Final Exam Flashcards

1
Q

What is the anal canal?

A

The portion between the pelvic diaphragm and anus

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2
Q

What is the anocutaneous line?

A

Distal termination of the anal canal (where it meets the skin)

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3
Q

Which sphincter of the anal canal is a continuation of smooth muscle and is under involuntary control?

A

Internal sphincter

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4
Q

Which sphincter of the anal canal surrounds the anal canal and consists of 3 parts?

A

External sphincter

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5
Q

What are the 3 muscle layers of the external anal sphincter?

A

Subcutaneous (most superficial)
Superficial
Deep

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6
Q

What arteries supply the anal canal?

A

Superior rectal artery
Middle rectal artery
Inferior rectal artery
Median sacral artery

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7
Q

What artery supplying the anal canal is a branch of the internal iliac artery?

A

Middle rectal artery

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8
Q

What artery does the median sacral artery branch off of?

A

Abdominal aorta

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9
Q

What artery supplying blood to the anal canal is a branch off of the inferior mesenteric?

A

Superior rectal artery

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10
Q

What artery supplying the anal canal is branch off of the internal pudendal artery?

A

Inferior rectal artery

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11
Q

What are varicosities of the superior rectal vein?

A

Internal hemorrhoids

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12
Q

What hemorrhoids occur above the pectinate line?

A

Internal hemorrhoids

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13
Q

Which hemorrhoids are generally painless?

A

Internal hemorrhoids

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14
Q

Which hemorrhoids could cause severe bleeding?

A

Internal hemorrhoids

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15
Q

External hemorrhoids are varicosities of what vein?

A

Inferior rectal vein

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16
Q

T or F: external hemorrhoids occur below the pectinate line?

A

True

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17
Q

Can external hemorrhoids be very painful?

A

Yes

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18
Q

What are some causes of hemorrhoids?

A

Pregnancy
Heavy lifting
Sitting
Straining
Portal hypertension

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19
Q

Who is at a high risk for developing hemorrhoids?

A

Long distance truck drivers

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20
Q

What marks the lower limits of the anal valves?

A

Pectinate line

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21
Q

What is the importance of the pectinate line?

A

It divides the anal canal into an upper 2/3 and a lower 1/3

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22
Q

Where is the urinary bladder generally located?

A

Below the peritoneum

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23
Q

Size, shape, and position of the bladder varies depending on what?

A

Age

Amount of urine within

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24
Q

As the bladder fills, it can reach the level of what?

A

Umbilicus

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25
Q

What travels subperitoneally along the lateral wall of the placid and enter the bladder at its fundus?

A

Ureters

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26
Q

When the bladder of a female is empty, where does the body of the uterus sit?

A

It overlies the bladder

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27
Q

What is the retropubic space?

A

U-shaped space between pubis and bladder that contains retropubic fat.

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28
Q

What are 2 important ligaments of the urinary bladder?

A

Puboprostatic/pubovesical ligament

Lateral ligament of the bladder

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29
Q

What does the puboprostatic ligament attach in males?

A

The prostate gland to the pubis

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30
Q

What does the puboprostatic ligament attach in females?

A

Neck of the bladder to the pubis

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31
Q

What does the lateral ligament of the bladder attach in males?

A

Base of the bladder to the rectovesical fold

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32
Q

What does the lateral ligament of the bladder attach in females?

A

Base of the bladder to retrouterine fold

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33
Q

What is the trigone of the urinary bladder?

A

Smooth triangular structure on the posterior and inferior wall of the bladder

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34
Q

What are the openings to the trigone?

A

Internal urethral orifice

2 ureteric orifices

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35
Q

What is the smooth muscle within the wall of the bladder?

A

Detrusor muscle

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36
Q

What carries sperm from the epididymis to the ejaculatory duct?

A

Ductus deferens

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37
Q

What happens to the ductus deferens after entering the abdomen?

A

It crosses over the ureters and descends posterior to the bladder

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38
Q

What structure joins the duct of the seminal vesicle to make the ejaculatory duct?

A

Ductus deferens

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39
Q

Do seminal vesicles store sperm?

A

No

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40
Q

What are the seminal vesicles?

A

Lobulated glandular structures that lie lateral to the ampullae of the ductus deferens against the fundus of the bladder

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41
Q

What does the seminal vesicles produce?

