaries to lateral pelvic
  2. Cardinal –> cervix to side wall of pelvis
  3. Round ligament of uterus –> uterine fundus to labia major
  4. Broad –> uterus, fallopianm tuves and ovaries to pelvic side wall
  5. Ovarian –> madian pole of ovary to lateral uterus
  6. uterosacral –> uterus to the anterior aspect of the sacrum
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21
Q

infundibulopelvic ligament is AKA

A

suspensory ligament of the ovary

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22
Q

infundibulopelvic (suspensory ligament of the ovary) connects

A

ovaries to lateral pelvic

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23
Q

infundibulopelvic (suspensory ligament of the ovary) contains

A

ovarian vessels

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24
Q

cardinal ligament connects

A

cervix to side wall of pelvis

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25
Q

cardinal ligament contains

A

uterine vessels

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26
Q

Round ligament of the uterus connects

A

uterine fundus to labia majora

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27
Q

Round ligament of the uterus contains

A

nothing

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28
Q

Broad ligament connects

A

uterine, fallopian tubes and ovaries to pelvic side wall

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29
Q

Broad ligament contains

A

ovaries, fallopian tuves, round ligaments of uterus

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30
Q

uterosacral ligament connects

A

uterus to the anterior aspect of the sacrum

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31
Q

ovarian ligament connects

A

medial pole of ovary to lateral uterus

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32
Q

ovarian ligament contains

A

nothing

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33
Q

Derivatives of gubernaculum in females

A
  1. ovarian ligament

2. round ligament of the uterus

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34
Q

course of round ligmament of the uterus

A

travels along inguinal canal, in the broad ligament, above the artery of Sampson

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35
Q

Sampson artery

A
  • runs under the round ligament of uterus.

- is anastomosis of the uterine artery and ovarian artery

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36
Q

Broad ligament - structure

A

Fold of peritoneum that comprises the

  1. mesosalpinx
  2. mesometrium
  3. mesovarium (suspends the ovaries)
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37
Q

ureter course in females

A

retroperotoneally, close to gonadal vessels (risk at injury during ligation of ovarian vessels) and under uterine artery)
(risk at injury during ligation of ovarian or uterine vessels)

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38
Q

an operation with uterine vessels ligation

A

hysterectomy

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39
Q

clinical correlation of infundibulopelvic ligament

A
  1. very close to ureter –> risk of injury during ligation

2. ligate vessels during oophorectomy to avoid bleeding

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40
Q

vagina histology

A

stratified squamous epithelium, nonkeratinized

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41
Q

ectocervix histology

A

stratified squamous epithelium, nonkeratinized

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42
Q

transformation zone (female reproductive) histology

A

Squamocolumnar junction (ectocervic-endocervix)

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43
Q

endocervix histology

A

simple columnar epithelium

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44
Q

uterus histology

A

simple columnar epithelium with long tubular glands in proliferative phase
coiled glands in secretory phase

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45
Q

fallopian tube histology

A

simple columnar epithelium, ciliated

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46
Q

ovary, outer surface histology

A

simple cuboidal epithelium (germinal epithelium covering surface of ovary

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47
Q

uterus walls

A

inside –> endometrium
middle –> myometrium
outside –> Perimetrium

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48
Q

perimetrium?

A

Serous layer of visceral peritonium. It covers the outer surface of the uterus

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49
Q

ovarian artery arises from

A

abdominal aorta (above L2)

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50
Q

uterine artery arises from

A

anterior division of the internal iliac artery

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51
Q

ovarian and uterine anastomosis

A

Sampson artery

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52
Q

portions of cervix

A
  1. endocervix
  2. transitional zone
  3. ectocervix
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53
Q

cervical os?

A
  1. external os: the external opening into the vagina

2. internal os: theinternal opening into the endometrial cavity

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54
Q

Vaginal fornix (fornices of the vagina)

A

superior portions of the vagina, extending into the recesses created by the vaginal portion of cervix

  1. posterior - behind the cervix (largest)
  2. anterior
  3. twο lateral
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55
Q

infundibulopelic - course according to Fallopian tube

A

it goes under

56
Q

regions of Fallopian tube (from inner to outer)

A

uterine –> isthmus –> ampula –> infundibulum –> Fimbriae (ostium)

57
Q

parts of male urethra (and direction)

A

(AFTER bladder and bladder neck) preprostatic urethra –> prostatic –> membranous urethra (through pelvic floor) –> spongy (penile) within the bulb and corpus sponsgiosum

