ANATOMY Flashcards
1
Q
Layers of the abdominal wall
A
Skin
Campers fascia (fatty)
Scarpas fascia (membranous)
Muscles
2
Q
Blood supply to skin, subcu and mons pubis
A
Superficial epigastric artery
3
Q
Bllod supply to abdominal muscle and fascia
A
Deep/inferior epigastric artery
4
Q
Male homologues
Labia minora
A
Penile urethra and skin of prnis
5
Q
Male homologues
Labia majora
A
Scrotum
6
Q
Male homologues
Clitoris
A
Penis
7
Q
Male homologues
Skenes glands
A
Prostate gland
8
Q
Male homologues
Bartholins glands
A
Cowpers glands
9
Q
Border of vulva
Superior
A
Mons pubis
10
Q
Borders of the vulva
Lateral
A
Labiocrural fold
11
Q
Border of the vulva
Inferior
A
Perineal body
12
Q
Six openings of the vestibule
A
Urethra
Vagina
2 bartholin gland ducts (5 and 7 oclock)
2 skene gland ducts (paraurethral)
13
Q
Perineum
Urogential triangle boundaries
A
Pubic symphysis (tip) Ischiopubic rami (lateral) Ischial tuberosities
14
Q
Anal (posterior) triangle
Boundaries
A
Ischial tuberosities
Sacrotuberous ligaments (lateral)
Coccyx (tip)
15
Q
Anterior (pubic) triangle Superficial space (7)
A
Bartholins glands Vestibular bulbs (veins) Clitoral body and crura Pudendal vessels and nerves Ischiocavernosus muscle Bulbocavernosus muscle Superficial transverse perineal muscle
16
Q
Anterior (pubic) triangle Deep space (2)
A
Compressor urethrae muscles
Urethrovaginal sphincter muscles
17
Q
Posterior triangle contains
A
Ischioanal fossae (fat-filled)
Anal canal
Anal sphincter complex
Puborectalis muscle
18
Q
Internal anal sphincter
Innervation
A
Pelvic splanchnic nerve
19
Q
Internal anal sphincter blood supply
A
Superior, middle, inferior rectal arteries
20
Q
External anal sphincter
Innervation
A
Inferior branch of pudendal nerve
21
Q
External anal sphincter
Blood supply
A
Inferior rectal artery
22
Q
Striated urogenital sphincter complex
A
Sphincter urethrae
Compressor urethrae
Urethrovaginal urethrae
23
Q
Bridge over water
A
Ureter lies underneath the uterine artery
24
Q
Ovaries in relation to internal iliac vessels
A
Ovaries are medial
25
Uterus boood supply
Ovarian artery
| Uterine artery
26
Blood supply to vaginal
| Proximal portion
Vaginal artery
| Uterine artery
27
Vaginal blood supply
| Posterior vaginal wall
Middle rectal artery
28
Vaginal blood suoply
| Distal portion
Internal pudendal artery
29
Ligaments of uterus
Round ligament
Broad ligament
Cardinal or Transverse cervical or Mackenrodt ligament (thick base of broad ligament)
Uterosacral ligament
30
Main support of the uterus
Cardinal ligament
| Uterosacral ligament
31
Structures in broad ligament
| 2-fold peritoneum
```
Uterine tube (and mesosalpinx)
Ureter
Ovarian ligament (and mesovarium)
Round ligament
Uterine vessels, lymph nodes, nerves
Ovarian vessels, lymph nodes, nerves
Parametrium
```
32
Peritoneum
Mesosalpinx - around fallopian tube
Mesoteres - around round ligament
Mesovarium - over the uterovarian ligament
33
Tissues
| Connetive tissue lateral to the uterus within the broad ligament
Parametrium
34
Tissue lateral tot eh cervix
Paracervical tissues
35
Tissue lateral to the vagina
Paracolpium
36
Arteries entering the true pelvis
```
MISO
Median sacral
Internal iliac
Superior rectal
Ovarian
```
37
Blood volume in pregnancy
40-45% above the nonpregnant by 32 to 34 wks aog
38
Pregancy is a state of hypervolemia secondary to
Blood volume expansion (both plasma ans RBC)
39
Abnormal hemoglobin levels
