Exam 2 Flashcards
(194 cards)
1
Q
- Describe how the three primary germ layers contribute to the formation of the GI tract.
A
- Endoderm creates the lining of the primitive gut tube and mesoderm becomes the visceral and parietal peritoneum
2
Q
- Describe the role of the embryonic body in folding in the formation of the primitive gut.
A
- Lateral folding contributes to folding the midgut tube and the cloacal/caudal folding contributes to forming the foregut and hindgut.
3
Q
- List the three divisions of the gut tube and describe the cranial and caudal boundaries of each division. List the arterial supply of each division.
A
- Foregut: Everything that is supplied by the celiac trunk. The cranial boundary is the oropharyngeal membrane and the caudal boundary is just below the liver primordium (in the adult it is the major papilla of the duodenum)
Midgut: Everything that is supplied by SMA. The cranial boundary is just below the liver primordium and the caudal boundary will extend to the end of the proximal 2/3 of the transverse colon
Hindgut: Everything that is supplied by the IMA. The cranial boundary is the distal 1/3 of the transverse colon down to the cloacal membrane.
4
Q
- Define peritoneum and mesentery. Define intraperitoneal and retroperitoneal.
A
- Peritoneum is a serous membrane that lines the walls of abdominal cavity. A mesentery is a double fold of peritoneum. Intraperitoneal is an organ that is connected to the posterior wall by a mesentery, retroperitoneal is when an organ lies against the posterior wall and is not connected via a mesentery.
5
Q
- Describe the dorsal mesentery and list the divisions of this mesentery.
A
- The dorsal mesentery is an embryonic mesentery made from visceral mesoderm that extends from the lower end of the esophagus to the cloacal region of the hindgut.
a. Divisions: Dorsal mesogastrium (greater omentum), mesoduodenum (in the region of the duodenum), dorsal mesocolon (mesentery in region of colon), mesentery proper (connects to jejunum and ileum)
6
Q
- Describe the ventral mesentery and the structures that arise from the ventral mesentery.
A
- The ventral mesentery is derived from the septum transversum.
a. Structures arising from it: Falciform ligament and lesser omentum of the liver and central tendon of the diaphragm.
7
Q
- List the derivatives of the foregut.
A
- The derivatives of the foregut are the biliary apparatus, esophagus, trachea, stomach, pancreas, duodenum, lungs, liver
8
Q
a. Describe the role that the respiratory diverticulum plays in dividing the foregut into the respiratory primordium and the esophagus.
A
a. The respiratory diverticulum is a blunt end pouch. This diverticulum grows cloacally and as it does, tracheoesophageal ridges form. These ridges eventually grow larger and fuse with one another forming the tracheoesophageal septum separating the trachea from the esophagus.
9
Q
b. Describe the process of stomach growth and rotation. How does stomach rotation affect the final positioning the left and right vagus nerves?
A
b. The stomach begins growth by rotating 90 degrees clockwise. As a result of this the previous left side is now anterior and the previous right side is now posterior (leading to the right and left vagus nerves innervating the posterior and anterior of the stomach respectively). After this rotation the new left side grows faster than the new right side and as a result we get a greater and lesser curvature of the stomach. Finally the cardia will grow inferior and slightly to the left as the pylorus grows superior and to the right.
10
Q
- Describe how stomach rotation leads to the formation of the omental bursa (lesser peritoneal sac).
A
- As the stomach rotates it pulls the dorsal mesogastrium with it, resulting in the dorsal mesogastrium looping around behind the stomach. The space that is created between the dorsal mesogastrium and the stomach is known as the omental bursa.
11
Q
- Describe the formation of the spleen.
A
- The spleen primordium begins as a mesodermal proliferation between the two peritoneal layers of the dorsal mesogastrium. As the dorsal mesogastrium swings dorsally and fuses with the posterior wall the spleen swings to the left of the body. The spleen now remaining intraperitoneal is connected to the posterior near the kidneys by the lienorenal ligament and to the stomach by the gastrolieneal ligament.
12
Q
- Describe the formation of the greater omentum.
A
Stomach rotation pushes part of the dorsal mesogastrium toward the anterior of the body. As this mesogastrium grows it grows inferior in front of the forming intestines. This loop of mesentery fuses and becomes 4 fused layers of peritoneum.
13
Q
- Describe the formation of the duodenum. Discuss the rotation process that occurs such that the duodenum reaches its final position.
A
- The duodenum is formed from the terminal end of the foregut and the cephalic end of the hindgut. As the stomach rotates it also rotates the duodenum. As the pancreas rapidly grows It pushed the duodenum to the right creating the C shape. Both these structures then push against the posterior wall to become retroperitoneal.
14
Q
- Describe the formation of the liver, gallbladder, and bile ducts.
A
- The liver begins to grow off of the duodenum as a liver bud (primordium). This bud begins to grow faster and penetrates the septum transversum (bare area). The connection between the liver and duodenum begins to narrow which forms the common bile duct. Ventrally off of this bile duct grows the gallbladder and cystic duct.
15
Q
- Describe the formation of the pancreas. Discuss the rotation of the ventral bud. What portions of the pancreas are formed by the dorsal bud? What portions are formed by the ventral bud?
A
- The pancreas begins two separate buds (ventral and dorsal) the ventral bud during stomach rotation swings dorsally and fuses with the dorsal bud. The ventral bud creates the uncinate process of the head and the dorsal creates the head proper, neck, body, and tail.
16
Q
- Define the main pancreatic duct (of Wirsung) and the accessory pancreatic duct (of Santorini). Describe their development in terms of the contributions of the dorsal and ventral pancreatic buds.
A
- The main pancreatic duct of Wirsung is made up of the duct from the uncinate process and the distal portion of the dorsal duct. This duct drains into the major papilla. The accessory duct (of Santorini) is formed by the proximal duct of the dorsal bud and empties into the minor papilla.
17
Q
- Describe the boundaries of the midgut in the adult.
A
- The boundaries of the midgut in the adult is just distal the major papilla all the way through the proximal 2/3 the transverse colon.
18
Q
- Discuss the formation of the primary intestinal loop. What structures arise from the cephalic limb? What structures arise from the caudal limb?
A
- The primary intestinal loop is a projection of the embryonic intestine that was forced out of the abdominal cavity into the extraembryonic cavity due to rapid liver growth. This loop is composed of a cephalic and caudal limb. The cephalic limb is responsible for the distal of the duodenum, jejunum, and most of the ileum. The caudal limb is responsible for forming the lower part of the ileum, the cecum, ascending colon, hepatic flexure, and proximal 2/3 of transverse colon.
19
Q
- Describe the process of midgut rotation. What structure serves as the axis of rotation for this process?
A
- Midgut rotation occurs around SMA. Upon physiological umbilical herniation the intestines rotate 90 degrees in a counterclockwise manner. As they are pulled back into the abdominal cavity they rotate another 180 degrees to give a total of 270 degrees of rotation.
