Functional Anatomy and Embryology Flashcards
What are the different shapes of epithelial tissue and their examples?
Squamous: capillaries, glomeruli, alveoli
Cuboidal: organs of secretion (thyroid follicles, salivary glands, kidney tubules)
Columnar: digestive tract, uterus
What are the different layer structures of epithelial tissue and their examples?
Simple: blood vessels
Pseudostratified: trachea
Stratified: cornea
What are the different surface specialisations of epithelial tissue and their examples?
Ciliated: airways
Brush border (microvilli): gut
Keratinized: skin
What are the three mechanisms of exocrine secretion?
Merocrine: exocytosis (salivary glands)
Apocrine: part of the apical cytoplasm of the cell is lost (sweat glands, mammary glands, prostate)
Holocrine: breakdown and discharge of the entire secretory cell (sebaceous glands)
What is the structure of tight junctions?
Non-anchoring, seal inter membrane space (occludin and claudin)
What is the structure of desmosomes and hemidesmosomes?
Anchoring;
Cytoskeletal IF: keratin
Linker protein complex/anchor protein: plakoglobin, desmoplankin
Adhesion proteins: cadherin family (homophillic proteins)
What is the structure of adherence junctions?
Anchoring, concerned with cell shape;
Actin filaments
Anchor proteins: catenins, p120
Cadherin dimers (require calcium)
What is the structure of gap junctions?
1 channel = 6 connexins –> 1 connexon
Allow passage of small peptide up to 10aa, glucose, ATP, O2
What are the three types of connective tissue?
Soft, semi-hard (cartilage) and hard (bone)
What are the types of soft connective tissue?
Mesenchyme: embryonic Loose (areolar): mesentery, papillary dermis Dense: tendon, reticular dermis Reticular: bone marrow, lymph nodes Adipose: fat cells
What is ECM composed of?
Proteins: glycoproteins
- collagen, elastin, adhesive
Glycosaminoglycans (GAGs)
What are the fibrillar and sheet collagen types?
Fibrillar: Type I - skin, bone, tendons, dentine Type II - cartilage Type III - blood vessels, skin Sheet: Type IV - basement membrane
What are elastic fibres composed of?
Network of fibrillin microfibrils embedded in a core of cross-linked elastin
What are adhesive proteins?
Cross-link cells of CT with collagen, bind to integrins
Fibronectin, tenascin (produced at wounds), laminin
What are GAGs?
sugar polymers - repeating units of disaccharides, draw water due to negative ionic charge forming porous hydrated gel –> allow ECM to withstand compressive forces
What are proteoglycans?
GAGs attached to proteins through link proteins
What are the indigenous cells of CT?
Mesenchymal stem cells: fibroblasts, adipocytes, mast cells
What are the immigrant cells of CT?
Neutrophils, monocytes/macrophages, dendritic cells, eosinophils, basophils, lymphocytes
What is the epidermis composed of?
Keratinocytes (90%)
Melanocytes
Langerhan cells
Merkel cells
What does the superficial fascia contain, where is it found and what are its functions?
collagen, elastic fibers and varying amount of fat; just beneath the dermis
storage of water and fat, conduction, protection against mechanical shock, thermal insulation
What is the deep fascia composed of and what are its functions?
highly organised connective tissue layer, contains little fat
conduction, movement of muscle, attachment for some muscles, capsules around organs and glands
Where does the thoracic duct drain?
Left brachiocephalic vein between left internal jugular and subclavian
What is cartilage composed of?
chondroblasts which secrete ground substance and collagen to form a rigid gel. Chondroblasts become chondrocytes once formed.
No neurovascular elements
What is foetal skeleton formed by?
Hyaline cartilage
Where in the bone is red bone marrow contained?
In the trabecular/spongy bone
Where in the bone is yellow bone marrow contained?
In the medullary cavity
What is endochondral ossification?
When bone develops by replacing hyaline cartilage
Primary ossification centre: along the diaphysis
Secondary ossification centre: in epiphysis
What is intramembranous ossification?
When compact and spongy bone develop directly from sheets of mesenchymal connective tissue.
How is an osteon arranged?
Osteocytes are arranged in concentric layers around a central (Haversian) canal containing blood vessels
What are the three types of joints?