58
Q

spongy (penile urethra) is sometimes further divided to

A

bulbar and penile urethra

59
Q

suspect urethreal injury in males if

A

blood seen at urethral meatus

60
Q

male urethral injury - division according to location

A

posterior urethra - membranous

anterior urethra - bulbar and penile urethra

61
Q

posterior urethra (membranous) trauma

A

prone to injury from pelvic fracture –> injury can cause urine to leak into retropubic space

62
Q

Retropubic space is the

A

extraperitoneal space between the pubic symphysis and urinary bladder

63
Q

anterior urethra bulbar and penile trauma

A

at risk of damage due to perineal straddle injury –> urine leak beneath deep fascia of Buck –> if fascia is torn, urine escapes into superficial perineal space

64
Q

straddle injury

A

perineal trauma

65
Q

Buck’s fascia?

A

or fascia of the penis –> is a layer of deep fascia covering the three erectile bodies of the penis

66
Q

Pathway of sperm during ejaculation

A

mnemonic: SEVEN UP
Seminiferous tubules –> Epidedidymis –> Vas deferens
–> Ejaculation ducts –> urethra –> penis

67
Q

histology of testis and epdidemis

A

seminiferous tubules (Leyding cells between them, separated by septa) and covered by tunica albuginea –> concentrate in Rete testis –> head of epididymis (efferent ductule) –> tale of epididymis –> vas deferens

68
Q

Prepuce?

A
  • Clitoral hood, skin surrounding and protecting the head of the clitoris
  • Foreskin, skin surrounding and protecting the head of the penis in humans
69
Q

Corpus cavernosum vs corpus spongiosum

according to anatomy

A

corpus spongiosum –> mass of spongy tissue surrounding the male urethra within the penis (ventral)
Corpus cavernosum –> 2 sponge like regions on erectile tissue of penis (dorsal)

70
Q

erection is control by

A

parasympathetic nervous system (pelvic nerve)

71
Q

erection mechanism

A

NO –> increased cGMP –> SMCs relaxation –> vasodilation -> proerectile

72
Q

norepinephrine in erection

A

norepinephrine increases Ca2+ concentration in in SMCs –> vasoconstriction –> antierectile

73
Q

emission definition/controled by

A

phase when sperm moves from testes upto prostatic urethra. It is controlled by sympathetic nervous systme (hypogastric nerve)

74
Q

ejaculation definition/controled by

A

phase when sperm moves from prostatic urethra to the outside. It is controlled by visceral and somatic nerves (The pudendal nerve)

75
Q

emission vs ejaculation according to definition

A

emission –> phase when sperm moves from testes upto prostatic urethra
ejaculation –> phase when sperm moves from prostatic urethra to the outside

76
Q

Seminiferous tubules - cells

A
  1. spermatogonia (germ cells)
  2. sertoli cells (non germ cells)
  3. Leyding cells (endocrine cells)
77
Q

Seminiferous tubules - cells/location

A
  1. spermatogonia (germ cells) –> line seminiferous tubules
  2. sertoli cells (non germ cells) –> line seminiferous tubules
  3. Leyding cells (endocrine cells) –> intersitium (outside the tubule)
78
Q

spermatogonia (germ cells) - function

A

maintain germ pool and produce primary spermatocytes

79
Q

spermatogonia to sprmatozoon (only the cells)

A

spermatogonium –> sprmatocytes (1ry and 2ry) –> speramtides –> spermatozoon (spermatozoon in the lumen of seminiferous tubule) (SPERMATOGENESIS)

80
Q

sertoli cells (non-germ cells) - location

A

line of seminiferous tubules

81
Q

sertoli cells (non-germ cells) - action

A
  1. secrete inhibin B (inhibits FSH)
  2. secrete androgen-binding protein (maintain local levels of testosterone –> stimulate spermatogenesis)
  3. produce MIF (suppress development of paramesonephric ducts)
  4. form the blood-testis barrier –> isolate gametes from autoimmune attack
  5. sapport and nourish developing spermatozoa
  6. Regulate spermatogenesis
  7. convert testosterone and androstenedione to estrogens via aromatase
82
Q

sertoli cells (non-germ cells) are sensitive to

A

temperature

83
Q

sertoli cells (non-germ cells) are sensitive to … (explain)

A

temperature:

increased Q –> low sperm production and low inhibin B

84
Q

situations that increases temperature in seminiferous tubules

A
  1. Varicocele

2. crytorchidism

85
Q

Blood-testis barrier - structure and function

A

structure: tight junction between Sertoli cells
function: a. isolates gametes from autoimmune attack
b. prevent cytotoxic agents