20
Q
- Describe the process of physiological umbilical herniation. When does it occur?
A
- This is the outpouching of the intestines into the extraembryonic cavity during the sixth week.
21
Q
- Describe the three vitelline duct abnormalities discussed in class: Meckel diverticulum, vitelline cyst, and vitelline fistula.
A
- Meckels diverticulum is when the vitelline duct persists as an outpouching of the ileum. The vitelline cyst is when both ends of the duct form fibrous cords and the middle part of the duct persists. The vitelline fistula is when the vitelline remains patent over the entire length and doesn’t close off to the outside.
22
Q
- Describe the mesenteries of the midgut.
A
- The mesenteries of the midgut are the mesentery proper (small intestine) and the transverse mesocolon.
23
Q
- List the derivatives of the hindgut.
A
- The hindgut creates the rest of the transverse colon, descending colon, sigmoid colon, rectum, upper anal canal.
24
Q
- Describe the role of that the urorectal septum plays in separating the urinary tract from the GI tract.
A
- The urorectal septum separates the cloacal membrane into two separate membranes, the urogenital and the anal.
25
1. Describe the difference in derivation of the superior 2/3 of the anal canal versus the inferior 1/3. What is the pectinate line? `
2. The superior 2/3 of the anal canal is created from endoderm and the inferior is created from ectoderm. These two are delineated by the pectinate line (columnar to stratified squamous)
26
1. What are the superior and inferior borders of the abdominal cavity?
The superior border is the diaphragm and the inferior border is the pelvic inlet.
27
1. What are the planes that define the four quadrants of the abdominal cavity?
1. Medan plane vertically and the transumbilical plane horizontally
28
1. What are the planes that define the nine regions of the abdominal cavity?
1. Vertically the midclavicular lines and horizontally the subcostal line and the intertubercular plane.
29
1. Name the nine layers of the anteriolateral wall from superficial to deep.
1. Skin→Camper’s fascia →scarpa’s fascia→External oblique→internal oblique→transverse abdominis→transversalis fascia→extraperitoneal fat→peritoneum (muscles separated by investing layers of deep fascia)
30
1. What are the three muscle layers of the abdominal wall? Where is their aponeurotic attachment and in what orientation do they run?
1. External oblique (runs anterioinferiorly), internal oblique (runs anteriosuperiorly), and transverse abdominis (runs medially). Their aponeurotic attachment is at the linea alba.
31
1. What does the rectus sheath cover? How does its structure change as you move superior and inferior of the arcuate line?
1. The rectus sheath covers the rectus abdominis. Superior to the arcuate line the external oblique and half of the internal oblique run superficial to rectus abdominis and the other half of internal oblique with and transverse abdominis run deep to rectus abdominis. Inferior to this line all muscles run superficial to the rectus abdominis and the transversalis fascia and peritoneum run deep.
32
1. What are the two layers that are always deep to the rectus abdominus?
1. Transversalis fascia and peritoneum.
33
1. What does the median umbilical fold cover and what are the connection points? What is this a remnant of?
1. The median umbilical fold covers the obliterated urachus which is a remnant of the allantois. This fold runs from the bladder to the umbilicus.
34
1. \What does the medial umbilical fold cover?
1. The medial umbilical fold covers the medial umbilical ligament which is the obliterated umbilical artery.
35
1. What does the lateral umbilical fold cover?
1. The lateral umbilical fold covers the inferior epigastric vessels.
36
1. Where are superficial vessels found?
1. The superficial vessels are found running through camper’s fascia.
37
1. What artery supplies the inguinal ligament? What is this artery a branch of?
1. The artery that supplies the inguinal ligament is the superficial circumflex iliac artery. This is a branch of the femoral artery.
38
1. What artery supplies the superficial abdomen inferior to the umbilicus? What is this artery a branch of?
1. The superficial epigastric vessels which are a branch of the femoral artery.
39
1. What supplies the inferior lateral abdominal muscles? What is this a branch of and what two muscle layers does this run between?
1. The inferior lateral abdominis muscles are supplied by the deep circumflex arteries which are a branch of the external iliac artery. It runs between the internal oblique and transverse abdominis.
40
1. What vessels supply the lower rectus abdominis muscles, what are they a branch of, where do they enter the rectus sheath, and with what do they anastomoses?
1. The lower rectus abdominis muscles are supplied by the inferior epigastric artery. This is a branch of the external iliac and enter the rectus sheath at the arcuate line. They anastomose with the superior epigastric arteries.
41
1. What vessels supply the upper rectus abdominis, what is it a branch of, and where does it enter?
1. The upper rectus abdominis is supplied by the superior epigastric muscles which are a branch off of the internal thoracic. The superior epigastrics enter just lateral to the sternum.
42
1. What vessels supply the upper abdominal muscles and diaphragm? What are they a branch of? What do they run along?
1. The upper abdominal muscles and diaphragm are supplied by the musculophrenic vessels. They are a branch of the internal thoracic and run along the costal cartilage.
43
1. Nerves of what vertebral levels supply the abdominal wall? Describe which nerves supply which regions.
1. Nerves of T7-L1 supply the abdominal wall. T7-T9 supply above the umbilicus, T10 is umbilicus, and T11-L1 supply below umbilicus. These nerves run between internal oblique and transverse abdominis.
44
1. Injury to what region causes hernias?
1. Injury to T11-L1 causes hernias.
45
1. At what vertebral level can the arcuate line be found?
1. The arcuate line can be found around cutaneous innervation level of T12.
46
1. Where can the inguinal region be found?
1. The inguinal region is found superior the thigh, median to ilium, and lateral to the pubic bone.
47
1. Where is the superficial inguinal canal ring?
1. Inguinal ligament, inguinal canal, superficial and deep rings, wall of canal
48
1. Where is the deep ring?
1. The superficial inguinal ring is a triangular ring found in the external oblique.
49
1. Where can an indirect hernia be found?
1. The deep ring is an opening in the transversalis fascia.
50
1. Where can a direct hernia be found?
1. An indirect hernia can be found running through the entire inguinal canal (in the deep ring and out the superficial ring). This one can enter the scrotum or labia majora.
51
1. What is the name for organs that lie behind the peritoneum called?
1. A direct hernia is busts through the conjoint tendon and can be found at or near the superficial ring.
52
a. Within the peritoneum?
1. Organs that lay behind the peritoneum are called retroperitoneal. Ones that lie within the peritoneum are intraperitoneal.
53
1. What do two peritoneal layers coming together make?
1. Two peritoneal layers that come together make a mesentery.
54
1. What are the functions of the greater omentum? What is it made of? Where does it attach?
1. The greater omentum serves to wall off infections and inflammation sites. It is made of 4 peritoneal layers (or two fused dorsal mesogastrium layers) and attaches to the greater curvature of the stomach and the transverse colon.
