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(PA school) Gross Anatomy > General review lectures 1-14 > Flashcards

General review lectures 1-14 Flashcards

Big/ higher yield concepts from all units

1
Q
A
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2
Q

[Nerves of the UE]
What does each innervate?:
1) Dorsal scapular n
2) Thoracodorsal n.
3) Long thoracic n.
4) Spinal accessory n.
Important*

A

1) Rhomboids, levator scapulae
2) Latissimus dorsi
3) Serratus anterior
4) Trapezius

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3
Q

Which is medial in AP, radius or ulna? Which finger is most lateral?

A

Ulna; thumb

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4
Q

What is the mnemonic to remember the carpal bones?

A

Some: Scaphoid.
Lovers: Lunate.
Tri: Triquetrum.
Positions: Pisiform.
That: Trapezium.
They: Trapezoid.
Can’t: Capitate.
Handle: Hamate.

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5
Q

[Nerves of the UE]
What innervates each of the following?:
1) Rhomboids & levator scapulae
2) Latissimus dorsi
3) Serratus anterior
4) Trapezius
Important

A

1) Dorsal scapular n
2) Thoracodorsal n.
3) Long thoracic n.
4) Spinal accessory n. (CN XI)

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6
Q

Describe the distribution of the hand’s cutaneous innervation by the median nerve
Important

A

Lateral palm (first 3 fingers and half of 4th) and dorsal tips of those fingers.

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7
Q

Describe the distribution of the hand’s cutaneous innervation by the ulnar nerve
Important

A

-Medial palm (pinky and half of ring finger).
-Dorsal hand, pinky, almost all of ring finger, small pt of middle finger

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8
Q

Describe the distribution of the hand’s cutaneous innervation by the radial nerve
Important

A

Medial aspect of dorsal wrist.
Dorsal aspect of thumb, adjacent two fingers (except tips), and back of hand.

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9
Q

List 3 superficial veins in the shoulder and arm. Where do they originate?

A

Cephalic, basilic, and antebrachial veins; in the dorsum of hand

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10
Q

Biceps tendon DTR (deep tendon reflex) tests what nerve? What spinal levels is this?

A

Musculocutaneous nerve; C 5-6

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11
Q

1) What type of joint is the shoulder/ glenohumeral joint?
2) What kind of ROM does it have? Is it stable or unstable?

A

1) Ball and socket
2) Wide ROM; inherently unstable

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12
Q

[Nerves of the UE]
What does each innervate?:
1) Dorsal scapular n
2) Thoracodorsal n.
3) Long thoracic n.
4) Spinal accessory n.
Important*

A

1) Rhomboids, levator scapulae
2) Latissimus dorsi
3) Serratus anterior
4) Trapezius

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13
Q

Which is medial in AP, radius or ulna? Which finger is most lateral?

A

Ulna; thumb

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14
Q

What is the mnemonic to remember the carpal bones?

A

Some: Scaphoid.
Lovers: Lunate.
Tri: Triquetrum.
Positions: Pisiform.
That: Trapezium.
They: Trapezoid.
Can’t: Capitate.
Handle: Hamate.

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15
Q

[Nerves of the UE]
What innervates each of the following?:
1) Rhomboids & levator scapulae
2) Latissimus dorsi
3) Serratus anterior
4) Trapezius
Important

A

1) Dorsal scapular n
2) Thoracodorsal n.
3) Long thoracic n.
4) Spinal accessory n.

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16
Q

Describe the distribution of the hand’s cutaneous innervation by the median nerve
Important

A

Lateral palm (first 3 fingers and half of 4th) and dorsal tips of those fingers.

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17
Q

Describe the distribution of the hand’s cutaneous innervation by the ulnar nerve
Important

A

-Medial palm (pinky and half of ring finger).
-Dorsal hand, pinky, almost all of ring finger, small pt of middle finger

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18
Q

Describe the distribution of the hand’s cutaneous innervation by the radial nerve
Important

A

Medial aspect of dorsal wrist.
Dorsal aspect of thumb, adjacent two fingers (except tips), and back of hand.

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19
Q

List 3 superficial veins in the shoulder and arm. Where do they originate?

A

Cephalic, basilic, and antebrachial veins; in the dorsum of hand

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20
Q

Biceps tendon DTR (deep tendon reflex) tests what nerve? What spinal levels is this?

A

Musculocutaneous nerve; C 5-6

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21
Q

1) What nerve controls the FDS of the intermediate layer of anterior forearm?
2) What is their proximal attachment?
3) What is their [distal] insertion? (will be on test)

A

1) Median nerve
2) Medial epicondyle (short story)*
3) Middle phalanx of digits 2-5

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22
Q

1) What type of joint is the shoulder/ glenohumeral joint?
2) What kind of ROM does it have? Is it stable or unstable?

A

1) Ball and socket
2) Wide ROM; inherently unstable

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23
Q

[Nerves of the UE]
What innervates each of the following?:
1) Rhomboids & levator scapulae
2) Latissimus dorsi
3) Serratus anterior
4) Trapezius
Important

A

1) Dorsal scapular n
2) Thoracodorsal n.
3) Long thoracic n.
4) Spinal accessory n.

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24
Q

Describe the distribution of the hand’s cutaneous innervation by the median nerve
Important

A

Lateral palm (first 3 fingers and half of 4th) and dorsal tips of those fingers.

