Anatomy Flashcards

1
Q

How long and wide is the female urethra

A

4cm long and 6mm in diameter

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2
Q

Lymph from the bladder drains to several groups of lymph nodes. What are they ?

A

External iliac nodes - superolateral aspect internal iliac nodes - posterior surface and neck sacral or common iliac nodes - some areas of the neck

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3
Q

Where are the paraurethral glands located?

A

Superior part of the urethra, they open into the sides of the external urethral meatus

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4
Q

How long is the male urethra

A

20cm (18 - 22cm)

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5
Q

What are the features of the intramural (preprostatic urethra)

A

surrounded by internal urethral sphincter, diameter varies on whether bladder is filling or emptying, it is the shortest component of the urethra

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6
Q

Each of the angles of the trigone represent an osmium, what are they?

A

Two superior - openings of the ureters one inferior - internal urethral orifice

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7
Q

In the adult where is the empty bladder located?

A

Entirely within the pelvis

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8
Q

What are the mechanisms to prevent reflux of urine from the bladder to the ureters?

A

Ureters pass obliquely through the detrusor muscle to the ureteric orifice fibres of the detrusor muscle encircle the ureteric orifices and theses tighten when bladder contracts

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9
Q

The ureters pierce the bladder wall obliquely what is the purpose of this?

A

Provides a valve like action which prevents a reverse flow of urine toward the kidneys as the bladder fills.

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10
Q

What is the blood supply for the male urethra?

A

proximal - middle rectal from inferior vesicle from internal iliac distal part - internal pudendal

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11
Q

What is the secretion of the prostate?

A

Secretes a milky fluid containing citric acid and acid phosphatase which neutralises the acidity of the vagina

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12
Q

Why does the trigone not have muscular folds

A

Mucosa is firmly attached tot he underlying muscle

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13
Q

Describe the pathway of the female urethra

A

Passes anteroinferior from the internal urethral orifice of the bladder posterior and inferior to pubis symphysis , passes through the pelvic diaphragm with the vagina and perineal membrane, lies parallel to the vagina and passes with it through the pelvic diapraghm, external urethral sphincter and perineal membrane, it exits via the external urethral orifice located in the vestibule, anterior to the vagina.

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14
Q

In the adult where is the full bladder located?

A

It ascends into the greater pelvis and lies within extra peritoneal fascia of the abdominal wall

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15
Q

What are the functions of the male urethra?

A

To convey urine and provide a passageway for semen

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16
Q

Describe the relations of the posterior surface of the prostate gland

A

Ampulla of the rectum

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17
Q

Describe the relations of the anterior surface of the prostate gland

A

separated from the pubic symphysis by retroperitoneal fat in the retropubic space

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18
Q

The anterior and lateral relations of the bladder are the same in male and female. Describe the lateral relations

A

Levator ani muscle Obturator interns muscle

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19
Q

The anterior and lateral relations of the bladder are the same in male and female. Describe the anterior relations

A

Anterior abdominal waal Symphysis pubis Retropubic fat

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20
Q

Describe the structure of the prostate gland

A

it is a branched tuboalveolar gland which is embedded in a fibromuscular stoma. the glandular part makes two thirds and the other third is fibromuscular. Surrounds the prostatic urethra. It has a fibrous capsule that is dense and contains neurovasculature

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21
Q

What are the mechanisms to prevent retrograde ejaculation of semen into the bladder

A

Muscles fibres toward the neck of the bladder form an involuntary internal urethral sphincter which contracts during ejaculation

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22
Q

Describe the apex of the bladder?

A

It lies anteriorly behind the upper margin of symphysis pubis, it is attached to the umbilicus by the median umbilical ligament

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23
Q

Describe the blood supply to the ureter

A

proximal part - vaginal arteries distal part - internal pudendal

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24
Q

Describe the relations of the base of the prostate gland

A

neck of the bladder

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25
Q

What is a urethra?

A

a muscular tube that conveys urine from the bladder to the external urethral orifice

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26
Q

Describe the route of the male urethra?

A

It extends from the internal urethral orifice to the external urethral orifice which is located on the tip of the glans penis

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27
Q

Describe the walls of the bladder

A

Consists of the same four layers as the ureter: epithelium lamina propria muscularis adventitia

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28
Q

The bladder is covered in endopelvic fascia what is it made of

A

Loose areolar, fatty connective tissue between adjacent structures

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29
Q

Describe the superior surface of the bladder

A

It is covered with peritoneum, it bulges into the abdominal cavity when distended

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30
Q

Describe the venous drainage of the bladder

A

vesical venous plexus drains blood from the bladder into the internal iliac vein

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31
Q

Describe the Inferolateral surface

A

Lies adjacent to the pubic bone and retropubic fat pad

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32
Q

What is the arterial supply to the prostate gland?

