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Anatomy > Exam 3 - Pelvis > Flashcards

Exam 3 - Pelvis Flashcards

1
Q

what parts of the pancreas are retroperitoneal?

A

everything except tail

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2
Q

describe the exocrine functions of the pancreas (cell, secretions)

A

acinar cells (go to pancreatic duct)
- neutralizing alkaline components
- trypsin (protein), amylase (starch)

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3
Q

describe the endocrine functions of the pancreas (cell, secretions)

A

islets of langerhans (go to blood)
- secrete insulin, glucagon, somatostatin, pancreatic peptide hormone, ghrelin

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4
Q

what cells make insulin, glucagon, and somatostatin?

A

beta cells = insulin
alpha cells = glucagon
delta cells = somatostatin

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5
Q

what stimulates secretion of the pancreas?

A

distention of stomach
acid in the duodenum

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6
Q

what is the INN of the pancreas? what is the result of each? referred pain?

A

vagus -> secretion
symp T7-9 -> dilate blood vessels (via celiac plexsus)
- referred to inf. epigastric (inflammation pushes against duodenum)

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7
Q

blood supply of pancreas

A

branches off of the splenic artery

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8
Q

what are the three parts of the sphincter of oddi?

A

sphincter ductus choledoci (bile duct)
sphincter ductus pancreatici (pancreatic duct)
around entire ampulla

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9
Q

what are the two ducts of the pancreas?

A

main pancreatic duct (Duct of Wirsung)
accessory pancreatic duct (Duct of Santorini)

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10
Q

what (9) things are in the transpyloric plane?

A

L1
9th costal cartilage
sup. part of duodenum
sup. of pylorus
hili of kidneys
neck of pancreas
SMA
start of portal vein
fundus of GB

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11
Q

what is the psoas sign? what organs are apart of this?

A

when contracted (flex/extend thigh) it will bulge and if an organ is inflamed it will cause pain
- kidneys, ureters, retrocecal appendix

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12
Q

where does lymph from organs on the lateral and retroperitoneal side go to?

A

para-aortic nodes

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13
Q

where does lymph from the midline gut go to?

A

pre-aortic nodes (along vessels)

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14
Q

where does lymph from organs belwo the diaphragm go to?

A

posterior abdominal nodes

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15
Q

where does all lymph drain to? describe it’s location

A

cisterna chyli
- right of aorta
- below renal artery
- L1-2

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16
Q

what organs drain their lymph to the lateral aortic nodes?

A

lateral body wall
kidney
suprarenals
testis
ovary

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17
Q

what nodes do the lower limbs and perineum drain their lymph to? (describe the pathway)

A

external iliac nodes
common iliac nodes
pre-aortic & lateral aortic nodes

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18
Q

what do lymph nodes do?

A

makes lymphocytes be exposed to antigens in the lymph system (fluid)
- blood and lymph flow through separate compartments
- uses high endothelial venules

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19
Q

what type of cells produce antigens?

A

B cells and T cells

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20
Q

what does MALT do for lymphocytes?

A

expose them to antigens from outside world
- antigens from respiratory or intestinal systems

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21
Q

what does the spleen do for lymphocytes?

A

expose them to antigens in the blood

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22
Q

at what rib is the spleen located? intra or retro peritoneal?

A

9th-10th rib
- intraperitoneal

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23
Q

what two ligaments hold the spleen?

A

splenorenal lig
gastrosplenic lig

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24
Q

what is the INN of the spleen? referred pain?

A

vagus
symp T7-9 (via celiac plexsus)
- referred to left hypochondriac region

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25
Q

what are the three functions of the spleen?

A

expose immune cells to antigens in the blood & prevent sepsis (white pulp) -> lymphocytes

filter out defective RBCs (red pulp) -> macrophages

in infants, it helps make blood

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26
Q

what does the right suprarenal gland touch? (3)

A

liver, IVC, diaphragm

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27
Q

what does the left suprarenal touch? (4)

A

stomach, pancreas, spleen, diaphragm

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28
Q

what does the cortex of the adrenal do?

A

makes mineralcorticoids, glucocorticoids, sex hormones

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29
Q

what does the medulla of the adrenal do? whats an important cell here??

A

circulates catecholamines (adrenaline, noadrenaline)
-basophilic cells (NS tissue)

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30
Q

what is the blood supply of the adrenals?

