Clinically Important Features Flashcards
1
Q
What is the bean-shaped retroperitoneal oragan extending from T12-L3 that is the posterior most organ in the abdomen
A
Kidney
2
Q
What organ functions to remove water, salts, and products of protein metabolism from the blood
A
Kidney
3
Q
Which kidney lies slightly lower
A
The right due to the size of the right lobe of the liver
4
Q
A strain of the psoas major m. can occasionally be mistaken for what
A
Kidney Pain
5
Q
What is the vertical fissure located on the medial surface of the Kidney
A
The Hilum
6
Q
What structures pass through the hilum of the kidney
A
The Renal Artery and Vein, Ureter, and Autonomic and Sensory nerves
7
Q
What is the expanded superior end of the ureter within the hilum
A
Renal Pelvis
8
Q
What is the recess within the hilum of the kidney that is filled with fat
A
Renal Sinus
9
Q
What term is used for all the structures collectively that enter the hilum
A
Renal Pedicle
10
Q
What does calyx mean
A
Cup
11
Q
What does the Left renal vein drain
A
Left kidney, Left suprarenal gland, Gonad, Diaphragm, and body wall
12
Q
The Celiac plexus, aortic plexus, and mainly the least splanchnic nerve form what
A
The renal plexus
13
Q
What is the function of the fat around the kidney
A
Protection, insulation, and support
14
Q
From innermost to outermost, what are the layers covering the kidney
A
Renal capsule, Perinephric fat, Renal fascia, and Paranephric fat
15
Q
What is the membranous layer of extraperitoneal tissue which splits to enclose the kidney
A
Renal Fascia
16
Q
What are renal calculi
A
Kidney stones
17
Q
What 3 things are kidney stones made up of
A
Calcium oxalate, Calcium phosphate, and Uric Acid
18
Q
What are the risk factors of renal calculi
A
Being male, low fluid intake, geographic (SE U.S.)
19
Q
Extracorporeal shock-wave lithotripsy can be used for what
A
To break up renal calculi
20
Q
What is it called when the kidney becomes hypermobile and moves downward w/in the renal fascia
A
Nephroptosis
21
Q
During nephroptosis, what can happen to the kidney
A
It can sometimes turn upside down, twisting blood vessels and ureter
22
Q
Where is nephroptosis MC
A
In very thin people
23
Q
Name the structure: Retroperitoneal and descends on psoas major, Crossed by gonadal vessels, crosses common iliac artery at its bifurcation, 3 constrictions, has upper abdominal and lower pelvic parts
A
Ureter
24
Q
The renal, gonadal, aorta, and common iliac, supply what portion of the ureter
A
Abdominal Portion of the ureter
25
What artery supplies the pelvic portion of the ureter
Superior Vesical artery
26
What is the innervation of the ureter
Renal and hypogastric plexuses
27
What 3 locations can renal calculi become lodged
Uretopelvic junction, pelvic brim, and where it enters the wall of the bladder
28
Relative to its size, what has the largest autonomic n. supply of any organ
Suprarenal gland
29
What system is the suprarenal gland a part of
The endocrine system
30
What 2 parts of the endocrine system are made up in the kidney
Medulla and Cortex
31
Which part of the endocrine system is a modified sympathetic ganglion
The Medulla
32
What part of the endocrine system of the kidney secretes Corticosteroids
Cortex
33
What part of the endocrine system of the kidney secretes Epinephrine and Norepinephrine
Medulla
34
What is importance of the Suprarenal glands secretions
They are essential for life
35
What is adrenal hypofuntion aka
Addison's Disease
36
What does Addison's disease mainly affect
Corticosteriod output (more effective on Cortex)
37
What are the shapes of the suprarenal glands
Right is pyramidal, Left is semilunar
38
Where does the suprarenal vein drain
Directly into the inferior vena cava
39
Where does the left suprarenal vein drain
Into the Left renal vein
40
The primary sympathetic innervation of the Suprarenal gland is from what
Celiac plexus and Thoracic Splanchnic nerves
41
Where is pain from the kidney or suprarenal gland referred