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25
Q

Describe the distribution of the hand’s cutaneous innervation by the ulnar nerve
Important

A

-Medial palm (pinky and half of ring finger).
-Dorsal hand, pinky, almost all of ring finger, small pt of middle finger

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26
Q

Describe the distribution of the hand’s cutaneous innervation by the radial nerve
Important

A

Medial aspect of dorsal wrist.
Dorsal aspect of thumb, adjacent two fingers (except tips), and back of hand.

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27
Q

List 3 superficial veins in the shoulder and arm. Where do they originate?

A

Cephalic, basilic, and antebrachial veins; in the dorsum of hand

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28
Q

Lateral epicondylitis is also called what? What group does it involve?

A

“Tennis elbow”; 4 superficial extensors

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29
Q

1) Name a nerve and artery in ulnar canal of Guyon.
2) What nerve is in the carpal tunnel?

A

1) Ulnar n. and artery
2) Median n. in carpal tunnel

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30
Q

1) What type of joint is the shoulder/ glenohumeral joint?
2) What kind of ROM does it have? Is it stable or unstable?

A

1) Ball and socket
2) Wide ROM; inherently unstable

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31
Q

Which UE digit is 1st?

A

Thumb

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32
Q

1) What is the primary blood supply to the UE?
2) Where does the primary artery come from?
3) What does the primary blood supply artery turn into distally?
4) What does that artery then turn into?

A

1) Axillary a
2) Subclavian a. (1st rib or clavicle)
3) Brachial a
4) Radial and ulnar aa.

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33
Q

1) What artery descends medial thru anterior compartment of antebrachium (arm)?
2) What artery descends lateral thru anterior compartment of antebrachium?
3) What do these two arteries become distally?

A

1) Ulna a
2) Radial a
3) Superficial and deep palmer arches

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34
Q

1) Ulnar nerve supplies what compartment?
2) What muscles are here?

A

1) Motor medial forearm anterior compartment
2) Flexors (FCU, FDP med part)
-& most of the intrinsic m. of hand

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35
Q

1) What does the radial nerve supply motor to?
2) What types of muscles are here?

A

1) Posterior compartment
2) Extensors of arm and forearm

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36
Q

Is moving your arm forward flexion or extension?

A

Flexion (think “forward flexion”)

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37
Q

Is moving the thumb on top of palm abduction or adduction?

A

Abduction

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38
Q
A
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39
Q

Where would you instill local anesthesia for a office procedure such as a skin biopsy or suturing a laceration?

A

Hypodermis/ SQ/ superficial fascia

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40
Q

What is the clinical significance of the skin tension lines?

A

You should cut parallel to them for better healing; keloids are a risk if perpendicular

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41
Q

What components of the skin are involved in stretch marks?

A

Collagen & elastic fibers in the dermis

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42
Q

List and describe the 3 types of joints

A

1) Fibrous joints: gomphoses (like teeth), syndesmoses, and sutures (like skull sutures)
2) Cartilaginous joints: synchondroses permit growth of length of bone, allow slight bending) and symphyses (like intervertebral disc, slightly movable, strong)
3) Synovial joints: most common, movable, synovial fluid and articular surface.

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43
Q

List and describe the 3 types of muscle

A
  1. Skeletal: striated, somatic innervation
  2. Cardiac: striated, visceral/ autonomic innervation
  3. Smooth: not striated, visceral/ autonomic innervation
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44
Q

List the two types of contraction, and the movements that happen during contraction

A
  1. Isometric: muscle doesn’t move but still exerts force
  2. Isotonic: muscle moves; two parts:
    a. Concentric: muscle shortens
    b. Eccentric: muscle lengthens
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45
Q

1) What is the functional unit of a muscle?
2) What are its components?

A

1) A motor unit
2) Consists of a lower motor neuron and the muscle fibers it innervates

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46
Q

What is the musculovenous pump?

A

As muscles contract in the legs, deep accompanying veins are compressed within the vascular sheath, resulting in increased return of venous blood.

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47
Q

Distinguish between preganglionic and postganglionic fibers of the autonomic nervous system.

A

1)”Preganglionic” refer to nerve fibers that originate in the central nervous system (brain or spinal cord) and travel to a ganglion (a cluster of nerve cell bodies outside the CNS), where they synapse with
2) “Postganglionic fibers” extend from the ganglion to the target organ, directly controlling its function
-Essentially, preganglionic fibers are the “first leg” of the signal from the CNS to the organ, while postganglionic fibers are the “final leg” that delivers the signal to the target tissue

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48
Q

Describe the 3 steps of the pupillary light reflex

A

1) Light enters the eye, stimulating photoreceptors in the retina which send signals via the optic nerve to the brain
2) Signals travel from the brain to the oculomotor nerve’s nucleus, then via the oculomotor nerve to the ciliary ganglion where they synapse.
3) Postganglionic fibers from the ciliary ganglion innervate the iris sphincter muscle, causing it to contract and constrict the pupil

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49
Q

Describe the enteric nervous system; how does it function and what is it made of?

