Functional Anatomy and Embryology Flashcards
Unilateral contraction of the abdominal external oblique muscle causes which movement?
Contralateral rotation
What forms the posterior wall of the inguinal canal?
Transversalis fascia
From which artery does the right gastric artery arise in most people?
Common hepatic artery
At which level does the thoracic aorta become the abdominal aorta?
T12
Which of these is intraperitoneal?
a) Ascending colon
b) Transverse colon
c) Descending colon
d) Rectum
Transverse colon
Which embryological structure forms the gallbladder?
a) Foregut
b) Midgut
c) Hindgut
d) Allantois
Foregut
Where are components of Herring bodies synthesised?
Preoptic and paraventricular nuclei of hypothalamus
Nuclei of which cells are most frequently stained in neurohypophysis?
Pituicytes and endothelial cells
Which adenohypophysis cells stain deep blue with trichrome/PAS stains?
Basophils
One possible role for chromaphobes in adenohypophysis?
Stem cells
What hormones are released from neurohypophysis?
ADH and Oxytocin
What hormones released from basophils?
TSH, ACTH, FSH, LH
What hormones released from acidophils?
Growth hormone and prolactin
Which cells are regulated by releasing hormones from hypothalamus?
Basophils
How do releasing hormones from hypothalamus reach pituitary?
Hypophyseal portal system
What do both calcitonin and parathyroid hormone regulate?
Ca homeostasis
How is parathyroid structure typical of most endocrine glands?
Cells arranged in cords alongside an extensive capillary bed
What structural features of thyroid gland is unusual?
Follicles
Thyroid parafollicular cells produce?
Calcitonin
What is unique to thyroid gland amongst all endocrine organs?
Hormone stored in inactive form outside cell
Mature hormones produced by thyroid follicular cells are called?
T3 +T4
Tri-iodothyronine and tetra-iodothyronine
Which AA is mature thyroid hormones related to?
Tyrosine
Inactive hormone precursor produced by thyroid follicular cells is?
Thyroglobulin (thyroid colloid)
What hormone is produced by parathyroid cells?
Parathyroid hormone
What region(s) of adrenal gland arise from neural crest in embryo?
Adrenal medulla
Which organ is adrenal glands fibrous capsule continuous with?
Kidney
Which region(s) of adrenal gland are regulated by sympathetic input?
Adrenal medulla
Which region(s) of adrenal gland arise from part of lining of abdominal cavity (coelom) in embyro?
Adrenal cortex
Which region(s) in adrenal glands are controlled by ACTH from pituitary?
Zona fasciculata, Zona reticularis
What do delta cells secrete?
Somatostatin
What proportion of islet cells produce insulin?
80%
Which technique can be used to detect insulin producing cells in an islet?
Immumohistochemistry
Which techniques could be used to detect changes in an individual carrying familial (Type 1) diabetes?
PCR
What is embryonic origin of adenohypophysis?
Up growth roof of buccal cavity
Embryonic origin of neurohypophysis?
Down growth from floor of hypothalamus
Where are Herring bodies found in neurohypophysis?
Aggregations of vesicles within axons
Where does endocytosis protein come from and what is it’s fate?
Blood being filtered from renal corpuscle
Absorbed into cells of proximal convoluted tubule and destroyed by lysosomes
Permeability of collecting ducts regulated by ADH only 9AA long. If hormone is present in bloodstream, would you expect it to be present:
a) Ultrafiltrate collected in Bowman’s capsule?
b) Lumen of collective tubule?
c) In urine?
Yes
No
Yes
Apart from bladder, where is urinary epithelium found?
Ureter and urethra
What are medullary rays?
Bundles of collecting tubules and ducts
Function of medullary rays?
Draining nephrons
Where are medullary rays located?
In medulla
What is the difference between the proximal and distal plane?
Proximal - towards trunk
Distal - away from trunk
What is the difference between ipsilateral and contralateral?
Ipsilateral - in same side
Contralateral - on opposite side
What is another name for external and internal rotation?
Lateral and Medial rotation
What is inversion and eversion?
Inversion - turn plantar surface of foot medially
Eversion - turn plantar surface of foot laterally
What are the the 3 epithelial cell shapes?
Squamous
Cuboidal
Columnar
What are the 3 layer structures of epithelial cells?
Simple
Pseudostratified - all cells contact with basement membrane
Stratified - only cells located basally have contact with basement membrane
What are the 3 types of surface specialisation of epithelial cells?
