Basic Science And Anatomy Flashcards
What spinal level do pain signals from the uterus, adnexae, ilium, colon and rectum travel via?
T10 - L1
Normal range of prolactin
50-450
Normal range of LH
2-12
Normal range of FSH
2 - 12
Normal range of Oestradiol
130-800
Arterial supply of the vagina
Vaginal artery and anastomoses with the uterine artery superiorly
At what gestation do limb buds develop
8 weeks
Average head circumference of a new born in the UK in CM
35 CM
Average length of the newborn in the UK in cm
50 CM
Average weight of a newborn in the UK in KG
3.5 KG
Borders of the femoral triangle
Lateral border = Medial border of sartorius
Superior border = inguinal ligament
Medial border = adductor longus
Branches of the anterior division of the internal iliac artery
Umbilical Obturator Inferior vesical Middle rectal Internal pudendal Inferior gluteal Uterine Vaginal
Branches of the pudendal nerve
Inferior rectal nerves
Dorsal nerve of the penis / clitoris
Perineal nerve
Cause of uterine didelphys
Failure of fusion of the Müllerian duct.
Causes double uterine body, cervix and vagina
Clinical effect of injury to the femoral nerve
Quadriceps muscle weakness –> weak knee extension.
Anterior thigh numbness.
Decreased / absent knee jerk
Clinical effect of injury to the sciatic nerve
Affects all muscles below the knee.
Foot drop, loss of knee flexion.
Inability to walk.
Loss of ankle jerk Normal knee jerk
Contents of the inguinal canal
Spermatic cord or round ligament
and Ilioinguinal nerve
Dermatome supply of anterior upper arm
C5
Dermatome supply of level of the nipple
T4
Dermatome supply of level of umbilicus
T10
Dermatome supply of medial ante-cubital fossa
T1
Dermatome supply of the acromio-clavicular joint
C4
Dermatome supply of the axilla
T2
Dermatome supply of the little finger
C8
Dermatome supply of the mid anterior thigh
L2
Dermatome supply of the middle finger
C7
Dermatome supply of the perianal area
S5
Dermatome supply of the thumb
c6
Duration for spermatogenesis
70-75 days
Floor of the femoral triangle
Adductor longus
Part of adductor brevis
Pectineus
Iliopsoas
Functions of the phrenic nerve
motor to the diaphragm
Sensory to the fibrous pericardium, mediastinal pleura, and diaphragmatic peritoneum.
How many umbilical arteries and veins
2 arteries
1 vein
In early pregnancy what action should be taken if the uterus is retroverted?
None - normal variant
unless fixed retroverted and becomes incarcerated in the pelvis during 2ndT onwards
Management of a fixed retroverted uterus which becomes incarcerated in the pelvis in 2nd T
Manual reduction
+/- bladder drainage with catheter
Or manual reduction under spinal
Failing that - laparoscopy to re-position uterus
Length of the inguinal canal in adults
4cm
Length of vagina
6 - 7.5cm anteriorly
9cm posteriorly
Lymph drainage of base of cervix
Internal iliac lymph nodes
Lymphatic drainage of the bladder
External Iliac nodes
Fundus to internal iliac nodes
Some to common Iliac and sacral
Lymphatic drainage of the distal rectum
Internal iliac nodes
Nerve root control of knee-jerk
L3/4
Nerve root of the femoral nerve
L2-4
Nerve root of the sciatic nerve
L4-5, S1-3
Nerve supply of the vagina
Lower part = pudendal nerve, inferior hypogastic and uterovaginal plexuses
Nerve supply of the vulva
Pudendal nerve gives branches of inferior rectal branch, divides into perineal nerve and dorsal nerve of the clitoris.
Perineal nerve = sensory to the vulva. Dorsal nerve of clitoris = sensory.
Sensation from the mons passes via the ilioinguinal and genitofemoral nerves.
Ovarian arteries are branches from where
Direct branch off abdominal aorta
Relation of the phrenic nerve to the hilum of the lung
Passes anterior
Relation of the uterine artery to the broad ligament and ureter
Lies in the base of the boad ligament.