55
1. Where does the lesser omentum attach? What are the two ligaments that attach the lesser omentum to the liver? Which contains the portal triad and what is it?
1. The lesser omentum attaches to the liver, duodenum, and lesser curvature of the stomach. The two ligaments are the hepatoduodenal and hepatogastric ligament. The hepatoduodenal ligament contains the portal triad (portal vein, hepatic artery, bile duct).
56
1. What anchors most of the small intestine?
1. The mesentery proper anchors most of the small intestine.
57
a. What two junctions does it run between?
It runs between the ileocecal and duodenojejunal junctions.
58
1. What is the duodenum anchored by?
1. The duodenum is anchored by the suspensory ligament of Trietz at the duodenojejunal junction.
59
1. What parts of the colon are anchored by a mesocolon?
1. The transverse colon and the sigmoid colon are both anchored by their respective mesocolon (which means these lie intraperitoneal and the other portions lie retroperitoneal).
60
1. How does the transverse mesocolon divide the abdominal cavity?
1. The transverse colon divides the abdomen into infracolic and supracolic (above and below the colon).
61
1. When do peritoneal pouches become relevant?
1. They become relevant when you are in a recumbent position.
62
1. What is the pouch that is found in the pelvis of the male?
1. The pouch that is found on the male is the rectovesicle pouch.
63
1. What are the two pouches found in the pelvis of a female?
1. The two pouches on the woman are the vesico-uterine pouch and the rectouterine pouch. (don’t forget about the pouch of Morrison (hepatorenal pouch))
64
1. Describe the following surfaces on the liver:
a. Diaphragmatic
b. Visceral
c. Right
d. Left (what tendon separates R and L?)
e. Caudate
f. Quadrate
g. What does the porta hepatis functionally allow?
a. The diaphragmatic surface is the surface that contacts the diaphragm.
b. The visceral surface is the one that faces the organs inferior the liver
c. The right lobe is to the right and is the larger lobe (forces many organs on the right side of the body to be more inferior than their counterparts i.e. the kidneys)
d. The left lobe is left. These lobes are separated by the falciform ligament.
e. Caudate is on the right lobe and is superior the quadrate.
f. Quadrate is also on the right lobe and is inferior to the caudate.
g. Porta hepatis functionally allows for the filtration of blood by the liver.
65
1. What does the round ligament contain?
| a. Where is it located?
1. The round ligament contains the obliterated umbilical vessels.
a. It is located at the inferior region of the falciform ligament anteriorly.
66
1. What divides the liver into the R and L lobes?
| a. What does this ligament anchor the liver to?
1. The falciform ligament divides the liver into the right and left lobes.
a. Anchors the liver to the anterior wall.
67
1. What ligament surrounds the bare area of the liver and where can the bare area be found?
a. What does this ligament attach the liver to?
1. Coronary ligament surrounds the bare area of the liver
| a. This ligament attaches the liver to the inferior region of the diaphragm.
68
1. What are the three regions of the gallbladder?
a. How much bile does it store and what artery supplies this organ?
b. What is the duct system that leads to and from the gallbladder?
1. Furthest from the cystic duct is the fundus, then body, then neck closest to the cystic duct.
a. 750 mL/day; supplied by the cystic artery from the hepatic proper.
b. Leading from the liver is the hepatic duct, and from the gallbladder is the cystic duct. These combine to form the common bile duct.
69
1. What are the regions of the pancreas?
a. how does this organ lay relative to the peritoneum?
b. What organs surround it?
c. Where and what does the main duct enter?
d. The accessory duct?
1. The head (made up of the uncinate process and the head proper), the neck, body, and tail.
a. This organ lays retroperitoneally.
b. It is surrounded by the duodenum, spleen, stomach
c. The main duct enters at the major papilla in the duodenum
d. The accessory duct enters at the minor papilla.
70
1. What does the spleen contact and where?
a. What connects it to the greater curvature of the stomach?
i. What does this connection contain?
b. What connects it to the kidney?
i. What does this connection contain?
c. What is an entry point for the splenic vessels?
d. What is the arterial supply?
1. The spleen contacts the diaphragm, the pancreas, and the stomach.
a. It is connected to the greater curvature of the stomach by the gastrosplenic ligament.
i. Contains the left gastro-epiploic vessels.
b. It is connected to the kidney by the splenorenal ligament.
i. Contains the splenic vessels.
c. The entry point for the vessels is the hilum of the spleen.
d. The arterial supply is the splenic artery which is a main branch of the celiac trunk.
71
1. What arteries distribute to the 12th rib?
| a. From where do they arise?
1. The subcostal arteries distribute to the twelfth ribs
| a. arise from the thoracic trunk.
72
1. Where does the upper abdominal supply begin?
1. The upper abdominal supply begins at the aortic hiatus T-12 (with the inferior phrenic arteries).
73
1. What bifurcation ends this supply and where?
1. The bifurcation of the aorta into the common iliac arteries ends this supply.
74
1. What does the common iliac divide into?
1. The common iliac artery divides into the internal and external iliacs.
75
1. What is the first major branch of the aorta?
1. The celiac trunk.
76
1. What does it branch into?
1. Celiac trunk branches into the common hepatic artery, left gastric artery, and the splenic artery.
77
What is the order of the digestive tract beginning with the esophagus?
1. The digestive tract order is esophagus →stomach →duodenum → jejunum → ileum → cecum → ascending → hepatic flexure → transverse colon → splenic flexure → descending colon → sigmoid colon
78
1. What are the entrance and exit points of the stomach called?
1. Cardiac orifice and the pyloric sphincter
79
1. What are temporary folds in the stomach called?
1. The temporary folds are known as rugae
80
1. What muscle allows for the stomach to act like a blender?
1. Muscularis externa (specifically the added muscle is the internal oblique.
81
31. What is the food mass called as it enters and exits the stomach?
1. Bolus.
82
1. What nerve plexus (common and anatomic name) controls the stomach contractions?
1. Auerbachs (myenteric) plexus
83
1. What are the three sections of the small intestine?
1. End of the duodenum, jejunum, and ileum
84
1. What is the blood supply for the duodenum?
1. The superior and inferior anterior and posterior pancreaticoduodenal arteries
85
1. What are the four portions of the duodenum and where can each be found?
1. 1-4 or superior (L1), descending (L1-L3), horizontal (L3), ascending (L3-L2).
