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Gross II Final > Clinically Important Features > Flashcards

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

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2
Q

What organ functions to remove water, salts, and products of protein metabolism from the blood

A

Kidney

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3
Q

Which kidney lies slightly lower

A

The right due to the size of the right lobe of the liver

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4
Q

A strain of the psoas major m. can occasionally be mistaken for what

A

Kidney Pain

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5
Q

What is the vertical fissure located on the medial surface of the Kidney

A

The Hilum

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6
Q

What structures pass through the hilum of the kidney

A

The Renal Artery and Vein, Ureter, and Autonomic and Sensory nerves

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7
Q

What is the expanded superior end of the ureter within the hilum

A

Renal Pelvis

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8
Q

What is the recess within the hilum of the kidney that is filled with fat

A

Renal Sinus

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9
Q

What term is used for all the structures collectively that enter the hilum

A

Renal Pedicle

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10
Q

What does calyx mean

A

Cup

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11
Q

What does the Left renal vein drain

A

Left kidney, Left suprarenal gland, Gonad, Diaphragm, and body wall

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12
Q

The Celiac plexus, aortic plexus, and mainly the least splanchnic nerve form what

A

The renal plexus

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13
Q

What is the function of the fat around the kidney

A

Protection, insulation, and support

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14
Q

From innermost to outermost, what are the layers covering the kidney

A

Renal capsule, Perinephric fat, Renal fascia, and Paranephric fat

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15
Q

What is the membranous layer of extraperitoneal tissue which splits to enclose the kidney

A

Renal Fascia

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16
Q

What are renal calculi

A

Kidney stones

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17
Q

What 3 things are kidney stones made up of

A

Calcium oxalate, Calcium phosphate, and Uric Acid

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18
Q

What are the risk factors of renal calculi

A

Being male, low fluid intake, geographic (SE U.S.)

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19
Q

Extracorporeal shock-wave lithotripsy can be used for what

A

To break up renal calculi

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20
Q

What is it called when the kidney becomes hypermobile and moves downward w/in the renal fascia

A

Nephroptosis

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21
Q

During nephroptosis, what can happen to the kidney

A

It can sometimes turn upside down, twisting blood vessels and ureter

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22
Q

Where is nephroptosis MC

A

In very thin people

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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

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24
Q

The renal, gonadal, aorta, and common iliac, supply what portion of the ureter

A

Abdominal Portion of the ureter

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25
Q

What artery supplies the pelvic portion of the ureter

A

Superior Vesical artery

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26
Q

What is the innervation of the ureter

A

Renal and hypogastric plexuses

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27
Q

What 3 locations can renal calculi become lodged

A

Uretopelvic junction, pelvic brim, and where it enters the wall of the bladder

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28
Q

Relative to its size, what has the largest autonomic n. supply of any organ

A

Suprarenal gland

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29
Q

What system is the suprarenal gland a part of

A

The endocrine system

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30
Q

What 2 parts of the endocrine system are made up in the kidney

A

Medulla and Cortex

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31
Q

Which part of the endocrine system is a modified sympathetic ganglion

A

The Medulla

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32
Q

What part of the endocrine system of the kidney secretes Corticosteroids

A

Cortex

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33
Q

What part of the endocrine system of the kidney secretes Epinephrine and Norepinephrine

A

Medulla

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34
Q

What is importance of the Suprarenal glands secretions

A

They are essential for life

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35
Q

What is adrenal hypofuntion aka

A

Addison’s Disease

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36
Q

What does Addison’s disease mainly affect

A

Corticosteriod output (more effective on Cortex)