Crosses anterior to the ureter
Sensory supply of the perineum
Posterior femoral cutaneous nerve.
Shape of external cervical os
In primips = circular
Multips= slit
Signs and symptoms of femoral nerve injury
Numbness over anterior thigh and medial leg
Weakness of the quadriceps muscle causing weak knee extension
Decreased knee-jerk
Signs and symptoms of sciatic nerve damage
Affects all muscles below the knee causing loss of knee flexion, foot drop and inability to walk Loss of ankle jerk Normal knee jerk
Symptoms of lateral cutaneous nerve injury / compression
Pain - paraesthesia / sensory loss over upper lateral thigh
The perineal body is the point of attachment for:
Bulbospongiosus Deep transverse perineal muscles External anal sphincter Pubococcygeus Superficial transverse perineal muscles Levator ani
The right ureter lies in close relation to what structures
Descending duodenum Right of the IVC Crossed by right colic and iliocolic vessels Uterine artery Suspensory ligament of the ovary
To what lymph group does the cervix drain to
Internal iliac
To what lymph group does the distal rectum drain to
Internal iliac
To what lymph group does the majority of the breast drain to
Pectoral group of
the axillary lymph nodes
To which lymph nodes does lymph from the scrotum and penis first pass?
Superficial inguinal lymph nodes
Venous drainage of the bladder
Internal iliac veins
Venous drainage of the right ovary
Direct into inferior Vena cava
Venous drainage of the vagina
Vaginal plexus
With vaginal vein to internal iliac vein or uterine vein
Venus drainage of the left ovary
Left renal vein
into inferior Vena cava
What % of women have a retroverted uterus?
20%
What and where is the squamocolumnar junction?
Junction between ectocervix and endocervix.
Exterior = squamous epithelium.
Interior = columnar epithelium
What cell type is the ectocervix
squamous epithelium.
What cell type is the endocervix
columnar epithelium
What are he ovarian arteries a branch of
Direct branch off the abdominal aorta
What are the 3 cutaneous branches of the femoral nerve
Medial and intermediate cutaneous nerve of the thigh.
Saphenous nerve
What are the 3 sites of constriction of the ureters
Crossing the Pelvic brim
Pelvo-ureteric junction
vesico-uretreic junction
What are the borders of the femoral canal
Anterior - inguinal ligament
Posterior - pectineal ligament
Medial - lacunar ligament
Lateral - femoral vein
What are the options for correction of a retroverted uterus?
Gilliam’s ventrosuspension (laparoscopic)
Hodge pessary
Manchester procedure
what do leydig cells produce
Testosterone
What does the ductus venosus do
Connects left umbilical vein with upper inferior vena cava
What does the embryo have by 4 weeks
Closed neural tube
Primitive heart
Gill arches
0.5 cm long
What does the epidural space contain?
Fat Epidural veins (batsons plexus) Small arteries Lymphatics Spinal nerve roots
What does the thymus develop from
endoderm
of the third pharyngeal pouch
What hormone controls spermatogenesis
FSH (and Testosterone)
What is meralgia paraesthetica
Entrapment neuropathy - lateral cutaneous nerve
What is the anal reflex?
Pin prick of perianal skin causes a reflex contraction of external anal sphincter
What is the cervix composed of
Fibrous tissue
What is the ductus arteriosus
Connection between the pulmonary artery and descending aorta
What is the effect of vaginal doderleins bacteria
Lower vaginal PH
What is the Epiploic foramen
Communicating passage between the greatest sac and the lesser sac of the abdomen
What is the Manchester operation a correction for?
Retroverted uterus - reposition within pevis
OR repair uterine prolapse and cysto-urethrocele
What is the nerve root supply for the muscle group of the ankle reflex
S1-2
What is the nerve root supply for the muscle group of the biceps reflex
C5 - 6
What is the nerve root supply for the muscle group of the knee reflex
L3 - 4
What is the pituitary gland derived from embryologically
Anterior pituitary from Ectoderm
Posterior pituitary from neuroderm
What is the rectus sheath composed of?