86
1. How is the duodenum relative to the peritoneum?
1. The duodenum is intraperitoneal at the cap and is retroperitoneal nearing the jejunum.
87
1. What is the transpyloric plane?
1. The transpyloric plane is the plane on which the pyloric sphincter lies.
88
1. Describe how each of the following are found moving more distal toward the ileum (and describe what each is?)
a. Plicae
b. Vasa rectae
c. Vascular arches (arcades)
d. Fat deposits
e. Lymphatic vessels
f. Goblet cells
1.
a. Plicae are the folds that are found in the small intestine. They become less numerous as you move more distal.
b. Vasa rectae are the arteries that are closer to the intestinge. They become shorter as you move more distal.
c. Arcades are further away and are arches of arteries. They become larger and more numerous as you move more distal.
d. Fat deposits (epiploic appendages) become more numerous as you move more distal.
e. Lymphatic vessels become more numerous as you move distal. Are known as peyers patches near the cecum.
f. Goblet cells are surface mucous producing cells and become more numerous as you move distally.
89
1. What is Meckel’s diverticulum?
1. Meckel’s diverticulum. Outpouching of the small intestine that is a remnant of the vitelline duct.
90
1. Name all five segments and two flexures of the large intestine
1. Cecum, ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, sigmoid colon.
91
1. Where does appendicitis pain begin?
a. Where does severe pain begin?
i. What causes this pain?
b. At what vertebral level can the most severe pain be felt?
1. Near T10 cutaneous innervation near the umbilicus
a. Severe pain begins in the lower right quadrant
i. Peritoneal irritation
b. Near the spinoumbilical point around L4
92
1. What are the two compartments made by the transverse mesocolon?
a. What is contained in each compartment?
1. Supracolic and infracolic.
| a. Infracolic: small intestine; supracolic: liver, spleen, stomach, etc.
93
1. What are the three colon specializations?
1. Haustra, tenia coli, epiploic appendages.
94
1. What are the three main branches off of the aorta?
1. Celiac trunk, SMA, IMA
95
1. What does the celiac trunk supply; what are the three main arteries branching from the celiac trunk?
1. Celiac trunk supplies the foregut, with the three main branches (common hepatic, left gastric, splenic)
96
1. What does the SMA supply?
1. The SMA supplies the midgut (duodenum (after major papilla), small intestine, large intestine (up to proximal 2/3 of transverse))
97
1. What are the four arteries the come off of the SMA
| a. What are the branches of each, does each supply, and anastomoses with?
1. Iliocecal artery, right colic artery, middle colic artery, and the intestinal arteries
98
1. What does the IMA supply?
1. IMA supplies hindgut.
99
1. What are the three branches of the IMA and what does each supply?
1. Three branches of the IMA are left colic, sigmoid arteries, and superior rectal artery
100
1. What is the consistent vasculature arch around the colon called?
1. The marginal artery of Drummond.
101
1. What arteries supply the pancreas, where are they derived from?
1. The pancreatico duodenal arterie (superior and inferior) and arteries branching off of the splenic artery.
102
1. What does the renal artery supply?
1. The renal artery supplies the two kidneys and part of the adrenal glands.
103
1. What does the gonadal artery supply and what is it a branch of?
a. How does the ovarian travel to reach the ovaries?
b. How does the testicular reach the testies?
1. The gonadal artery supplies the testes in the male and ovaries in the female. It is a branch off of the aorta just inferior to the renal arteries.
a. Ovarian travels inferiorly crosses over the ureters and iliac vessels, and descends into the pelvis
b. The testicular veins travel inferiorly, cross over the ureters, enter the inguinal canal, and descend into the scrotum
104
1. What is the largest vein in the body?
| a. Where does this vein begin?
1. Inferior vena cava
| a. This vein begins at L5 with the union of the common iliac veins.
105
1. Where does viscera blood go?
1. The visceral blood goes to the portal system.
106
1. What organs contribute to the portal vein and the union of what two veins form the portal vein?
1. Stomach, small intestine, large intestine, spleen, pancreas, gallbladder. The union of the superior mesenteric vein and the splenic vein for the portal vein.
107
1. What are the four portal/caval anastomoses in the portal system?
1. Gastric → Esophageal
Paraumbilical → epigastric
Superior Rectal → Middle/Inferior Rectal
Colic → Retroperitoneal
108
1. Where do abdomen sympathetic fibers extend from?
| a. Parasympathetic fibers?
1. They extend from T1-L2
| a. The parasympathetic fibers are found extending from CN X and S2-4
109
1. Where can the pregalnglionic sympathetic synapses be found?
a. Where do the postganglionic fibers leave and go?
1. Preganglionic sympathetic synapses can be found in collateral ganglia
a. The postganglionic fibers leave and go to the affector organs.
110
1. What do the post synaptic fibers follow?
| a. Specifically which?
1. The post synaptic fibers follow arteries
| a. Specifically the SMA, celiac trunk, renal, and IMA and all of their branches.
111
1. Describe the three splanchnic nerve bundles
1. The Greater splanchinic nerve bundle consists of the T5-T9 nerves (serving the foregut). Lesser splanchnic T10-T11 (serving the midgut) and least is T12 serving the renal arteries. NOTE: L! and L2 serve hindgut.
112
1. Where do the cell bodies for the pre ganglionic nerves of the parasympathetic nerves reside?
1. In the lateral horns of the CNX and S2-4
113
1. What do each of the parasympathetic nerve divisions innervate?
1. CNX: Innervates everything from foregut through the midgut.
1. S2-4 innervates hindgut and travels with SMA.
114
1. What are the 4 major autonomic ganglial plexuses?
**
115
1. Review the gross anatomical structures associated with the digestive system, both those that are part of the alimentary canal and those considered accessory digestive organs.
1. Alimentary canal is from oral cavity to the anus and everything in between. The accessory organs are the teeth, tongue, salivary glands, liver, pancreas, gallbladder.
116
1. Review the overall functions of the digestive system.
1. Ingestion, secretion, mixing and propulsion, digestion, absorption, defecation, barrier, and immunologic protection
117
1. Discuss the functional role of saliva.
1. Moisten oral cavity, moisten dry foods, provide medium for food to dissolve, buffer oral contents, contains amylase
118
1. Name, describe, and identify histologically the different layers of the wall of the alimentary canal. Be sure to include a detailed description of the different tissues and structures found in each layer.
a. What are the three layers of the mucosa? Which layers make up the mucous membrane?
b. What types of cells can be found in the lining epithelium?
c. What makes up the lamina propria? The muscularis mucosae?
d. What can be found in the submucosa (2)? What are the functions?
e. Describe the two muscular layers found in the muscularis externa and their functions.
f. What is the nerve plexus associated with the muscularis externa and where can it be found?
g. When is the outer layer considered serosa or adventitia? What are the two layers of serosa?
a. Three layers of mucosa are epithelium, lamina propria, muscularis mucosae. The lamina propria and epithelium create the mucous membrane.
b. Lining epithelium, simple columnar and stratified squamous
c. The lamina propria is made up of loose areolar connective tissue.
d. Dense irregular connective tissue binds mucosa to muscularis externa and meissners plexus innervates glands and supplies the muscularis mucosae.
e. Outer longitudinal (dilates the lumen and shortens the organ) and inner circular (constricts the lumen and lengthens the organ).
f. Auerbachs plexus it runs between the inner circular and outer longitudinal
g. It is serosa when the organ is intraperitoneal and adventitia when retroperitoneal. The two layers of serosa are mesothelium and loose connective tissue.
