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PLE > Anatomy Part 3 > Flashcards

Anatomy Part 3 Flashcards

1
Q

Vertebral level of the kidney

A

T12 - L3

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2
Q

3 coverings of the kidney

A

perirenal fat
renal/Gerota’s fascia - also encloses adrenal glands, continuous laterally with fascia transversalis
pararenal fat - most external, forms part of retroperitoneal fat

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3
Q

structures that leave the renal hilum

A

Anterior to posterior: VAP
renal v.
renal a.
renal pelvis

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4
Q

Organs related to the kidney

A

Both R and L posterior: diaphragm, 12th rib (11th also on L kidney), costodiaphragmatic recess of the pleura

Anterior:

R - suprarenal gland, liver, 2nd part of duodenum, right colic flexure

L - suprarenal gland, spleen, pancreas, stomach, left colic flexure, jejunum

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5
Q

T or F?

Kidneys are retroperitoneal

A

True

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6
Q

R kidney hilum vertebral level

A

L1 and L2 (lower than L since the liver is there)

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7
Q

L kidney vertebral level:
superior pole
hilum
inferior pole

A

superior pole - 11th rib
hilum - L1
inferior pole - L3

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8
Q

How many renal pyramids per kidney?

A

12

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9
Q

Trace flow of pee

A

renal pyramids –> renal papilla –> 2 or 3 minor calyces –> 2 or 3 major calyces –> renal pelvis –> ureter

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10
Q

Blood supply of kidneys

A

renal a. from aorta at level L2

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11
Q

Venous drainage of kidneys

A

renal v. to IVC

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12
Q

Lymphatic drainage of kidneys

A

R and L lateral aortic lymph nodes (a.k.a. para-aortic or lumbar LN)

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13
Q

Nerve supply of kidneys

A

renal sympathetic plexus (afferent fibers enter spinal cord at T10, 11 and 12)

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14
Q

Preaortic lymph nodes comprised of

A

Celiac, superior and inferior mesenteric LN

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15
Q

Flow of blood into (and out of in reverse) kidney

A

aorta –> renal a. –> segmental a. –> interlobar a. (between pyramids in the medulla) –> arcuate a. –> interlobular a. (extend into cortex)

For drainage, reverse and replace a. to v.

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16
Q

In renal transplant, what are the vascular connections of the new kidney?

A

Renal vEIn –> renal v. anastomosed to external iliac
Renal artery –> anastomosed to internal iliac a.
Ureterocystostomy

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17
Q

Nutcracker syndrome

A

Compression of L renal vein between superior mesenteric a. and aorta

Compression may cause renal and adrenal hypertension on the left, and in males, a varicocele on the left

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18
Q

Which is longer, R or L renal a.?

A

R renal a. is longer, posterior to IV

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19
Q

Which is longer, R or L renal v.?

A

L renal v. is longer, between SMA and abdominal aorta

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20
Q

What part of the adrenal gland hypertrophies in response to elevated levels of ACTH?

A

zona fasciculata and reticularis

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21
Q

Normal weight of adrenal gland

A

4 grams

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22
Q

3 zones of adrenal cortex and what they produce

A

Out to in, GFR and ACA
Outer - Zona glomerulosa - Aldosterone (mineralocorticoids)
Middle - Zona fasciculata - Cortisol (glucocorticoids, thickest layer, 75% of cortex)
Inner - Zona reticularis - Androgens

Cortex is derived from mesoderm

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23
Q

What does the adrenal medulla produce?

A

Catecholamines: NE and Epi

From neural crest ectoderm

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24
Q

Right adrenal gland

A

triangular

anteromedially: IVC
anterolaterally: liver
posterior: diaphragm

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25
Q

Left adrenal gland

A

crescent

anterior: spleen, stomach, pancreas
posterior: diaphragm

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26
Q

Suprarenal a. supplied by

A

Superior from inferior phrenic
Middle from abdominal aorta
Inferior from renal

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27
Q

Venous drainage of adrenal gland

A

R adrenal v. drains into IVC

L adrenal v. drains into L renal vein

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28
Q

Lymphatic drainage of adrenal glands

A

Lateral aortic LNs

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29
Q

Innervation of adrenal glands

A

Celiac ganglion?

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30
Q

Adrenocortical insufficiency

A

Addison disease

Increased pigmentation - bronze skin tone
Muscular weakness
Weight loss
Hypotension

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31
Q

Cortical hyperplasia due to adenoma or carcinoma of cortex

A

Cushing syndrome

Moon-shaped face
Truncal obesity
Abnormal hairiness/hirsutism
Hypertension
Buffalo hump
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32
Q

Virilization in females, due to excessive androgen production during fetal period

A

Congenital adrenal hyperplasia

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33
Q

Ureters enter the bladder at the level of

A

Ischial spines

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34
Q

Structures near ureter

A

Lateral angle of bladder
In males, crossed by vas deferens
In females, turns forward medially beneath broad ligament, crossed by uterine a.

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35
Q

Structures related to R ureter

A

Ant: duodenum, ileum, R colic and ileocolic vessels, R gonadal vessels

Post: R psoas, bifurcation of R common iliac a.