A

From branches of the inferior vesicle artery

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33
Q

What are the paraurethral glands homologues off

A

prostate gland of the male

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34
Q

Describe the base/fundus of the bladder

A

faces posteriorly it is triangular in shape and slightly convex

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35
Q

What are the features of the intermembranous urethra?

A

narrowest and least distensible part surrounded by the external urethral sphincter penetrates perineal membrane

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36
Q

What is the lymphatic drainage from the prostate?

A

Drains into the internal iliac nodes

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37
Q

What gives the bladder’s internal surface mucosal folds?

A

the epithelium and underlying lamina propria are loosely connected to the muscular layer of the bladder

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38
Q

Describe the relations of the apex of the prostate gland

A

fascia on the superior aspect of the urethral sphincter and deep perineal muscles

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39
Q

Describe the relations of the inferolateral surface the prostate gland

A

Levator ani

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40
Q

Describe the prostatic sheath?

A

Visceral layer of pelvic fascia that is thin anteriorly and continuous anterolaterally with the puboprostatic ligaments and posteriorly blends with retrovesicle septum

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41
Q

Describe the neck of the bladder?

A

This structure is held in position by the puboprostatic (male) or pubovesical (female) ligaments

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42
Q

What are the features of the spongy urethra?

A

Longest and most mobile part Bulbourethral glands open into bulbous part urethral glands open into small urethral lacunae entering lumen surrounded by corpus spongiousum dilated section of the navicular fossa

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43
Q

What are the features of the prostatic urethra

A

Widest and most dilatable part Features urethral crest with seminal colliculus on posterior wall Flanked by prostatic sinus which prostatic ducts open ejaculatory ducts open

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44
Q

Where is the bladder of an infant or young child located within the bladder

A

Projects into the abdomen even when empty

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45
Q

What arteries supply the male and female bladder and where do they arise

A

superior vesical arteries and inferior vesicle in male superior vesicle and vaginal arteries in female All the arteries arise from the internal iliac artery

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46
Q

What is the largest accessory gland of the male reproductive system

A

Prostate gland

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47
Q

Where is the beginning and the end of the small intestines

A
  • pyloric sphincter to ileocaecal junction
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48
Q

What is the function of the small intestine

A
  • main site of digestion and absoption
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49
Q

What are the adaptations of the small intestine to increase its surface area?

A
  • Plicae circulares - circular folds in the mucosa that can be seen with the naked eye
  • microvilli - microscopic protrusions from luminal surface of the intestinal cells
  • villi - finger like progections of the mucosa
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50
Q

How long is the root of the mesentery?

A

15cm

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51
Q

What enters at the root of the mesentery

A
  • blood vessels
  • nerves
  • lymphatics

prevents tangling and trapping of neurovascular structure

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52
Q

What are the three different divisions of the SI

A
  • Dudodenum
  • Jejunum
  • Ileum
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53
Q

What sre the anterior relations of the duodenum

A
  • superior part
    • quadrate lobe
    • gall bladder
  • descending
    • fundus of the gall bladder
    • right lobe of the liver
    • T. colon
    • coils of jej
  • horizontal
    • coils of jej
    • root of mesentery
  • ascending
    • coils of jej
    • root of mesentery
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54
Q

Describe the arterial supply of the duodenum.

A
  • proximal to duodenal papillae supplied by
    • superior pancreaticoduodenal artery from gastroduodenal artery from coeliac trunk
  • distal to major duodenal papillae
    • inferior pancreaticoduodenal artery from SMA
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55
Q

What are the features of the superior part of the duodenum

A
  • short 5cm
  • anterolateral to L1 body
  • attached to the lesser omentum at superior border
  • attached to greater omemtum at inferior border
  • only part that is intraperitoneal
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56
Q

What are the features of the descending part of the duodenum

A
  • longer 7- 10cm
  • descends along right side of L1 - 3
  • Minor and major duodenal papillae open
  • most distal part of foregut
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57
Q

What are the features of the horizontal part of the duodenum

A
  • 6 - 8 cm
  • crosses at L3 vertebrae
58
Q

What are the features of theascending part of the duodenum

A
  • Short 5cm
  • Begins left of L3
  • Rises superiorly as far as L2 superior border
  • supported by the suspensory muscle of the duodenum the ligament of Treitz
59
Q

Which part/s of the duodenum is/are intraperitoneal

A
  • superior
60
Q

What part of the duodenum is supported by the ligament of Treitz

A
  • ascending
61
Q

What are the posterior relations of the duodenum?