119
1. For the esophagus and stomach: Describe and identify histologically. What wall modifications are associated? What lining epithelium (or epithelia) is associated? What cells are associated with epithelium? What is the function of these different cells? What glands are associated? Relate these wall modifications to function.
a. Describe the four layers of the wall for the esophagus.
b. How is the stomach divided grossly and histologically?
c. What glands can be found in each histologic division?
d. Describe the four wall layers of the stomach
a. Mucosa: Stratified squamous epithelium in the first 1/3, stratified squamous and simple columnar mix in the middle 1/3, and simple columnar in the distal 1/3; near the duodenum can find esophageal cardiac glands in the lamina propria (help with acid reflux)
Submucosa: can see esophageal glands proper here
Muscularis Mucosa: Outer longitudinal and inner circular. First 1/3 is skeletal muscle, second 1/3 is skeletal and smooth muscle mix, distal 1/3 is smooth muscle
Adventitia: until it passes through the esophageal hiatus then is serosa.
b. Grossly is divided into cardia, fundus, body, and pylorus. Histologically is divided into cardia, fundus/body, and pylorus.
c. In the cardia cardiac glands can be found which are primarily mucous secreting. Similarly pyloric glands can be found in the pylorus, also secreting mucous. In the fundic region, fundic (not gastric) glands can be found. These are the glands that produce pepsin (chief cells) and HCl (Parietal cells)
d. Mucosa: simple columnar epithelium with gastric pits leading to the chief and parietal cells
Submucosa: no glands are present
Muscularis externa: three layers of muscle (outer longitudinal, middle circular, and inner oblique)
Serosa
120
1. For the small intestine and large intestine: Describe and identify histologically. What wall modifications are associated? What lining epithelium (or epithelia) is associated? What cells are associated with epithelium? What is the function of these different cells? What glands are associated? Relate these wall modifications to function.
a. What three sections make up the small intestine
b. What are the folds called and what is found in their core?
c. Describe the four wall layers of the small intestine
d. In ileum what are lymphatic nodules called in the small intestine? What cells overlay these?
e. Histologically, how can you differentiate between plicae and microvilli?
f. What are the absorptive cells called in the small and large intestine?
a. Distal of duodenum, jejunum, and ileum
b. Rugae, found at their core is submucosa.
c. Mucosa: Simple columnar with microvilli (enterocytes) that lie on villi who’s core is lamina propria; Crips of lieberkuhn, these are tubular glands containing stem cells Paneth cells and enteroendocrine cells
Submucosa: Brunner’s glands in duodenum that secrete an alkaline mucous
Muscularis externa: two muscle laters, outer longitudinal, inner circular
Serosa
d. Peyers patches, the cells that overlay these are microfold cells
e. Pilcae containe the submucosa and muscularis mucosae at the core whereas villi only have lamina propria
f. Enteryocytes are the absorptive cells in the small intestine and colonocytes are in the large intestine
121
1. Describe and histologically identify the parts of the pancreas. What is the role of the pancreas? What parts function as an exocrine gland? Endocrine gland? Describe the acinar cells of the pancreas.
1. Pancreas is mad of the head (head proper and uncinate process), neck, body, and tail. The pancreas has endocrine (glucagon and insulin) and exocrine (digestive enzymes) functions. The acinar cells are the ones that function as an exocrine gland whereas the Islets of Langerhans are the ones that produce and secrete insulin and glucagon.
122
1. Describe blood flow to/from the liver.
1. Blood flow to the liver comes from the portal vein and the hepatic artery → liver sinusoids →central vein → hepatic vein → IVC →right atrium
123
1. Describe and histologically identify the parts of the liver (e.g. portal triad, hepatic lobule, hepatocytes, Kupffer cells, Ito cells, bile canaliculi, etc.). What are some functions of the liver?
1. Portal triad: The portal triad is made up of the portal vein, the hepatic artery, and the hepatic bile duct; hepatic lobule: a six sided (hexagonal structure) that if filled with sinusoids and 1 layer thick hepatocytes; hepatocytes: contain microvilli that extend into the space of disse to increase the absorptive ability; Kupffer cells: large macrophage like cells that contribute to phagocytosis and can even phagocytize red blood cells; Ito cells: stellate cells that lie in the space of disse to store vitamin A; bile canaliculi: this is where numerous hepatocytes contact one another to form the beginning of the bile system
124
1. Describe and histologically identify the gallbladder. What is the function of the gallbladder?
1. The fundus is furthest from the cystic duct then the body and finally the neck. Mucosa: Simple columnar cells with microvilli for absorbing (does not contain a muscularis mucosae) Submucosa: nonexistent Muscularis Externa: very large to be able to squeeze the bile out
125
1. Describe the three zones of the anal canal.
1. Three zones of the anal canal: colorectal zone: superior 1/3, simple columnar epithelium; anal transitional zone: mix of simple columnar, stratified columnar/cuboidal, and stratified squamous; squamous zone: nonkeratinized stratified squamous with a mucocutaneous junction.
126
1. Describe the fat & fascia surrounding the kidneys. Be sure you can distinguish between perinephric fat and paranephric fat.
1. On the outside of the kidney is a fibrous renal capsule. This capsule contacts PARArenal fat which is fat that surrounds the kidneys. PERIrenal fat is fat found in the renal sinus.
127
1. Describe the structure, position, vasculature and drainage of the kidneys.
a. Describe the structure, vasculature, and location of the adrenal glands.
1. Structure: The kidneys have an outer fibrous capsule, the renal cortex deep to that (this is the layer that contains the renal corpuscles), the renal medulla deep to that (contains the columns and pyramids), the pyramids lead to a minor calyce, major calyce, renal pelvis, and ureter. Position: lateral to vertebral column T12-L3. The apicies of the right and left lay at the 12 and 11 rid respectively. Vasculature: the renal arteries supply the kidneys and the renal veins drain it. The veins lie most anterior, then the arteries, then the ureters. Drainage: the kidneys drain from the renal papillae, to the minor calyces, to the major calyces, to the renal sinus, and to the ureters.
a. Structure: fibrous cap, cortex (makes adrenalin) and medulla (acts as nerve tissue). The right is a triangle where the left is more of a crescent sometimes reaching down to the hilum. Vasculature: three main suprarenal vascular branches that supply each adrenal gland. The superior one is a branch off of the inferior phrenic, the middle is a branch off of the, aorta, and the inferior is a branch off of the renal artery.
