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YR 3 MED > anatomy revision > Flashcards

anatomy revision Flashcards

1
Q

what are paracolic gutters??

A

spaces between the colon and the abdominal wall

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2
Q

pouches in women and men?? what is their clinical importance??

A

recto uterine - pouch of Douglas
vesico uterine

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3
Q

name 9 regions of the abdomen

A

r and l
epigastric, r and l flank, suprapubic, r and l iliac fossa

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4
Q

2 major arteries that supply blood to the brain??

A

coronary arteries
vertebral arteries

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5
Q

where do majority of the arteries of pelvis and perineum arise from??

A

internal iliac artery

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6
Q

where do the gonadal arteries arise from?

A

L2 - abdominal aorta
supplying the testicles and ovaries

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7
Q

where do superior rectal artery arise from??

A

inferior mesenteric artery

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8
Q

where does internal pudendal artery come from

A

internal iliac artery

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9
Q

where does anterior scrotal artery come from

A

external iliac artery, from the common iliac artery

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10
Q

clinical importance of anastomosis between uterine and ovary artery

A

ovarian artery coming from L2 (abdo aorta)
uterine artery coming from internal iliac artery
ovarian artery supplies part of uterus

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11
Q

clinical importance of anastomosis between uterine and vaginal artery

A
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12
Q

what structure Is v close to uterine artery and need to be careful when doing ligation??

A

ureter

need to be careful when doing hysterectomy

ureter wiggles when uterine artery does not

“water (ureter) under the bridge (uterine artery)”.

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13
Q

where do left and right side of gonadal vein drain to??

A

left -> renal vein
right -> IVC

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14
Q

where do the superior rectal vein mainly drain to??

A

internal iliac vein
some will drain into the hepatic portal system
or via lateral sacral veins into internal vertebral venous plexus

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15
Q

which plexus does obturator
nerve come from??

A

lumbar plexus
L2-L4

other ones from sacral plexus - eg. pudendal, sciatic nerve

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16
Q

S2,3,4??

A

PUDENDAL

pelvic splanchnic nerve - carries motor (also S2,3,4)

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17
Q

Nerve to levator ani

A

L4

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18
Q

lymphatics of pelvis - where do superior pelvic viscera go to??

There is a high amount of cross-over in the lymphatics of the pelvis - cancer can spread in any direction, pattern is not sufficiently predictable to anticipate spread

A

external iliac nodes -> common iliac, aortic

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19
Q

where do inferior or deep pelvic viscera go to first

A

deep perineum -> internal iliac nodes -> common iliac

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20
Q

where do superficial perineum go to first

A

superficial inguinal nodes

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21
Q

GONADS LYMPHATIC DRAINAGE

A

para-aortic
or lumbar

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22
Q

what makes up the ischium

A

ischial tuberosity - true hamstrings attach here, aka seat bone

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23
Q

pelvic inlet / brim structures

pelvic outlet structures

A

prominent part of sacrum
ilium
superior public ramus
pubic symphysis

pubic symphysis
ischiopubic ramus
ischial tuberosities
sacrotuberous ligaments
coccyx

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24
Q

why palpate pubic symphysis??

A

constant point to measure fundal height - and measure development of the foetus

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25
Q

pubic symphysis relaxes

A
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26
Q

are sacroiliac joints stable / unstable ??
what type of joint is it??

A

stable - synovial joint

27
Q

importance of the 2 ligaments of pelvis??
what 2 foramina do they form

A

sacrotuberous
sacrospinous

protects against sudden weight transfer eg. jumping

greater + lesser sciatic foramina (when ligaments are not in place they are called greater + lesser sciatic notch)

28
Q

clinical relevance - trauma

A

fractures tend to break in multiple places eg like a pretzel

29
Q

clinical relevance - childbirth

A
  • AP and transverse diameters of female pelvis are larger than male
  • subpubic angle and pubic arch is wider
  • pelvic cavity is more shallow in females
30
Q

moulding

A

the movement of 1 bone over another, to allow the foetal head to pass thru the pelvis during labour

31
Q

largest fontanelle??

A

soft spot
anterior

32
Q

Above levator ani muscle = pelvis
below = perineum

A

ABOVE - parasympathetic, visceral afferents

BELOW - somatic sensory, pudendal nerve

33
Q

suprapubic pain is from what levels
superior aspect of pelvic organs

A

T11-L2

34
Q

inferior aspect of pelvic organs

A

S2,3,4

35
Q

at what level is anaesthetic injected ??