Fibrous (united by collagen): sutures, syndesmoses, gomphoses;
Cartilaginous (united by cartilage): synchondroses, symphyses;
Synovial (fluid filled cavity, separates skeletal elements which are united by a fibrous capsule)
What is isometric and isotonic contraction?
Isometric: muscle exerts force without changing length
Isotonic: concentric - muscle shortens during force production (eccentric: muscle produces force but length increases)
What are the layers of connective tissue that hold muscle fibres in position in skeletal muscle?
Epimysium: surrounds entire muscle
Perimysium: surrounds bundles of muscle fibres to form fascicles
Endomysium: surrounds each muscle fibre within fasciculus
What is the myotendinous junction?
Where endo, peri and epimysium merge with the dense collagenous connective tissue of the tendon
How does skeletal muscle form?
Myoblasts fuse into myotubes (immature muscle fibers)
Muscle fibres contain satellite cells on the surface –> can provide new myonuclei
What are myofibrils composed of?
Myosin and actin filaments; divided into sarcomeres
What are the different bands and zones of a sarcomere?
A band: whole myosin part with overlap
I band: where you find only actin
H band/zone: only myosin
Z lines: delimit the sarcomere (alpha-actinin and desmin)
What are the different sub-types of muscle fibres?
Slow myosin isoform: found in red muscle fibres, contain a lot of myoglobin
Fast myosin isoform: found in white muscle fibres, contain small amounts of myoglobin
Type I slow: oxidative
Type IIa: fast oxidative
Type IIb: fast glycolytic
Type IIx: super fast glycolytic
What is Duchenne muscular dystrophy?
Loss of dystrophin (helps link contractile apparatus to ECM)
X-linked recessive
What factors drive a precursor cell to undergo terminal differentiation to form a muscle cell?
Myogenic regulatory factors
What is the function of astrocytes?
Maintenance of blood-brain barrier, structural strength to CNS, produce scar tissue, direct neuronal growth development, control interstitial environments (NT recycling)
What is the function of microglia?
Similar function to macrophages and monocytes; remove cell debris, wastes and pathogens by phagocytosis
What is the function of ependymal cells?
Line CSF cavities, probably monitor composition of CSF
What is the function of oligodendrocytes?
Form myelin sheaths around neuronal axons in CNS
What are satellite cells of the peripheral nervous system?
Surround neuron cell bodies in ganglia; control O2, CO2, NT and nutrient levels around it
What type of neurons are in the sensory ganglia?
Pseudo unipolar
What type of neurons are in motor autonomic cells?
Multipolar
Where do nerves of the sympathetic ANS arise from?
T1-L2
Where do nerves of the parasympathetic ANS arise from?
CN III, VII, IX, X
Sacral spinal nerves S2-4
What are the NTs and receptors in the sympathetic and parasympathetic ANS?
Sympathetic: Ach to N, NorEpi to alpha or beta (Ach to M in sweat glands)
Parasympathetic: Ach to N, Ach to M
What is image resolution?
The number of pixels along each axis
What is intensity/grey-scale resolution?
The range of possible intensity values
What is spatial resolution?
The measure of the smallest discernible detail in an image
What is the aspect ratio of an image?
Width/height
What does ‘n bit image’ mean?
means 2^n different intensity values
What is the most common format for medical imaging?
DICOM; non-compressed
Order the following from least to most attenuating material: bone, air, metal, fat, soft tissue/water
air, fat, soft tissue/water, bone, metal
What is CT?
Computed tomography; x-ray projections at many different angles
What is the principle behind PET?
Positron emission tomography;
Inject isotope, emit particle (positron and gamma photons), detect particle
Most commonly used: fluoro-deoxyglucose
What is the principle of nuclear magnetic resonance?
Sample is placed in strong magnetic field
Irradiated with radio waves at resonance frequency
Re-emission of radio waves
Beauty is in the level of differentiation of soft tissue, bone doesn’t show up
What is the principle of US?
Emit short ultrasound waves, listen to what is reflected back
What layers does the abdomen have?
Skin is thin
Superficial fascia is thick
Deep fascia is thin/absent
Epimysium covers the muscles
Which are the retroperitoneal organs?
Suprarenal glands Aorta Duodenum (second and third segments) Pancreas Ureters Colon (ascending and descending) Kidneys Esophagus Rectum
What type of superficial fascia is present in the abdomen?