128
1. Describe the structure, neurovascular supply of the diaphragm, particularly the inferior surface.
1. The diaphragm extends from the sternum anteriorly to the 12th vertebrae posteriorly. It is supplied by the phrenic nerve coming from C3-C5. Its vasculature is the pericardiophrenic artery and the superior phrenic artery supplying the diaphragm superiorly, the inferior portion is supplied by the inferior phrenic artery (first branch off of aorta in the abdomen) and the musculophrenic supplies the periphery.
129
1. Describe the features of the inferior surface (arcuate ligaments) of the diaphragm and the structures that pass through the diaphragm. Correlate these structures with vertebral levels.
1. Arcuate ligaments: Median crosses over the aorta, Medial cross of the psoas major, and Lateral cross over the quadratus lumborum. Holes: vena cava passes through at T8, esophagus passes through at T10, and aorta passes through at T12.
130
1. Describe the musculature and vasculature of the posterior abdominal wall.
a. Where does the aorta bifurcate (vertebral level)
1. Transversus abdominis is found on the periphery, Quadratus lumborm is medial to that, and the psoas major even more so. Illiacus fills the depressions of the ilium, and the psoas minor lies on top of the major. The diaphragm is found superior most. Vascular supply is four pairs of lumbar arteries.
a. About L5
131
1. Describe the composition & innervation pattern of the lumbar plexus of nerves.
1. Lumbar plexus is T12-L4. The iliohypogastric and iliinguinal are first and come off of L1. lateral cutaneous of the thigh is inferior to those (L2-3). Then there is femoral that is lateral to the psoas major, Genitofemoral is just superior to the psoas major (L2), and obturator is medial and deep to the psoas major.
132
1. Name the embryonic germ layer from which the urinary system arises.
The urinary system arises from the intermediate mesoderm.
133
1. Describe the development of the pronephros, mesonephros, and metanephros in detail. Include the body regions in which each stage of the kidney arises as well as the embryonic timing in weeks for each stage.
1. This development begins cranially and proceeds caudally. The pronephros form and degenerate in week 4. These are basically useless. The mesonephros then form in the thoracic region in week four and continue to form caudally. Urine is formed and excreted in the mesonephros (Wolffian) duct. The thoracic segments begin to regress as the ones in the cloacal region fuse with the cloaca. This initiates ureteric bud formation. This formation triggers the metanephric phase which induces intermediate mesoderm in the sacral region to differentiate and form the metanephric blastemal.
134
1. What structures will the mesonephric ducts and mesonephric tubules persist as in the male genital system? (This will be discussed further in the genital system development lecture.)
1. The mesonephric ducts and tubules will persist as the vas derefens, epididymis, seminal vesicle, and ejaculatory duct.
135
1. Describe the role of reciprocal induction in the formation of the permanent kidney. What can result if this critical process fails to occur properly?
1. Reciprocal induction is the induction of nephron differentiation from the close proximity of the ureteric bud. Without this proximity will be no differentiation and no kidney formation.
136
1. List the derivatives of the ureteric bud and the metanephrogenic blastema that together form the collecting and excretory portions of the kidney, respectively.
1. Collecting portion from bud (ureter, renal pelvis, major and minor calyces) and excretory from metonephrogenic blastema (bowman’s capsule, proximal convoluted tubule, loop of henle, DCT).
137
1. Describe the ascent and progressive revascularization of the kidneys. What structure could potentially block kidney ascent, resulting in a pelvic kidney? What is a horseshoe kidney, and what arterial structure blocks its ascent?
1. As the body grows longer the kidneys begin to ascend with this growth. As they move superior, they begin to devascularize and revascularize. As they are ascending they can become caught up on the IMA as a horseshoe kidney or may have an abnormality that doesn’t allow them to ascend.
138
1. Explain the role that the urorectal septum plays in urinary system development.
1. The urorectal septum grows towards the cloacal membrane separating this region into the urogenital ventral sinus and the rectal dorsal portion. The urogenital then differentiates into three different regions moving superiorly.
139
1. List the derivatives of the urogenital sinus. What embryonic structures give rise to the trigone of the urinary bladder?
1. Derivatives of the urogenital sinus are the 1. Superior vesicle region; this region creates the bladder 2. Middle pelvic region 3. Inferior phallic region.
a. Trigone is formed on the posterior of the bladder by the attachment of the mesonephric ducts and their eventual fusion.
140
1. List parts of the urinary system. What is the function(s) of each part and the urinary system overall?
1. The function overall of the urinary system is to filter blood and excrete waste. The parts of the urinary system are the kidneys (filtration), ureters, bladder, and urethra.
141
1. Locate and describe the gross anatomical features of the kidney – include the renal hilum, renal sinus, renal capsule, renal cortex, renal medulla, renal pyramids, renal columns, renal papilla, minor calyces, major calyces, renal pelvis, and renal lobe.
1. Renal hilum: location in the kidneys where the renal artery, vein, and ureters enter/exit the kidney. Renal sinus: region of the kidney where perinephric fat can be found and the arteries branch and veins come together. Renal capsule: fibrous capsule around the kidneys (contacts paranephric fat) Renal Cortex: area where the corpuscles, DCT and PCT can be found. Renal Medulla: where the loop of henle can be found in addition to the pyramids and columns. Near the bottom find renal papilla. Renal Pyramids: one lobe of the kidney that contains collecting ducts, loop of henle, etc. separated by Renal columns which contain the blood vessels. Renal Papilla the End of the renal pyramids that contact the minor calyces, each of which combine to form major calyces leading to the renal pelvis and the ureters. Renal lobe is a renal pyramid and half of the surrounding columns.
142
1. Describe the general blood flow to and blood drainage from the kidneys, paying particular attention to the renal artery, afferent arterioles, glomerular capillaries, efferent arterioles, peritubular capillaries, and renal vein.
1. Blood flow begins from the renal artery, separates into the segmental arteries in the renal sinus, then form the interlobar arteries. These then form the arcuate arteries, interlobular arteries, and the afferent arteriole leading to the first bed of capillaries, the glomerulus. After the glomerulus is the efferent arteriole leading to the second bed of capillaries, the peritubular capillaries. This then leads to the interlobular vein, the arcuate vein, the interlobar vein, the renal vein and finally IVC back to the heart.
Renal artery → segmental arteries → interlobar arteries → arcuate arteries → interlobular arteries → afferent arteriole → glomerulus → efferent arteriole → peritubular capillaries → interlobular vein → arcuate vein → interlobar vein → renal vein → IVC
143
1. Define and histologically identify a nephron and its associated parts.
a. What are the parts of the renal corpuscle?
b. What are the different parts of Bowman’s capsule?
c. What’s a podocyte, filtration slit, and filtration membrane?
d. What are the parts of the renal tubule?
e. What types of epithelial cells line each part of the renal tubule?
f. What are the two types of nephrons found in the human kidney?
g. What is a uriniferous tubule?
h. What are the two poles of a renal corpuscle?