A
  • superior
    • lesser sac
    • IVC
    • bile duct
    • portal vein
    • gastroduodenal artery
  • descending
    • hilus of the right kidney
  • horizontal
    • IVC
    • right ureter
    • aorta
  • ascending
    • left margin of aorta
62
Q

What is the landmark marking the end of the duodenum and beginning of jej?

A

Duodenojejunal junction

63
Q

What is absorbed in the terminal ileum?

A
  • B12
64
Q

Where is the jej located?

A
  • LUQ of infracolic compartment
65
Q

Where is the ileum located?

A
  • RLQ of infracolic compartement
66
Q

What are the features of the ileum?

A
  • short vasa recta
  • short looped araced
  • paler in colour
  • narrow diamete
  • more fat in mesentery
  • less vascular
  • thinner walled
  • peyer’s patches
67
Q

What are the features of jej?

A
  • fewer and larger arcades
  • thicker walled
  • long vasa recta
  • redder in colour
  • less fat in the mesentery
  • more vascular
  • wider in diameter
68
Q

Describe the the blood supply of the SI?

A
  • SMA enters the mesentery at the root and divides into 15 - 18 branches
  • Arteries unite to form loops (arcades)
  • The arcades give rise to straight vessels, vasa recta which project into the intestinal wall
69
Q

What is the arterial supply and venous drainage of the ascending colon?

A
  • Arterial from SMA
    • right colic
    • ileocolic
  • Venous drainage to SMV
    • Right colic
    • ileocolic
70
Q

What are the anterior relations of the ascending colon?

A
  • Greater omentum
  • coils of SI
  • anterior abdominal wall
71
Q

What are the posterior relations of the ascending colon?

A
  • Iliac crest
  • iliacus
  • lower pole of the left kidney
  • quadratus lumborum muscle
  • ilioinguinal and iliohypogastric nerves
72
Q

What are the anterior relations of the transverse colon?

A
  • Greater omentum
  • Anterior abdominal wall
73
Q

What are the posterior relations of the transverse colon?

A
  • Coils of jejunum
  • coils of ileum
  • head of pancreas 2nd part of duodenum
74
Q

Which part of the colon is intraperitoneal?

A

Transverse colon

  • transverse mesolon
75
Q

What quadrant is the descending colon located?

A
  • LUQ
  • LLQ
76
Q

What are the anterior relations of the descending colon?

A
  • Omentum
  • coils of SI
  • Anterior abdominal wall
77
Q

What are the posterior relations of the descending colon?

A
  • Iliac crest
  • iliacus muscle
  • lateral border of the left kidney
  • quadratus lumborum muscle
  • transverse abdominis
  • iliohypogastric ilioinguinal
  • lateral cutaneous nerve of the thigh
78
Q

At what verterbal level does the sigmoid colon and the rectum meet?

A
  • S3
79
Q

What are the changes to the muscle layer that occur at the rectosigmoid junction?

A
  • Marked by changes in the muscle layer
  • Teniae coli disappear and are replaced by a complete layer of longitudinal muscle
80
Q

What leveld does the rectum pierce the pelvic diaphragm and become continuous with the with the anal canal?

A
  • At the level of the tip of the coccyx
81
Q

Describe the sacral flexure?

A

Follows the curve of the sacrum and coccyx

82
Q

Describe the anorectal flexure?

  • What is its importance
A
  • The sharp postero-inferior angle where the rectum pierces the pelvic diaphragm it is important in maintaining feacal continence
83
Q

What are the anterior relations of the rectum?

A
  • base of bladder (males)
  • prostate
  • vagina
  • coils of intestine
  • seminal vesicles
84
Q

What are the posterior relations of the rectum?

A
  • Median sacral artery
  • sacrum
  • coccyx
85
Q

What type of epithelium is present in the upper half of the anal canal?

A

columnar epithelium

86
Q

Where are the anal columns found?

A

Upper half of the anal canal

87
Q

Which half of the anal canal is sensitve to stretch?

A

upper half

88
Q

Which half of the anal canal is sensitve to

  • pain
  • temperature
  • touch
  • pressure
A

Lower half

89
Q

Which half of the anal canal is a hindgut derivative?