The paralumbar region
42
Why are kidney infections MC in women
They have a shorter urethra
43
What % of the population is the Psoas Minor present in
~60%
44
Weakness of the right crus in the diaphragm splitting around the esophagus can lead to what
Hiatal Hernia
45
What is it called when there is pain when the thigh is passively extended or actively flexed
Psoas Sign
46
A positive right psoas sign may suggest what
Appendicitis
47
What anterior primary rami form the lumbar plexus
L1, L2, L3, and part of L4
48
What anterior primary rami form the sacral plexus
L4-S4
49
What does the abdominal aorta pass through descending anterior to the vertebral bodies
Aortic Hiatus
50
Where does the abdominal aorta bifurcate into the L and R common iliac artery
Anterior to L4
51
What does each common iliac bifurcate into
Internal and External iliac arteries
52
What are the 4 functions of the pelvis which often exert conflicting demands upon it
Locomotion, Parturition, & Support and Protection of abdominal viscera
53
What 4 bones make up the pelvis
Sacrum, Coccyx, and R/L hip bones
54
What 3 parts make up each hip bone
Ilium, Ischium, and Pubis
55
Anatomical position pelvis is tilted so that: ASIS and upper margin of pubic symphysis ___________
Lie in the same vertical plane
56
Anatomical position pelvis is tilted so that: Tip of coccyx and upper margin of pubic symphysis ___________
Lie in the same horizontal plane
57
In what direction does the pelvic cavity project from the abdominal cavity
Posteriorly
58
What is the superior aperture of the pelvis
Pelvic inlet
59
What are the boundaries of the pelvic inlet
Sacral Promontory, Sacral Alae, Arcuate line, Pectin pubis (Pectineal Line), and Pubic crest
60
The boundaries of the pelvic inlet form a continuous border known as the _______
Pelvic brim or Linea Terminalis
61
What are the functions of the Greater (false) pelvis
Support abdominal viscera and M. attachment for m. of locomotion
62
What does the Lesser (true) pelvis contain
Lower part of GI tract, Urinary bladder, Lower part of ureter, and Internal Reproductive Organs
63
What is the diamond shaped inferior aperture of the pelvis
Pelvic outlet
64
What are the boundaries of the Pelvic outlet
Pubic symphysis, Ischiopubic rami, Ischial tuberosities, Sacrotuberous ligament, and Tip of the coccyx
65
What is formed by the pubic symphysis, ischiopubic rami, and ischial tuberosities
Pubic Arch
66
Pelvic type: Long A-P and short transverse. Some males & 20% females
Anthropoid
67
Pelvic type: Short A-P and wide transverse. Rare in males, 2% of females. Most associated with birthing difficulties
Platypelloid
68
Pelvic type: Heart-shaped inlet. Most males and 30% of females
Android
69
Pelvic type: Ovoid or round inlet. 50% of females and no males. Ideal for childbirth
Gynecoid
70
MALE VS. FEMALE Pelvis pg. 155
155
71
Joint btwn. L5 and Sacrum. Contains an IVD
Lumbosacral joint
72
Joint btwn. Sacrum and Ilium. Synovial. Least moveable/moblie
Sacroiliac
73
Fibrocartilagionous joint btwn. 2 pubic bodies containing an interpubic disc
Pubic symphysis
74
Joint btwn. sacrum and coccyx containing IVD and often fused
Sacrococcygeal joint
75
What is responsible for the joints of the pelvis becoming loose during pregnancy
The hormone relaxin
76
What ligament extends from the sacrum and coccyx to the ischial tuberosity
Sacrotuberous
77
What ligament extends from the sacrum and coccyx to the ischial spine
Sacrospinous
78
What is bound by the greater sciatic notch, sacrotuberous, and sacrospinous lig
Greater sciatic foramen
79
What is bound by the lesser sciatic notch, sacrotuberous and sacrospinous ligaments
Lesser sciatic notch
80
What structures pass through both the greater and lesser sciatic foramina
Pudendal n., internal pudendal vessels, and n. to obturator internus
81
Misalignment of the sacrum may cause what
Impingement on structures which exit the greater sciatic foramen (especially sciatic n.)