A

1) Functions autonomously from CNS; it’s only modulated by para and sympathetic input
2) Made of 2 interconnected plexuses
A) Myenteric plexus: wall smooth muscle
B) Submucosal plexus: deep to mucosa

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50
Q

What are the 3 ways the sympathetic nerves can reach the body? Describe each

A

1) Synapse at level of exit: postsynaptic distributed by thoracic cardiopulmonary splanchnic nerve (to middle trunk)
2) Descend and then synapse: postsynaptic distributed by spinal nerves (to lower trunk and limb)
3) Don’t synapse: and enter abdominopelvic splanchnic nerve (to abdominopelvic viscera)

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51
Q

List the 4 curves of the spine, whether they’re primary or secondary, and what it’s called when their angles change too much

A

1) Cervical lordosis: in neck, secondary curve
2) Thoracic kyphosis: curve of the thoracic spine, primary curve
-Excessive curvature here is called excessive thoracic kyphosis, aka kyphosis. Characterized by an abnormal increase in thoracic curvature; the vertebral column curves posteriorly
3) Lumbar lordosis: Curve of lumbar spine, secondary curve
-Excessive lumbar lordosis: Excessive anterior rotation of the pelvis, producing excessive lumbar curvature
4) Sacral kyphosis: Curve of sacrum, primary curve

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52
Q

1) Describe the shape of the thoracic spinous processes.
2) Describe the shape of the lumbar spinous processes.
3) Where is the supraspinous ligament?

A

1) Thoracic: long and overlap with sub adjacent vertebral body
2) Lumbar: spinous processes are short and sturdy here
3) Runs vertically down the spinous processes

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53
Q

Compare the numbers of vertebrae to the numbers of spinal nerves

A

Vertebrae: C7, T12, L5, S5, C4
Spinal nerves: C8, T12, L5, S5, C1

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54
Q

Where do the spinal nerves exit with respect to the vertebral number?

A

Cervical nerves exit through the IV foramen superior to corresponding vertebral number, thoracic exit below.

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55
Q

Locate and describe what structures pass through the:
1) Vertebral foramen
2) Interverbal foramen
3) The foramen transversarium

A

1) Vertebral foramen: big hole in middle; spinal cord
2) Foramen transversarium: tiny lateral holes; vertebral artery & vein and sympathetic nerves
3) Intervertebral foramen: formed by the notches of pedicles; spinal nerves exit through here, ganglion

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56
Q

1) What is the vertebral body?
2) What two things make up the vertebral arch? Describe them
3) Where is the spinous process?
4) Where is the transverse process?

A

1) Main round part
2)
A) Pedicle: connects lamina and transverse process to body of vertebrae
B) Lamina: forms a triangle
3) Spinous process: on top of lamina
4) Transverse process: lateral to lamina

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57
Q

Anatomically, why is the lumbar vertebra the best region to access the subarachnoid space and obtain cerebral spinal fluid?

A

The spinal cord ends around L1-L2 in adults, and the lumbar cistern allows easy CSF access, and it has the biggest space between spinous processes

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58
Q

What is the most common non-cervical vertebrae to be fractured? Why?

A

T11-12 because of the abrupt transition between immobile thoracic and more mobile lumbar regions

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59
Q

Compare the spinal cord, conus medullaris, and cauda equina and relate these structures to the level of spinal cord in children and adults.

A

1) Spinal cord: goes from brainstem to L1-2 disc in adults, L2-3 disc in newborns
2) Conus medullaris: the terminal end of the spinal cord
3) Cauda equina: the nerves continue as the cauda equina through sacrum and coccyx, looks like a horse’s tail)

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60
Q

1) What is the importance of the vertebral venous plexuses?
2) Why are they also a negative thing?

A

1) Blood may return from pelvis and abdomen through this plexus when the inferior vena cava is obstructed; goes through the superior vena cava this way.
2) Can also provide a route for cancer metastasis to the vertebrae and brain from an abdominal or pelvic tumor

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61
Q

1) What spaces do a lumbar puncture pass through?
2) Where specifically is CSF collected from?

A

1) Passes through the epidural space, dura, and arachnoid mater into the subarachnoid space.
2) Specifically, CSF is gathered from the lumbar cistern (usually below L1)

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62
Q

What contains parts of the proximal parts of the cranial nerves and the vasculature of the brain?

A

Neurocranium

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63
Q

What two things make up the neurocranium?

A

Calvaria (skullcap) and cranial base (basicranium)

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64
Q

What is also known as the facial skeleton? Describe how this structure develops

A

Viscerocranium; composed of facial bones that mainly develop in the mesenchyme of embryonic pharyngeal arches

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65
Q

1) Where is the nasal bone?
2) What two things make up the boney part of the septum?

A

1) Top-bridge of nose
2) Vomer and perpendicular plate of the ethmoid.

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66
Q

The pterion is the joining of what 4 bones?

A

Frontal, parietal, temporal, & sphenoid bones

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67
Q

The place where the the sagittal and coronal sutures meet is called ___________

A

bregma

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68
Q

What is lambda?

A

Where the sagittal and lambdoid sutures meet

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69
Q

What are the 5 named muscles of facial expression? List what each controls

A

1) Occipitofrontalis frontal belly: Skin and SQ tissue of eyebrows and forehead
-Occipital belly: epicranial neurosis
2) Orbicularis oculi: orbital sphincter
3) Orbicularis oris: mouth sphincter
4) Buccinator: cheek muscle
5) Platysma: SQ tissue of infra and supraclavicular regions

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70
Q

What parts of CN7 innervate the muscles of facial expression?

