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Kaplan: Anatomy and Physiology Part II > Chapter 3: Abdomen, Pelvis, and Perineum (continued 5) > Flashcards

Chapter 3: Abdomen, Pelvis, and Perineum (continued 5) Flashcards

1
Q

Which kidney is positioned slightly lower and why?

A

the right kidney is slightly lower because of the mass of the liver

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2
Q

What are the most common sites of blockage of renal calculi?

A
  • where renal pelvis joins the ureter
  • where the ureter crosses the pelvic inlet
  • where the ureter enters the wall of the urinary bladder
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3
Q

What is the bladder trigone?

A

smooth triangular area of mucosa located internally at the base of the bladder

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4
Q

Describe the blood supply of the bladder.

A
  • supplied by vesicular branches of the internal iliac arteries and umbilical arteries
  • vesicular venous plexus drains to internal iliac veins
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5
Q

Describe the lymphatics of the urinary bladder.

A

drain to the external and internal iliac nodes

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6
Q

Describe innervation of the urinary bladder. (parasympathetic)

A

parasympathetic innervation is from sacral segments S2, S3, and S4. The preganglionic parasympathetic fibers travel in pelvic splanchnic nerves to reach the detrusor muscle

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7
Q

Describe innervation of the urinary bladder. (Sympathetic innervation)

A

through fibers derived from L1 through L2 (lumbar splanchnics) which supply the trigone muscle and internal urethral sphincter

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8
Q

What is spastic bladder caused by?

A

lesions of the spinal cord above the sacral spinal cord levels.

There is loss of inhibition of the parasympathetic nerve fibers that innervate the detrusor muscle during the filling stage.

This the detrusor muscle responds to a minimum amount of stretch, causing urge incontinence

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9
Q

What does atonic bladder form as a result of?

A

from lesions to the sacral spinal cord segments or the sacral spinal nerve roots

loss of pelvic splanchinic motor innervation with loss of contraction of the detrusor muscle results in a full bladder with. continuous dribble of urine from the bladder

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10
Q

Weakness of which part of the levator ani muscle may result in rectal incontinence?

A

puborecatlis part

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11
Q

Weakness of what part of the urogenital diaphragm may result in urinary incontinence?

A

sphincter urethrae

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12
Q

What is the contraction of the detrusor muscle from?

A

under control of the parasympathetic fibers of the pelvic splanchnics (S2, S3, S4)

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13
Q

What is the internal urethral sphincter? Also another name for them?

A

(sphincter vesicae) smooth muscle fibers that enclose the origin of the urethra at the neck of the bladder

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14
Q

Where does the internal urethral sphincter receive its innervation? What is the purpose of this innervation?

A

under control of sympathetic fibers of the lower thoracic and lumbar splanchncis (T11-L2) and are activated during the filling phase of the bladder to prevent urinary leakage

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15
Q

What is the external urethral sphincther? Another name for it?

A

(sphincter urethrae) the voluntary sk. muscle component of the urogenital diaphragm that encloses the urethra and is relaxed during micturition (voluntary muscle of micturition)

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16
Q

What is the external urethral sphincter innervated by?

A

the pudendal nerve

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17
Q

What are the 3 parts of the male urethra?

A

prostatic,
membranous, and
spongy (penile)

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18
Q

What is the papilla of the kidney?

A

the place where the glomeruli and medulla are in the shape of an inverted pyramid

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19
Q

Label the diagram for the distribution of the superior mesenteric artery.

A

Label figure.

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20
Q

Label the diagram for the distribution of the inferior mesenteric artery.

A
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21
Q

Are podocyte foot processes motile?

A

why yes, yes they are chap

they contain actin and myosin

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22
Q

What areas of the kidney are involved in erythropoietin production?

A

renal cortex and medullary fibroblasts

23
Q

Which type of cell, principal or intercalated of the collecting ducts, is responsive to aldosterone?

A

principal cells

24
Q

What is another name for mesangial cells of the kidney?

A

Polkissen or Lacis cells

25
Q

Where are mesangial cells located in the kidney?

