Anatomy III Exam Flashcards

1
Q

Where is TSH secreted from?

A

Anterior Pituitary

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2
Q

What hormones are released by posterior pituitary?

A

Oxytocin

ADH

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3
Q

What hormone is released by paraventricular nucleus?

A

Oxytocin

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4
Q

What hormone is released by supraoptic nucleus?

A

Antidiuretic Hormone

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5
Q

What are tropic hormones and gives some examples

A

target other endocrine glands

PRL, GH

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6
Q

What causes increase in IGF-1 from liver?

A

protein
exercise
fasting
sleep

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7
Q

What causes decrease in IGF-1 from liver?

A

insulin
stress (cortisol)
estrogen

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8
Q

Age of peak secretion from pineal gland?

A

1-5 year olds

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9
Q

What does calcitonin do and where is it secreted from?

A

thyroid

decrease Ca++

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10
Q

What does calcitriol do?

A

increase Ca++ by:
Inc GI absorption
Dec renal excretion
Inc bone resorption

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11
Q

What is bone resorption

A

osteoclast break down bone to release Ca++ (Inc Blood Ca++)

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12
Q

What are the three main layers of adrenal gland? (in to out)

A

Adrenal medulla
Adrenal cortex
connective tissue capsule

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13
Q

What are the layers of adrenal cortex (in to out)?

A

Zona reticularis
Zona fasciculata
Zona glomrulosa

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14
Q

What does the zona reticularis secrete?

A
DHEA
progesterone
estrogen
testosterone
androstenedione
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15
Q

What does the zona fasciculata secrete?

A

cortisol

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16
Q

What does the zona glomerulosa secrete?

A

aldosterone

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17
Q

What does the adrenal medulla secrete?

A

EPI

NE

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18
Q

What is the action of adrenal medulla?

A

fight or flight

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19
Q

What is the action of zona fasciculata?

A
regulate blood sugar
anti-inflammatory
immune response modification
heart and blood vessel toning
stimulate CNS
stress rxn normalization
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20
Q

What is the action of zona reticularis?

A
antioxidant
tissue repair
sex hormones
balance cortisol
anti-aging
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21
Q

What is the action of zona glomerulosa?

A

aldosterone: inc Na+, dec K+, conserve water –> increase BP

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22
Q

What cell of pancreas secretes insulin?

A

Beta cell

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23
Q

where is pancreas located?

A

retroperiotoneal and

inferior and dorsal to stomach

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24
Q

what are Islets of Langerhans

A

pancreatic islets

contain alpha and beta cells

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25
Q

what is sphincter of Oddi?

A

where pancreatic duct opens

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26
Q

what does delta cells of pancreas secrete?

A

somatostatin –> inhibit insulin

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27
Q

What do Sertoli cells do and where are they?

A

testis

progress germ cells to spermatozoa

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28
Q

What do Leydig cells do and where are they?

A

testis

produce testosterone

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29
Q

What are granulosa cells?

A

ovarian cells that surround eggs to form follicles

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30
Q

What do granulosa cells secrete?

A

estrogen

progesterone

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31
Q

What does somatostastin do and where is it secreted from?

A

increase glucose

pancreatic delta cells

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32
Q

What do F cells do?

A

inhibit somatostatin

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33
Q

What does aldosterone do?

A

Na/K pump: Na in, K out –> water conservation –> increase BP

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34
Q

What is the alimentary canal?

A

mouth to anus GI tract

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35
Q

What do accessory digestive organs do?

A

secretions that contribute to food breakdown

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36
Q

What are the layers of alimentary canal?

A

Mucosa
Submucosa
Muscularis Externa
Serosa/Adventitia

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37
Q

What are the layers of the Mucosa layer and what do they each do?

A

lamina propria: nutrient absorption

muscularis mucosae: movement

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38
Q

Where is serosa and adventitia each present?

A

serosa: below diaphragm, intraperitoneal organs
adventitia: esophagus; retroperitoneal organs

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39
Q

What does the submucosa layer do?