A

1) Posterior auricular branch or
2) Parotid plexus’s temporal, zygomatic, buccal, marginal mandibular, or cervical branches

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71
Q

What is the difference between pre-orbital cellulitis and orbital cellulitis?

A

1) Pre orbital: infection of the eyelid and area around the eye
2) Orbital: infection of the eyeball and the tissues around it

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72
Q

What nerve provides motor to the orbicularis oculi muscles?

A

The facial nerve (CN 7)

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73
Q

1) What does the lacrimal gland do? Where is it?
2) Where is the lacrimal punctum and what does it lead to?
3) What does the lacrimal lake do?

A

1) Produces and secretes tears; by superior rim of orbit.
2) Hole at bottom of the eye lid (top and bottom) and leads to lacrimal canaliculi
3) Holds the tears until it gets full (in corner of eye, surrounding lacrimal canaliculi)

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74
Q

1) What does the lacrimal canaliculi do? Where are they?
2) What does the nasolacrimal duct do when the above structure gets full?

A

1) Leads tears from papilla into lacrimal sac.
2) Once the lacrimal sac gets full, tears drain into the nasolacrimal duct and down the nasal cavity

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75
Q

What provides superficial vascular supply to the orbit and associated tissues?

A

Uveal tract (consisting of the choroid, ciliary body/process, iris/pupil)

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76
Q

Describe the 2 main paths of drainage of the orbit

A

1) Superior & inferior ophthalmic veins > superior orbital fissure > cavernous sinus
2) Inferior ophthalmic vein > inferior orbital fissure > pterygoid venous plexus

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77
Q

When taking a flash picture, often times you get “red” eyes. Which layer of the globe is responsible for this?

A

Choroid (vascular bed b/t sclera and retina)

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78
Q

Which parts of the uvea are involved in pupil reaction to light and accommodation to near vision?

A

1) Pupil reaction to light: iris
2) Accommodation: ciliary body

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79
Q

What is responsible for the pupillary light reflex arc?
(i.e., what are the afferent and efferent components of the arc and muscle observed?)

A

1) Afferent: CN 2 (optic)
2) Efferent: CN 3 (oculomotor)
3) Sphincter pupillae muscle: innervated by parasympathetic fibers. Innervation of one of these fibers causes dilation of the pupil due to the sympathetic system of the dilator pupillae muscle being unopposed.

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80
Q

The corneal (touch) reflex involves which nerves providing afferent and efferent components? What is the result of touching the cornea?

A

CNV1: afferent (sensory, you feel it)
CN7: efferent (eyelid closure)

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81
Q

When the optometrist dilates your eyes for a complete retinal exam, they use what two types of drugs?

A

1) Parasympatholytic (blocks parasympathetic motor fibers)
2) Sympathomimetic (stimulates sympathetic motor fibers) drugs

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82
Q

1) What effect does blocking the parasympathetic motor fibers to the eye cause?
2) What effect does stimulating the sympathetic motor fibers cause?
3) Which paralyses the ciliary body and affects the pupil, a parasympatholytic (inhibits para) drug or a sympathomimetic (stimulates symp) drug?
4) Which of the above only affects the pupil?

A

1) Keeps the pupil from being constricted
2) Dilation of the pupil
3) Parasympatholytic paralyses the ciliary body and affects pupil
4) Sympathomimetic; stimulates dilator muscles of iris. Ciliary only parasympathetic.

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83
Q

Where is the platysma m. found and what is the motor innervation and major action of these muscles?

A

1) Found within the superficial fascia (of the neck); thin, all over neck and onto mandible.
2) Innervation: CN7 motor for facial expression
3) Contract the muscles of the neck when teeth are clenched

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84
Q

Where are the sternocleidomastoid muscles found and what is the motor innervation and major action of these muscles?

A

1) Goes from occipital bone to medial part of clavicle
2) Innervation: motor by CN 11
3) Tilts head side to side and rotates the neck.

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85
Q

Name the 4 cervical regions from anterior to posterior

A

1) Anterior cervical region
2) SCM region
3) Lateral cervical region
4) Posterior cervical region

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86
Q

1) What cervical region visibly divides the anterior and lateral regions?
2) Name 4 things found within it

A

1) Sternocleidomastoid (SCM) region (A)
2) SCM muscle, superior portion EJV, greater auricular nerve, transverse cervical nerve

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87
Q

What does the posterior cervical region (B) contain? (3 things)

A

1) Descending part of trapezius muscle
2) Cutaneous branches of posterior rami of cervical spinal nerves
3) Suboccipital region lies deep to superior part of this region

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88
Q

What does the lateral cervical region (C) contain? (7 things)

A

1) Part of EJV
2) Posterior branches of cervical plexus nerves
3) CN 11
4) Cervical lymph nodes
5) Third part of subclavian artery
6) Suprascapular artery
7) Supraclavicular lymph nodes

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89
Q

What does the anterior cervical region (D) contain? (8 things)

A

1) Submandibular gland
2) Submandibular lymph nodes
3) CN 12
4) Parts of facial artery & vein
5) Common carotid artery & its branches
6) Thyroid gland
7) Larynx and pharynx
8) Deep cervical lymph nodes

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90
Q

What cranial nerve courses through the lateral cervical region (c)? What does it innervate?

A

CN 11, innervates the trapezius and SCM

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91
Q

1) What forms the roots of the cervical plexus? Where is this?
2) Which part of this cervical plexus forms sensory nerves?
3) What is the nerve point of the neck?