A

between capillaries, under the basal lamina but outside the capillary lumen.

26
Q

Is there basal lamina between mesangial and endothelial cells?

A

no

27
Q

What is the function of mesangial cells in the kidney?

A

may be phagocytic and may be involved in the maintenance of the basal lamina

28
Q

What is the JG complex composed of?

A

complex comprised of the JG apparatus in the wall of the afferent arteriole, the macula densa (a special domain of the DCT) and a group of mesangial cells

29
Q

What is the cell type that makes up the macula densa?

A

formed by tall cuboidal cells in the wall of the DCT

30
Q

Purpose of the macula densa?

A

to detect sodium levels in the tubular fluid

31
Q

What is the genotype for female pseudointersexuality?

A

46,XX genotype

32
Q

What is the most common cause of female pseudointersexuality?

A

most common cause is congenital adrenal hyperplasia.

33
Q

What is congenital adrenal hyperplasia?

A

a condition in which the fetus produces excess androgens

34
Q

What are the symptoms of female pseudointersexuality?

A

have ovarian (but no testicular) tissue and masculinization of the female external genitalia

35
Q

What is the genotype for male pseudointersexuality?

A

46, XY genotype

36
Q

What are the symptoms of male pseudointersexuality?

A

testicular (but no ovarian) tissue and stunted development of male external genitalia

37
Q

What is the most common cause of male pseudointersexuality?

A

most common cause is inadequate production of dihydrotestosterone due to 5a-reductase deficiency

38
Q

Pathology of 5a-reductase 2 deficiency.

A

caused by a mutation in the 5a-reductase 2 gene that renders 5a-reductase 2 enzyme underactive in catalyzing the conversion of testosterone to dihydrotestosterone

39
Q

What are some clinical findings of 5a-reductase 2 deficiency?

A

underdevelopment of the penis and emission of sperm (microphallus, hypospadias, and bifid scrotum) and prostate.

epididymis, ductus deferens, seminal vesicle, and ejaculatory duct are normal

40
Q

Why do patients with 5a-reductase 2 deficiency undergo virilization at puberty?

A

at puberty, these patients undergo virilization due to an increased T: DHT ratio

41
Q

What is another name for CAIS (Complete androgen insensitivity)?

A

Testicular feminization syndrome

42
Q

Most common cause for CAIS?

A

mutation in the androgen receptor (AR) gene that renders the AR inactive

43
Q

This condition occurs when a fetus with a 46, XY genotype develops testes and female external genitalia with a rudimentary vagina; the uterus and uterine tubes are generally absent.

A

CAIS or testicular feminization

44
Q

How do individuals with CAIS appear to others?

A

present as normal appearing females, and their psychosocial orientation is female despite genotype

45
Q

Considerations to remember for a person with CAIS?

A

testes may be found in the labia majora and are surgically removed to circumvent malignant tumor formation

46
Q

Pathology behind hypospadias.

A

occurs when the urethral folds fail to fuse completely, resulting in the external urethral orifice opening onto the ventral surface of the penis.

47
Q

Features/associations of hypospadias?

A

generally associated with a poorly developed penis that curves ventrally (known as chordee)

48
Q

Presentation of epispadias

A

occurs when the external urethral orifice opens onto the dorsal surface of the penis

49
Q

What is epispadias generally associated with?

A

extrophy of the bladder

50
Q

What is cryptorchidism?

A

udescended testes

51
Q

What is the pathology of cryptochordism? (when do testes typically fall)

A

occurs when the testes fails to descend into the scrotum (typically occurs within 3 months after birth)

52
Q

Where may the undescended testes in cryptorchidism be found?

A

in the abdominal cavity or in the inguinal canal

53
Q

Can bilateral cryptochordism result in sterility?

A

yes

54
Q

What is hydrocele of the testes?

A

occurs when a small patency of the processus vaginalis remains, so that peritoneal fluid can flow into the processus vaginalis leading to a fluid filled cyst near the testes

Kaplan: Anatomy and Physiology Part II (19 decks)

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