Camper’s fascia: thick layer formed of fat
Scarpa’s fascia: membranous layer, only present beneath umbilicus
Where is extra-peritoneal fat thickest?
Posteriorly
What are the superficial veins of the abdomen above and below the umbilicus?
Above: paraumbilical, thoracoepigastric (thoracoabdominal), lateral thoracic
Below: superficial epigastric (from femoral vein), superficial circumflex iliac
Which nerves supply rectus abdominis, external oblique and the skin above them?
intercostal nerves T7-T12
Which nerves supply internal oblique and transversus abdominis?
T7-L1
What is the conjoint tendon?
Joins internal oblique and transversus abdominis onto the pubic crest
What is the arcuate line?
1/2 the distance between umbilicus and pubic crest
Above arcuate line: anterior rectus sheath includes EO aponeurosis and anterior lamina of IO, posterior rectus sheath includes posterior lamina of IO and transversus abdominis aponeurosis
Below arcuate line: rectus sheath is all anterior
What are the cutaneous nerves of the pubic area and where do they arise from?
Iliohypogastric (L1) and ilioinguinal (L1)
What are the arteries of the abdominal wall?
Internal thoracic artery –> musculophrenic artery + superior epigastric
Posterior intercostal arteries, anterior intercostal arteries
Lumbar arteries
Inferior epigastric (from external iliac)
What is a hernia?
A protrusion of the parietal peritoneum; it doesn’t have to include organs
What are the positions of inguinal and femoral hernias?
Inguinal: above and medial to pubic tubercle
Femoral: below inguinal ligament and lateral to pubic tubercle
What are the boundaries of the superficial inguinal ring?
medial and lateral crura, external oblique aponeurotic tendon
What is the position of the deep inguinal ring?
one finger breadth above midpoint of inguinal ligament, lateral to inferior epigastric artery
What are the layers within the spermatic cord?
Tunica vaginalis: visceral and parietal (from peritoneum)
Internal spermatic fascia (from transversalis fascia)
Cremasteric fascia + cremaster (from internal oblique)
External spermatic fascia (from external oblique)
Dartos fascia (from Scarpa’s fascia)
What are the boundaries of the inguinal triangle?
Inferior epigastric vessels, linea semilunaris and inguinal ligament
What is the difference between direct and indirect inguinal hernias?
Indirect: protrusion of peritoneum through inguinal canal
Direct: protrusion through external ring, bypassing internal ring
What does the vitelline duct become?
Umbilical cord
Which are the foregut structures?
Pharynx and oesophagus Lower respiratory tract Stomach Duodenum (proximal to bile duct opening) Liver Pancreas Biliary system
How does the pancreas develop?
Ventral bud: forms lower part of head and uncinate process
Dorsal bud: upper part of head, neck, body and tail
Which are the midgut structures?
Duodenum (distal to opening of bile duct) Jejunum Ileum Caecum and appendix Ascending colon Proximal 2/3rd of transverse colon
What are the blood supplies of the foregut, midgut and hindgut?
Foregut: coeliac artery
Midgut: superior mesenteric artery
Hindgut: inferior mesenteric artery
What is a volvulus?
Rotation of the small intestine
What are omphalocoele and gastroschisis?
Omphalocele: intestines remain outside of the abdomen inside a sac
Gastroschisis: intestines are uncovered outside of the abdomen
Which are the hindgut structures?
Distal 1/3rd of transverse colon Descending colon Sigmoid colon Rectum Superior part of anal canal Epithelium of the urinary bladder and most of the urethra
What is the cloaca?
Structure in the development of the urinary and reproductive organs
What is the proctodeum?
Inferior ectodermal part of an alimentary canal, below the pectinate line
At how many days does the rotation of the stomach start?
35 days
What ligaments do the dorsal and ventral mesogastrium give rise to?
Spleno-renal ligament
Gastrosplenic ligament
gastrohepatic ligament (lesser omentum)
Falciform ligament
In what direction is the rotation of the stomach?
Clockwise, as opposed to midgut rotation
Leads to left vagus in the front and right vagus in the back
What is the gastrocolic ligament?
Ligament between the stomach and the colon formed by the omental bursa (useful to get into lesser sac)
What foramen connects the greater and lesser sac?
Omental (gastroepiploic) foramen
Which ligament contains the portal triad?
Hepatoduodenal ligament
What are the two flexures of the colon?