Fibrous condensation of the aponeurotic layers of the anterior abdominal wall
What is the sacrum composed of
5 fused vertebral bodies
What is the transformation zone of the cervix?
The area where the columnar epithelium has under gone metaplasia to become squamous epithelium.
What is the uterine artery a branch off?
Anterior trunk of the Internal iliac artery.
What is uterine didelphys?
Uterine malformation where the uterus is paired.
Due to failure of fusion of Müllerian ducts
What is waldeyers sheath
And the investment of muscles surrounding the ureteral opening in the bladder wall
What joins the bladder to the umbilicus
Remains of the urachus - middle umbilical ligament
What lies within the femoral sheath
Femoral artery
Femoral vein
Lymphatics
What lymph group does the vulva drain to
Superficial inguinal lymph nodes
What muscle is mainly responsible for knee extension
Quadriceps
What muscles does the median nerve innervate
LOAF muscles
Flexor carpi radialis
Pronator teres
What muscles does the radial nerve supply
Triceps,
brachioradialis,
supinator,
abductor pollicis longus
What never roots mediates the anal reflex
S3-4
What roots supply the pudendal nerve
Anterior rami of S2-4
What separates the female bladder from the anterior surface of the uterus
Vesicouterine excavation
What structures prevent prolapse of the uterus and vagina
Uterosacral ligaments
Cardinal ligaments
Levator ani muscles
What substance keeps the ductus arteriosus patent during pregnancy
Prostaglandin E2
What type of epithelium lines the vagina
Stratified squamous epithelium
What vessel does the left ovarian vein drain into
Left renal vein
then the IVC
What vessel does the right ovarian vein drain into
Direct to Inferior vena cava (IVC)
Where does lymph from the Fallopian tube drain to?
Para-aortic nodes
Where does the femoral artery lie
Midinguinal point
Where does the foramen ovale connect
Connects right and left atria
Where is the metopic suture
Between the 2 frontal bones
Where is the midinguinal point
Midway between symphysis pubis and ASIS
Where is the optic chiasm in relation to the pituitary gland
Superior
Where is the pituitary gland found
Hypophyseal fossa in the sphenoid bone
Inferior to the optic chiasm
Where is the Sagittal suture
Separates the parietal bones
Extends from anterior fontanelle to posterior fontanelle
Which embryological structure is the round ligament of the uterus derived from
Gubernaculum
Which muscles in the lower limb is mainly responsible for ankle dorsiflexion
Tibialis anterior
What is finasteride
Finasteride is a 5-alpha-reductase inhibitor.
What is goserelin
Goserelin is a gonadotrophin-releasing hormone analogue.
What is Eflornithine
Eflornithine is an antiprotazoal
What is Cyproterone acetate
Cyproterone acetate is an anti-androgen and progestogen
What type of drug is metformin
Metformin is an insulin sensitiser
Inheritance pattern of Cystic Fibrosis
Autosomal recessive disorder
What is the velocity of ultrasound dependent upon?
Compressibility of the medium through which it travels. Greater compressibility = slower speed
Compressibility is also affected tb temperature
Effects of ultrasound on tissues
Cavitation
Heat generation
Microstreaming
When does organogenesis occur?
Maximal at 6 - 8 weeks.
Occurs throughout 4 - 10 weeks
When does the neural tube close?
24-28 days after conception
Why is pre conceptual folic acid so important
Neural tube closes early - between 24-28 days after conception.
By what % does the maternal metabolic rate increase by during pregnancy?
25%
What cell type is the yolk sac lined by
Extra-embryonic endoderm.
Outside this is extra-embryonic mesenchyme
What is a blastocyst?
The structure formed in early pregnancy.
Formation begins 5 days after fertilization.
Rapid cleavage to 200-300 cells then embeds itself into the endometrium of the uterine wall
What is a zygote
A fertilized ovum
When does an embryo become a fetus
9 weeks