A

inferior phrenic a
aorta
renal a

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31
Q

what does the right adrenal drain to? what about the left?

A

right = drains to IVC
left = drains to left renal v.

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32
Q

what is the arterial blood flow of the kidney?

A

renal a
segmental a
interlobar a
arcuate a
inerlobular a
superficial glomeruli OR juxtamedullary glomeruli
- afferent a
- glomerulus
- efferent a.
- peritubular capillary bed OR vasa recta

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33
Q

how is blood filtered in bowman’s space?

A

using fenestrated capillaries with podocytes
- uses transport mechanisms to only allow certain molecules in

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34
Q

what is an important cell type in the juxtaglomerular aparatus? what does it secrete?

A

macula densa
-secretes renin

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35
Q

what is the function of lacis cells? describe the pathway this starts

A

reads BP in afferent arteriole
- LOW = triggers macula densa to release renin
- renin induces liver to produce angiotensin 1 -> angio 2
- constricts vessels, increases aldosterone (adrenal), and increases water retention (kidneys)

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36
Q

what things lead to renal failure?

A

drop in pH, hematocrit, calcium
rise in K+, phosphate, urea, BP

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37
Q

what is the blood supply of the ureters? (4)

A

renal a
testicular / ovarian a
common iliac
internal iliac

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38
Q

what are the three constriction areas in the ureters? (areas for kidney stones)

A

ureteropelvic junction (ureter / kidney)
pelvic inlet (over iliac a.)
entrance to bladder

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39
Q

what is the pathway of urine after the collecting duct?

A

ducts of bellini
area cribrosa at apex of papilla
minor calyx
major calyx
renal pelvix
ureter

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40
Q

what is the INN of the kidney & ureter?

A

parasymp
- vagus = kidney, upper ureter
- pelvic splanchnic = lower ureter, bladder

symp T10-L1 (along aorta & thru sacrum)

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41
Q

describe the effect of parasympathetic activity on the bladder

A

nerve of empty!!
- contracts detrusor muscle (+)
- relaxes internal urethral sphincter (-)
- pudendal nerve constricts external sphincter (somatic)

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42
Q

describe the effect of sympathetic activity on the bladder?

A

nerve of full!!
- relaxes detrusor muscle (-)
- constricts internal urethral sphincter (-)

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43
Q

describe what occurs in the process of micturation

A
  1. pelvic splanchnic nerve
  2. spinobulbospinal reflex
  3. pontine micturation center (PMC)
    - inhibits sympathetic & Onuf’s nucleus
    - activates parasymp (empty)
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44
Q

what are the three pelvic bones? where do they all meet?

A

illium
ischium
pubis
- meet at acetabulum (VINEGAR BOWL)

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45
Q

what are the three palpable bony points?

A

pubic symphysis
ischial tuberosity
coccyx

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46
Q

what does the genital tubercle become in males and females?

A

F = clit, corpora cavernosa
M = penis, corpora cavernosa

47
Q

what does the labioscrotal swellings become in males and females?

A

F = labia majora
M = scrotum

48
Q

what does the urogenital fold become in males and females?

A

F = labia minor, bulbs of vestibule
M = penile urethra, corpus spongiosum

49
Q

where is the superficial perineal pouch?

A

between colle’s fascia and perineal MB

50
Q

where is the deep perineal pouch?

A

between pelvic diaphragm and perineal MB

51
Q

where is the ischio-anal fossae?

A

fat filled areas on the sides of the deep pouch and below the pelvic diaphragm, on the posterior side of the body!!

52
Q

what is the order of the pelvic diaphragm muscles? (back -> front) what is the INN of these muscles?

A

coccygeus
iliococcygeus
pubococcygeus
puborectalis (contains posterior part of rectum)

  • pudendal S2-4
53
Q

what arteries branch off of the internal iliac?

A

lateral sacral
superior gluteal
umbilical -> superior vesicle
obturator
inferior vesicle
middle rectal
vaginal
uterine / vas deferens
inferior gluteal
internal pudendal

54
Q

what artery goes outside of the pelvis (above piriformis)?

A

superior gluteal

55
Q

what artery and main nerve goes inside the pelvis by the piriformis (below piriformis)?

A

sciatic nerve
inferior gluteal artery & vein

56
Q

what artery goes on the inside of the piriformis but outside of the sacrospinous ligament? (lesser sciatic foramen)

A

internal pudendal
- this nerve also follows this pathway

57
Q

what are the branches off of the internal pudendal artery?