| 1sr tri
Less than 10
40
Abnormal hemoglobin
| 2nd tri
Less than 10.5
41
Abnormal hemoglobin
| 3rd tri
Less than 11
42
Average hemoglobin at term
12.5 g/dl
43
The arterial supply of the placenta which vasodilates but completely loses contractility
Spiral arteries
44
Potent vasodilator with central role in reduced vascular resistance
Nitric oxide
45
Hormones and growth factors that augment NO syntase and NO production
```
Estrogen
Progesterone
Activin
Placental growth factor
Vascular endothelial growth factor
```
46
Cervical mucus shows poor crystallization
Beading
47
Hormone responsible for poor crystallization in pregnancy
Progesterone
48
Presumptive signs of pregnancy
```
Cessation of menses
Beading cervical mucus
Chadwicks sign
Changes in breast
Skin changes
— chloasma
— melasma
— linea nigra
— striae gravidarum
— spider telangiectasia
Increased temperature
```
49
seen on glass slide, result of amniotic fluid leakage, arborization of ice crystals
Ferning
50
Endocervical gland hyperplasia and hypersecretory appearance which is difficult to differentiate from atypical glandular cells
Arias Stella reaction
51
Greater vascularity and hyperemia in the skin and muscles of perineum, vulva, vagina, and cervix resulting in violet color
Chadwick sign
52
Presumptive symptoms of pregnancy
Morning sickness
Fatigue
Frequency in urination
Quickening
53
slightly elevated clear or red patches that bleed easily seen on and just beneath the ovarian surface. Arise from subcoelemic mesenchyme or endometriotic lesions
Decidual reaction
54
Protein hormone secreted by corpus luteum, decidua, placera, brain, heart and kidney. Aids in remodeling the reproductive tract connective tissue to accomodate labor
Relaxin
55
Exaggerated physiological follicle stimulation. Usually bilateral, moderately to massively enlarged cystic ovaries due to markedly elavated serum hCG
Theca Lutein Cysts
56
Hormone involved in decidual reaction
progesterone
57
Hormone involved in theca lutein cyst
Serum hCG — markedly elevated
58
peak of hCG
8-10 weeks
59
Plateau of hCG
16 errks
60
Morning sickness usually occurs during which AOG.
6-18 weeks
61
Quickening in primigravid
18-20
62
Quickening in multigravid
16-20
63
amenorrhea is not reliable until how long after expected menses?
10 days or more
64
When does beading usually occur?
6 weeks
65
Shen does chadwick sign usually occur
6 weeks
66
Breast engorgement usually starts at?
6-8 weeks
67
Skichloasma and melasma in pregnancy due to what hormone?
MSH
68
Striae gravidarum is due to what?
Collagen breakdown
69
Spider telangiectssia is due to what hormone?
Increased estrogen
70
Mask of pregnancy
Chloasma/melasma
71
Darkening of linea alba
Linea nigra
72
Hormone responsible for increase in temperature in pregnancy
Progesteorone at 6 weeks
73
Probable evidence
```
Enlargment of abdomen
Hegars
Goodells
Braxton hicks
Physical outlining of the fetus
Ballotememt
Detection of B hCG
```
74
enlargement of abdomen starts at?
6 weeks
75
When does the uterus become an abdominal organ?
12 weeks
76
Softening of the uterine isthmus;
| Firm cervix now contrasts with softer fundus and isthmus
Hegars sign
77
Softening of the cervix
Goodells sign
78
When does goodells and hegars sign appear?
6-8 weeks
79
When do braxton hicks start?
28 weeks
80
when does BhCG get detected?
6 days after fettilization
| 8-9 days post implantation
81
Sensitivity of pregnancy test?