A

vascular, lymphatics, and nerve supplies

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40
Q

What does the muscularis externa do?

A

peristalsis

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41
Q

What does the serosa/adventitia do?

A

reduce friction and lubricate

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42
Q

Mesenteric Adenitis

A

inflammation of lymph nodes

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43
Q

Meissner’s plexus (Submucosal)

A

regulates glands (enzymes) and smooth muscle

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44
Q

Auberchach’s plexus (Myenteric)

A

controls motility (pushes food down)

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45
Q

What are the tongue muscles and what do they each do?

A

Intrinsic: speech; not attached to bone
Extrinsic: protrude and deviate tongue; attach to bone
Lingual frenulum: tongue to floor of mouth

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46
Q

What layer does stomach have that the rest of the alimentary canal doesnt?

A

innermost oblique layer in muscular externa

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47
Q

What does the parietal cell of stomach secrete?

A

HCl

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48
Q

What does the chief cell of stomach secrete?

A

pepsinogen

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49
Q

What cell secretes gastrin in stomach

A

G cell (neuroendocrine cell)

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50
Q

What does the intrinsic factor in stomach do?

A

required for B12 absorption in intestines

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51
Q

What does somatostatin in the stomach do?

A

inhibit acid secretion

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52
Q

What does gastrin do?

A

regulates stomach secretion and motility

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53
Q

What does histamine in the stomach do?

A

help produce acid

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54
Q

What are the phases of gastric secretion?

A

Cephalic
Gastric
Intestinal

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55
Q

What enzyme increases the pH of chyme and what is it secreted by?

A

Secretin
GIP
CCK
by duodenum

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56
Q

upper esophageal sphincter blood supply

A

inferior thyroid artery

vein drains from inferior thyroid vein to brachiocephalic v.

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57
Q

thoracic esophagus blood supply

A

thoracic aorta, bronchial arteries

veins drain from azygous vein to superior vena cava

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58
Q

lower esophagus blood supply

A

left gastric and left splenic arteries

veins drain from gastric veins to portal system

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59
Q

What is esophageal varices caused by?

A

portal hypertension, cirrhosis. liver disease

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60
Q

What arteries supply greater curve of stomach

A

L/R gastro-omental arteries

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61
Q

What arteries supply lesser curve of stomach

A

L/R gastric a.

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62
Q

What arteries supply fundus of stomach

A

short gastric a.

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63
Q

What is caput medusa?

A

portal hypertension with accumulation of peritoneal fluid

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64
Q

What does secretin stimulate?

A

secretion of sodium bicarbonate from pancreas and bile in liver

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65
Q

What supplies upper duodenum?

A

gastroduodenal artery

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66
Q

What supplies most of small intestines?

A

superior mesenteric artery

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67
Q

What layer of small intestines is villi and microvilli in?

A

mucosa

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68
Q

What is Crypts of Lieberkuhn?

A

immune cells and STEM cells in mucosa layer of small intestine

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69
Q

What is the strongest layer of small intestine?

A

submucosa

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70
Q

Where are Brunners Glands and what does it do

A
duodenum submucosa
increase pH (alkaline secretions and inhibit chief and parietal cells)
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71
Q

What are in the submucosal layer and what does each do?

A

brunners glands: increase pH
peyers patches: lymph nodules in ILEUM
lacteals: lymph capillary absorbs fats in villi

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72
Q

Where is Peyers patches?

A

Ileum submucosa

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73
Q

Does small intestines have serosa or adventitia?

A

serosa

74
Q

gastroileal reflex

A

food in stomach –> ileum segmentation (constriction) –> gastrin release –> ileocecal sphincter relax –> chyme to large intestine

75
Q

Peristalsis v. Segmentation

A

Peristalsis: moves
Segmentation: mix and churn

76
Q

Bile functions

A

digest/absorb fat

excrete bili

77
Q

What are epiploic appendages?

A

fatty sacs on colon

78
Q

What is a haustrum?

A

balloon pouches of colon

79
Q

teniae coli

A

3 longitudinal bands

contracts to produce bulges (haustra)

80
Q

What parts of large intestines have serosa layer?