Ciliated - e.g. airways
Brush border (microvilli) - held erect by cytoskeleton
Keratinized - e.g. skin
Where are transitional epithelium cells found?
ONLY in urinary system
Stratified squamous
What is the difference between exocrine and endocrine glands?
Exocrine - secrete to free surface
Endocrine - secrete to bloodstream
During the development of glands, do epithelial cells break through the basal lamina?
No
What are the 3 types of exocrine secretion?
Brief explanation of each
Merocrine - secretory vesicle produced and fuse with plasma membrane to release contents
Apocrine - Part of apical cyto lost with secretory products
Holocrine - Breakdown and discharge of entire secretory cell (skin sebaceous glands)
What are the 5 types of cell junctions?
brief descrip of each
Tight junctions - seals neighbouring cells together, prevent leakage of molecules
Adherens junctions - joins actin bundle in 1 cell to bundle in another
Desmosomes - joins intermediate filaments in neighbouring cells
Gap junctions - passage of small diffusible ions + molecules
Hemidesmosome - anchors intermediate filaments to basal lamina
What is the strongest type of cell junction?
Desmosome
Which cell junctions are:
a) Anchoring
b) Non-anchoring
a) Desmosomes, Hemidesmosomes
b) Adherens junctions, Tight junctions, Gap junctions
What are the 3 superficial layers of skin?
Epidermis
Dermis
Superficial fascia (Hypodermis)
What muscle keeps the mouth closed?
Temporalis muscle
What is the serous membrane and what are the 3 structures in the body?
Consists of mesothelium and is double layered
Pleura (lungs)
Pericardium
Peritoneum - lines cavity of abdomen + covering of abdominal organs
What are the 2 sections the body drains to in the lymphatic system?
Top right bit (inc right arm) - subclavian veins
Rest of body - thoracic duct into left subclavian vein
What the 5 types of connective tissues?
Mesenchyme - embryo only Loose (areolar) - mesentery + hyperdermis Dense Reticular Adipose
How many types of fibrillar collagens are there and where commonly found?
4 Type 1 - skin, bone, tendons, Type 2 - cartilage Type 3 - blood vessels, skin Type 4 - only basement membrane
Which type of fibrillar collagen doesn’t form a triple helix?
Type 4
What is GAG and what are proteoglycans?
Glycosaminoglycans
GAGs attached to proteins
What are the indigenous cells of connective tissue and what gives rise to them?
Mast cells - His secretion, origin immune system
Fibroblasts - ECM producer
Adipocytes - leptin secretion, fat storage, passive hormone uptake
Mesenchymal stem cells produces fibroblast + adipocytes
What are the immigrant cells of connective tissue?
(Immune system cells) Neutrophils Monocytes/Macrophages Dendritic cells Eosinophils Basophils Lymphocytes
What type of cells make up cartilage of bone?
Chondroblasts
Secrete ground substance and collagen
What is the perichondrium?
Connective tissue that envelops cartilage when it’s not at a joint
Separates cartilage from blood + nerve supply
What is the axial skeleton and what is the rest called?
Skull, thoracic cavity
Appendicular skeleton
What is a sesamoid bone?
Developed in tendons where passes over angular structure
e.g. patella
What are the 3 general sections of a long bone called?
Proximal epiphysis
Diaphysis (shaft of bone)
Distal epiphysis
What is endochondral ossification?
Growing cartilage replaced by bone to form growing skeleton
Cartilaginous template and bony collar forms around it which cuts off blood supply + nutrients
Cell swell up + die + calcify
What is intramembranous ossification?
Bone tissue created directly over mesenchymal tissue
e.g. flat bones of skull or in healing of bone fractures
What are the 2 types of tissue in mature bone?
Compact
Trabecular (spongy)
What are the 3 classifications of joints?
Fibrous
Cartilaginous
Synovial
What are the 3 types of fibrous joints?
Sutures - only between skull bones
Syndesmoses - interosseous membranes, immovable joints where bones are joined by connective tissue
Gomphoses - only between bones and teeth (fibrous periodontal ligament)
What are the 3 types of suture joints?
Squamous
Serrated
Denticulate
What are the 2 types of cartilaginous joints and brief descrip of each?
Primary: synchondroses - plate of hyaline cartilage between opposing surface, x movement
Secondary: symphyses - apposing surface covered by hyaline, separated by fibrocartilage, partial movement
What is the tidemark barrier?