A

Upper half

90
Q

Which half of the anal canal is a proctoedrm derivative

A

lower half

91
Q

What type of epithelium is found in the lower half of the anal canal?

A
  • Stratified squamous epithelium
92
Q

What is the arterial supply and venous drainage of the upper half of the anal canal

A
  • Arterial supply
    • Superior rectal - IMA
  • Venous
    • Superior rectal to IMV and splenic
93
Q

What is the innervation of the upper half of the anal canal?

A
  • ANS - nerve fibres from hypogastric plexus
94
Q

What is the lymphatic drainage of the upper half of the anal canal?

A
  • Inferior mesenteric - lumbar nodes
95
Q

What is the arterial supply and venous drainage of the lower half of the anal canal?

A
  • Arterial supply:
    • inferior rectal - pudendal
  • Venous drainage
    • inferior rectal - internal iliac - pudendal vein
96
Q

What is the innervation of the lower half of the anal canal

A
  • inferior rectal to pudendal nerve
97
Q

What is the lymphatic drainage of the lower half of the anal canal?

A

Superficial inguinal nodes

98
Q

Describe the the lumen of the appendix in:

  • adults
  • adolescence
  • middle aged

Which age group is most prone to appendicytis

A
  • Lumen is wide in children
  • narrow in adolescents
  • obliterated by middle age
  • Adolescents are most prone to appendicitis 6 - 13 cm in lenght
99
Q

Is the appendix an intra or retroperitoneal organ?

A
  • Intraperitoneal organ
  • mesoappendix
100
Q

How can you locate the appendix?

A
  • Following the teniae coli as they descend and converge at the tipid of the appendix
  • It is located at McBurney’s point 2/3 from umbilicus to ASIS
101
Q

Describe the neurovasculature of the appendix

  • Aterial
  • Venous
  • Lymphatic
  • Innervation
A
  • Aterial
    • apendicular artery - ileocolic - SMA
  • Venous drainage
    • appendicular vein - ileocolic - posterior ceacal
  • Lymphatics
    • Ileocoilic nodes - efferent drains to SM nodes
  • Innervation
    • afferent pain fibres accompany SNS fibres to enter at T10
102
Q

Describe the structure and function of the ileocaecal valve?

A
  • Consists of 2 horizontal folds of mucous membrane one above and one below the ileal orifice
  • prevents reflux of caecal contents into the ileum
103
Q

What are the anterior relations of the caecum?

A
  • Coils of SI
  • greater omemntum
  • anterior abdominal wall in right iliac region
104
Q

What are the posterior relations of the caecum?

A
  • Iliopsoas
  • Femoral nerve
  • lateral cutaneous nerve of the thigh
105
Q

What are the medial relations of the caecum?

A
  • Appendix
106
Q

What is the neurovascular supply of the caecum

  • Aterial
  • venous
A
  • Anterior and posterior caecal arteries - ileocolic artery - SMA
  • Anterior posterior caecal - ileocolic - SMV
107
Q

Describe the coverings of the kidneys

A
  • Capsule - fibrous - adheres the the surface of the kidney
  • Perirenal fat - present in the renal sinus, surrounds the kidney
  • Renal fascia - fibrous, covers the kdineys and suprarenal glands
  • Pararenal fat - covers the posterior aspect fo the kidneys, region of the retroperitoneal
108
Q

When do the kidneys move?

A
  • During respiration
    • descend up to 3cm on inspiration
  • Moving from a supine to an erect position
109
Q

What are the superior and inferior relations of the kidneys?

A
  • superior
    • diaphragm
  • Inferior
    • psoas major medially
    • quadratus lumborum muscle
110
Q

What are the antior relations of the:

  • right kidney
  • left kidney
A
  • right kidney
    • liver
    • duodenum
    • ascending colon
  • Left kidney
    • stomach
    • spleen
    • pancreas
    • jejunum
    • descending colon
111
Q

What are the posterior relations of both kidneys?

A
  • Subcostal nerve
  • Iliogastric
  • ilioinguinal
  • transversus abdominis
112
Q

What is the renal pelvis?

A
  • The funnel shaped expansion of the superior ureter
113
Q

What are the renal papilla?

A
  • Apex of the renal pyramid that project into the minor calyx
114
Q

Which renal artery passes posterior to IVC

A

Right renal artery

115
Q

Each renal artery divides into 5 segments, name all these segments.