A

The alkaline component of sperm

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42
Q

Where does the ejaculatory duct open into?

A

The seminal colliculus within prostatic urethra

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43
Q

What tissues make up the prostate gland?

A

Smooth muscle
Glandular tissue
Fibrous tissue

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44
Q

What structure makes the non-alkaline portion of semen?

A

Prostate gland

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45
Q

In a male. What structure surrounds the urethra?

A

Prostate gland

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46
Q

The prostate gland is immediately anterior to what structure?

A

Rectal ampulla

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47
Q

What part of the prostate gland lies anterior to the urethra?

A

Isthmus of prostate

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48
Q

What do we call the portion of the urethra that is surrounded by the prostate?

A

Prostatic urethra

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49
Q

After age ____ the prostate tends to enlarge.

A

40

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50
Q

What leads to difficulty in micturition through compression of the urethra in men?

A

Benign prostatic hypertrophy

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51
Q

What is the main difference in prostate cancer in older men vs younger men?

A

In older men it is slow growing

In younger men it is very aggressive

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52
Q

How does prostate cancer metastasize?

A

Through blood and lymph tissue

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53
Q

T or F: Bone involvement is common in prostate cancer

A

True

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54
Q

Chronic inflammation of the prostate or prostatic cancer may cause referred pain where?

A

To the sacrum

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55
Q

What subluxations may be related to prostate or bladder problems?

A

Sacral misalignments or L1/L2 subluxations

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56
Q

What do ovaries produce?

A

Oocytes

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57
Q

When do ovaries start to produce oocytes?

A

After puberty

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58
Q

Ovaries secrete what hormones?

A

Estrogen, progesterone, relaxin

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59
Q

T or F: ovaries are covered by a peritoneum?

A

False

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60
Q

Where are ovaries located?

A

The posterior aspect of the broad ligament on the lateral wall of the true pelvis

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61
Q

What transports oocytes from the ovary to the uterus?

A

Uterine tubes

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62
Q

Uterine tubes transport sperm in the same or opposite direction of ovary transportation?

A

Opposite

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63
Q

What are the 4 parts of the uterine tubes?

A

Infundibulum
Ampulla
Isthmus
Uterine part

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64
Q

What is the opening of the uterine tube near the ovary?

A

Abdominal ostium

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65
Q

What are fibriae?

A

Finger link projections that catch the oocyte being released

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66
Q

What are ovarian fimbria?

A

The longest fibria. They are fused to the ovary.

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67
Q

What is the function of the ovarian fimbria?

A

To keep the infundibulum close to the ovary

68
Q

What is an ectopic pregnancy?

A

The development of a fetus at some other site than the uterine cavity

69
Q

What is the most common type of ectopic pregnancy?

A

Tubal ectopic pregnancy
- account of 90-95% of ectopic pregnancies

70
Q

What is a tubal ectopic pregnancy?

A

Development of the fetus in the uterine tube

71
Q

Why are tubal ectopic pregnancies dangerous?

A

They usually result in rupture of the uterine tube with severe hemorrhage

72
Q

What are the big 3 risk factors for having an ectopic pregnancy?

A

STD

Reversal of tubal ligation
- meaning a woman got her tubes tied and then had it reversed

Endometriosis

73
Q

Implantation in the rectourerine pouch causes what type of ectopic pregnancy?

A

Abdominal ectopic pregnancy

74
Q

What forms the birth canal?

A

Cavities of the uterus and vagina

75
Q

A uterus is variable in size, shape, location, and structure depending on what?

A

of pregnancies

Age

76
Q

What is a nulliparous woman?

A

One with no children

77
Q

What is the position of the uterus?

A

Anteverted and anteflexed

78
Q

What would we expect the structure of the uterus to be in a nulliparous woman?

A

Thick and muscular uterine walls and shaped like an inverted pair

79
Q

What part of the uterus lies within the body of the uterus?

A

Uterine cavity

80
Q

The cervical canal extends from ______ to the ______.

A

Internal os

External os

81
Q

Where is the vesicouterine pouch?

A

Between the uterus and bladder

82
Q

Where is the rectouterine pouch?

A

Between the uterus and rectum

83
Q

What extends from the uterus to the lateral wall of the pelvis and has 3 parts?