Between cartilage + bone
Osteoblasts from bone can damage cartilage
What are the 3 basic features of synovial joints?
+ 2 present in some cases
Ends of bones covered in articular (hyaline) cartilage
Joint cavity
Synovial membrane - lines joint capsule ONLY
(Disc)
(Bursae)
What are the 7 classifications of the synovial joints?
Hinge Pivot Ball + socket Saddled shape Ellipsoid Condyloid Plane
What are the 3 types of muscle tissue and which one(s) are voluntary?
Striated skeletal muscle - voluntary
Striated cardiac muscle - involuntary
Non-striated smooth muscle - involuntary
What is the difference between ligament and tendon?
Ligament - bone to bone
Tendon - muscle to bone
What are the 2 types of muscle contraction?
Isotonic - concentric: muscle shortens during force production
eccentric: muscle produces force but length increases
Isometric - exert force with no change in length
What are the 3 layers of connective tissue that hold muscle fibre in place?
Epimysium - tough, outermost layer, surround whole muscle
Perimysium - surrounds bundles of muscle fibres to create fascicle
Endomysium - surrounds each muscle fibre within fasciculus
What are myoblasts?
Embryonic precursors of myocytes
What does mitotically quiescent mean?
Not normally dividing
What are the muscle’s equivalent stem cells?
Satellite cells - multipotent, on surface muscle fibres
activate to enter cell cycle + become myoblasts
What is the:
a) A band?
b) I band?
a) Anisotropic band, thick myosin filament
b) Isotropic band. thin actin filament
What is the centre of the sarcomere called?
H band/zone
What is Duchenne muscle dystrophy?
X-linked disorder
Defective gene for protein dystrophin
What is the embryological origin of the axial and appendicular muscle?
Somites
What is the embryological origin of the head muscles?
Unsegmented cranial mesoderm
What is the embryological origin of the trunk muscles?
Segmented paraxial mesoderm
What are the 2 cell types in neural tissue?
Neuron/nerve cells - transmit electrical impulses
Support cells - support nerve cells, bring nutrients and remove waste products
What are the 4 types of glial cells?
Astrocytes
Microglia
Ependymal cells
Oligodendrocytes
What are neuroglial/glial cells?
Non-neuronal cells in nervous system
What are ganglia?
Nerve cell bodies of neurons that lie outside CNS collected into groups
What is the fissure between the 2 cerebral hemispheres of the brain called?
Corpu colosum
What is the foramina in the skull?
Where nerves enter and leave brain and spinal cord
What are the 3 meninges of the brain?
Dura mater (periosteal, meningeal)
Arachnoid mater
Pia mater
What is the difference between lossy and lossless compression?
Lossy - can’t go back to original
Lossless - can go back to original image without losing original information
What is the general alpha decay equation?
Unstable radioactive nuclei of an element ==> mass number - 4, atomic number -2, + 1 helium atom
What is the general beta - decay equation?
neutron ==> proton + beta - + antineutrino
Atomic no increase by 1
Neutron number decrease by 1
Mass number unchanged
What is the general beta + (positron) decay equation?
proton ==> neutron + positron + neutrino
Atomic no decrease by 1
Neutron no increase by 1
Mass number unchanged
What is the difference between dorsal and ventral?
Both relate to surface
Dorsal - back/upper side of an organism
Ventral - front/lower side of an organism
What is recanalisation?
Restoring flow to an interrupted channel
e.g. to pharynx and oesophagus
What is oesophageal stenosis?
Walls x recannulate properly, walls too thick
What is oesophageal duplication?
Duplication of tube
Bacterial growth
What is atresia?
Blockage of tube during recanalisation
What is reversed rotation of the midgut?
Duodenum in front of large bowel
What is non rotation of the midgut?
When cranial and caudal limbs pulled back into abdominal cavity
Large intestine on left
What is mixed rotation of the midgut?
Cranial and caudal limbs go opposite directions
Caecum top right of abdomen
What is a volvulus?
Loop of intestine twists around itself and the mesentery that supports it
What is omphalocele?
Intestines, liver/ other organs stick outside of belly through belly button
Has covering of umbilical cord around it
What is gastroschisis?
Intestines protrude from anterior abdominal wall
Lateral to umbilicus
No covering
What makes up the foregut?
Lower resp tract (larynx) Stomach Duodenum Liver + pancreas Biliary apparatus
What makes up the midgut?