A

inferior rectal
perineal -> transverse perineal -> post. scrotal / labial
artery of the bulb
deep artery of penis / clitoris
dorsal artery of penis / clitoris

58
Q

where does fluid fill if the membranous urethra is broken?

A

fills up deep perineal space surrounding bladder and prostate

59
Q

where does fluid fill if the spongy / penile urethra is broken?

A

fills in the superficial perineal pouch along colle’s fascia

60
Q

what is the dermatome of mons pubis?

A

L1-2

61
Q

what is the dermatome of the phallus, scrotum, and anterior labia?

A

S3

62
Q

what is the dermatome of the posterior scrotum and labia?

A

S4

63
Q

what is the dermatome of the skin around anus?

A

S5

64
Q

what are the (4) muscles of the superficial perineal pouch?

A

ischiocavernosus (along sides of perineum)

bulbopongiosus (ontop of scrotum OR along labia)

superficial transverse perineal (splits urogential & anal triangle)

levator ani (pelvic diaphragm)

65
Q

what is in the deep perineal pouch in men?

A

deep transverse perineal muscle
bulbourethral gland
membranous urethra
external sphincter

66
Q

what are the tissues of the genitalia under the muscle fascia?

A

corpus cavernosum (crus)
corpus spongiosum

67
Q

what are the erectile tissue of the male genitalia?

A

corpus cavernosum (VERY)
glans
bulb of penis

68
Q

what are the four main arteries of the male genitalia? what are their branches? which artery are they coming from?

A

(int. pud) dorsal artery of penis
(int. pud) arteries of bulb -> bulbourethral arteries
(int. pud) deep arteries of penis -> cavernous a. & helical a.
(ex. pud) superficial dorsal

69
Q

which artery is responsible for erection?

A

deep artery of penis / clitoris

70
Q

what are the three main veins in the male genitalia? where do they drain to?

A

deep dorsal v -> circumflex v -> prostatic plexsus
post. scrotal, cavernous, bulbar -> int. pudendal
superficial dorsal v -> ex. pudendal)

71
Q

what is the venous drainage pathway from the external pudendal?

A

saphenous -> femoral -> ex. iliac -> IVC

72
Q

where does the testicular vein drain to?

A

pampiniform plexsus

73
Q

what is the INN pathway of the male genitalia?

A

pudendal -> inferior rectal , perineal , dorsal of penis

74
Q

what is the area b/w the penis and pubic bone called?

A

infrapubic aperture
- deep dorsal v. goes through here!

75
Q

what is the pathway of sperm?

A

seminiferous tubules
straight tubules
rete testis
efferent ductules
epididymis (head -> body -> tail)
vas deferens
ampulla of vas deferens
ejaculatory duct
urethra

76
Q

what are the four parts of the male urethra? (go in order)

A

prostatic
membranous
bulbar
spongy / penile

77
Q

what are the two main cell types in the seminiferous tubules? what do they do?

A

leydig (OUTSIDE) = testosterone, androgens
sertoli (INSIDE) = support & nourish sperm

78
Q

what 6 things are in the spermatic cord?

A

genital branch of genitofermoral nerve
visceral nerve to testis
testicular artery
afferent of vas deferens
pampiniform plexsus of veins
lymphatics

79
Q

what are the three glands of the male reproductive tract? what are their main secretions?

A

seminal gland = prostaglandin hormones
prostate gland = buffers
bulbourethral gland = mucus

80
Q

what is the fascia b/w the prostate and rectum called?

A

denoviller fascia

81
Q

what are the tissue layers of the penis (outer first)? b/w what layers are the veins squeezed during erection?

A

skin
superficial fascia
bucks fascia
SQUEEEEEEEZE
tunica albuginea surrounds corpa cavernosa

82
Q

what type of NT allows for erection?

A

ACh

83
Q

what two things are dialated / relaxed during erection?

A

arteries
trabeculae

84
Q

what allows for veno-occulsion? (besides NT activity)

A

somatic stimulation of the perineal muscles

85
Q

what happens during the secretion portion of erection?

A

parasymp stimulates glands to release semen fluids

86
Q

what happens during the emission (semen -> urethra) portion of erection?

A

symp stimulates muscles of epididymis, vas deferenes, prostate, and seminal glands to move fluid along
- also constricts internal urethral sphincter (no pee, ew)

87
Q

what happens during the expulsion portion of erection?