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37
Q

What are the shapes of the suprarenal glands

A

Right is pyramidal, Left is semilunar

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38
Q

Where does the suprarenal vein drain

A

Directly into the inferior vena cava

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39
Q

Where does the left suprarenal vein drain

A

Into the Left renal vein

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40
Q

The primary sympathetic innervation of the Suprarenal gland is from what

A

Celiac plexus and Thoracic Splanchnic nerves

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41
Q

Where is pain from the kidney or suprarenal gland referred

A

The paralumbar region

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42
Q

Why are kidney infections MC in women

A

They have a shorter urethra

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43
Q

What % of the population is the Psoas Minor present in

A

~60%

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44
Q

Weakness of the right crus in the diaphragm splitting around the esophagus can lead to what

A

Hiatal Hernia

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45
Q

What is it called when there is pain when the thigh is passively extended or actively flexed

A

Psoas Sign

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46
Q

A positive right psoas sign may suggest what

A

Appendicitis

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47
Q

What anterior primary rami form the lumbar plexus

A

L1, L2, L3, and part of L4

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48
Q

What anterior primary rami form the sacral plexus

A

L4-S4

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49
Q

What does the abdominal aorta pass through descending anterior to the vertebral bodies

A

Aortic Hiatus

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50
Q

Where does the abdominal aorta bifurcate into the L and R common iliac artery

A

Anterior to L4

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51
Q

What does each common iliac bifurcate into

A

Internal and External iliac arteries

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52
Q

What are the 4 functions of the pelvis which often exert conflicting demands upon it

A

Locomotion, Parturition, & Support and Protection of abdominal viscera

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53
Q

What 4 bones make up the pelvis

A

Sacrum, Coccyx, and R/L hip bones

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54
Q

What 3 parts make up each hip bone

A

Ilium, Ischium, and Pubis

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55
Q

Anatomical position pelvis is tilted so that: ASIS and upper margin of pubic symphysis ___________

A

Lie in the same vertical plane

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56
Q

Anatomical position pelvis is tilted so that: Tip of coccyx and upper margin of pubic symphysis ___________

A

Lie in the same horizontal plane

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57
Q

In what direction does the pelvic cavity project from the abdominal cavity

A

Posteriorly

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58
Q

What is the superior aperture of the pelvis

A

Pelvic inlet

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59
Q

What are the boundaries of the pelvic inlet

A

Sacral Promontory, Sacral Alae, Arcuate line, Pectin pubis (Pectineal Line), and Pubic crest

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60
Q

The boundaries of the pelvic inlet form a continuous border known as the _______

A

Pelvic brim or Linea Terminalis

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61
Q

What are the functions of the Greater (false) pelvis

A

Support abdominal viscera and M. attachment for m. of locomotion

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62
Q

What does the Lesser (true) pelvis contain

A

Lower part of GI tract, Urinary bladder, Lower part of ureter, and Internal Reproductive Organs

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63
Q

What is the diamond shaped inferior aperture of the pelvis

A

Pelvic outlet

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64
Q

What are the boundaries of the Pelvic outlet

A

Pubic symphysis, Ischiopubic rami, Ischial tuberosities, Sacrotuberous ligament, and Tip of the coccyx

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65
Q

What is formed by the pubic symphysis, ischiopubic rami, and ischial tuberosities

A

Pubic Arch

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66
Q

Pelvic type: Long A-P and short transverse. Some males & 20% females

A

Anthropoid

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67
Q

Pelvic type: Short A-P and wide transverse. Rare in males, 2% of females. Most associated with birthing difficulties

A

Platypelloid

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68
Q

Pelvic type: Heart-shaped inlet. Most males and 30% of females

A

Android

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69
Q

Pelvic type: Ovoid or round inlet. 50% of females and no males. Ideal for childbirth