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36
Q

Structures related to L ureter

A

Ant: Sigmoid colon, L colic vessels, L gonadal vessels

Post: L psoas, bifurcation of L common iliac a.

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37
Q

Ureteric constrictions - where renal stones may lodge

A
  1. Where renal pelvis joins ureter (origin)
  2. Where it crosses the pelvic brim and external iliac a. (pelvic brim)
  3. Where is pierces the bladder wall (VUJ)
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38
Q

Blood supply of ureters

A

Abdominal
Upper - renal a.
Middle - gonadal a., abdominal a. common iliac a.

Pelvic
Lower - superior vesical a. (from internal iliac a.)
Also, uterine a., middle rectal a., vaginal a., inferior vesical a.

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39
Q

Where is the ureter located? How long is it?

A

Retroperitoneal, 1/2 is abdominal, 1/2 is pelvic, 10 inches or 25 cm long

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40
Q

Lymphatic drainage of
Kidney
Ureter
Pelvic ureter and bladder

A

Kidney: R and L lumbar (aortic and caval) LN
Upper ureter: kidney lymphatics or to lumbar LNs
Middle ureter: common iliac LNs
Lower ureter: common, external, internal iliac LNs
Pelvic ureter and bladder: internal (and external) iliac LN

In summary, ureter LN drainage:
Lateral aortic nodes
Iliac nodes

41
Q

Nerve supply of ureter

A

Renal plexus
Testicular/ovarian plexus
Hypogastric plexus
Afferent fibers travel with sympathetic nerves and enter the SC in 1st and 2nd lumbar segments

42
Q

Referred pain: gall stone, colic, angina pectoris

Where does pain of ureter from a calculus get referred to?

A

T 11 though L2 dermatomes
Back above iliac crest
Through inguinal region
Into scrotum or labia majora

43
Q

Uterine a. is where in relation to uterus

A

Uterine a. passes above ureter to reach cervix (internal os)

Ureter is below and behind the a.

44
Q

Ureters are ___ to the ovarian/testicular a.

A

“Water under the bridge”
Posterior

Surgical error: Cutting ureter instead of ovarian a. when removing the uterus

45
Q

The ureter runs down the lateral wall of the pelvis ___ to the external iliac a.

A

Medially

46
Q

In males, near the termination of the ureter, it is crossed by what structure?

A

Vas deferens

47
Q

Ureter surgical risk at the 3 pelvic site, what are the procedures?

A

Oophorectomy

Vaginal hysterectomy

48
Q

Urinary bladder capacity

A

500 ml

49
Q

Muscle of bladder

A

detrusor

50
Q

Bladder trigone openings

A

2 ureters

1 urethra

51
Q

True ligaments of bladder

A
  1. pubo-vesical

2. recto-vesical

52
Q

False ligaments of bladder

A
  1. medial umbilical ligament

2. median umbilical ligament - obliterated urachus, urachal fistula

53
Q

Arterial supply of bladder

A

Superior vesical a.

Inferior vesical a. from internal iliac

54
Q

Venous drainage of bladder

A

Vesical plexus to internal iliac

55
Q

Nerves of bladder

A

Sympathetic - hypogastric plexus

Parasympathetic - pelvic splanchnic

56
Q

Urogenital sinus, parts and fates

A

Vesical - urinary bladder
Pelvic - urethra in bladder neck, prostatic and membranous part in males, entire part in females, lower part of vagina
Phallic - genital tubercle

57
Q

Origin of vagina

A

Upper - paramesonephric duct

Lower - Pelvic part of UG sinus

58
Q

Urethra lengths

A

Male: 20 cm
Prostatic = 3 cm
Membranous = 1.25 cm
Penile = 15.75 cm

Female: 3.8 cm

59
Q

Tubular sheath of fascia enclosing 3 erectile tissue in body of penis

A

Buck’s Fascia

60
Q

What is Denonvillier’s fascia?

A

The rectoprostatic fascia (Denonvilliers’ fascia) is a membranous partition at the lowest part of the rectovesical pouch. It separates the prostate and urinary bladder from the rectum. It consists of a single fibromuscular structure with several layers that are fused together and covering the seminal vesicles.

61
Q

Total number of bones in body

A

206

62
Q

Axial bones

A

skull
hyoid
vertebral column
bony thorax

63
Q

Appendicular bones

A

limbs/appendages
pectoral girdle (shoulder blades and clavicles)
pelvic girdle

64
Q

Metacarpals are what kind of bone?

A

Long bone

65
Q

Carpals, tarsals and calcaneus are what kind of bon?

A

Short bone (spongy, cuboidal)

66
Q

Examples of flat bones

A

sternum, ribs, skull

67
Q

The vertebrae and hip are what kinds of bones?

A

Irregular bones

68
Q

Articular cartilage is made up of

A

hyaline

69
Q

What is in the medullary cavity?

A

yellow marrow in adults

red marrow in infants

70
Q

What makes up diaphysis and epiphysis?

A

diaphysis - compact bone

epiphysis - spongy bone

71
Q

What structures are derived from the mesoderm?