A
  • Apical
  • Anterosuperior
  • Anteroinferior
  • Inferior
  • Posterior
116
Q

Describe the renal arterial supply from the aorta to the IVC

A
  • Aorta
  • Renal artery
  • Segmental artery
  • Lobar arteries
  • Interlobar arteries
  • arcuate
  • interlobular
  • afferent
  • efferent
  • peritubular cap/ vasa recta to interlobular veins
  • arcuate vein
  • interlobar vein
  • segmental
  • renal vein
  • IVC
117
Q

Describe the lymphatic drainage of the kidneys

A
  • Drains into the para-aortic lumbar nodes located around renal artery
  • These drain into lumbar trunks
  • Lumbar trunks join intestinal trunks to form cysterna chyli
  • cysterna chyli is an elongated sac sac anterior to the body of L1 - L2 continuous with thoracic duct
118
Q

Describe the innervation of the kidneys?

A
  • Preganglionic sympathetic fibres arise in the lateral grey matter (T10 - L1) of the spinal cord
  • They pass in the least spanchnic nerve to the aorticorenal ganglion
  • Post ganglionic SNS fibres supply the renal vasculature of the cortex and efferent arterioles of the juxtaglomerular nephrons and the vasa recta
  • Sympathetic stimulation leads to vasoconstriction of these vessels
  • Afferent information from the kidneys enter the spinal cord at T10 - L1 pain is transferred to the T10 - L1
119
Q

Where are the suprarenal glands located and what are they surrounded by?

A
  • Superomedial aspects of the kidneys and diaphragm
  • surrounded by connective tissue containing perinephric fat
  • Enclosed by renal fascia attached to the crura of the diaphragm
120
Q

What enters and exits at the hilum of the suprarenal glands?

A
  • Veins and lymphatics exit the hilum
  • Arteries and nerves enter the glands at multiple sites
121
Q

Describe the structure and function of the adrenal cortex

A
  • Derived from mesoderm
  • Secretes:
    • androgens
    • glucocorticoids
    • mineralocorticoids
  • Yellow in colour
  • These hormones cause the kidneys to retain sodium and water in response to stress increasing blood volume and blood pressure
  • Affects muscles, heart and lungs
122
Q

Describe the structure and function of the medulal

A
  • Derived from neural crest cells (NCC)
  • Considered an SNS ganglion
    • Chromaffin cells are post ganglionic
  • Secretes:
    • Catechoalamines
    • Norepinephrine
    • adrenaline
  • Activates fight or flight
  • Increase heart rate, blood presure, dilate bronchioles and change blood flow patterns
123
Q

Where do the suprarenal arteries arise?

A
  • Superior artery - inferior phrenic
  • Middle artery - abdominal aorta
  • Inferior artery - renal artery
124
Q

Describe the venous drainage of the suprarenal glands?

A
  • Right suprarenal vein drains into the IVC
  • Left suprarenal vein drains into the left renal
125
Q

What does the exocrine pancreas release

A
  • Pancreatic juice froma cinar cells it contains:
    • chymotripsinogen
    • lipase
    • elastase
    • amylase
    • trypsinogen
    • ribonuclease
126
Q

What does the endocrine pancrease release?

A
  • Consists of the ilsets of Lnagerhans secretes
    • Inulin
    • glucagon
    • somatostatin
    • vasoactive intestinal polypeptide
127
Q

At what anatomical plane does the pancreas lie?

A
  • Transpyloric plane
128
Q

What is the uncinate process?

A

part of the pancreatic head that extends behind SMA/SMV

129
Q

What forms posterior to the neck of the pancreas?

A
  • hepatic portal vein
130
Q

What is the location of the tail of the pancreas and what is it in contact with?

A

Passes between the a

131
Q

Right crus

A
  • arises from 3/4 lumbar vertebra
132
Q

left crus of diaphragm

A

Arises from 2/3 lumbar vertebra

133
Q

Median arcuate ligament

A

Joins right and left crus

134
Q

Medial arcuate ligament

A

thickekning of fascia that covers psoas majort extends from the body to the tip of L1

135
Q

Lateral arcuate ligament

A
  • thickening of the fascia that covers quadrutus lumborum extends from t12 to 12th rib
136
Q

What forms the aortic hiatus

A

Median arcuate ligament right and left crus

137
Q

What passes through the caval opening and at what level?

A
  • T8
  • IVC
  • right phrenic nerve
138
Q

What passes through oesophageal hiatus and at what level?

A
  • T12
  • Oesophagus
  • lymphatics
  • right and left vagi
139
Q

What passes through aortic hiatus

A
  • aorta
  • thoracic duct
  • azygous vein
140
Q
A