A

Broad ligament

84
Q

What attaches the uterus below and anterior to the uterine tubes?

A

Round ligament

85
Q

Which passes through the inguinal canal?

Broad ligament
Round ligament

A

Round

86
Q

What is the transverse cervical ligament?

A

Thickening of pelvic fascia passing laterally to the cervix and merging with the upper fascia of pelvic diaphragm

87
Q

What ligament runs within the rectouterine fold from the cervix to the sacrum?

A

Uterosacral ligament

88
Q

What ligament runs from the cervix lateral to the urethra to the pelvis?

A

Pubocervical ligament

89
Q

What are the 3 functions of the vagina?

A
  1. Female organ of copulation
  2. Lower portion of birth canal
  3. Excretory duct for products of menstruation
90
Q

What lies anterior to the vagina?

A

Bladder and urethra

91
Q

What lies posterior to the vagina?

A

Rectum

92
Q

What is a recess between the cervix and the walls of the vagina?

A

Fornix

93
Q

What is the blood supply to the upper part of the vagina?

A

Uterine artery

94
Q

What is the blood supply to the lower part of the vagina?

A

Vaginal artery

95
Q

T or F: there is little sensation in the vagina

A

True. Except for the lower most part of it

96
Q

What is bulging of the rectum into the posterior wall of the vagina?

A

Rectocele

97
Q

What is rectocele due to?

A

Damage to the posterior part of the Levator ani and posterior wall of vagina

98
Q

T or F: Rectocele may cause difficulty in defacation

A

True

99
Q

What is a cystocele?

A

Bulging of the bladder into the anterior wall of the vagina

100
Q

What is cystocele due to?

A

Damage of more anterior parts of Levator ani and anterior wall of vagina

101
Q

T or F: Cystocele may cause difficulty in defecation

A

False

Cause difficulty in micturation

102
Q

________ is when the uterus slips down into vagina and descends to an abnormally low position in the pelvis

A

Uterine prolapse

103
Q

What causes uterine prolapse?

A

Problems with pelvic floor integrity

Risk factors: multiple births and retroverted uterus

104
Q

What is diamond shaped and has the same boundaries as the pelvic outlet?

A

Perineum

105
Q

What 2 triangles make up the perineum?

A

Urogenital

Anal

106
Q

What are the layers of the perineum from superficial to deep?

A

Skin
Superficial perineal pouch
Perineal membrane
Feel perineal pouch
Inferior fascia of the pelvic diaphragm

107
Q

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

A

Colles Fascia

108
Q

What is fused anteriorly with the suspensory ligament of the penis/clitoris?

A

Deep perineal pouch

109
Q

What is the perineal body?

A

Fibromuscular mass located at the center of perineum between anal canal and bulb of penis/vagina

110
Q

What is the significance of the perineal body?

A

It is an important point of attachment for muscles.

111
Q

What muscles attach to the perineal body?

A

Superficial transverse perineal
Deep transverse perineal
Bulbospongiosus
Levator ani
Sphincter ani externus

112
Q

T or F: Ischiocavernosus attaches to the perineal body

A

False

113
Q

What are the 2 glands which lie posterolateral to the intermediate part of the urethra in males?

A

Bulbourethral glands

114
Q

What is the pathway of the Bulbourethral duct?

A

It passes downward through the perineal membrane into the bulb of the penis to empty into the spongy urethra

115
Q

What is the function of the Bulbourethral gland?

A

Secrete mucus-like substance

116
Q

Bulbourethral gland is to male as _________ is to female.

A

Greater vestibular gland

117
Q

What is the space called that lies ok either side of the anal canal?

A

Ischioanal fossa

118
Q

What are the contents of the ischioanal fossa?

A

-Fat
-Pudendal canal
-Inferior rectal nerve and vessels
-Perineal branch of the posterior cutaneous nerve of the thigh

119
Q

What part of the ischioanal fossa extends anteriorly into the urogenital triangle?

A

Anterior recesses

120
Q

What part of the ischioanal fossa connects the external anal sphincter to the coccyx?

A

Anococcygeal ligament

121
Q

What are the contents of the female external genitalia?