A

Skeletal muscles
- paraxial mesoderm: axial muscle
- somatic/lateral mesoderm: limb muscle
Cardiac muscles - visceral/splanchnic mesoderm
Smooth muscles - visceral/splanchnic mesoderm

72
Q

Embryonic origin of humerus?

A

Somatic mesoderm

73
Q

Synarthroses

  • connecting medium
  • examples, exact bones
  • mobility
A

Synarthroses

  • connecting medium: fibrous
  • examples, exact bones: suture, syndesmosis, gomphosis (mandible and teeth, maxilla and teeth)
  • mobility: immovable joints
74
Q

Amphiarthroses

  • connecting medium
  • examples, exact bones
  • mobility
A

Amphiarthroses
- connecting medium: cartilagenous
- examples, exact bones:
primary, synchondrosis, hyaline, rib and sternum
secondary, symphysis, fibrocartilage, symphysis pubis
- mobility: slightly movable

75
Q

Diarthroses

  • connecting medium
  • examples, exact bones
  • mobility
A

Diarthroses

  • connecting medium: synovial
  • examples, exact bones: ball and socket joints
  • mobility: freely movable
76
Q

Synovial joint types and examples:

Plane

A

sternoclavicular

acromioclavicular

77
Q

Synovial joint types and examples:

Hinge/ginglymus

A

elbow
knee
ankle

78
Q

Synovial joint types and examples:

Pivot/trochoid

A

atlantoaxial (C1, C2)

radioulnar

79
Q

Synovial joint types and examples:

Condyloid

A

metacarpophalangeal/knuckles

80
Q

Synovial joint types and examples:

Ellipsoidal

A

wrist

81
Q

Synovial joint types and examples:

Saddle

A

carpometacarpal of thumb

82
Q

Synovial joint types and examples:

Ball and socket/Enarthroses

A

shoulder

hip

83
Q

Boundaries of the axilla (no structures yet)

A 
Anterior (pectoral)
Posterior (scapular)
Medial (costal)
Lateral (humeral)
Apex
Base
84
Q

Contents of the axilla

A

Axillary v.
Axillary a.
Brachial plexus

All are covered by the axillary sheath/fascia (lateral extension of prevertebral fascia, extends up to elbow)

85
Q

Contents of anterior boundary of axilla

A

Pectoral boundary

Pectoralis major
Pectoralis minor
Subclavius

86
Q

Contents of the posterior boundary of the axilla

A

Scapular boundary

Subscapularis
Latissimus dorsi
Teres major

87
Q

Contents of the medial boundary of the axilla

A

Costal boundary

2nd to 6th ribs and intercostal muscles
Serratus anterior muscle
Thoracic wall

88
Q

Contents of the lateral boundary of the axilla

A

Humeral boundary

```
Humerus
Long head of biceps brachii
Short head of biceps brachii
Coracobrachialis
Intertubular sulcus
~~~

89
Q

Contents of the base and apex of the axilla

A

Apex
Ant - clavicle
Post - scapula
Medial - 1st rib

Base
Skin
Subcutaneous fascia
Axillary fascia

90
Q

Rotator cuff muscles and their location

A

Supraspinatus - above
Infraspinatus - posterior
Teres minor - posterior
Subscapularis - anterior

91
Q

Intrinsic muscles of the shoulder, nerve supply and action

A

SITS + Deltoid and Teres major
All are innervated by suprascapular n. except deltoid and teres minor, which are innervated by the axillary n.

S - initiates abduction
I - lateral rotation
Tmin - lateral rotation
S - medial rotation
D - main abductor
TMaj - medial rotation
92
Q

Dislocations of the shoulder joint

A

Posterior - rare, violent force from anterior

Anterior inferior - force on humerus with joint fully abducted

93
Q

Rotator cuff inflammation: affected tendon and symptom

A

Tendon of supraspinatus

Pain anterior and posterior to shoulder during abduction

94
Q

Most commonly dislocated and separated joints of shoulder

A

Dislocation: Glenohumeral
Separation: Acromioclavicular (clavicle torn away from end of acromion)

95
Q

Boundary and content of quadrangular or quadrilateral space of dorsal scapula

A 
Boundaries:
Above - teres minor
Below - teres major
Medial - long head of triceps brachii
Lateral - surgical neck of humerus

Contents:
Axillary / Circumflex n. - injured in humeral fracture
Posterior circumflex humeral vessels

96
Q

Boundary and content of triangular space

A

Boundaries:
Above - teres minor
Below - teres major
Lateral - long head of triceps brachii

Contents:
Circumflex scapular vessels

97
Q

Arm anterior compartment

Action
Innervation
Muscles and their specific actions

A

FLEXORS
Musculocutaneous n.

Coracobrachialis - adducts/flexes arm
Brachialis - main flexor of forearm
Biceps brachii - flexes and main supinator of forearm

98
Q

Arm posterior compartment

Action
Innervation
Muscles and their specific actions

A

EXTENSORS
Radial n.

Triceps brachii - main extensor of forearm

PLE (14 decks)

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