86
Q

sertoli cells - homolog of female

A

granulosa cells

87
Q

Leyding cells (endocrine cells) - function

A

secrete testosterone in the presence of LH

88
Q

Leyding cells (endocrine cells) vs temperature

A

testosterone production unaffected by temperature

89
Q

Leyding cells - area

A

interstitium of Seminiferous tubules

90
Q

Leyding cells - homolg of female

A

theca interna cells

91
Q

which ligaments of the female reproductive system contain nothing

A

the derivatives of gubernaculum

  1. Round ligaments of the uterus
  2. ovarian ligament
92
Q

which ligaments of the female reproductive system contain tha major vessels of the area

A
  1. infundibulopelvic ligament –> ovarian vesses

2. cardinal vessels –> uterine vessels

93
Q

Female reproductive epithelial histology - MC area of cervical cancer

A

transformation zone

94
Q

breast - suspensory ligaments - aka and course

A

aka: Cooper
course: separate the the lobes + attach the skin

95
Q

breast - arterial supply

A

branches of:

  1. internal thoracic (sublavian)
  2. lateral thoracic (axillary)
  3. anterior + posterior intercoastal
96
Q

breast - lymph nodes

A
  1. most: axillary

2. part of medial quadrants: parasternal

97
Q

radial mastectomy?

A

breast is removed along with pectoralis major and minor, axillary nodes and vessels, and tributaries of axillary vein

98
Q

SA node location

A

in the sinus venarum of the RA near the entrance of the SVC

99
Q

AV node location

A

interatrial septum - RA near TV and the orifice of coronary sinus

100
Q

inf epigastric artery - course

A

branch of ext iliac immediately proximal to inguinal ligament –> supply to lower anterior abdominal wall as it rans superiorlu + and medially up to abdomen

101
Q

superior gluteal artery - course

A

the continuation of internal iliac artery –> post/inf to supply gluterus and a portion of hip

102
Q

obturator artery - course

A

branch of internal iliac –> inf to supply pelvic organs

103
Q

ext iliac artery branches

A
  1. inf epigastric

2. deep circumflex iliac

104
Q

great saphenous course

A

medial side of food –> anterior to medial malleolus –> medial aspect of leg + tight –> drains into demoral in the femoral tirangle (inferolateral to pupitubercle)

105
Q

small saphenous vein course

A

lateral foot –> posteriorly –> into popliteal vein

106
Q

perineal body?

A

central tendon of the perineum –> lies in the midline between urogenital + anal triangle
the following structures are anchored to it:
1. bulbospongiosus muscle
2. external anal sphincter
3. superficial + deep transverse perinal muscle
4. fibers from external urethral sphincter, levator ani + muscular coat of rectum

107
Q

hip bone is consists by

A

3 bones: ilium, ischium, pubis

108
Q

pelvis diaphragm weakness –>

A

prolapse of uteros, bladder or rectum into vagina

109
Q

vesicouterine vs rectovesical pouch

A

females –> peritoneum onto anterior aspect of uterus (between uterus + bladder) –> vesicouterine pouch
males –> peritoneum onto anterior aspect of the rectum (between rectum + uterus –> rectovesical pouch

110
Q

position of uterus

A

50% –> anterverted
25% retroverted
25% midverted
due to uterosacral ligament –> loss of the ligament –> prolapse into vagina

111
Q

fructose rich compoment of sperm, and area

area of Bulbourethral gland of Cowper

A 
seminal vesicle (posteriolateral of bladder) 
seminal vesicle in ductus deferans (behind bladder) --> ejaculation duct 
cowper: junction between membranous + boublous urethra
112
Q

The recto-uterine pouch( pouch of Douglas)?

A

extension of the peritoneal cavity between the rectum and the posterior wall of the uterus in the female human body

113
Q

epistomy - definition + types

A

it is an incision of the posterior wall of the vagina during labor:

  1. medline: extend posteriorly in the midline throught perineal body (vertical)
  2. mediolateral: extend througth the bulbospongiosus + transcerus perineus muscle (less risk of damage fibers of external anal sphincter)
114
Q

urogenital dipahragm is transverse by / contains

A

urethra in both sexes + by vagina

contains deep transversus perineus muscles + sphincter urethrae (external sphincter)