Duodenum distal to opening of bile duct Jejunum Ileum Caecum + appendix Ascending colon Proximal 2/3 of transverse colon
What makes up the hindgut?
Distal 1/3 of transverse colon Descending colon Sigmoid colon Rectum Superior part of anal canal Epithelium of urinary bladder + most of urethra
Under what ligament does the left side of the greater sac connect to the right?
Falciform ligament
Under what ligament does the greater sac connect to the lesser sac?
Gastrohepatic ligament
What is the lesser omentum?
Double layer of peritoneum that extends from liver to lesser curvature of stomach + 1st prt of duodenum
What is the greater omentum?
Double layer of peritoneum that extends from greater curvature of stomach and sits in front of intestine
When lifted, releases transverse colon
What is the difference between parietal and visceral peritoneum?
Parietal - covers abdominal and pelvic cavities
Visceral - covers each organ individually
In the subdivisions of the abdomen, what are the vertical lines called?
Lateral lines
In the subdivisions of the abdomen, what are the horizontal lines called (from top to bottom)?
Transpyloric plane - transversely through pylons
Subcostal plane
Transtubercular plane - passes 2 tubercles that lie on crest of ileum
What costal cartilages does the rectus abdominis arise from and where does it attach?
Costal cartilage of ribs 5,6,7
Attaches to ridge between pubic crest
What 2 layers is the superficial fascia of the abdomen made up of?
Camper’s fascia - full fat
Scarpa’s fat - membraneous layer
What is the innervation of rectus abdominis?
T7-T12
What is the innervation of external oblique?
T7-T12
What is the innervation of internal oblique?
T7-L1
What is the innervation of transverse abdominis?
T7-L1
Which way does internal oblique pull the trunk?
To same side
Which direction do these muscles go around rectus abdominis?
a) External oblique
b) Internal oblique
c) Transverse abdominis
a) In front, bottom end folds under on self, forms inguinal ligament
b) Splits in 2, half in front, half goes behind
c) Behind
What percentage of hernias are umbilical?
14-20%
What is the difference between femoral and inguinal hernias?
Femoral - lies lateral to pubic tubercle, below inguinal ligament
Inguinal - lies medial to pubic tubercle, originates above inguinal ligament
In the development of the spermatic cord, what does Camper’s fascia become?
Dartos muscle, as lose fat as go around testes
In the development of the spermatic cord, what does Scarpa’s fascia become?
Colles fascia, becomes continuous with deep fascia
In the development of the spermatic cord, what does external oblique become?
External spermatic fascia
In the development of the spermatic cord, what does internal oblique become?
Cremasteric muscle + fascia
Takes some of muscle fibres
In the development of the spermatic cord, what does transverse fascia become?
Internal spermatic fascia
What is the difference between a direct and an indirect hernia?
Direct - through inguinal triangle, through superficial ring, weakened muscles of abdominal wall
Indirect - through deep and superficial ring
What is a….?
a) Hypertonic stomach
b) Hypotonic stomach
c) Atonic stomach
d) Steer Horn stomach
Look at shapes on stomach and spleen notes
a) Fundus is much bigger
b) Overstretched stomach
c) Stomach is long
d) Long, transverse, seen in endomorphs
What is a…..?
a) Ectomorph
b) Endomorph
c) Mesomorph
a) Tall, slim person
b) Short, stumpy person
c) The norm person
What are the 5 parts of the stomach?
Cardia - where oesophagus meets stomach Fundus - normally gas filled Body - HCl, pepsinogen, intrinsic factor Pyloric antrum - gastrin Pylorus - where sphincter is
Why does the carida of the stomach secrete mucus?
Protect oesophagus from acidic stomach content
Why is the duodenum positioned above the stomach?
If below, gravity would move chyme into duodenum + cause it to become overloaded
What does the stomach absorb?
Water
Electrolytes
Alcohol
Aspirin - can cause leakage of blood vessels in stomach wall
How long does food remain in the stomach for? (approx)
4 hours
What 3 layers does the mucosa of the stomach consist of?
Columnar epithelium - absorbing
Lamina propria - contain gastric glands
Muscularis mucosa - movement within lumen to propel gut contents
What 5 layers does the submucosa of the stomach have?
Loose connective tissue Blood vessels Lymphatics Nerves - prt of enteric NS Glands
What is Meissner’s plexus?