A

Gynecoid

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70
Q

MALE VS. FEMALE Pelvis pg. 155

A

155

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71
Q

Joint btwn. L5 and Sacrum. Contains an IVD

A

Lumbosacral joint

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72
Q

Joint btwn. Sacrum and Ilium. Synovial. Least moveable/moblie

A

Sacroiliac

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73
Q

Fibrocartilagionous joint btwn. 2 pubic bodies containing an interpubic disc

A

Pubic symphysis

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74
Q

Joint btwn. sacrum and coccyx containing IVD and often fused

A

Sacrococcygeal joint

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75
Q

What is responsible for the joints of the pelvis becoming loose during pregnancy

A

The hormone relaxin

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76
Q

What ligament extends from the sacrum and coccyx to the ischial tuberosity

A

Sacrotuberous

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77
Q

What ligament extends from the sacrum and coccyx to the ischial spine

A

Sacrospinous

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78
Q

What is bound by the greater sciatic notch, sacrotuberous, and sacrospinous lig

A

Greater sciatic foramen

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79
Q

What is bound by the lesser sciatic notch, sacrotuberous and sacrospinous ligaments

A

Lesser sciatic notch

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80
Q

What structures pass through both the greater and lesser sciatic foramina

A

Pudendal n., internal pudendal vessels, and n. to obturator internus

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81
Q

Misalignment of the sacrum may cause what

A

Impingement on structures which exit the greater sciatic foramen (especially sciatic n.)

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82
Q

What are possible intrapelvic causes of sciatica

A

Piriformis syndrome, Compression by fetal head during pregnancy, Pelvic tumors

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83
Q

What covers the lateral walls of the pelvis

A

Obturator internus m. and Obturator Fascia

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84
Q

What covers the posterior wall of the pelvis

A

Piriformis and Coccygeus

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85
Q

What compose the floor of the pelvis

A

Peritoneum (above) and Pelvic Diaphragm (below)

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86
Q

What can accumulate in the rectovesical pouch (lowest point in peritoneum of the male)

A

Blood and ascites

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87
Q

What can accumulate in the rectouterine pouch (lowest point in peritoneum of the female)

A

Blood and ascites

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88
Q

Where can an abdominal ectopic pregnancy possibly implant

A

Rectouterine pouch

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89
Q

What 2 m. make up the pelvic diaphragm

A

Coccygeus and Levator Ani (Major constituent)

90
Q

What are the 2 openings within the pelvic diaphragm

A

Urogenital hiatus (urethra in males, both urethra and vagina in females) and Anal aperture

91
Q

What is the most posterior part of the levator ani

A

Iliococcygeus

92
Q

What is the main part of the levator ani

A

Pubococcygeus

93
Q

What forms a sling around the urethra beneath the prostate in the male

A

Puboprostaticus

94
Q

What forms a sling around the urethra and vagina in females

A

Pubovaginalis

95
Q

What attaches to the anorectal junction

A

Puboanalis

96
Q

What is the function of the puborectalis

A

Perineal flexure. relaxes during defecation and directs the fetal head forward during parturition

97
Q

What is the curved thickening of the obturator fascia which gives origin to parts of the pubococcygeus and iliococcygeus

A

Tendinous Arch of Levator Ani

98
Q

What 4 things may misalignment of the sacrum affect

A

Loss of integrity of pelvic floor, Urinary continence, Fecal continence, and parturition

99
Q

What does the external iliac continue as below the inguinal ligament

A

The femoral artery

100
Q

What are the 2 branches of the iliolumbar artery

A

Iliac and lumbar

101
Q

What does the lateral sacral artery anastomose with

A

The median sacral artery

102
Q

What artery exits the pelvis through the greater sciatic foramen superior to the piriformis m. Usually btwn. the lumbosacral trunk and 1st sacral n.

A

Superior Gluteal artery

103
Q

What portion of the umbilical artery is obliterated and continues forward as the median umbilical ligament

A

the distal portion

104
Q

What is the major supply of blood to the pelvis

A

Internal iliac artery

105
Q

What is the unpaired artery which arises from behind the bifurcation of the abdominal aorta

A

Median Sacral artery

106
Q

Where do most pelvic structures drain

A

Into the caval system

107
Q

What structures have some drainage into the portal system

A

Rectum and anal canal

108
Q

Where does the sacral plexus lie

A

Primarily on the anterior surface of the piriformis

109
Q

What M. prevents the pelvis from slumping to the unsupported side during gait

A

Anterior gluteal

110
Q

Damage to what n. can cause Trendelenberg gait

A

Superior Gluteal n.