Hepatic and splenic flexures
What are the mesenteries of the mid and hind gut?
The mesentery
Transverse mesocolon
Sigmoid mesocolon
Mesoappendix
What are the pelvic peritoneal folds?
Vesicouterine pouch Rectouterine pouch (pouch of Douglas) Rectovesical pouch (male)
What is the incisura angularis?
the superior curvature of the pyloric antrum
What type of epithelium lines the oesophagus?
Upper 1/3rd: stratified squamous epithelium, non-keratinized
Lower 1/3rd: simple columnar
What is the function of the cardia?
Mucus secretion –> prevents regurgitation of acid
What type of epithelium lines the stomach?
Columnar epithelium
What are the components of the mucosa of the gut wall?
Epithelium, lamina propria, muscularis mucosa
Contains accessory duct entrance, glands and gut-associated lymphoid tissue (GALT)
What are the components of the submucosa of the gut wall?
Loose CT, blood vessels, lymphatics, nerves and glands
Submucosal Meissener’s plexus
What are the components of the muscularis externa of the gut wall?
Outer longitudinal, inner circular, inner oblique layer (only in stomach)
Myenteric (Auberbach’s) plexus
What are the components of the adventitia/serosa of the gut wall?
CT or peritoneum, extrinsic nerves, blood vessels
Do the SMA and SMV lie above or below the:
pancreas
duodenum
Below the body of the pancreas, above the uncinate process of the pancreas and the 3rd part of the duodenum
What is the arterial supply of the stomach?
From coeliac trunk:
- Right gastric (from common hepatic) –> lesser c
- Left gastric (form coeliac trunk) –> lesser c
- Right epiploic (from gastroduodenal, a branch of the common hepatic) –> greater c
- Left epiploic (from splenic artery, branch of coeliac trunk) –> greater c
What is the venous drainage of the stomach?
Right and left gastric –> portal vein –> IVC
Short gastrics and left epiploic vein –> splenic vein
Right epiploic vein –> superior mesenteric vein
What is the venous drainage of the oesophagus?
azygous vein –> SVC
What are the lymphatics of the stomach?
Right and left gastric, pyloric, right gastro-omental, pancreaticolienal
All drain into pre-aortic lymph nodes (coeliac lymph nodes)
What is the nerve supply of the stomach?
Vagus: motor and secretomotor
Sympathetics: T6-T9 (to coeliac plexus through greater splanchnic nerve)
- Afferent: pain (epigastric)
- Efferent: vasoconstriction and antiperistaltic
What are the three visceral surfaces of the spleen?
Gastric, renal and colic
What are the structures of the portal triad?
Proper hepatic artery
Portal vein
Common bile duct
What are Couinaud’s divisions?
The functional divisions of the liver (8)
What are the ligaments of the liver?
Anteriorly: falciform ligament (round ligament of the liver at inferior edge)
Superiorly: coronary ligament + left and right triangular ligaments
Posteriorly: lesser omentum (contains ligamentum venosus) + groove of umbilical vein
What is the order of ducts of the biliary system?
left and right hepatic ducts, common hepatic duct, cystic duct, common bile duct
What is Calot’s triangle?
Triangle between common hepatic duct, cystic duct and liver (cystic artery passes through the triangle)
What are the two porto-systemic anastomoses?
Lower end of oesophagus: systemic drainage to azygous vein and portal drainage to hepatic portal vein
Around rectum: portal drainage through superior rectal (final tributary of inferior mesenteric) and systemic drainage through inferior and middle rectal to internal iliac
What are the upper and lower boundaries of the mesentery?
duodenal-jejunal flexure and ileo-caecal junction
What are the divisions of the small intestines?
Duodenum (5%)
Jejunum (<40%)
Ileum (<60%)
What is segmentation and where is it predominant?
Larger section of bowel contracts at the same time —> pushes chyme backwards and forwards
Segmentation occurs more in large bowel together with mass peristalsis, in small bowel peristalsis prevails
What are the sections of the duodenum?
- Duodenal cap: smooth (no plicae circulares)
- Descending
- Transverse
- Ascending
What holds up the duodeno-jejunal flexure?
Ligament of treitz (suspensory ligament of the duodenum)
Anchors to the diaphragm, comes from right crus
What is the difference between adventitia and serosa?
Adventitia: retroperitoneal organs
Serosa: intraperitoneal organs
What are Brunner’s glands?