A

L3-L4 region

36
Q

epidural anaesthetic pathway

A
37
Q

spinal anaesthetic pathway - what structures does it pass thru?

A

faster-acting anaesthetic compared to epidural

skin
supraspinous ligament
interspinous ligament
ligamentum flavum

38
Q

what happens if there is a blockade of sympathetic tone to all arterioles in lower limb??

A

vasodilation

may also cause hypotension

39
Q

what structure is used as a landmark for pudendal nerve block??

A

ischial spine

for things like forceps delivery, painful vaginal delivery, episiotomy incision (posterior fourchette, where the labia minora meet posteriorly, between vagina and perineum)

40
Q

1-4th degree tear

A

1st - skin only
2nd -
3rd - anal sphincter
4th - thru anal sphincter and bowel

41
Q

LSCS

what structures do you incise through??

A

Lower segment C-section, part of uterus where it is thinner,

incise thru
skin
fascia
anterior rectus sheath
rectus abdominis but NOT rectal muscles
fascia and peritoneum
retract bladder
uterine wall
amniotic sac

42
Q

laparotomy vs laparoscopy - what structures do u cut thru

A

midline incision - which is bloodless but increases risk of wound complications

skin and fascia
linea alba
perineum

laparoscopy - sub umbilical incision

43
Q

abdominal vs vaginal hysterectomy

A

removal of uterus either thru abdominal wall or vagina

44
Q

nerve supply to abdo wall

A

7th-11th nerves turn from intercostal nerves to thoracoabdominal nerves

T12 = subcostal and iliohypogastric

L1 = ilioinguinal

45
Q

blood supply to abdo wall

A

intercostal and subcostal arteries
superior epigastric artery
be careful of the inferior epigastric artery

46
Q

relationship between arcuate line and rectus sheath

A

above = anterior and posterior rectus sheath

below = anterior rectus sheath

47
Q

how to find the deep inguinal ring??

A

halfway between ASIS and pubic tubercle

48
Q

structures found in pelvic inlet vs outlet

A

inlet = ilium, pubic symphysis

outlet =

49
Q

Which nerves and vessels may be damaged as a result of pelvic trauma?

A

brachial nerve palsy - erb’s and klumpke’s

facial nerve damage

50
Q

Describe the preferred position of the fetal head as it descends through each region of the pelvis during labour, through to delivery. Understand and describe why these rotations have to occur.

A

transverse

OA

51
Q

3 muscles that make up the pelvic floor?

A

pelvic diaphragm
deep perineal pouch
perineal membrane

52
Q

deepest layer of the pelvic floor??
what 2 muscle groups does it contain??

A

pelvic diaphragm

levator ani and coccygeus

53
Q

3 muscle groups of levator ani

A

puborectalis
pubococcygeus
iliococcygeus

54
Q

endo-pelvic fascia

pelvic ligaments - extra support

A

utero-sacral
transverse cervical
tendinous arch of pevlic fascia
tendinous arch of levator ani

55
Q

what structures are inside the deep perineal pouch

to get rid of urine and fixate perineal body

A

dorsal vein of clitoris / penis
external urethral sphincter
compressor urethrae

-bulbourethral aka cowper’s gland in males
-deep transverse perineal muscle

56
Q

what is the perineal membrane

A

covers the urogential triangle

57
Q

superficial perineal pouch - contains erectile tissue

what makes up the clitoris and crura

A

corpus cavernosum

crura - like crucifix, long thing at each side
bulb

58
Q

another name for greater vestibular glands

A

bartholin’s gland

59
Q

in males, what makes up the bulb and crura

A

corpus spongiosum - bulb
corpus cavernous - crura

60
Q

functions of pelvic floor

A

support to pelvic organs
normally tonically contracted
actively contracts during sneezing, coughing

helps maintain continence
-urinary (external anal sphincter)
-faecal (puborectalis contraction, smaller angle)

61
Q

injury to the pelvic floor

A

*pregnancy
*childbirth
obestiy
chronic constipation

62
Q

1st-4th degree of prolapse

A

1st - cervix has dropped down into the superior part of the vagina
2nd - more than halfway down
3rd - cervix is protruding from the vaginal orifice
4th - completely outside vagina

63
Q
A

YR 3 MED (23 decks)

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