111
Q

What n. supplies the glut. maximus only and is responsible for trunk control and standing up from a seated position

A

Inferior gluteal n.

112
Q

What is the largest n. in the body and what does impingement of it lead to

A

Sciatic n. and impingement can lead to sciatica

113
Q

What is the number 1 possible cause of sciatica

A

Piriformis syndrome

114
Q

What n. supplies the quadratus femoris and inferior gemellus m.

A

N. to quadratus femoris m.

115
Q

What n. supplies sensory information to part of the gluteal region and perineum

A

Posterior Cutaneous n. of the Thigh

116
Q

What nerves are can be implicated in fecal/urinary incontinence, pelvic floor integrity, and possible parturition probs

A

Nerves to levator ani and coccygeus muscles

117
Q

Damage to the External anal sphincter m. can cause what

A

Fecal incontinence

118
Q

What n. is implicated with Sexual dysfunction (erectile)

A

Pudendal n.

119
Q

What is formed by VPR of S4, S5, and coccygeal n.

A

Coccygeal Plexus

120
Q

What are the 2 ways sympathetic fibers reach the pelvis

A

Sympathetic trunk and aortic plexus

121
Q

The right and left sympathetic trunks join together in front of the coccyx to form what

A

Ganglion impar

122
Q

What are the components of the pelvic autonomic system

A

Superior hypogastric plexus, L and R hypogastric nerves, L and R Inferior hypogastric plexuses, Sacral splanchnic nerves, and Pelvic splanchnic nerves

123
Q

What part of the LI is between the Sigmoid colon and anal canal

A

The rectum

124
Q

What is the upper limit of the rectum, located at the middle of the sacrum

A

Rectosigmoid junction

125
Q

What is the lower limit of the rectum, located at the upper border of the pelvic diaphragm

A

Anorectal junction

126
Q

What forms a sling around the rectum at the anorectal junction

A

The puborectalis

127
Q

What is the dilated terminal portion of the rectum, immediately above the pelvic diaphragm

A

The rectal ampulla

128
Q

How many transverse rectal folds are there

A

3

129
Q

What 3 things does the rectum lack

A

Mesentary, omental appendices, and haustra

130
Q

What is different about the taeniae coli of the rectum

A

More spread out to form a more complete outer layer

131
Q

What is the pattern of covering the peritoneum has over the rectum

A

Upper 1/3: front and sides
Middle 1/3: Front
Lower 1/3: no covering

132
Q

What portion of the LI is between the pelvic diaphragm and anus

A

Anal canal

133
Q

What 3 parts make up the External anal sphincter

A

Subcutaneous, Superficial, Deep

134
Q

What n. root is the n. supply to the external anal sphincter from

A

S4

135
Q

T/F:The contraction of the External anal sphincter can be increase voluntarily

A

True

136
Q

What are varicosities of the superior rectal vein which cause bulging of anal columns and occur above the pectinate line

A

Internal Hemorrhoids

137
Q

Why are internal hemorrhoids generally painless

A

The only have an autonomic n. supply from the hindgut

138
Q

What are varicosities of the inferior rectal vein which occure below the pectinate line and may be very painful

A

External hemorrhoids

139
Q

What nerve is responsible for the pain caused by external hemorrhoids

A

Pudendal n.