A

1) Anterior rami of C1-C5; lateral cervical region
2) Superficial branches of plexus
3) The superficial part of the cervical plexus; along posterior border of the SCM jct superior and middle 3rds

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92
Q

Which part of the cervical plexus forms the motor nerves: phrenic n. and ansa cervicalis? What does each do?

A

1) Deep branches of plexus.
2) Phrenic: sole motor to diaphragm
3) Ansa cervicalis: swallowing, vocalization, and neck stabilization

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93
Q

Where would you expect to find the internal jugular vein?

A

Superficial and lateral to the carotid artery; between the clavicular heads of the sternocleidomastoid.

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94
Q

1) What is the function of the hyoid bone?
2) What innervates the suprahyoid muscles?
3) What innervates the infrahyoid muscles?

A

1) Support and move larynx
2) Mainly by CNs 3, 7, 12
3) Spinal nerves

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95
Q

What major vessels are found in the anterior cervical region? (3 things)

A

1) Carotid system (common, internal, and external carotid)
2) Internal jugular vein
3) Anterior jugular veins

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96
Q

1) Right common carotid comes off what?
2) Left common carotid artery comes directly off _____________

A

1) Brachiocephalic trunk.
2) Aorta

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97
Q

Name 3 things found within the carotid sheath

A

1) Common carotid artery
2) IJV
3) CN 10 (vagus)

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98
Q

1) Where is the carotid body found?
2) What function does this structure perform?
3) What innervates it?

A

1) Next to the trachea where carotid artery splits
2) Chemoreceptor that detects low PO2 in blood; increases rate and depth of respiration & HR, BP
3) CNs 9 and 10 (visceral afferent)

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99
Q

What are the two main parts of the pulmonary cavity?

A

1) Viscera: primarily lungs, vessels, airways
2) Pleura: Pleural cavity

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100
Q

1) What is the sternal angle (manubriosternal joint)?
2) What spinal level is it at?
3) What is found here?

A

1) 2nd rib articulation and connection between manubrium and body of sternum
2) T5
3) Bifurcation of the trachea; base of the heart/root of the ascending aorta

101
Q

Describe the thoracic inlet and thoracic outlet

A

1) Thoracic inlet: trachea, esophagus, vessels and nerves
2) Thoracic outlet: closed by diaphragm; IVC, esophagus pass through diaphragm, aorta passes posterior to diaphragm

102
Q

List the 8 parts of the sternum

A

1) Manubrium: upper section of sternum
2) Clavicular notch: superior lateral notches of manubrium
3) Jugular notch: superior medial notch of manubrium
4) Costal cartilage: lateral part of manubrium
5) Costal notches: lateral notches of body
6) Sternal angle: The manubriosternal joint
7) Body: general longer part
8) Xiphoid process: inferior small piece attached to body

103
Q

What 3 types of muscles can be involved with inhalation?

A

1) Intercostals
2) Diaphragm
3) Accessory

104
Q

1) How many pairs of thoracic spinal nerves are there?
2) What do their posterior rami innervate?

A

1) 12
2) Bones, joints, intrinsic back mm., and over lying skin (dermatomes)

105
Q

What are the two things formed by the thoracic spinal nerve anterior rami?

A

1) Anterior rami T1-11: forms intercostal nerves
2) Anterior rami T12: forms subcostal nerve

106
Q

What is the order of the vessels and nerve in each rib from superior to inferior?

A

V.A.N (vein, artery, nerve)

107
Q

What are the 4 main arteries that supply the thoracic wall?

A

1) Posterior intercostal arteries
2) Internal thoracic artery
3) Anterior intercostal arteries (2)
4) Subcostal arteries

108
Q

Where does the subcostal artery come from?

A

Aorta

109
Q

What provide blood to the intercostal space?

A

1) Posterior intercostal arteries + collateral br.
2) Anterior intercostal arteries + collateral br.

110
Q

How many thoracic veins are there?

A

1) 11 pairs intercostal veins
2) 1 pair subcostal veins

111
Q

1) What do the posterior IC veins anastomose with?
2) What do most posterior IC veins drain into?

A

1) Anterior IC veins.
2) Azygos/hemi-azygos venous system to SVC

112
Q

1) What are the lactiferous ducts?
2) What is the lactiferous sinus?

A

1) Drains each lobule, open independently on the nipple
2) Dilated portion of each lactiferous duct just deep to areola

113
Q

1) Where do the medial breast quadrants drain?
2) Where may the inferior quadrants pass?

A

1) Parasternal nodes or contralateral breast
2) Deeply to abdominal lymph nodes

114
Q

1) What do the right and left pulmonary cavities contain?
2) What is between the parietal and visceral pleura?

A

1) Lungs and pleura
2) Pleural cavity

115
Q

What 6 things are found within the mediastinum?

A

1) Heart
2) Great vessels
3) Trachea
4) Esophagus
5) Thymus
6) Lymph nodes

116
Q

What are the 4 parts of the parietal pleura?

A

1) Apical or cervical pleura
2) Costal pleura
3) Diaphragmatic pleura
4) Mediastinal pleura

117
Q

What does the parietal pleura cover?

A

Endothoracic fascia/wall

118
Q

List the lobes of the right lung and what separates each

A

1) Superior lobe
-Horizontal fissure
2) Middle lobe
-Oblique fissure
3) Inferior lobe
-Has costodiaphragmatic recess

119
Q

1) What ribs articulate directly with the sternum?
2) What about via the costal arch?
3) What ribs are floating?