A

Mons pubis, labia majora, labia minora, vestibule, clitoris, bulb of the vestibule

122
Q

What is the name of the external female genitalia?

A

Vulva

123
Q

Labia majora is to female as __________ is to male

A

Scrotum

124
Q

What is the hymen?

A

A membranous crescentric fold which partially closes opening of vagina into vestibule

125
Q

Penis is to male as __________is to female

A

Clitoris

126
Q

What tissue primarily makes up the clitoris?

A

Erectile tissue

127
Q

T or F: the clitoris has a corpus spongiosum

A

False

128
Q

The crura of the clitoris are covered by what muscle?

A

Ischiocavernosus

129
Q

What is the function of the kidneys?

A
  • Remove water and salts
  • Produce protein metabolism for blood
130
Q

T or F: kidneys are retroperironeal

A

True

131
Q

What vertebral levels do kidneys lie?

A

T12-L3

132
Q

The right kidney is slightly ________ than the left due to the ________.

A

Lower
Liver

133
Q

Kidneys lie anterior to what muscle?

A

Papas major

134
Q

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

A

Renal pelvis

135
Q

What is the recess located within the hilum filled with fat?

A

Renal sinus

136
Q

All the structures that enter the hilum of the kidney are collectively called what?

A

The renal pedicle

137
Q

What structures enter the hilum of the kidney?

A

Renal vein
Renal artery
Ureter
Autonomic and sensory nerves

138
Q

What part of the kidney contains the filtration system?

A

Renal cortex (The outside part)

139
Q

What are projections of the renal cortex into the medulla between renal pyramids?

A

Renal columns

140
Q

How many pyramids are there in each kidney?
*renal pyramids are in the medulla of kidney

A

8-12

141
Q

Where do renal pyramids terminate?

A

Renal papilla

142
Q

What are minor calices of the kidney?

A

Cup shaped structures into which renal papillae fit

143
Q

What are major calices?

A

2 to 3 major channels into which the minor calices empty

144
Q

What do the major calices empty into?

A

Renal pelvis

145
Q

What is the anatomical nutcracker?

A

Left renal vein and third part of duodenum May be compressed between aorta (behind) and superior mesenteric artery (front)

146
Q

What causes anatomical nutcracker?

A

Compressive abdominal trauma

Application of body cast

Aortic aneurysm (Most common)

147
Q

What are the layers covering the kidney from superficial to deep?

A

ParAnephric fat
Renal fascia
PerInephric fat
Renal capsule

148
Q

What is a membranous layer of extraperitoneal tissues which split to enclose the kidney?

A

Renal fascia

149
Q

What is the legit term for kidney stones?

A

Renal calculi

150
Q

What are kidney stones made of?

A

Calcium oxalate, calcium phosphate, uric acid

151
Q

What are the big risk factors of renal calculi?

A

Male
Dehydration
Living in southeastern USA

152
Q

What is it called when a kidney becomes hyper mobile and moves down into pelvis? Aka a floating kidney

A

Nephroptosis

153
Q

What group of people are at risk for nephroptosis?

A

Very thin people

154
Q

What is the danger in nephroptosis?

A

The kidney can turn upside down, twisting blood vessels and ureters

155
Q

What is a muscular tube which connects kidney to urinary bladder?

A

Ureter

156
Q

What muscle does the ureter descend down?

A

Psoas major

157
Q

T or F: the ureter is retroperironeal?

A

True

158
Q

What crosses the ureter?

A

Gonadal vessels

159
Q

What does the ureter cross?

A

Common iliac artery at it bifurcation

160
Q

What are the 3 constriction areas of the ureter?

A

Ureteropelvic junction

Pelvic brim

Where it enters the wall of the bladder

161
Q

What are the 2 parts of the suprarenal gland and what do they secrete?

A

Medulla: secretes epinephrine + norepinephrine

Cortex: secretes corticosteroids

162
Q

What body system is the suprarenal glands apart of?

A

Endocrine

163
Q

What are the shapes of the suprarenal glands?

A

Right= pyramid

Left=senilunar

164
Q

T or F: kidney infections are more common in males

A

False. More common in females due to short urethra

165
Q

Kidney or suprarenal gland pain is often referred where?

A

Paralumbar region/flank

166
Q

An infection is probably present if kidney pain presents with a ________.

A

Fever