140
Q

What are the potential causes of Hemorrhoids

A

Pregnancy, Heavy lifting, Sitting, Straining (chonic constipation) and portal hypertension

141
Q

Of the potential causes of hemorrhoids, what are the 2 things that they can cause leading to hemorrhoids

A

Inc. intra-abdominal pressure or Dec. venous return

142
Q

What particular group is at risk for hemorrhoids

A

Long distance truck drivers

143
Q

What divides the anal canal into and upper (visceral) 2/3 and a lower (somatic) 1/3

A

The pectinate line

144
Q

What part of the LI accumulates fecal matter

A

The sigmoid colon. Rectum is normally empty

145
Q

How does the sigmoid colon empty its contents into the rectum

A

Mass peristaltic movement

146
Q

Where does the urinary bladder lie when empty

A

Entirely within the pelvis and rests against the pubis and adjacent pelvic floor

147
Q

What happens as the bladder fills

A

It rises into the abdomen and may reach the level of the umbilicus

148
Q

What causes frequent micturition during pregnancy

A

The position of the uterus over the bladder

149
Q

What is contained in the retropubic space

A

The retropubic fat pad

150
Q

What is the function of the retropubic fat pad

A

Cushion/shock absorber

151
Q

What can happen in runners if the retropubic fat pad is insufficient

A

Blood can be in the urine after a long run

152
Q

What 2 ligaments hold the bladder in place (Female and male have different names so 3)

A

Puboprostatic (Male) or Pubovesical (female) and Lateral ligament of the bladder

153
Q

What is the Detrusor m.

A

Smooth m. in wall of bladder

154
Q

What does the flat valve (normally compressed when bladder is full) prevent during micturition

A

Prevents backflow into kidneys

155
Q

What prevents reflux of semen into bladder during ejaculation

A

Internal Urethral Sphincter

156
Q

What does bladder fullness initiate

A

The micturition reflex (we learn to suppress with potty training)

157
Q

What inhibits relaxation of internal urethral sphincter

A

Sympathetics

158
Q

T/F: The external urethral sphincter is relaxed under voluntary control

A

True

159
Q

What is nocturnal enuresis

A

Bedwetting

160
Q

What is a vasectomy aka

A

Deferentectomy

161
Q

What is a possible complication of vasectomy

A

Epididymitis

162
Q

What is the MC technique for male sterilization

A

Deferentectomy (vasectomy)

163
Q

How does a deferentectomy work

A

Transection and ligation of ductus deferens

164
Q

What do the seminal vesicles produce

A

The alkaline component of semen (neutralizes vaginal acidity)

165
Q

What is the innervation of the seminal vesicles

A

Inferior hypogastric plexus

166
Q

What is formed by the union of the ductus deferens with the seminal vesicle

A

The ejaculatory duct

167
Q

What is the most important blood supply to the ejaculatory duct

A

Inferior vesical artery

168
Q

What is the function of the prostate gland

A

Produce semen

169
Q

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

A

Benign Prostatic Hypertrophy

170
Q

Condition: MC in men, Metastisis via blood and lymph, Can metastasize to vertebral column and pelvis, bone involvement is common