82
What are possible intrapelvic causes of sciatica
Piriformis syndrome, Compression by fetal head during pregnancy, Pelvic tumors
83
What covers the lateral walls of the pelvis
Obturator internus m. and Obturator Fascia
84
What covers the posterior wall of the pelvis
Piriformis and Coccygeus
85
What compose the floor of the pelvis
Peritoneum (above) and Pelvic Diaphragm (below)
86
What can accumulate in the rectovesical pouch (lowest point in peritoneum of the male)
Blood and ascites
87
What can accumulate in the rectouterine pouch (lowest point in peritoneum of the female)
Blood and ascites
88
Where can an abdominal ectopic pregnancy possibly implant
Rectouterine pouch
89
What 2 m. make up the pelvic diaphragm
Coccygeus and Levator Ani (Major constituent)
90
What are the 2 openings within the pelvic diaphragm
Urogenital hiatus (urethra in males, both urethra and vagina in females) and Anal aperture
91
What is the most posterior part of the levator ani
Iliococcygeus
92
What is the main part of the levator ani
Pubococcygeus
93
What forms a sling around the urethra beneath the prostate in the male
Puboprostaticus
94
What forms a sling around the urethra and vagina in females
Pubovaginalis
95
What attaches to the anorectal junction
Puboanalis
96
What is the function of the puborectalis
Perineal flexure. relaxes during defecation and directs the fetal head forward during parturition
97
What is the curved thickening of the obturator fascia which gives origin to parts of the pubococcygeus and iliococcygeus
Tendinous Arch of Levator Ani
98
What 4 things may misalignment of the sacrum affect
Loss of integrity of pelvic floor, Urinary continence, Fecal continence, and parturition
99
What does the external iliac continue as below the inguinal ligament
The femoral artery
100
What are the 2 branches of the iliolumbar artery
Iliac and lumbar
101
What does the lateral sacral artery anastomose with
The median sacral artery
102
What artery exits the pelvis through the greater sciatic foramen superior to the piriformis m. Usually btwn. the lumbosacral trunk and 1st sacral n.
Superior Gluteal artery
103
What portion of the umbilical artery is obliterated and continues forward as the median umbilical ligament
the distal portion
104
What is the major supply of blood to the pelvis
Internal iliac artery
105
What is the unpaired artery which arises from behind the bifurcation of the abdominal aorta
Median Sacral artery
106
Where do most pelvic structures drain
Into the caval system
107
What structures have some drainage into the portal system
Rectum and anal canal
108
Where does the sacral plexus lie
Primarily on the anterior surface of the piriformis
109
What M. prevents the pelvis from slumping to the unsupported side during gait
Anterior gluteal
110
Damage to what n. can cause Trendelenberg gait
Superior Gluteal n.
111
What n. supplies the glut. maximus only and is responsible for trunk control and standing up from a seated position
Inferior gluteal n.
112
What is the largest n. in the body and what does impingement of it lead to
Sciatic n. and impingement can lead to sciatica
113
What is the number 1 possible cause of sciatica
Piriformis syndrome
114
What n. supplies the quadratus femoris and inferior gemellus m.
N. to quadratus femoris m.
115
What n. supplies sensory information to part of the gluteal region and perineum
Posterior Cutaneous n. of the Thigh
116
What nerves are can be implicated in fecal/urinary incontinence, pelvic floor integrity, and possible parturition probs
Nerves to levator ani and coccygeus muscles
117
Damage to the External anal sphincter m. can cause what
Fecal incontinence
118
What n. is implicated with Sexual dysfunction (erectile)
Pudendal n.
119
What is formed by VPR of S4, S5, and coccygeal n.
Coccygeal Plexus
120
What are the 2 ways sympathetic fibers reach the pelvis
Sympathetic trunk and aortic plexus
121
The right and left sympathetic trunks join together in front of the coccyx to form what
Ganglion impar
122
What are the components of the pelvic autonomic system
Superior hypogastric plexus, L and R hypogastric nerves, L and R Inferior hypogastric plexuses, Sacral splanchnic nerves, and Pelvic splanchnic nerves
123
What part of the LI is between the Sigmoid colon and anal canal
The rectum
124
What is the upper limit of the rectum, located at the middle of the sacrum
Rectosigmoid junction
125
What is the lower limit of the rectum, located at the upper border of the pelvic diaphragm
Anorectal junction
126
What forms a sling around the rectum at the anorectal junction
The puborectalis
127
What is the dilated terminal portion of the rectum, immediately above the pelvic diaphragm
The rectal ampulla
128
How many transverse rectal folds are there
3
129
What 3 things does the rectum lack
Mesentary, omental appendices, and haustra
130
What is different about the taeniae coli of the rectum
More spread out to form a more complete outer layer
131
What is the pattern of covering the peritoneum has over the rectum
Upper 1/3: front and sides
Middle 1/3: Front
Lower 1/3: no covering
132
What portion of the LI is between the pelvic diaphragm and anus
Anal canal
133
What 3 parts make up the External anal sphincter
Subcutaneous, Superficial, Deep
134
What n. root is the n. supply to the external anal sphincter from
S4
135
T/F:The contraction of the External anal sphincter can be increase voluntarily
True
136
What are varicosities of the superior rectal vein which cause bulging of anal columns and occur above the pectinate line
Internal Hemorrhoids
137
Why are internal hemorrhoids generally painless
The only have an autonomic n. supply from the hindgut
138
What are varicosities of the inferior rectal vein which occure below the pectinate line and may be very painful
External hemorrhoids
139
What nerve is responsible for the pain caused by external hemorrhoids
Pudendal n.