115
Q

branches of internal iliac artery

A
  1. pelvic visceral branches: umbilical ar, uterine ar, ductus deferens, vaginal art, inferior vesical ar, middle rectal ar
  2. perineal branches: internal pubendal –> inf rectal, perineal branch, artery to bulb, deep ar of penis, dorsal ar of penis
  3. pelvic wall branches –> iliolumbar, lateral sacral
  4. lower limb branches –> superior glut, inf glut, oburator ar
116
Q

pudendal nerve - branches

A

3 main branches –> inf rectal, perineal nerve, dorsal nerve of penis + clitoris

117
Q

unresponsive to medical management postpartum hemorrhage –>

A

bilateral ligation of the internal iliax artery (aka as hypogasric artery)
the uterus has collateral blood flow (from ovarian art) –> sufficient to maintain uterine function

118
Q

internal pupendal artery course

A

branch of anterior trunck of internal iliac –> runs througth the schiatic foramina –> supply the perineum

119
Q

main risk of ovarian torsion

A

large ovarian mass

120
Q

pampiform plexus

A

receive venous blood from testis, epididymis, ductus deferans –> drains into testicular veins

121
Q

pelvic innervation

A
  1. pudendal (S2-4) –> sensory: perineum, motor: urethral+anal sphincter
  2. Lateral femoral cutaneous (L2-3) –> sensroy: anter + lateral tight (injury during hyperflexion of the thighs for pelvic surgery or vaginal delivery
  3. inferior gluteal
  4. Genitofemoral (L1-2) –> sensory: scrotum/labia majora, medial thigh (anterior to psoas, injury during laparotomy), motor to parts of genitalia (eg. cremasteric reflex)
  5. Obturator
  6. Iliohypogastric (T12-L1) –> sensory hypogastric (injury due to Pfnannestiel skin incisions, like cesarean, appendidectomy), motor to anterolateral abdom walls
  7. ilioinguinal (L1) –> sensory from skin of the upper + medial thigh, the root of penis + upper scrotal, labia major
122
Q

pupendal nerve - landamark

A

ischial spine + sacrospinous ligament

(other important structures: internal pupendal ar + inf gluteal ar - run medial to nerve

123
Q

prostatic plexus - lies … / origin /

A
  • lies within the fascia of prostate
  • origin: inferior hypogastric plexus
  • gives rise to lesser + greater carvenous nerves
    risk for injury in prostatectomy –> erectile dysfunctin
124
Q

fibrinoids of uterus may located

A
  1. serosal surface (subserosal) –> IRREGULAR ENLARGED UTERUS –> bulk symptoms (eg. constipation)
  2. within uteral wall (intramural) –> reproductive difficulties
  3. below endometrium (SUBMUCOSAL) –> reproductive difficulties, bleeding
125
Q

imperforate hymen

A

by incomplete degeneration of the central portion of fibrous tissue band connecting the wall vagina –> priamary amenorrhea, normal secondary sexal, cyclic pelvic pain due to accumulation of blood in vagina + uterus (hematocopos), palbable mass anterior to rectum, difficulties in defecation

126
Q

endometriosis in pouch of douglas

A

painful defecation, dyspareunia, plpable nodularity on rectpvaginal examination

127
Q

main target of kegel exercise

A

levator ani:

  1. iliococcygeus
  2. pubococcygeus
  3. puborectalis
128
Q

levator ani injury –>

A
  1. urethral hypermobility

2. pelvic organ prolapse

129
Q

gonadal arteries course

A

right travels in front of IVC + behind ileum + left ar behind left colic + sigmoid art + iliac colon –> cross anteror the ureter –> paraller the external iliac vessels –> inguinal canal –> testes

130
Q

prostate location

types of obstruction in BPH

A

between pubic symphisis + + anal canal

  1. static obstriction (androgen-mediated)
  2. dynamic obstriction (α adrenoreceptor mediated)
131
Q

penile venous outflow anomalies

A

eg. leakflow of vein –> erectile dysfunction

132
Q

vasectomy?

A

remove of ductures deferens (vas deferens) –> birth control

133
Q

lymphatic system of lower extremities

A
  1. superficial lymphatic vessels (follow venous system)
  2. deep lymphatic vessels (follow arterial system)
    the superficial lymphatic system is also divided to medial + lateral
    medial bypass the popliteal nodes (like saphenus) –> inguinal area
    lateral do not bypass –> popliteal AND inguinal area
134
Q

bladder lymph drainage

A

superior: external iliac
inferior: internal iliac

135
Q

arcuate line?

A

horizontal line below the umbilicus that demarcates the lower limit of the posterior rectus sheath. Above that, the rectus abdominis is sourounded by anterior + posterior sheath. Below only by anterior sheath

136
Q

inscision in cesarea delivery

A
  1. midline vertical sepration of the rectus abdominis muscle
  2. when additionally space necessary –> horizontal transection of the rectus abdominis –> risk for inferior epigastric arteries

Reproductive (20 decks)

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