12.5 mIU/ml (very sensitive)
82
Rare causes of fale positive pregnancy test
```
Exogenous hCG injection
Renal failure with impaired hCG clearance
Physiologic pituitary hCG
hCG-producing tumors
— usually GI, ovarian, bladder or lung
```
83
Mormal pregnancy carbohydrate metabolism is characterized by?
Mild fasting hypoglycemia
Postprandial hyPERglycemia
HYPERinsulinemia
84
Factors responsible for insulin resistance
```
Progesterone
Placental growth factor
Cortisol
Lectin
TNF
```
85
Hormone secreted by adipose tissue
Important for implantation, cell proliferation, angiogenesis
Important for development of pancreas, kidney, heart, brain
Leptin
86
Low levels of leptin causes what?
Fetal greoth restriction
87
In pregnancy what happens to lipid, lipoproteins, apolipoproteins, TAG, Ce,
Increased
88
Increased or Decreased?
| Iron requirements
Increased
89
Increased or Decreased?
| Iodine requirements
Increased
90
Increased or Decreased?
| Sodium
Decreased
91
Increased or Decreased?
| potassium
Decreased
92
Increased or Decreased?
| Total serum calcium
Decreased
93
Increased or Decreased?
| Serum magnesium
Decreased
94
Increased or Decreased?
| Blood volume
Increased
95
Increased or Decreased?
| Hgb
Increased
96
Increased or Decreased?
| Hct
Increased
97
Increased or Decreased?
| Whole blood viscosity
Decreased
98
Increased or Decreased?
| Immunity
Decreased
99
Increased or Decreased?
Th1 response
Th1 secretion of IL2, IF-g, TNG-B
Decreased
100
Increased or Decreased?
| Th2 secretion of IL4, IL6, IL13
Increased
101
Increased or Decreased?
| IgA and IgG in cervical mucus
Increased
102
Increased or Decreased?
| Chemotaxis and adherence
Decreased
103
Increased or Decreased?
| WBC count
Increased
104
Increased or Decreased?
| ESR
Increased
| *pregnancy is a post inflammatory state
105
Increased or Decreased?
| CRP
increased
106
Increased or Decreased?
| Procalcitonin
Increased in 3rd Tri
107
Is Pregnancy a hypercoagulable state?
Yes
108
Increased or Decreased?
| Fibrinogen
Increased
109
Increased or Decreased?
| Factor VII
Increased
110
Increased or Decreased?
| Factor X
Increased
111
Increased or Decreased?
| Plasminogen
Increased
112
```
Increased or Decreased?
APTT
tPA
Anticoagulants
— protein C
— Protein S
— Antithrombin III
```
Decreased
113
Increased or Decreased?
| Platelet count
Decreased
114
Increased or Decreased?
| Cardiac output
Increases at 5th week
115
Increased or Decreased?
| SVR
decreased
116
Increased or Decreased?
| Plasma volume
Increases at 10-20 weeks
117
Increased or Decreased?
| Preload
In
118
Increased or Decreased?
| Arterial pressure
Dec
| Nadir at 24-26 weeks
119
Increased or Decreased?
| Diastolic pressure
Dec
120
Increased or Decreased?
| Renin and angiotensin
Increased
121
ECG changes due to elevated diaphragm in 3rd tri?
Leftward deviation of the mean QRS axis
122
Secreted in response to chamber wall stretching
ANP and BNP
123
principal prostaglandin of the endothelium
Prostacyclin
| PGI2
124
increases in late pregnancy and regulates blood pressure and platelet function, maintains vasodilation
PGI2
125
Regulates blood volume by natriuresis and diuresis and vascular smooth muscle relaxation
ANP and BNP
126
Preeclampsia molecular changes
```
increase
— BNP
— endothelin 1
Decreased
— prostacyclin PGI2
Abnormal synthesis of NO
```
127
Produced in endothelial and vascular smooth muscle
Endothelin 1
128
Production of endothelin 1 is stimulated by which hormones?