140
What are the potential causes of Hemorrhoids
Pregnancy, Heavy lifting, Sitting, Straining (chonic constipation) and portal hypertension
141
Of the potential causes of hemorrhoids, what are the 2 things that they can cause leading to hemorrhoids
Inc. intra-abdominal pressure or Dec. venous return
142
What particular group is at risk for hemorrhoids
Long distance truck drivers
143
What divides the anal canal into and upper (visceral) 2/3 and a lower (somatic) 1/3
The pectinate line
144
What part of the LI accumulates fecal matter
The sigmoid colon. Rectum is normally empty
145
How does the sigmoid colon empty its contents into the rectum
Mass peristaltic movement
146
Where does the urinary bladder lie when empty
Entirely within the pelvis and rests against the pubis and adjacent pelvic floor
147
What happens as the bladder fills
It rises into the abdomen and may reach the level of the umbilicus
148
What causes frequent micturition during pregnancy
The position of the uterus over the bladder
149
What is contained in the retropubic space
The retropubic fat pad
150
What is the function of the retropubic fat pad
Cushion/shock absorber
151
What can happen in runners if the retropubic fat pad is insufficient
Blood can be in the urine after a long run
152
What 2 ligaments hold the bladder in place (Female and male have different names so 3)
Puboprostatic (Male) or Pubovesical (female) and Lateral ligament of the bladder
153
What is the Detrusor m.
Smooth m. in wall of bladder
154
What does the flat valve (normally compressed when bladder is full) prevent during micturition
Prevents backflow into kidneys
155
What prevents reflux of semen into bladder during ejaculation
Internal Urethral Sphincter
156
What does bladder fullness initiate
The micturition reflex (we learn to suppress with potty training)
157
What inhibits relaxation of internal urethral sphincter
Sympathetics
158
T/F: The external urethral sphincter is relaxed under voluntary control
True
159
What is nocturnal enuresis
Bedwetting
160
What is a vasectomy aka
Deferentectomy
161
What is a possible complication of vasectomy
Epididymitis
162
What is the MC technique for male sterilization
Deferentectomy (vasectomy)
163
How does a deferentectomy work
Transection and ligation of ductus deferens
164
What do the seminal vesicles produce
The alkaline component of semen (neutralizes vaginal acidity)
165
What is the innervation of the seminal vesicles
Inferior hypogastric plexus
166
What is formed by the union of the ductus deferens with the seminal vesicle
The ejaculatory duct
167
What is the most important blood supply to the ejaculatory duct
Inferior vesical artery
168
What is the function of the prostate gland
Produce semen
169
Condition: Prostate tends to enlarge under influence of hormones, >40 y.o., difficulty with micturition from compression of urethra. and can be helped with Saw Palmetto, an herbal tea
Benign Prostatic Hypertrophy
170
Condition: MC in men, Metastisis via blood and lymph, Can metastasize to vertebral column and pelvis, bone involvement is common
Prostate cancer
171
What test can be used to test for prostate cancer
PSA (prostate specific antigen) blood test used for early detection
172
Where can chronic inflam of prostat or prostate cancer cause referred pain
To the sacrum
173
Sacral misalignment or L1/L2 subluxations may be related to what
Prostate or bladder probs
174
The endocrine function of the ovaries can secrete what hormones
Estrogen, Progesterone, and Relaxin
175
How long can it take for an oocyte to pass from the ovary to the uterus
3-4 days
176
What is the abdominal ostium
Opening of the uterine tube near the ovary
177
Is there a gap btwn. the abdominal ostium and ovary
YES, they are not connected
178
What is the longest fimbria attached to the ovary
Ovarian Fimbria
179
1st and 2nd MC places for fertilization
MC in ampulla, 2nd MC is infundibulum
180
What is development of fetus at some site other than uterine cavity
Ectopic Pregnancy
181