Submucosal glands in the duodenum –> help for mucous secretion
How is the jejunum supplied?
The mesentery (not a lot of fat) superior mesenteric arteries --> jejunal arteries --> arterial arcades (short) --> long vasa recta
Where are plicae circulares more prominent?
Jejunum –> helps distinguish jejunum from ileum (half-plicae)
How is the ileum supplied?
The mesentery (with lots of fat) More complex anastomoses of arterial arcades, shorter vasa recta
What are Peyer’s patches?
Islands of lymphoid tissue in mucosa of distal ileum
What are para-aortic lymph nodes?
Lymph nodes draining paired organs
What is the structure of the large intestine?
3 longitudinal strips of teniae coli (longitudinal muscle) –> create haustra
Epiploic appendages
What is the blood supply to the appendix?
Appendicular artery from SMA
What is the blood supply to the caecum?
Anterior and posterior caecal arteries from SMA
Where is the McBurney’s point?
2/3rd way down line between umbilicus and ASIS
At what level is the rectum?
S2 vertebra
What is the blood supply to the duodenum?
Above major duodenal papilla: gastroduodenal artery (coeliac trunk branch)
Below major duodenal papilla: inferior pancreaticoduodenal artery (SMA)
What are the branches of the superior mesenteric artery?
L1
Jejunal and ileal arteries on the left
Ileocolic artery –> anterior and posterior caecal + appendicular
Right colic –> ascending colon
Middle colic –> transverse colon
Inferior pancreaticoduodenal artery (first branch)
What are the branches of the inferior mesenteric artery?
L3
Left colic (distal third of T colon)
2-3 sigmoidal arteries
Superior rectal artery
What is the motor and secretory supply for the gut?
Vagus for foregut and midgut
Pelvic splanchnic nerves (S2-S4) –> inferior hypogastric plexus (includes sympathetic fibers; superior hypogastric plexus is only sympathetic) –> hindgut
What is the sympathetic innervation to the gut?
T5-T9: greater splanchnic nerve –> coeliac trunk (some to SM ganglion) –> foregut + adrenal gland (chromaffin cells)
T10-T11: lesser splanchnic nerve –> SM ganglion and aorticorenal ganglia –> midgut
T12-L2: least splanchnic nerve –> hindgut
T11-12: kidneys
Stomach and liver: T6-T9
Small intestine: T9-T10
Ascending colon: T11
Descending colon: T12
Rectum: L1-2
Kidneys: T11-12
Bladder: L1-L2
What are the folds in the rectum called?
Plicae transversalis: two from the left, one from the right –> form rectal valves
No plicae circulares
What is the main muscle that forms the pelvic floor and where does it arise?
Levator ani; 2/3rd up the obturator internus muscle
What is the pudendal canal and where is it situated?
Covered by fascia from obturator internus and levator ani at lateral wall of perineum; includes internal pudendal artery, vein and pudendal nerve
Which nerve supplies the anal canal?
Inferior rectal nerve, branch of the pudendal
What are the perineal body and the anal-coxygeal body/raphi/ligament?
Fibrous bodies; give anchorage to external anal sphincter that surrounds the anal canal
What is the function of the puborectalis?
Pull the anorectal junction forwards
What is the structure of the anal canal?
Upper anal canal: from hindgut, longitudinal folds (anal columns) with anal valves at pectinate line
Lower anal canal: from proctodeum, pecten (mucosal wall is thin) with anocutaneous ridge forming internal sphincter, below anocutaneous ridge –> subcutaneous bundle of external sphincter
What are the parts of the external anal sphincter?
Puborectalis, deep, superficial and subcutaneous
What is the blood supply of the anal canal and the lower part of the rectum?
Anal canal: inferior rectal artery (from internal pudendal artery branch of internal iliac)
Lower part of rectum: middle rectal artery (from internal iliac)
Similar for veins
What are the lymphatic drainages of the rectum and anal canal?
Superior part of rectum –> inferior mesenteric pre-aortic lymph nodes
Middle part –> internal iliac
Proctodeum territory –> superficial inguinal
What is the neural control of defecation?
Parasympathetic stretch receptors (S2-4)
Ascending sacral spinal nerves (S2-4) inhibit lumbar sympathetics (L1-2) to relax internal sphincter
What are the 3 different types of hormones?