Submucosal plexus
Derived from myenteric plexus, which is derived from plexuses of parasymp nerves around superior mesenteric arteries
What are the 2 layers in the muscularis externa?
And nerve supply?
Outer longitudinal
Inner circular
Myenteric (Auerbach’s) plexus
What is the serosa?
Peritoneum membrane wrapping around gut
What extra layer does the stomach wall have in addition to the layers in the muscularis externa?
Inner oblique layer
What is the rugae of the stomach?
Longitudinal folds of the mucosa
What is the incisura angularis of the stomach and what is above it anatomically?
Sharp angle in stomach
Abdominal aorta
What is the difference between intraperitoneal and retroperitoneal?
Intraperitoneal - completely surrounded in peritoneum, flexible
Retroperitoneal - partly covered in peritoneum, rigid
What areas of the stomach does the left lobe of the liver cover?
Cardia, and prt of fundus
What organ(s) is behind the stomach?
Pancreas, left kidney
What is the parasympathetic innervation of the stomach?
Vagus nerve
Left crosses in front of oeso ==> Anterior vagal trunk
Right goes behind oeso ==> Posterior vagal trunk
What is the sympathetic innervation of the stomach?
Splanchnic nerve
T6-T9
What is hepatomegaly?
Enlargement of liver - is palpable
What organ is the bare area of the liver in direct contact with?
Diaphragm
What flexure of the colon leaves an indentation on the visceral surface of the liver?
Hepatic flexure - junction between ascending colon and transverse colon
What ligament divides the right and left lobes of the liver?
Falciform ligament
How many functional lobes can the liver be divided into and what are they called?
8
Couinaud’s Divisions
What are the lobes in the H division of the liver?
Caudate
Quadrate
Left
Right
What are the ligaments at the top of the liver?
Left triangle ligament
RIght triangle ligament
Coronary ligament
What manoeuvre is used to cut off blood supply to liver?
Pringle maneouvre
What is Calot’s triangle?
Identifies cystic artery + cuts off blood supply when need to remove gall bladder
What vein is the …… drained by?
a) Foregut
b) Midgut
c) Hindgut
a) Splenic vein
b) Superior mesenteric - joins splenic + joining of both forms hepatic portal vein
c) Inferior mesenteric vein - joins splenic
Where do the oesophageal veins drain to?
Upwards to azygos vein in thorax
What part of the duodenum does the bile and pancreatic duct terminate?
2nd part
What is the sphincter of Oddi?
Smooth muscle surrounding end portion of common bile duct and pancreatic duct
What is the greater duodenal papilla?
Where the common bile duct and pancreatic duct open into the duodenum
What is the hepatopancreatic ampulla/ampulla of Vater?
Union of bile duct and pancreatic duct
Where is the
a) Head
b) Tail
of the pancreas located?
a) Curve of duodenum - under superior mesenteric artery
b) Extends to spleen
What are the indentations of the rectum?
1 fold right
2 folds left
What are the female rectal pouch(es)?
Rectouterine pouch (Pouch of Douglas) - uterus and rectum Vesicouterine pouch - uterus and bladder
What are the male rectal pouch(es)?
Rectovesical pouch - rectum and bladder
How many sections is the rectum divided into and and what is the peritoneum covering of each?
3
Upper third - peritoneum on front and sides
Middle third - peritoneum in front only
Lower third - devoid of peritoneum
What is the ischiorectal fossa?
Wraps around anal canal
What is the pudendal canal/Alcock’s canal?
Structure in pelvis through where internal pudendal artery, internal pudendal veins, + pudendal nerve pass.
What is the perineal body?
Area to allow anchoring of muscle fibres
What structure attaches at the anal coccygeal body?
External anal sphincter muscle
When does the puborectalis muscle relax?
During defecation,
Changes angle between rectum + anal canal by straightening junction
What is the area under the last fold of the rectum?
Rectal ampulla
What is the name of the line that indicates the end of the rectum?
(What is name of region under this line)
Pectinate line
Proctodeum
Which part of the anal canal has longitudinal folds of mucosa (anal columns)?
Upper anal canal
What is the name of the line where the internal sphincter of the anal canal ends?
Hilton’s white line
What area does the proctoscope see?
Looks at anal canal + rectal ampulla
Sees area of proctodeum
Which anal sphincter is under somatic control?
External anal sphincter
What area does the superior rectal artery supply?