1.
a. Renal corpuscle is made up of the glomerulus and Bowman’s capsule
b. Bowman’s capsule is made up of a visceral (podocyte) and parietal layer
c. A podocyte is the cell that lines the glomerulus as the visceral later of bowman’s capsule. The filtration slid is the space between the podocytes podicles. The filtration membrane covers these filtration slits
d. Renal tubule is made up of PCT, loop of henle, DCT
e. PCT and DCT thick tubules are simple columnar while loop of henle is simple squamous
f. There is the Juxtamedullary nephron (extends deep into medulla) and corticol nephron (short loop of henle)
g. The uriniferous tubule is the is the nephron and its collecting duct
h. The vascular pole and the urinary pole
144
1. What type of cells are found lining the collecting tubule and collecting duct?
1. Collecting ducts are simple cuboidal with very clear borders; collecting tubules are simple cuboidal with not so clear borders
145
1. List and briefly describe the three physiological processes of the nephron. Where do each of these processes take place relative to the nephron?
1. Filter, secrete, resorb
146
1. Define and identify histologically the juxtaglomerular apparatus.
1. This apparatus is where the ascending loop of henle touches the glomerulus. Here you can find a thick macula densa (cells on cells on cells on cells) and modified muscle cells known as juxtaglomerular cells
147
1. Trace, describe, and histologically identify the structures that urine passes through to be removed from the body. How does the urethra differ anatomically and histologically between males and females?
1. Male urethra contains a prostatic, membranous, and spongy urethra, whereas the female contains just prostatic and membranous.
148
1. Trace a molecule of water (that is to be removed from the body) from the blood to the urethra.
1. From the blood a molecule of water will travel through the afferent arteriole to the glomerulus where it is to be filtered out. This water will then travel through the PCT, loop of henle, and DCT (assuming it is not resorbed) and then the collecting duct. This collecting duct will travel through the cortex, through the medulla and eventually meet up with a minor calyce. This minor calyx empties into a major, and then into the renal sinus and ureter.
149
1. Describe the functions of the reproductive system. What are the roles for the male? What are the roles for the female?
1. Functions of the reproductive system are both endocrine and exocrine. Males produce sperm and testosterone, females produce eggs, estrogen, and are responsible for maintaining a hospitable environment for an implanted egg.
150
1. Discuss the role of the male gonads – include a description of the endocrine and exocrine functions of the male gonads. What are the male gonads and gamete? Why are the male gonads found in the scrotum?
1. The male gonads are responsible for producing sperm (exocrine) and testosterone (endocrine). The male gonads are the testes and the gamete is a spermatozoa. The testes are found in the scrotum to maintain a constant temperature of 34 C.
151
1. Describe and identify the gross and histological features of the testes.
1. Seminiferous tubules: tubules that are responsible for sperm production. These are housed in lobules that are created by the tunica albuginea. Outside of the tunica albuginea is the tunica vaginalis with both a parietal and visceral layer. The seminiferous tubules connect to the rete testis by way of the straight tubules. The rete testis then connects to the efferent ductules leading to the epididymis.
152
1. Discuss and histologically identify the cells of the testes. Be sure to discuss spermatogenesis and spermiogenesis.
a. Spermatogonia (cells that are involved with the spermatogonial phase; mitosis)
i. Type A dark: Stem cells of the spermatogonia, develop into Ap
ii. Type A pale: go through mitosis but have incomplete cytokinesis
iii. Type B: biggest and have condensed chromatine
b. Primary spermatocyte: arrested in PI
c. Secondary Spermatocyte: rapidly goes through meiosis II
d. Spermatid: (early is circular and cell looking; late looks more like spermatozoa that is stuck to Sertolli cells)
e. Sertolli cells: where spermatogenesis occurs.
f. Spermatogenesis is the process of going through spermatogonial phase, spermatocyte phase, and spermatid phase. Spermiogenesis is just the spermatid phase. Spermatocytogenesis is the first two phases (spermatogonial phase and spermatocyte phase)
153
1. Trace, locate, histologically identify, and discuss the intratesticular and excretory genital ducts of the male.
a. Seminiferous tubules: sperm production; sertoli cells and numerous other cells going through spermatogenesis. Each tubule is surrounded by a layer of myoid cells
b. Straight tubules: lined with sertoli cells only
c. Rete testis: cuboidal or low columnar epithelium with underlying dense connective tissue
d. Efferent ductules: pseudostratified columnar epithelium with some ciliated cells and some with microvilli
e. Ductus Epididymis: pseudostratified and columnar with stereocilia. Here is where the sperm is stored and matures
f. Ductus deferens: pseudostratified columnar epithelium, lots of smooth muscle.
g. Urethra: Prostatic (lined by transitional epithelium) membranous (stratified columnar or pseudostratified columnar) spongy/penile urethra (lined by pseudostratified columnar)
154
1. Locate, histologically identify, and discuss the male accessory reproductive glands.
a. Seminal vesicles: simple columnar or pseudostratified columnar; joins ductus deferens to form ejaculatory duct and secretes many of the components of semen.
b. Prostate Gland: glands embedded in fibromuscular stroma, contains prostatic secretions, and empties into prostatic urethra. Releases fluid to be part of the semen.
c. Bulbourethral glands: lined with mucous secreting tubuloalveolar glands; empties into proximal part of penile urethra
4.
155
1. Discuss the role of the female gonads – include a description of the endocrine and exocrine functions of the female gonads. What are female gonads and gamete?
*
156
1. Describe and identify the gross and histological features of the ovaries.
*
157
1. Discuss the process of follicular growth and ovulation, as well as histologically identify the different components involved.
*
158
1. Discuss and histologically identify the uterine tubes, the uterus, the vagina, the cervix, and the mammary glands and their components.
*
159
1. What are the two regions of the pelvic cavity?
8. True pelvis (below pelvic brim) and false pelvis (above pelvic brim).
160
1. What are the extents of each cavity?
1. False pelvis goes from ASIS to pelvic inlet and true pelvis goes from pelvic inlet to perineum.
161
1. What lines make up the pelvic brim?
1. Pubic symphysis, pubic crest, pectin pubis, arcuate line, ala of the sacrum, then sacral promontory
162
1. How is the pelvic cavity angled and why?
1. The pelvic cavity is angled anteriorly to aid in child bearing and birth
163
1. How do viscera lie relative to the peritoneum?
1. All of the viscera found in this region are retroperitoneal.
164
1. What is the pouch that is found in the male? What two are found in the female? Which is deeper in the female?
1. The pouch in the male is the rectovesicle pouch. Those found in the women are rectouterine and vesicouterine pouch.
165
1. What bones make up the pelvis?
1. The pelvis is made up by two os coxae and a sacrum. The os coxae is composed of the ilium, ischium, and pubis.
166
1. How do the male and female pelvises differ in the following aspects:
a. Pelvic brim shape
b. Pubic symphysis
c. Pubic arch (bonus, where is the pubic arch located)
d. Iliac wings
e. Ischial tuberosity
f. Sacrum
g. Obturator foramina
a. The male brim is heart and the female brim is oval.