A

1) First 7 ribs (“true ribs”)
2) 8-10
3) Ribs 11 & 12

120
Q

Describe the dermatomes of the neck and trunk

A

1) C1: inferior neck
2) C3: clavicle
3) C4: includes top of shoulder
4) T2: below C4 on thorax
5) T3-12 until L1
>T5 is where the male nipple is

121
Q

What supply each segment of the lungs with air, blood to oxygenate, and drainage of blood?

A

1) Segmental bronchus (air)
2) Tertiary branch of pulmonary artery (blood)
3) Intersegmental parts of pulmonary vein (blood drainage)

122
Q

1) What fissure does the right lung have that the left doesn’t?
2) Where is it?

A

1) Horizontal fissure
2) Extends from oblique fissure along 4th rib and costal cartilage anteriorly

123
Q

1) What arteries supply the lung tissues and structures?
2) Is the blood deoxygenated or oxygenated?
3) Where does the left one arise from?
4) Where does the right one arise from?

A

1) Bronchial arteries
2) Oxygenated
3) Aorta
4) Right varies

124
Q

1) What do bronchial veins drain? Where do they drain into?
2) What do pulmonary veins drain?

A

1) Only proximal parts [of lungs] into azygos vein
2) More distal tissue

125
Q

Most post ganglionic sympathetic nerves are ______adrenergic/ cholinergic__________

A

adrenergic (relating to epinephrine)

126
Q

Most pre ganglionic neurons are ______adrenergic/ cholinergic__________

A

cholinergic (relating to acetylcholine)

127
Q

What are the 3 openings in the diaphragm? List their locations.

A

1) Caval opening (in central tendon)
2) Esophageal hiatus (right crus forming sphincter)
3) Aortic hiatus (posterior to diaphragm)

128
Q

What two things go through the aortic hiatus posterior to diaphragm?

A

Azygos vein & thoracic duct

129
Q

Where does gas exchange occur?

A

The last 3 parts of the trachea:
1) Bronchioles
2) Alveolar ducts
3) Alveolar sacs

130
Q

__________ is slightly on left side of vertebral bodies, __________ is on the right side.

A

Aorta; SVC

131
Q

Why do we care about the phrenic innervation of the diaphragm?

A

Right phrenic nerve may be responsible for paralysis of right hemidiaphragm

*might be on quiz

132
Q

What are the 3 divisions of the inferior mediastinum, and what do they contain?

A

1) Anterior mediastinum: clear space
2) Middle mediastinum: heart
3) Posterior mediastinum: esophagus and descending thoracic aorta

133
Q

What are the 3 layers of the pericardium?

A

1) Fibrous (gray)
2) Parietal serous
3) Visceral serous (aka epicardium)

134
Q

What are two branches of the right brachiocephalic trunk?

A

1) Right common carotid
2) Right subclavian

135
Q

What two things come off the arch of the aorta?

A

1) Left common carotid
2) Left subclavian

136
Q

What is inside the aortic SL valve?

A

Lateral sinuses contain the right and left coronary arteries

137
Q

What are the 4 main parts of the abdomen?

A

1) Abdominal wall
2) Abdominal cavity
3) Peritoneal cavity
4) Viscera

138
Q

What innervates the viscera pre-splenic flexure?

A

Vagus nerve

139
Q

What does the pelvic brim separate?

A

Greater pelvis of abdominal cavity and lesser pelvis of pelvic cavity

140
Q

What are the two layers of the superficial fascia of the anterolateral abdominal wall? Describe each

A

1) Camper fascia: fatty layer
2) Scarpa fascia: deep membranous layer

141
Q

What is the aponeurosis of flat abdominal muscles?

A

Rectus sheath

142
Q

Superior to the arcuate line:
1) What makes up the anterior rectus?
2) What makes up the posterior rectus?

A

1) Anterior: EO fascia + anterior lamina of IO
2) Posterior: Posterior lamina of IO + TA fascia

(eo is external oblique, io is internal oblique, TA is transversus abdominis

143
Q

1) What 2 muscles are contained within the rectus sheath?
2) What vessels are enclosed within it?
3) What nerves are enclosed within it?

A

1) Rectus abdominis m. and pyramidalis m.
2) Anastomosing inferior and superior epigastric vessels, lymphatics
3) Thoraco-abdominal and subcostal nerves (anterior rami of distal T7-12 spinal nerves)

144
Q

Infection below umbilicus will infect ___________ nodes first, chest infection will affect the ______________ lymph nodes

A

inguinal; axillary

145
Q

1) What does the inguinal canal do?
2) What is responsible for much of the structural features of the inguinal canal/ region

A

1) Allows structures to travel between abdominal cavity and scrotum
2) Descent of testis from abdomen into perineum during development; “vascular and nerve follow the bouncing ball”

146
Q

What structures are inferior (not to be confused w deep) to the inguinal ligament? What can one of them cause?

A

1) Lateral cutaneous nerve of the thigh (compression can cause meralgia parasthetica)
2) Femoral canal with: femoral n., fem art, fem vein (VAN)

147
Q

1) The internal surgical landmark corresponding to the inguinal ligament is the ____________________
2) What does the EO form?
3) Which is important to surface anatomy, inguinal ligament and iliopubic tract?