What is the MC type of ectopic pregnancy
Tubal Ectopic pregnancy
182
What are risk factors of Ectopic Pregnancy
STDs, Reversal of tubal ligation, Endometriosis
183
Where does an abdominal Ectopic Pregnancy implant
Rectoruterine pouch
184
When is there an increase in fiberous tissue and cysts in the uterus
After menopause
185
What is the normal position of the uterus
Anteverted and Anteflexed
186
What is the opposite of anteversion
Retroversion
187
What can change the position of the of the uterus
Fullness of the bladder on which it rests
188
What can a retroverted uterus cause
Severe menstral cramps, Unusually painful parturition, and an increased risk of uterine prolapse
189
What is a remnant of Gubernaculum of the ovary
Uterine tubes
190
What is always in danger during a hysterectomy
Ureter
191
What is the Recess btwn. cervix and walls of vagina
The fornix
192
What is the superior, expanded portion of the vagina below the cervix
Vaginal Vault
193
What is Bulging of the rectum into the posterior wall of the vagina. May cause difficulty in defecation
Rectocele
194
what is bulging of the bladder into the anterior wall of the vagina. May cause difficulty in Micturition
Cystocele
195
What is it when the uterus slips down into the vagina and descends to an abnormally low level in the pelvis. The cervix may protrude externally through the vaginal orifice. Risk factors:1)multiple births 2)retroverted uterus
Uterine Prolapse
196
Chiro note: pain from a retroverted uterus, inflammation of the uterine lining, or traction of a large uterus on the uterosacral ligament may cause pain where
In the sacrum
197
What are the 2 triangles of the perineum
Urogenital (ant.) and Anal triangle (post)
198
In anatomical position, where do the 2 triangles lie
Urogenital lies in horizontal, while anal triangle is tilted upward
199
What fascia is continuous with the dartos layer of the scrotum and with scarpa's fascia
Colles' fascia
200
What intimately invests the muscles of the superficial perineal pouch, and is fused anteriorly with the suspensory lig of the penis or clitoris
Deep perineal fascia
201
What is the fibromuscular mass which is located in the center of the perineum btwn. the anal canal and bulb of the penis (or vagina)
Perineal body
202
What m. does not attach to the perineal body
Ischiocavernosus
203
Para and sympathetic effects of erection
Point and Shoot
204
What is contained within the anal triangle
Anal canal, external anal sphincter and ischioanal fossa
205
What is the space on either side of the anal canal
Ischioanal fossa
206
What forms the lateral wall of the ischioanal fossa
Obturator fascia
207
What connects the external anal sphincter to the coccyx
Anococcygeal ligament
208
What structures pass through the pudendal canal
Internal pudendal artery and pudendal nerve
209
What small branch of the femoral artery supplies the male and femal external genitalia
External Pudendal artery
210
Where does the pudendal n. exit the pelvis
Through the greater sciatic foramen below the piriformis
211
Where does the pudendal n. ENTER the perineum
Through the lesser sciatic foramen
212
What marks the division of the scrotum into L and R compartments
A median raphe
213
What is the nonmobile portion of the penis
The root
214
What do the crura of the penis become below the pubic symphysis
The corpora cavernosa of the body of the penis
215
What covers each crus of the penis
An ischiocavernosus m.
216
What lies btwn. the 2 crura of the penis in the superficial perineal pouch, and as it runs forward becomes the corpus spongiosum
The bulb of the penis
217
What is the prepuce of the penis
A fold of skin which covers the glans
218
What are the female external genitalia collectively referred to as
The Vulva
219
What is the membranous crescentic fold which partially closes the opening of the vagina into the vestibule in virgins
Hymen
220
What is homologous to the penis consisting primarily of erectile tissue
Clitoris
221
What part of the clitoris is highly sensitive
The glans