Supplies rectum + upper half of anal canal
What artery does middle rectal artery branch from?
Internal iliac artery
What artery supplies below the pelvic floor and pectinate floor?
Inferior rectal artery - branch of internal pudendal artery
What is an internal hemorrhoid?
Swelling of vein into anal canal above pectinate line
What is an external hemorrhoid?
Swelling of vein below pectinate line
If examining patient, see bulges in 11, 3, 7 o clock positons
Where are the stretch receptors of the anal canal arise from?
Parasymp S2-4
What nerve carries somatic sensation from anal sphincter + ischioanal fossa?
Pudendal nerve
Where does the foregut end?
After entry of common bile duct
Where does midgut end?
2/3 of way along transverse colon
Where does the hindgut end?
Halfway down anal canal
What are the intraperitoneal organs?
Stomach, spleen, liver, bulb (start) of duodenum, jejunum, ileum, transverse colon, sigmoid colon
What are the retroperitoneal organs?
Remainder of duodenum, cecum + ascending colon, descending colon, pancreas, kidneys
For the parts bowel that aren’t covered in peritoneum , what are they hinged on?
The Mesentery
Hinged on posterior abdominal wall
From duodenal jejunal flexure to ileocaecal joint
15cm long
What are the 3 divisions of the SI and where does it start and end?
Duodenum (<5%)
Jejunum (<40%)
Ileum (<60%)
Runs from pyloric sphincter to ileocecal junction
How many parts of the duodenum are there?
4
What are the folds in the duodenum called?
Pliegues circulares
Which part of the duodenum is crossed by the superior mesenteric artery and vein?
3rd part
What ligament holds up the duodenal jejunal flexure?
Suspensory ligament AKA Ligament of Treitz
Connected to diaphragm
What are the names of the mucus glands in the duodenum?
Brunner’s glands
What type of arteries are vasa recta?
Anatomical end arteries
X anastomotic connections to each other
What are the blood vessels like in the jejunal mucosa?
Long vasa recta
Short arterial arcades
Mesentery has v little fat so can see blood vessels easily
What are the blood vessels like in the ileal mucosa?
Short vasa recta
Complex arterial arcades
Fat-filled mesentery
What are Peyer’s patches and where are they found?
Islands of lymphoid tissue in ileum wall
GALT - gut associated lymphoid tissue
Which part of the small intestine has little pliegues circulares?
Ileum
What lymphatic nodes drain:
a) Foregut?
b) Midgut?
c) Hindgut?
a) Coeliac node
b) Superior mesenteric node
c) Inferior mesenteric node
What are the 3 main structural features of the large intestine?
Teniae coli - 3 longitudinal strips, thickening of longitudinal muscle of muscularis externa Haustra - sac-like divisions Epiploic appendages (Omentus appendages) - fat-filled pouches
What is a diverticula?
Outpouching of gut wall of muscularis in LI
Common in sigmoid colon
What does the large intestine absorb and where does it start and end?
Absorbs H2O + electrolytes
Starts caecum + end upper half anal canal
Where is the vermiform appendix attached to?
Attached to caecum
Where is the initial pain of appendicitis and where does it move to?
Umbilical region
Right iliac fossa when infection of inflamed appendix reaches parietal peritoneum
Where is Mcburney’s point and where is the maximal appendix pain?
Line drawn from anterior, superior iliac spine to umbilicus
2/3 down from umbilicus
Where do the preganglionic nerves arise from for the:
a) Foregut?
b) Midgut?
c) HIndgut?
a) T5-T9 ==> coeliac ganglion
b) T10-T12 ==> mesenteric ganglion
c) T12, L1-2 ==> inferior mesenteric ganglion
In the gut, does symp/parasymp innervation promote gut movement?
Parasymp
What 5 endocrine organs produce hormones that are proteins + peptides?
Hypothalamus Pituitary Parathyroid GI tract Pancreas
What organs produce steroid hormones?
Adrenal glands
Gonads
Placenta (e.g. oestrogen)
What is a monomeric receptor?
Single unit crosses plasma M e.g. EGF receptor
What is a multimeric receptor?
Several membrane spanning subunits + extracellular subunits e.g. insulin receptor
How does blood reach the anterior pituitary glands?
Via capillary loops though either long/shrt hypophyseal portal vessels
What are the 5 types of endocrine cells in the anterior pituitary glands?