b. The pubic symphysis is wider in males.
c. Females have a wider pubic arch (located between inferior pubic rami)
d. The iliac wings of women are more flared relative to men.
e. Ischial tuberosities in women are further apart.
f. The sacrum comes in much more curved anteriorly than the female
g. The obturator foramen in women are more oval than round like in men
167
1. Describe the following ligaments
a. Pubic symphysis
b. Anterior sacroiliac ligament
c. Posterior sacroiliac ligament
d. Sacrotuberous ligament
e. Sacrospinous ligament
f. Obturator membrane
g. Inguinal ligament
h. Interosseous ligament
a. Pubic symphysis is between the two pubic bones that fuses the two os coxae together.
b. Anterior sacroiliac ligament attaches to the sacrum and ilium; is the anterior most
c. Posterior sacroiliac also attaches to the sacrum but posteriorly
d. The sacrotuberous ligament extends from the sacrum (superiorly) to the iliac tuberosity inferiorly.
e. The sacrospinous extends laterally from the sacrum to the spinous process of the ilium.
f. Obturator membrane: covers the obturator foramen leaving a small gap for the obturator nerve and vessels
g. Inguinal ligament extends from ASIS to the pubic tubercle.
h. Interosseous ligament is hidden inside of the two sacroiliac ligaments.
168
1. What two above ligaments cross to create a greater and lesser foramen? Describe their orientations and the name of the foramen.
3. The sacrospinous and sacrotuberous ligaments cross to form the greater and lesser sciatic foramina. The sacrospinous runs laterally to create the floor of the greater sciatic foramen and the sacrotuberous runs inferiorly and creates the inferior border of the lesser sciatic foramen
169
1. What muscle runs through the greater sciatic notch? How is it innervated, what does it act on, and where does it originate and insert?
3. the piriformis runs through the greater sciatic foramen. Runs from the anterior of the sacrum to the greater trochanter. Innervated by S1 and S2. It acts on the hip.
170
1. Which muscle runs through the lesser sciatic notch? Where does it originate, how is it innervated?
3. The obturator internus runs through the lesser sciatic foramen. It is innervated by L5 and S1. It originates at the obturator foramen and runs to the greater trochanter. Acts on the hip.
171
Describe what nerves run through the following gapertures:
a. Greater sciatic foramen above piriformis…below piriformis
b. Lesser sciatic notch (superior to it and inferior to it)
c. Obturator canal
a. Above piriformis is the superior gluteal nerve. Below piriformis is the sciatic nerve, inferior gluteal nerve, femoral cutaneous, and quadratus femoris.
b. Pudendal nerve and nerve to obturator internis are superior and inferior is obturator internis muscle.
c. Obturator nerve and vessels.
172
1. What are the muscles that compose the pelvic floor?
| a. Describe the position of each
4. Pelvic floor is made up by five muscles
a. Puborectalis: wraps around the anal sphincter
b. Pubococcygeus: lateral to puborectalis
c. Iliococcygeus: lateral to pubococcygeus
i. All above are part of levator ani
d. Coccygeus: superior to the levator ani muscles.
e. Obturator internus assists laterally.
173
1. What are the two diamond shaped regions of the perineum?
| a. Describe what passes through each
4. the two diamond shaped regions are the anal triangle and urogenital triangle.
a. Anus and rectum pass through anal triangle. Urethra and (vagina) pass through urogenital
174
1. Describe the track of the ureters once in the pelvic cavity for both males and females
4. Once in the pelvic cavity the ureters cross between the internal and external iliac arteries. They then travel to the posteriolateral aspect of the bladder.
175
1. What is the function of the urinary bladder?
| a. What muscle contracts to expel urine?
1. the urinary bladder works to store and expel waste formed by the kidneys.
a. Detrusor muscle contracts to expel urine
176
1. Where does it extend to when it is full?
1. The bladder can extend up into the false pelvis when it is full.
177
1. What ligament is it connected to?
1. The bladder is connected to the median umbilical ligament
178
1. Where can the external urethral sphincter be found?
1. The external urethral sphincter is found in the deep perineal pouch.
179
1. What enzyme keeps semen thin?
1. PSA is an enzyme that works to keep semen thin such that sperm can swim.
180
1. Where is the rectum located? What muscle constricts it?
1. The rectum is located in the true pelvis superior to the pelvic floor
181
1. Where does the anal canal emerge?
1. The anal canal emerges in the anal triangle of the perineum inferior to the pelvic floor.
182
1. What does the spermatic cord comprise?
a. What sheath is this derived from?
b. This cord runs from where to where?
1. The spermatic cord contains the vas deferens, the testicular artery and vein and testicular nerves
a. Derived from fascial sheath
b. It runs from the inguinal canal (deep ring) to the scrotum
183
1. What are the three reproductive glands and where can they be found?
1. The three glands are the seminal vesicles (found joining the vas deferens to form the ejaculatory duct), prostate gland (between the UG diaphragm and bladder), and bulbourethral (cowper’s) glands (in UG diaphragm emptying into penile urethra).
184
1. Describe the following uterine ligaments
a. Suspensory
b. Broad ligament
c. Ovarian Ligament
d. Round ligament of uterus
e. mesovarium
1.
a. Suspensory ligament is covering the ovarian vessels and nerves (female equivalent of the spermatic cord)
b. The broad ligament covers the uterus and adnexa (basically everything else associated with the uterus)
c. Ovarian ligament is a derivative of the gubernaculum and anchors the ovary to the uterus
d. Round ligament of uterus is continuous with the ovarian ligament (gubernaculum) and anchors the uterus to the labia majora.
185
Foregut
Oralpharyngeal membrane to liver outgrowth
- Derivatives: Endoderm, ectoderm.
- Blood supply: celiac trunk
* duodenum part proximal to major papilla
186
Midgut
Proximal 2/3rds of transverse colon.
| SMA artery - has 5 branches.
187
Hindgut
Remaining 1/3 of trasnverse colon, cloacal membrane (endo and ectoderm).
188
Space behind stomach
Bursae (lesser peritoneal sac)
189
Rotation of midgut
270 degrees counterclockwise. Axis of rotation is the SMA.
190
Meckel Diverticulum remains from what?
Vliteline duct
191
Urinary System mesoderm
intermediate.
192
Kidneys development
Pronepherons (not functional). Mesonephros overlap, are briefly functional. Metenephros (originate from pelvis)
193
Development of bladder
urorectal septum divides, forms urogenital sinus and anorectal canal. Urogenital sinus has vesicle part (forms bladder)
194
Reproductive System
Primordial germ cells (from lining of yolk sac), intermediate mesoderm. Wolfians duct