A

visceral = contract smooth muscle of glands, vas def., and epididymis

somatic = contract striated muscle of ex. sphincter, bulbospongiosus

88
Q

what are Bartholin’s Glands?

A

the bulbourethral glands but in women
- secrete mucus

89
Q

what are the muscles of the deep perineal pouch in women? what INN these?

A

TOP: external urethral sphincter
deep transverse perineal (stabilizes perineal MB)
MIDDLE: compressor urethrae (help close urethra)
BOTTOM: sphincter urethrovaginalis (close vagina & urethra)

  • pudendal S2-4
90
Q

what is the INN pathway of the female genitalia?

A

pudendal -> inferior rectal , perineal , dorsal of clit

91
Q

what is the arteriole blood supply of the female genitalia?

A

int. pudendal
- artery of bulb
- deep a. of clit
- dorsal a. of clit

ext. pudendal
- branch of femoral
- superficial dorsal a. (anastomoses w/ int. pudendal)

92
Q

what is the vein drainage of the female genitalia?

A

dorsal v. of clit -> venous plexus -> int. iliac
deep v. of clit -> int. pudendal -> int. iliac
superficial dorsal -> ex. pudendal

93
Q

what is the pathway of the female reproductive tract?

A

ovary
fallopian tube
uterus
cervix
vagina
vulva

94
Q

what is the blood supply of the superficial tissues in the female genitalia?

A

perineal -> transverse perineal a. & posterior labia

95
Q

what is the lowest point in peritoneal sac?

A

Pouch of Dougless
- front gap of uterus

96
Q

describe the development of the germ cells

A

at the 4-6th week it migrates from yolk sac to germinal ridge
- mitosis & meiosis (stop at prophase 1)
- sit in primordial follicles surrounded by celomic mesothelium until FSH increases

97
Q

what is primary follicle?

A

cells are more cuboidal (granulosa cells) due to increase FSH from pituitary

98
Q

what is secondary follicle?

A

multiple layers of granulosum (makes zona pellucida)
- theca folliculi derived from stroma

99
Q

what is tertiary follicle?

A

creates an antrium (fluid), theca produces estrogen & progesterone
- proliferative phase
- granulosum cells + oocyte = cumulus oophorus

100
Q

what is a graffian follicle?

A

prior to ovulation, radiating crown of granulosum, secondary oocyte (now metaphase 2)

101
Q

what happens when the egg breaks out of the follicle?

A

the follicle turns into a corpus luteum
- secretes progesterone

102
Q

what does the follicle become if the egg isn’t fertilized and progesterone secretion stops?

A

corpus albicans

103
Q

what are the three types of cells in the fallopian tube?

A

ciliated
non-ciliated secretory cells
intercalated cells

104
Q

what is the difference between a follicular cyst and luteual cyst?

A

follicular does not rupture and just fills with fluid

luteum does not fill w/ stroma cells and the invagination fills w/ fluid

105
Q

what are the two hormones that impact the endometrium? what do they do?

A

estrogen = vascular, grow
progesterone = stop growth
* once theres a decrease in prog., the layer sheds

106
Q

what is the blood supply pathway of the uterus?

A

uterine
arcuate
radial
spiral

107
Q

what is endometriosis?

A

endometrial tissue growing in the wrong spot
- will still proliferate adn shed each cycle

108
Q

what type of risk is a hysterectomy? why?

A

Iatrogenic Risk
- ligation of uterine artery occurs where it passes over ureter

109
Q

what two ligaments attach uterus to body wall and elongate & widen during pregnancy?

A

round ligament
uterosacral iigament

110
Q

what occurs during the four stages of labor?

A

1 = cervix effaced (thins), dilates
2 = birth
3 = placenta
4 = recovery (constriction of vessels)

111
Q

what is a pudendal nerve block? at what sensory region gets numb?

A

injection at sacrospinous ligament through vagina
- numbs S2-4 & lower 1/4 of vagina
- perineal region! = S2-4 pudendal

112
Q

what is an epidural block? at what sensory region gets numb?

A

injection at L2-3
- numbs entrie sacral region except top of uterus
- subperitoneal region! = S2-4

113
Q

what is a spinal block? at what sensory region gets numb?

A

injection at space b/w L3-4
- numbs everything below waist
- intraperiotneal region! = L1-2

Anatomy (4 decks)

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