A

transverse and sigmoid

81
Q

What supplies large intestines?

A

superior mesenteric artery: lower duodenum to 2/3 of transverse colon
inferior mesenteric artery: descending, sigmoid, rectum

82
Q

Which hemorrhoids do not hurt?

A

internal hemorrhoidal plexus

83
Q

What vitamins does large intestine produce?

A

Vitamin B and K

84
Q

When does defecation occur?

A

when external sphincter VOLUNTARILY relax

85
Q

What are the quadrants of liver where are they ?

A

Right: seen on all views
Left
Caudate: posterior to left, by IVC
Quadrate: inferior to left (between falciform lig and gallbladder)

86
Q

What is the round ligament?***

A

fibrous remains of fetal umbilical vein

87
Q

What gives 75% of hepatic blood supply?

A

portal vein

88
Q

What does portal vein collect from?***

A
distal esophagus
stomach
small/large intestines
pancreas
spleen
89
Q

What is bile canaliculi?

A

small tubes that collect bile secreted from hepatocytes; merge to form bile ductiles –> merge into common bile duct

90
Q

bilirubin

A

product of RBC breakdown (heme)

91
Q

“hilum of liver”

A

porta hepatis

92
Q

what is cystic duct and what does it join with?

A

duct of gallbladder
merge with common hepatic duct
–> common bile duct

93
Q

what is the Portal Triad and where is it?

A

Hepatic vein: nutrients
Hepatic artery: O2
Bile duct
@each of 6 corners of lobules

94
Q

Kupffer cells

A

hepatic stellate macrophages on sinusoid wall

95
Q

“Space of Disse”

A

where plasma filtered into lymph

between hepatic cells and epithelial cells

96
Q

Hepatic sinusoid

A

vascular channels;

between central vein and hepatic a/v

97
Q

most versatile and multifunctional cell in body

A

hepatocyte

98
Q

Hepatocyte functions***

A
thousands of enzymes
store glycogen
breakdown RBC
Synthesize plasma proteins
produce non-essential AA
gluconeogenesis
hormones
detox
bile
urea
99
Q

what is urea produced from?

A

ammonia and CO2

100
Q

Cirrhosis

A

when hepatocyte death > reproduction

101
Q

Kupffer cell functions***

A

destroy RBC
produce AB/plasma proteins/bile pigments
phagocytosis
activation –> early alcohol induced liver injury

102
Q

Liver functions

A
produce bile salts
eliminate bili
metabolise steroid hormones
drug detox
produce urea
breakdown carbs, fat, protein
recycle and store minerals and vitamins
remove bacteria
coagulation
103
Q

How is hemoglobin metabolized?

A

by spleen

globin: cut up and AA recycled
heme: iron and bili (iron stored in liver; bili in liver)

104
Q

Which is direct and indirect bilirubin?

A

conjugated bili = direct (measured)

unconjugated = indirect (calculated; bound to albumin)

105
Q

Which bili is water soluble and which is not?***

A
conjugated = water soluble
unconjugated = insoluble
106
Q

What level of total bili indicated diseased state?

A

4mg/dL or more

107
Q

Dark urine means…

A

elevation of direct bili (bc soluble)

108
Q

What happens to bilirubin in bowels?

A

bacteria metabolize conjugated bili to urobilinogen

109
Q

What happens to urobilinogen

A
  1. reabsorbed and secreted in urine (yellow)

2. or exit colon and convert to urobilin and stercobilin (brown feces)

110
Q

How is bilirubin conjugated?

A

glucuronyl transferase in hepatocyte combine bili and glucuronic acid

111
Q

cause of jaundice

A

excessive RBC destruction
impaired bili uptake
decrease bili conjugation
bile flow obstruction

112
Q

cause of prehepatic jaundice

A

excessive hemolysis

113
Q

cause of intrahepatic jaundice

A

impaired conjugation or removal of bili in bile

114
Q

cause of posthepatic jaundice

A

obstruction of bile between liver and intestine

115
Q

absorptive state of liver***

A

break down carbs and proteins –> liver regulate levels (storage as glycogen/triglycerides or usage or synthesize protein) –> enter portal vein –> IVC

116
Q

postabsorptive state of liver***

A
  1. plasma glu level <80 –> break glycogen to glu

2. after 4+hrs of this and if get to <70, gluconeogenesis (glu from alt sources like adipose, AAs)

117
Q

what happens in transamination?