A

Prostate cancer

171
Q

What test can be used to test for prostate cancer

A

PSA (prostate specific antigen) blood test used for early detection

172
Q

Where can chronic inflam of prostat or prostate cancer cause referred pain

A

To the sacrum

173
Q

Sacral misalignment or L1/L2 subluxations may be related to what

A

Prostate or bladder probs

174
Q

The endocrine function of the ovaries can secrete what hormones

A

Estrogen, Progesterone, and Relaxin

175
Q

How long can it take for an oocyte to pass from the ovary to the uterus

A

3-4 days

176
Q

What is the abdominal ostium

A

Opening of the uterine tube near the ovary

177
Q

Is there a gap btwn. the abdominal ostium and ovary

A

YES, they are not connected

178
Q

What is the longest fimbria attached to the ovary

A

Ovarian Fimbria

179
Q

1st and 2nd MC places for fertilization

A

MC in ampulla, 2nd MC is infundibulum

180
Q

What is development of fetus at some site other than uterine cavity

A

Ectopic Pregnancy

181
Q

What is the MC type of ectopic pregnancy

A

Tubal Ectopic pregnancy

182
Q

What are risk factors of Ectopic Pregnancy

A

STDs, Reversal of tubal ligation, Endometriosis

183
Q

Where does an abdominal Ectopic Pregnancy implant

A

Rectoruterine pouch

184
Q

When is there an increase in fiberous tissue and cysts in the uterus

A

After menopause

185
Q

What is the normal position of the uterus

A

Anteverted and Anteflexed

186
Q

What is the opposite of anteversion

A

Retroversion

187
Q

What can change the position of the of the uterus

A

Fullness of the bladder on which it rests

188
Q

What can a retroverted uterus cause

A

Severe menstral cramps, Unusually painful parturition, and an increased risk of uterine prolapse

189
Q

What is a remnant of Gubernaculum of the ovary

A

Uterine tubes

190
Q

What is always in danger during a hysterectomy

A

Ureter

191
Q

What is the Recess btwn. cervix and walls of vagina

A

The fornix

192
Q

What is the superior, expanded portion of the vagina below the cervix

A

Vaginal Vault

193
Q

What is Bulging of the rectum into the posterior wall of the vagina. May cause difficulty in defecation

A

Rectocele

194
Q

what is bulging of the bladder into the anterior wall of the vagina. May cause difficulty in Micturition

A

Cystocele

195
Q

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

A

Uterine Prolapse

196
Q

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

A

In the sacrum

197
Q

What are the 2 triangles of the perineum

A

Urogenital (ant.) and Anal triangle (post)

198
Q

In anatomical position, where do the 2 triangles lie

A

Urogenital lies in horizontal, while anal triangle is tilted upward

199
Q

What fascia is continuous with the dartos layer of the scrotum and with scarpa’s fascia

A

Colles’ fascia

200
Q

What intimately invests the muscles of the superficial perineal pouch, and is fused anteriorly with the suspensory lig of the penis or clitoris

A

Deep perineal fascia

201
Q

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)

A

Perineal body

202
Q

What m. does not attach to the perineal body

A

Ischiocavernosus

203
Q

Para and sympathetic effects of erection

A

Point and Shoot

204
Q

What is contained within the anal triangle

A

Anal canal, external anal sphincter and ischioanal fossa

205
Q

What is the space on either side of the anal canal

A

Ischioanal fossa

206
Q

What forms the lateral wall of the ischioanal fossa

A

Obturator fascia

207
Q

What connects the external anal sphincter to the coccyx

A

Anococcygeal ligament

208
Q

What structures pass through the pudendal canal

A

Internal pudendal artery and pudendal nerve

209
Q

What small branch of the femoral artery supplies the male and femal external genitalia

A

External Pudendal artery

210
Q

Where does the pudendal n. exit the pelvis

A

Through the greater sciatic foramen below the piriformis

211
Q

Where does the pudendal n. ENTER the perineum

A

Through the lesser sciatic foramen

212
Q

What marks the division of the scrotum into L and R compartments

A

A median raphe

213
Q

What is the nonmobile portion of the penis

A

The root

214
Q

What do the crura of the penis become below the pubic symphysis

A

The corpora cavernosa of the body of the penis

215
Q

What covers each crus of the penis

A

An ischiocavernosus m.

216
Q

What lies btwn. the 2 crura of the penis in the superficial perineal pouch, and as it runs forward becomes the corpus spongiosum

A

The bulb of the penis

217
Q

What is the prepuce of the penis

A

A fold of skin which covers the glans

218
Q

What are the female external genitalia collectively referred to as

A

The Vulva

219
Q

What is the membranous crescentic fold which partially closes the opening of the vagina into the vestibule in virgins

A

Hymen

220
Q

What is homologous to the penis consisting primarily of erectile tissue

A

Clitoris

221
Q

What part of the clitoris is highly sensitive

A

The glans

Gross II Final (1 decks)

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