Proteins/peptides: all hormones of hypothalamus, pituitary, parathyroids, GI tract, pancreas
Steroids: sex hormones, adrenal cortex hormones
Amines: thyroid hormones, adrenaline, melatonin (derived from tyrosine), thyroid hormones are lipid soluble while catecholamines are water soluble
What is the role of eicosanoids?
Promote inflammation, role in ovulation, prevent gastric secretions
What are the 3 types of extracellular hormone receptors?
Monomeric: EGF receptors
Multimeric: insulin receptor
Receptors with seven membrane-spanning domains: b-adrenergic receptor
What is the structure of the pituitary gland?
Adenohypothysis: anterior lobe, glandular
Neurohypothysis: posterior lobe, neuronal processes from supraoptic nucleus (SON –> ADH) and paraventricular nucleus (PVN –> oxytocin)
How does the anterior pituitary work?
Hormones are produced in the hypothalamus and released at the median eminence, travel down the portal blood vessels and control release of anterior pituitary hormones
What are herring bodies?
Accumulations of hormones within the axons
Which are the secretory cells of the pars distalis?
Acidophils: GH and prolactin
Basophils: TSH, ACTH, FSH, LH
Chromophobes: stem cells or resting cells
What are the actions of dopamine and somatostatin on the hypothalamic hormones?
Dopamine: blocks prolactin release
Somatostatin: blocks GH and TSH
How do the thyroid glands work?
Epithelium organised in follicles –> secretes thyroglobulin into the lumen
1. thyroid follicular cells take up iodide, oxidise to iodine and attach to tyrosines of thyroglobulin in the lumen
2. TSH stimulates endocytosis of thyroglobulin, breakdown into lysosomes and release as tetra-iodothyronine (T4) or tri-iodothyronine (T3)
Thyroid C-cells/parafollicular cells –> secrete calcitonin
What is the structure and organisation of parathyroid glands?
2 pairs; chief/principal cells –> PTH (stimulates calcium mobilisation), oxyphil cells (unknown function)
What are the layers of the adrenal cortex and what do they secrete?
Zona glomerulosa: mineralocorticoids (aldosterone), arranged in rounded clusters
Fasciculata: glucocorticoids, arranged in straight cords
Reticularis: sex steroids, irregular cords
Which cells are present in the adrenal medulla?
Chromaffin cells
Which are the endocrine cells of the pancreas and what do they secrete?
More lightly stained than the exocrine cells alpha cells: glucagon (20%) beta cells: insulin (70%) delta cells: somatostatin (5-10%) F or PP cells: pancreatic polypeptide
What is the diffused neuroendocrine system?
Scattered cells found especially in the gut and respiratory system; secrete amines or polypep with neuroendocrine or NT function (gastrin, CCK, secretin, serotonin…), often paracrine
What are the origins and insertion of psoas major and what is its nerve supply?
Lumbar vertebrae –> lesser trochanter of femur
L1-2-3 (lumbar plexus)
What is the nerve supply of iliacus?
femoral nerve L2-3
Which nerves are associated with the psoas major?
Genitofemoral nerve: pierces through (L1-2)
Femoral nerve: lateral to psoas (L2-4)
Obturator nerve: medial to psoas (L2-4)
What is the function of the iliohypogastric nerve?
L1; around abdominal wall, pierces internal oblique muscle and becomes cutaneous to skin around pubic area
What is the function of the ilioinguinal nerve?
L1; joins inguinal canal, supplies muscles of conjoint tendon (IO and TA), cutaneous to anterior 1/3 of scrotum and labia majora
What is the function of the genitofemoral nerve?
L1-L2
Femoral part: supplies skin on top of thigh
Genital branch: supplies cremaster muscle
At what level does the aorta divide into the common illiac branches?
L4
At what level does the IVC and aorta enter the diaphragm?
IVC: T8; aorta: T12
What are the branches of the aorta?
Inferior phrenic arteries (T12): pair Lumbar arteries (L1-4): 4 pairs Median sacral Coeliac trunk (T12) SMA (L1) IMA (L3) Middle suprarenal (L1): paired Renal (L1/2): paired Gonadal (L2): paired
What are the branches of the IVC?
3 hepatic inferior phrenic: paired Suprarenal, gonadal: on right side Renal: paired Left suprarenal and gonadal: go to renal vein
At what level is the hilum of the kidneys?
right just below L1 (rib 12 –> L3), left just above L1 (rib 11 and 12)
What are the coverings of the kidneys?