A

amine switched from AA to keto acid –> AA forms glutamic acid

118
Q

what happens in oxidative deamination?

A

amine of glutamic acid (ammonia) combines with CO2 –> urea

119
Q

keto acid modification

A

keto acids from transamination altered to enter Krebs cycle –> ATP

120
Q

what happens to pts with excessive ammonia?

A

confused; hepatic encephalopathy

121
Q

What is urea?

A

CO2 + Ammonia; way for body to remove ammonia

122
Q

HIGH AST

A

alcohol hepatocyte damage

123
Q

HIGH ALT

A

viral hepatocyte damage

124
Q

HIGH ALK PHOS

A

biliary canaliculi/duct obstruction (or bone issues)

125
Q

HIGH GGT

A

Alcohol abuse

or obstruction

126
Q

Bile duct obstruction signs

A

elevated ALK PHOS and GGT

127
Q

Early liver failure

A

hepatosplenomegaly

128
Q

late liver failure

A

small liver

129
Q

Portal hypertension manifestations

A

ascites
hemorrhoids
esophageal > gastric varicose –> GI bleed
spider angiomata

130
Q

hepatocyte destruction manifestations

A
hypocoagulation
jaundice
hepatic encephalopathy (coma and death!)
feminization (testicular failure)
ascites/edema
131
Q

Albumin

A

produced in liver and keeps fluid in blood and prevent leakage
low levels: kidney/liver problem

132
Q

hepatorenal syndrome

A

cirrhosis can lead to poor renal blood supply –> renal failure –> death

133
Q

3 systems of alcohol metabolism

A

Alcohol dehydrogenase (ADH) system –> liver cytoplasm
Microsomal ethanol-oxidizing system (MEOS) –> ER
Catalase –> peroxisomes

134
Q

what is the function of transitional epithelium of mucosal layer of bladder?

A

expands!

135
Q

trigone

A

opening of ureters and urethra; triangular

136
Q

afferent arteriole and efferent arteriole

A

afferent: blood enter glomerulus
efferent: exit glomerulus

137
Q

podocyte

A

wrap around capillaries in bowman’s capsule with basement membrane

138
Q

proximal convoluted tubule

A

REabsorption: ions, AA, glu, H2O (65%) back in blood

ACTIVE

139
Q

SGLT2 inhibitor

A

account for 90% of glu reabsorption

140
Q

What does the Loop of Henle do (Asc/Desc)?

A

Descending: passively absorb water (drive by osmolarity from asc)
Ascending: actively pump out salts (Na, K, Cl)

141
Q

What does the distal convoluted tubule do?

A

absorb ions, monitor pH

low pressure –> macula densa cells stimulate JG cells of afferent arteriole to release renin –> increase BP

142
Q

Collecting ducts

A

Multiple distal convoluted tubules dump into duct
absorb water
breakdown Urea!

143
Q

Where does urea go from collecting ducts?

A

major part of urine released; some urea held to increase osmolarity of medulla and drive water resorption in Loop of Henle

144
Q

Where does collecting duct connect to?

A

collecting duct –> renal calyx –> pelvis –> ureter –> bladder –> urethra

145
Q

Diuretics and what are they used for?

