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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
Left adrenal gland
crescent anterior: spleen, stomach, pancreas posterior: diaphragm
26
Suprarenal a. supplied by
Superior from inferior phrenic Middle from abdominal aorta Inferior from renal
27
Venous drainage of adrenal gland
R adrenal v. drains into IVC | L adrenal v. drains into L renal vein
28
Lymphatic drainage of adrenal glands
Lateral aortic LNs
29
Innervation of adrenal glands
Celiac ganglion?
30
Adrenocortical insufficiency
Addison disease Increased pigmentation - bronze skin tone Muscular weakness Weight loss Hypotension
31
Cortical hyperplasia due to adenoma or carcinoma of cortex
Cushing syndrome ``` Moon-shaped face Truncal obesity Abnormal hairiness/hirsutism Hypertension Buffalo hump ```
32
Virilization in females, due to excessive androgen production during fetal period
Congenital adrenal hyperplasia
33
Ureters enter the bladder at the level of
Ischial spines
34
Structures near ureter
Lateral angle of bladder In males, crossed by vas deferens In females, turns forward medially beneath broad ligament, crossed by uterine a.
35
Structures related to R ureter
Ant: duodenum, ileum, R colic and ileocolic vessels, R gonadal vessels Post: R psoas, bifurcation of R common iliac a.
36
Structures related to L ureter
Ant: Sigmoid colon, L colic vessels, L gonadal vessels Post: L psoas, bifurcation of L common iliac a.
37
Ureteric constrictions - where renal stones may lodge
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)
38
Blood supply of ureters
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.
39
Where is the ureter located? How long is it?
Retroperitoneal, 1/2 is abdominal, 1/2 is pelvic, 10 inches or 25 cm long
40
Lymphatic drainage of Kidney Ureter Pelvic ureter and bladder
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
Nerve supply of ureter
Renal plexus Testicular/ovarian plexus Hypogastric plexus Afferent fibers travel with sympathetic nerves and enter the SC in 1st and 2nd lumbar segments
42
Referred pain: gall stone, colic, angina pectoris | Where does pain of ureter from a calculus get referred to?
T 11 though L2 dermatomes Back above iliac crest Through inguinal region Into scrotum or labia majora
43
Uterine a. is where in relation to uterus
Uterine a. passes above ureter to reach cervix (internal os) | Ureter is below and behind the a.
44
Ureters are ___ to the ovarian/testicular a.
"Water under the bridge" Posterior Surgical error: Cutting ureter instead of ovarian a. when removing the uterus
45
The ureter runs down the lateral wall of the pelvis ___ to the external iliac a.
Medially
46
In males, near the termination of the ureter, it is crossed by what structure?
Vas deferens
47
Ureter surgical risk at the 3 pelvic site, what are the procedures?
Oophorectomy | Vaginal hysterectomy
48
Urinary bladder capacity
500 ml
49
Muscle of bladder
detrusor
50
Bladder trigone openings
2 ureters | 1 urethra
51
True ligaments of bladder
1. pubo-vesical | 2. recto-vesical
52
False ligaments of bladder
1. medial umbilical ligament | 2. median umbilical ligament - obliterated urachus, urachal fistula
53
Arterial supply of bladder
Superior vesical a. | Inferior vesical a. from internal iliac
54
Venous drainage of bladder
Vesical plexus to internal iliac
55
Nerves of bladder
Sympathetic - hypogastric plexus | Parasympathetic - pelvic splanchnic
56
Urogenital sinus, parts and fates
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
Origin of vagina
Upper - paramesonephric duct | Lower - Pelvic part of UG sinus
58
Urethra lengths
Male: 20 cm Prostatic = 3 cm Membranous = 1.25 cm Penile = 15.75 cm Female: 3.8 cm
59
Tubular sheath of fascia enclosing 3 erectile tissue in body of penis
Buck's Fascia
60
What is Denonvillier's fascia?
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
Total number of bones in body
206
62
Axial bones
skull hyoid vertebral column bony thorax
63
Appendicular bones
limbs/appendages pectoral girdle (shoulder blades and clavicles) pelvic girdle
64
Metacarpals are what kind of bone?
Long bone
65
Carpals, tarsals and calcaneus are what kind of bon?
Short bone (spongy, cuboidal)
66
Examples of flat bones
sternum, ribs, skull
67
The vertebrae and hip are what kinds of bones?