Gonadotroph cells Corticotroph cells Somatotroph cells Lactotroph cells Thyrotroph cells
What 2 features are involved in the control anterior pituitary?
Release of hypothalamic hypophysiotropic hormones
Feedback by target gland hormones
Which part of the pituitary is connected to the hypothalamus and what is it’s posh name?
Posterior Pituitary - Neurohypophysis
Which part of the pituitary is non-neuronal and what is it’s posh name?
Anterior pituitary - Adenohypophysis
What are the 2 parts of the posterior pituitary?
Infundibulum
Pars nervosa
What are the 3 parts of the anterior pituitary?
Pars tuberalis
Pars distalis
Pars intermedia
What is the shape of the adrenal gland on the :
a) Right kidney?
b) Left kidney?
a) Pyramidal
b) Crescent
What are the 3 cell zones in the adrenal cortex?
Zona glomerulosa - salt, mineralocorticoids - aldosterone
Zona fasciculata - sugar, glucocorticoids - cortisol
Zona reticularis - sex, sex steroids (some gluco)
What is the release of mineralocorticoids regulated by?
Renin/anngiotensin
What is the release of glucocorticoids regulated by?
ACTH
What hormones does the adrenal medulla secrete?
Cholamines
80% adrenaline
20% noradrenaline
What are the 4 main types in the islet of Langerhans and what do they secrete?
Alpha cells - 20% glucagon
Beta cells - 70% insulin
Delta cells - 5-10% somatostatin
F/pp cells - 1-2% pancreatic polypep
What is the medial arcuate ligament?
Under diaphragm, goes around aorta
Connects diaphragm to spine
Where does the quadratus lumborum attach to?
Innervation?
Attaches to 12th rib + arises from iliac crest of hip bone
Stabilises 12th rib during breathing
L1, 2, 3
Where does the psoas major attach to?
Innervation?
Arise from vertebral bodies + intervertebral discs of L1-L5
Runs down in front of hip joint, attaches to lesser trochanter, main flexor of hip joint
Where does the iliacus attach to?
Innervation?
Inside iliac fossa + joins psoas major Unites to form iliopsoas tendon + inserts into lesser trochanter Femoral nerve (L2, 3)
What is the psoas major covered by?
Psoas sheath
What nerve passes through middle of psoas major?
Genitofemoral nerve
What vertebral level does abdominal aorta bifurcate?
L4
What vertebral level does vena cava form by merging of veins?
L5
What is the difference between the ureter and the urethra?
Ureter - drains urine from kidney to bladder
Urethra - drains urine from bladder to outside body
What is the hilum of the kidney?
Where blood vessels, nerves, lymphatics enter
Located transpyloric plane (L1)
From the capsule of the kidney, what are the layers going outwards?
(Kidney capsule), Perirenal fat, renal fascia, pararenal fat
What artery supplies the top of suprarenal glands?
Superior suprarenal arteries
Branch from inferior phrenic artery
What artery supplies the bottom of the suprarenal glands?
Inferior suprarenal arteries
Branch from venal arteries
Where does the middle suprarenal artery arise from?
Directly from abdominal aorta
What are the arteries called in the renal columns?
Interlobular arteries
What are the arteries in the cortex called?
Arcuate arteries
Where is the narrowest part of the ureter?
Junction between renal pelvis + ureter
Pelvi-ureteric junction
What is the name of the junction where the ureter enters the posterior wall of bladder?
Ureterovesical junction
What are the 5 parts of the male urethra?
Preprostatic urethra Prostatic urethra Membranous urethra Bulbous urethra Spongy/penile urethra
When catheterising a male, what can the catheter initially get stuck in?
Navicular fossa
What is cystitis?
Inflammation of bladder
What are the muscles of the pelvic floor?
Levator ani
Coccygeus muscle
What are the 3 muscle components of the levator ani?
Pubococcygeus - from pubis to around coccyx
Iliococcygeus - from ileum to around coccyx
Puborectalis - from pubis to around rectum
What is the urogenital hiatus?
Hole in puborectalis so urethra and vagina can pass through muscle
What do these sphincters surround?
a) Urethrovaginalis
b) External urethral sphincter
c) Compressor urethrae
a) Around both urethra and vagina
b) Around urethra (Male + Female)
c) Around front of urethra (Female)
Where is the paraurethral (Skene’s) gland located?
In wall of female urethra
Lubricate distal prt of urethra, urine flow freely
When does the internal urethral sphincter of the male contract and why?