A

increase rate of volume output

Usage: edema, HTN, intoxication

146
Q

Osmotic diuretic

A

Mannitol

not easily reabsorbed and increases osmolarity in urine –> water retention/in

147
Q

Loop diuretic

A

Lasix
blocks Na/Cl co transporters in Ascending Limb of Loop–> decrease active absorption –> increase water retention in urine
lose K tho

148
Q

Thiazide diuretics

A

hydrochlorothiazide (HCTZ)

blocks Na/Cl co transporters in DISTAL tubule

149
Q

aldosterone antagonists

A

spironolactone (aldactone)

inhibit aldosterone in collecting tubule; decrease Na resorption and decrease K secretion

150
Q

sodium channel blockers

A

triamterene
also blocks Na out/K in pump; Na stays in Collecting tubule, drawing water in, K stays in medulla
doesnt affect aldosterone system

151
Q

What is a K sparing diuretic?

A

aldosterone antagonist, sodium channel blockers

K stays in medulla

152
Q

What is the leading cause of kidney failure

A

diabetes

153
Q

Second cause of kidney failure

A

HTN

154
Q

What are the three categories of acute renal failure?

A
  1. prerenal: decreased blood to kidney
  2. intrarenal: abnormality in kidney
  3. postrenal: obstruction
155
Q

what is chronic renal failure?

A

progressive and irreversible loss of nephrons (complications after 70-75% loss)
remaining nephrons enlarge

156
Q

fourchette and what is opposite of it anteriorly?

A

frenulum of labia minora (posterior)

prepuce of clitoris (anteriorly)

157
Q

What are Skene’s glands (paraurethral glands) and what is it analogous to in the male?

A

lesser vestibular glands

male prostate

158
Q

where are Bartholin’s glands?

A

right beneath fascia

greater vestibular glands/bulbourethral glands

159
Q

What length of pelvic outlet might prevent fetus passage?

A

< 9.5cm

160
Q

What is the most uncommon bony pelvis type and what can happen with it?

A

platypelloid

C section

161
Q

What are the types of bony pelvis?

A

anthropod: AP>transverse; not good
platypelloid: not good
android: wide transverse
gynecoid: most spacious (more common); best

162
Q

What do Kegel exercises do and what muscle does it target?

A

strengthen pelvic floor muscle (pubovaginalis)

help w/incontinence

163
Q

What are the pelvic floor muscles

A

levator ani: iliococcygeus, pubococcygeus, puborectalis

164
Q

Most likely muscle damage in child birth?

A

pubococcyeus

165
Q

What is the pouch of Douglas?

A

rectouterine pouch

166
Q

What cells are in the middle of cervix?

A

columnar epithelia

swabbed in pap smears

167
Q

What are the four parts of fallopian tube?

A

infundibulum
ampulla
isthmus
uterine part

168
Q

what is the introitus?

A

vaginal vestibule

169
Q

What structure has fimbriae?

A

infundibulum

170
Q

Where does fertilization occur in the fallopian tube?

A

ampulla

171
Q

Where is the most common site for ectopic pregnancy?

A

ampulla

172
Q

What layer does the ovary not have and why?

A

peritoneum

to expel oocyte

173
Q

which ligament of uterus looks like bat wings and what does it do?

A

broad ligament

encloses uterus, holds nerves and vessels

174
Q

What keeps the ovaries up and in place?

A

suspensory ligament of ovaries

175
Q

What layer is shedded during menses?

A

stratum functionalis of endometrium

176
Q

What artery constricts during menses?

A

spiral artery –> necrosis of stratum functionalis

177
Q

veinous drainage of lateral 2/3 of uterus

A

pampiniform plexus–>ovarian veins–>IVC(R)/renal vein(L)

178
Q

veinous drainage of medial 2/3 of uterus

A

uterine plexus–> internal iliac

179
Q

What are the lymph nodes of the pelvis?

A
superficial inguinal nodes: external genitalia, anus
sacral nodes: lower third vagina
internal
common iliac
external: 
lumbar nodes: upper uterus, ovaries
180
Q

External perineal innervation

A

ilioinguinal nerve and genitofemoral nerve
pudendal nerve
perineal branch of post femoral cutaneous
coccygeal and last sacral

181
Q

what is most common acute complicatin of lymph node dissection?

A

pelvic hemorrhage

182
Q

what lymph node should you sample when dealing with ovarian cancer?

A

aortic and subaortic nodes bc metastasis spreads in cephalad direction