Angiotensin II
arginine vasopressin
Thrombin
129
Potent vasodilator
Nitric oxide
130
Released by endothelial cells
| Mediator of placental vascular tone and development
Nitric oxide
131
Stimulates secretion of ANP, aldosterone and cathecholamines
Endothelin 1
132
Increase/Decrease
| Peak inspiratory flow rates in pregnancy
Increase progressively
133
Increase/Decrease
| Airway conductance
Inc due to progesterone
134
Increase/Decrease
| Total pulmonary resistance
Dec due to progesterone
135
Increase/Decrease
| Lung compliance
Unchanged
136
Increase/Decrease
| Thoracic circumference
Increase
137
Increase/Decrease
| Thoracic cage
Increase
138
Increase/Decrease
| Serum creatinine
Dec
139
Increase/Decrease
| Crea clearance
Inc by 30%
140
Urinalysis in pregnancy
May have glucosuria
No proteinuria
May have hematuria
141
Increased risk of urinary tract infection in pregnancy is due to?
```
Ureter displacement (lateral) and compression (at pelvic brim)
And dilatation (right ureter) and elongation
```
142
Urinary incontinence during pregnancy is due to?
Hyperplasia of the bladder muscle which elevates trigone
| Reduced bladder capacity due to uterine compression
143
When to investigate for DM?
| UA results of
Glucosuria
Inc GFR
Dec tubular resorption
144
When is Proteinuria in pregnancy significant?
>300 mg/dl
145
Increase/Decrease
| GFR in pregnancy
Inc by 50%
146
How does GFR increase in pregnancy? What hormone is involved?
RELAXIN boosts NITRIC OXIDE production leading to renal vasodilation and lower renal arteriolar resistance
147
Increase/Decrease
| Alkaline Phosphatase
Inc
148
Increase/Decrease
AST
ALT
Dec
149
Increase/Decrease
| GGT
Dec
150
Increase/Decrease
Bilirubin
Albumin
Dec
151
Increase/Decrease
| Globulin
Inc
152
Increase/Decrease
| Leucine aminopeptidase
Inc
153
Gallbladder contractility
Decrease
Due to progesterone
Prone to gallstones
154
Increase/Decrease
| Pituitary size
Increase
155
Increase/Decrease
| Maternal growth hormone
Inc
156
Increase/Decrease
| Placental growth hormone
Increases
157
Increase/Decrease
| Prolactin
Increases
158
This organ Increases due to estrogen-stimulated hyperplasia of lactotrophs
Pituitary gland
159
Increase in the pituitary size may lead to?
Compression of optic chiasm and reduction of visual fields
160
During 10-20 weeks, absence of growth hormone causes regression or cessation of fetal growth. True or false?
False. Fetal growth continues even in the complete absence of maternal growth hormone
161
Secreted by syncytiotrophoblasts which upregulates insulin-like growth factor for fetal growth
Placental growth hormone
162
Increased placental growth hormone levels is associated with what disease condition?
Preeclampsia
163
Increases during normal pregnancy and drops after delivery. Initiates DNA synthesis and mitosis of glandular epithelial cells and presecretory alveolar cells of the breast
Prolactin
164
Increase/Decrease
| Thyrotropin
Increase
165
When does fetal thyroid begin to concentrate iodine?
10-12 weeks
166
When does fetal thyroid synthesize thyroid hormone?
20 weeks
167
Increase/Decrease
| Cortisol
Increase
168
Increase/Decrease
| Aldosterone
Increase
169
How does the principal glucocorticoid, cortisol, increase in pregnancy?
Decreased metabolic clearance
| There is no increase in adrenal secretion
170
Why is there elevated free cortisol in pregnancy
Balance elevated progesterone
Prepare for stress
Modulates trophoblastic growth and placental size
171
What is the principal mineralocorticoid of pregnancy
Aldosterone
172
Why is aldosterone increased in pregnancy?
Protect against natriuretic effects of ANP and progesterone
Modulates trophoblastic growth and placental size