Irregular bones
68
Articular cartilage is made up of
hyaline
69
What is in the medullary cavity?
yellow marrow in adults | red marrow in infants
70
What makes up diaphysis and epiphysis?
diaphysis - compact bone | epiphysis - spongy bone
71
What structures are derived from the mesoderm?
Skeletal muscles - paraxial mesoderm: axial muscle - somatic/lateral mesoderm: limb muscle Cardiac muscles - visceral/splanchnic mesoderm Smooth muscles - visceral/splanchnic mesoderm
72
Embryonic origin of humerus?
Somatic mesoderm
73
Synarthroses - connecting medium - examples, exact bones - mobility
Synarthroses - connecting medium: fibrous - examples, exact bones: suture, syndesmosis, gomphosis (mandible and teeth, maxilla and teeth) - mobility: immovable joints
74
Amphiarthroses - connecting medium - examples, exact bones - mobility
Amphiarthroses - connecting medium: cartilagenous - examples, exact bones: primary, synchondrosis, hyaline, rib and sternum secondary, symphysis, fibrocartilage, symphysis pubis - mobility: slightly movable
75
Diarthroses - connecting medium - examples, exact bones - mobility
Diarthroses - connecting medium: synovial - examples, exact bones: ball and socket joints - mobility: freely movable
76
Synovial joint types and examples: Plane
sternoclavicular | acromioclavicular
77
Synovial joint types and examples: Hinge/ginglymus
elbow knee ankle
78
Synovial joint types and examples: Pivot/trochoid
atlantoaxial (C1, C2) | radioulnar
79
Synovial joint types and examples: Condyloid
metacarpophalangeal/knuckles
80
Synovial joint types and examples: Ellipsoidal
wrist
81
Synovial joint types and examples: Saddle
carpometacarpal of thumb
82
Synovial joint types and examples: Ball and socket/Enarthroses
shoulder | hip
83
Boundaries of the axilla (no structures yet)
``` Anterior (pectoral) Posterior (scapular) Medial (costal) Lateral (humeral) Apex Base ```
84
Contents of the axilla
Axillary v. Axillary a. Brachial plexus All are covered by the axillary sheath/fascia (lateral extension of prevertebral fascia, extends up to elbow)
85
Contents of anterior boundary of axilla
Pectoral boundary Pectoralis major Pectoralis minor Subclavius
86
Contents of the posterior boundary of the axilla
Scapular boundary Subscapularis Latissimus dorsi Teres major
87
Contents of the medial boundary of the axilla
Costal boundary 2nd to 6th ribs and intercostal muscles Serratus anterior muscle Thoracic wall
88
Contents of the lateral boundary of the axilla
Humeral boundary | ``` Humerus Long head of biceps brachii Short head of biceps brachii Coracobrachialis Intertubular sulcus ```
89
Contents of the base and apex of the axilla
Apex Ant - clavicle Post - scapula Medial - 1st rib Base Skin Subcutaneous fascia Axillary fascia
90
Rotator cuff muscles and their location
Supraspinatus - above Infraspinatus - posterior Teres minor - posterior Subscapularis - anterior
91
Intrinsic muscles of the shoulder, nerve supply and action
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
Dislocations of the shoulder joint
Posterior - rare, violent force from anterior | Anterior inferior - force on humerus with joint fully abducted
93
Rotator cuff inflammation: affected tendon and symptom
Tendon of supraspinatus | Pain anterior and posterior to shoulder during abduction
94
Most commonly dislocated and separated joints of shoulder
Dislocation: Glenohumeral Separation: Acromioclavicular (clavicle torn away from end of acromion)
95
Boundary and content of quadrangular or quadrilateral space of dorsal scapula
``` 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
Boundary and content of triangular space
Boundaries: Above - teres minor Below - teres major Lateral - long head of triceps brachii Contents: Circumflex scapular vessels
97
Arm anterior compartment Action Innervation Muscles and their specific actions
FLEXORS Musculocutaneous n. Coracobrachialis - adducts/flexes arm Brachialis - main flexor of forearm Biceps brachii - flexes and main supinator of forearm
98
Arm posterior compartment Action Innervation Muscles and their specific actions
EXTENSORS Radial n. Triceps brachii - main extensor of forearm

PLE (14 decks)

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