A

1) Iliopubic tract
2) Inguinal ligament
3) Inguinal ligament

148
Q

1) What makes up the inguinal triangle? (3 things)
2) A direct hernia pushed through triangle medially to what?

A

1) Rectus, inguinal ligament, inferior epigastric vessels
2) Inferior epigastric vessels

149
Q

What muscles (2) and veins (1) help keep the testicle close to body in cold temps?

A

1) Cremaster muscle and dartos muscle
2) Pampiniform venous plexus

150
Q

What do the parietal and visceral layers of the tunica vaginalis make up?

A

1) Parietal: Cavity of the tunica vaginalis
2) Visceral: Testis

151
Q

-What do the left and right testicular veins empty into?
-In which testicular vein are varicoceles more common? Where are they concerning?

A

1) Left testicular vein empties into left renal vein
-Varicocele more common
2) Right testicular vein empties into IVC
-Varicocele concerning for IVC mass; renal cell carcinoma

152
Q

Where is fluid located in the scrotum?

A

Tunica vaginalis

153
Q

1) Where does vascular supply and drainage of the scrotum come from?
2) Where do the scrotal lymphatics drain? How is this different from testicular lymphatics?

A

1) Pudendal vessels
2) To superficial inguinal nodes
-Testicular lymphatic drainage: goes to midline (pre-aortic) nodes

154
Q

1) Where does lymph from the scrotum drain?
2) Where does lymph from the testes drain?
3) What does this explain?

A

1) To the inguinal lymph nodes and veins
2) To the pre-aortic lymph nodes
3) Difference in area at risk from cancer and infection of testes vs. scrotum

155
Q

What are the two layers of the peritoneum? What does each line?

A

1) Parietal peritoneum: lines internal surface of the abdominopelvic wall
2) Visceral peritoneum: covers viscera; retro peritoneal and intraperitoneal visceral

156
Q

1) What is the peritoneal cavity (space)?
2) What does it contain?
3) Is it closed or open in men and women?

A

1) Potential space between the parietal and visceral peritoneum
2) Thin fluid; peritoneal fluid, but NO ORGANS in this cavity (except ovaries in females)
3) Closed in males; open in females (fallopian tubes into uterus, cervix and vagina to exterior)

157
Q

1) What is the mesentery? Describe it.
2) What type of communication does it provide the means for?
3) What property does it provide?

A

1) Double layer of peritoneum, occurs from invagination of peritoneum by organ, continuity of parietal and visceral peritoneum
2) Means for neurovascular communication between organ and body wall
3) Mobility (also allows torsion)

158
Q

1) What organs are retroperitoneal?
2) What organs are intraperitoneal?

A

1) Retroperitoneal: kidneys, aorta, IVC, pancreas (except tail), ascending and descending colon, duodenum (except ampulla)
2) Intraperitoneal: stomach, spleen, transverse colon, jejunum and ilium

159
Q

Where is the lesser omentum? What is deep to it?

A

Lateral to the curve of the stomach, continues behind greater omentum to portal triad; lesser sac

160
Q

What are the two ligaments that form the lesser omentum? What does one contain?

A

1) Gastrohepatic ligament
2) Hepatoduodenal ligament: contains portal triad: Portal vein, hepatic artery,& bile duct

161
Q

1) What is the portal triad?
2) What does the lesser omentum’s omental foramen open into?

A

1) Portal vein, hepatic artery, & bile duct
2) Into omental bursa (lesser sac of peritoneal cavity)

162
Q

1) What divide the greater sac?
2) What two compartments does this form?

A

1) Greater omentum (gastrocolic ligament) and transverse mesocolon (mesentery of transverse colon)
2) Supracolic and infracolic compartments

163
Q

What do the supracolic and infracolic compartments contain?

A

1) Supracolic compartment – stomach, liver, spleen
2) Infracolic compartment – small intestines, colon

164
Q

1) Where is the infracolic compartment?
2) What spaces are in this compartment?
3) What allows for free communication between the infracolic and supracolic compartments?

A

1) Lies posterior to Gr Omentum
2) Right and left infracolic spaces
3) Right and left Paracolic gutters

165
Q

1) What is an omental bursa hernia (internal hernia) of the peritoneal cavity?
2) What can it cause?

A

1) Abdominal contents from infracolic region cause internal herniation; where a piece of omentum or small intestine goes through the bursa to the lesser sac
2) Can cause strangulation of herniated tissue.

166
Q

Fluid from a ruptured appendix can do what?

A

Go up right paracolic gutter up into hepatorenal recess, subphrenic recess, or subhepatic space

167
Q

1) What supplies the midgut? Be specific about the boundaries of this area
2) What supplies the hindgut? Be specific

A

1) SMA
-second part of duodenum to splenic flexure of colon (transition point)
2) IMA
-splenic flexure of colon to the sigmoid colon & superior rectal aa

168
Q

Is McBurney’s point somatic or visceral pain?

A

Somatic

169
Q

1) What is the esophagogastric junction/ where is it?
2) Is the esophagus retroperitoneal or intraperitoneal in the abdomen?
3) What is the difference between the gastric mucosa and esophageal mucosa?

A

1) It’s the “Z” line; abrupt transition in mucosa; left of the midline, 7th costal cartilage/T11
2) Retroperitoneal in abdomen
3) Esophageal mucosa is not well-suited to high-acidity like gastric juices, gastric mucosa is because it has tight junctions and lots of mucous cells.