During ejaculation
Controls potential of semen entering from distal to proximal as semen highly nutritious so can cause infection
What is the pelvic course of the urethra in…
a) Males?
b) Females?
a) Cross over external iliac artery Cross over obliterated umbilical artery Cross under ductus (vas) deferens b) Crosses over external iliac artery Crosses over obliterated umbilical artery Crosses under uterine artery
What muscle inside the bladder is folded and what is the name of the smooth area?
Detrusor muscle
Trigone
What is supropubic catherisation?
Catheter pushed into bladder wall through anterior abdominal wall
What are the 4 joints in the pelvis?
Sacroiliac joint
Sacrococcygeal joint
Pubic symphysis
Lumbosacral joint
What is the angle of inclination of the….
a) Pelvic inlet?
b) Pelvic outlet?
a) 50-60 degrees with horizontal inferiorly
b) 10-15 degrees to horizontal inferiorly
What is the name for a normal pelvic shape in…
a) Male?
b) Female?
a) Android
b) Gynecoid
What is the name of a flat pelvis shape?
Platypelloid
X do vaginal delivery
What is prolapse?
1/more of pelvic organs slip down from normal position + bulge into vagina
What is an episiotomy?
Deliberate unilateral incision of perineum + posterior vaginal wall
Bypass damage at perineum body
What is cryptorchidism?
Undescended testes
X surgical intervention unless haven’t descended by a year
What are the 3 fascia in the inguinal canal in males?
External spermatic fascia - aponeurosis of external oblique
Cremasteric - internal oblique
Internal spermatic fascia - transverse fascia
What are the 3 arteries in the inguinal canal in males?
Testicular
Cremasteric
Deferential artery
What are the 3 veins in the inguinal canal in males?
Pampiniform plexus + testicular vein
Cremasteric vein
Deferential vein
What are the 3 nerves in the inguinal canal in males?
Genital branch of the genitofemoral nerve
Ilioinguinal
Autonomic nerves
What are the contents of the inguinal canal in females?
Round ligament of uterus
Genital branch of genitofemoral branch
Ilioinguinal nerve
What are the seminiferous tubules?
In testes
Site of meiosis + synthesis of sperm
Made up of columnar Sertoli cells
What are Leydig cells?
Secrete testosterone
What are the 4 zones of the prostate gland?
Central zone
Peripheral zone
Fibromuscular zone
Transitional zone
Which zone of the prostate gland does hyperplasia occur?
Transitional zone
What are the erectile tissue in the penis?
Paired corpora cavernosa
Corpus spongiosum
What is an ectopic pregnancy?
Where fertilised egg implants self outside womb
What are the 3 layers in the uterus?
Perimetrium
Myometrium (muscle layers)
Endometrium (lining is shed)
What is cleavage in embryology?
Series of rapid cell divisions without growth of embryo
Follows immediately after fertilisation
What is gastrulation?
Process through which cells sort out to generate body plan
What are the germ layers established in gastrulation?
Endoderm
Mesoderm
Ectoderm
What is neurulation?
Formation of neural tube
What are the 4 divisions of the mesoderm?
Intermediate mesoderm
Chordamesoderm
Paraxial mesoderm
Lateral plate mesoderm
What type of cells synthesise elastic fibres?
Embryonic + juvenile fibroblasts
Puberty stop making
How many cycles of stretch-recoil can elastin fibres endure before losing elasticity?
2 billion cycles
In the humerus, what is the…
a) Intertubercular groove
b) Deltoid tuberosity
a) Where bicep runs down
b) Where deltoid muscle attaches
What is the tentorium cerebelli?
Extension of dura mater that holds brain in place so X move around much
What is…
a) oesophageal atresia
b) oesophageal fistulae
a) Gap between proximal and distal oesophagus
b) Extra connection of oesophagus to lower prt of trachea
What percentage of groin hernias are inguinal?
95%
How many peripheral nerves in spine?
Cranial - 12 pairs (Vagus is 10) Cervical - 8 pairs Thoracic - 12 pairs Lumbar - 5 pairs Sacral - 5 pairs Coccygeal - 1 pair
What shape classification would be used to describe the hip bone?
Flat
Which plane divides the body into superior and inferior parts?
Horizontal
Where do direct and indirect hernias occur in relation to inferior epigastric artery?
Direct - medial to inf epigastric artery
Indirect - lateral to inf epigastric artery