Renal capsule, perirenal fat, renal fascia, pararenal fat
How many branches of the renal artery into the kidneys are there?
5 –> anatomical end arteries
Veins anastomose with each other
What is the blood supply of the suprarenal glands?
superior suprarenal artery (from inferior phrenic artery), middle suprarenal artery (from aorta), inferior suprarenal artery (from renal artery) Suprarenal vein (right side into IVC, left side into left renal vein)
What are the places of possible constriction of the ureters?
Pelvo-ureteric junction, crossing over external iliac, uretero-vesical junction
What are the different parts of the male urethra?
Pre-prostatic urethra
Prostatic urethra
Membranous urethra
Spongy/penile urethra + bulbar urethra
What are the three muscles that wrap around the vagina and urethra in the deep perineal pouch?
Sphincter urethrovaginalis, compressor urethrae, external urethral sphincter (somatic skeletal muscles –> pudendal nerve S2-4)
What does the ureter cross on its way to the bladder?
external iliac artery (over), obliterated umbilical artery (over), ductus deferens (under) or uterine artery (under)
What is the muscle of the bladder called?
Detrusor muscle
Which ligaments hold the urethra straight?
pubovesical and pubourethral in female; pubovesical and puboprostatic in male
What is the lymphatic drainage of the urinary system?
Kidneys and upper ureters: lumbar paraortic lymph nodes
Middle ureters: common iliac lymph nodes
Lower ureters: common, external and internal iliac
Pelvic ureter and bladder: internal iliac lymph nodes
What is the innervation of the bladder?
Hypogastric plexus: T11-L2 –> sympathetics: prevent contraction of bladder and switch on internal urethral sphincter
Somatic: pudendal nerve S2-4 for external urethral sphincter
Parasympathetic control: S2-S4 –> contraction of the bladder
What are the three muscles of the levator ani?
Puborectalis, pubococcygeus, iliococcygeus
What are the muscles of the anal triangle?
Ischiocavernosus, bulbospongiosus, transverse perineal, perineal body
Which cells produce sperm?
Sertoli cells
What are the contents of the inguinal canal and spermatic cord?
Males:
3 fascia: external spermatic, cremasteric, internal spermatic
3 arteries: testicular, cremasteric, deferential
3 veins: pampiniform plexus, cremasteric, deferential
3 nerves: genital branch of genitofemoral, ilioinguinal, autonomic
lymphatics
Females: round lig. of uterus, genital branch of genitofemoral, ilioinguinal
What is the function of Leydig cells?
Secrete testosterone
What do the seminal vesicles, prostate and bulbourethral glands secrete?
Seminal vesicles: alkaline fluids with fructose, enzymes, prostaglandins
Prostate: citrate, enzymes
Bulbourethral glands: viscous fluid
What is the penis composed of?
Paired corpora cavernosa and corpus spongiosum
Are ovaries intra or retroperitoneal?
Intraperitoneal
What are the mesometrium, mesosalpinx and mesovarium?
Mesometrium: mesentery of the uterus
Mesosalpinx: mesentery of the fallopian tube
Mesovarium: mesentery of the ovaries
What are the openings of the vaginal vestibule?
Urethral openin, vaginal opening, 2 ducts of the greater vestibular glands (Bartholin) and 2 ducts of the lesser vestibular glands (Skene)
In which direction does neurulation occur?
From anterior to posterior
What are the derivatives of mesoderm?
Notochord (axial mesoderm)
Somites (paraxial mesoderm): sclerotome, myotome, dermatome
Intermediate mesoderm: kidneys and gonads
Lateral plate mesoderm: body wall, gut musculature and circulatory system
Which morphogens are important in neural tube patterning?
Shh –> ventral
Wnt, Bmp –> dorsal
What is the innervation of the pelvic organs?
Somatic (afferent and efferent): pudendal nerve Autonomic parasymp (efferent): pelvic splanchnic nerves and inferior hypogastric plexus Autonomic sympathetic (efferent): sacral sympathetic chains, inferior and superior hypogastric plexus and periarterial plexus Autonomic visceral (afferent): reflexive sensations from parasympathetic, pain sensation from sympathetic above pelvic pain line and parasympathetic below pelvic pain line