170
Q

The bile and main pancreatic duct enter the posteromedial wall via hepatopancreatic ampulla at what part of the small intestine?

A

Descending (2nd) part of the duodenum

171
Q

1) Suspensory ligament of duodenum (ligament of Treitz aka suspensory muscle of the duodenum) is located where?
2) What is its significance?

A

1) Duodenojejunal flexure
2) Clinically divides “upper GI” from “lower GI” tract

172
Q

1) What artery has branches that runs between layers of mesentery in the jejunum and iliac regions?
2) Where does it go?

A

1) Superior mesenteric artery (SMA)
2) Sends many branch arteries to jejunum & ilium, unite to form loops or arches called arterial arcades which gives rise to vasa recta

173
Q

All lymph drainage of the abdomen ultimately goes where?

A

To thoracic duct

174
Q

All the lymph vessels, arteries, and nerves that supply the large intestine are where?

A

Within the mesentery/ retroperitoneal

175
Q

What are the two anatomical arterial transitions in the gut

A

1) Duodenum has artery supply from 2 different vessels
-1st and 2nd part via celiac trunk via supraduodenal and gastroduodenal aa.
-3rd and 4th part of the duodenum to splenic flexure of colon via SMA via pancreaticoduodenal a.
2) Splenic or left flexure of the colon
-SMA and IMA

176
Q

Name two organs that are mobile because they have mesentery.

A

Spleen and stomach

177
Q

1) What two things form the left sagittal fissure?
2) What does this fissure do?

A

1) Round ligament (umbilical vein) & ligamentum venosum (ductus venosus)
2) Separates the right and left livers (portal lobes)

178
Q

1) What uses ductus venous to bypass the fetal liver?
2) What does this turn into after birth?

A

1) Umbilical vein
2) Round ligament & ligamentum venous

179
Q

1) What bypasses the fetal lungs?
2) What does it turn into after birth?

A

1) Ductus arteriosus
2) Ligamentum arteriosus

180
Q

-What two main things supply the liver with blood
Describe the oxygenation and origin of the blood in each, and how much of the liver each supplies.

-What do these two things divide into?

A

1) Hepatic Portal Vein (HPV) -75%
-Poorly oxygenated, nutrient dense blood from GI track
2) Hepatic Artery (HA) – 25%
-Oxygen rick blood from systemic circulation

-Both divide into right and left branches at or near portal hepatis then form Segmental branches

181
Q

Describe the “in” and “out” of the liver

A

1) IN: Hepatic portal veins and hepatic artery
2) OUT: Hepatic veins + bile collecting system

182
Q

1) What skips the liver?
2) What drains the liver of blood?

A

1) Systemic IVC
2) Hepatic vein (NOT the hepatic portal vein)

183
Q

1) Gallstones can occur in biliary passages; what is the most common location for impaction?
2) What is a cholecystectomy?

A

1) The narrowest site, the ampulla sphincter.
2) Removal of the gall bladder due to biliary colic

184
Q

Portosystemic anastomosis:
1) What anastomose with the superficial epigastric veins (systemic)?
2) What is it called when this anastomosing area is dilated?

A

1) Para umbilical veins of anterior abdominal wall (portal)
2) Caput medusa

185
Q

List the 3 areas of “constriction”/ potential sites of obstruction of the ureters.
What is the significance of these?

A

1) Ureteropelvic junction
2) Crossing external iliac vessels at sacrum
3) Ureter traverses bladder wall
-Most likely places to find a kidney stone stuck

186
Q

1) What protects the adrenal/ supra renal glands?
2) What is the second layer of the adrenal glands? What two things does this structure secrete?
3) What is the thick inner layer of the adrenal glands called? What does this structure secrete?

A

1) Fibrous capsule
2) Cortex: secrets corticosteroids and androgens
3) Medulla: secrets catecholamines (epinephrine and norepinephrine)

187
Q

What two things are different about the right renal artery when compared to the left one?

A

1) Longer
2) Passes posterior to IVC

188
Q

What does each renal vein of the kidneys drain into?

A

The IVC (NOT the hepatic portal)

189
Q

1) Define cisterna chyli
2) What flows into here?

A

1) A dilated sac at the lower end of the thoracic duct (in most mammals)
2) Lymph from the intestinal trunk and two lumbar lymphatic trunks flow.

190
Q

What does the IVC drain blood from? (4 places)

A

LE, most of the back, the abdominal walls, pelvic viscera

191
Q

What connect the IVC with SVC?

A

Ascending lumbar veins + azygos/hemi-azygos veins

192
Q

1) What part of what muscle is the lumbar plexus on?
2) What nerves does it come from?
3) Where does it supply motor innervation to?

A

1) Posterior part of psoas m.
2) L1-4 spinal nerves
3) Iliopsoas

193
Q

What are the two main parts of the pelvic cavity? What marks where each begins?

A

1) Greater; Supracristal plane
2) Lesser; pelvic brim

194
Q

What 3 things cover the pelvic diaphragm?

A

Levator ani + coccygeus muscles + fascia

195
Q

List the 4 main muscles of the pelvic walls.

Which of these makes up the lateral wall? What about the posterior wall?

A

1) Levator ani
2) Coccygeus m.
3) Obturator internus – lateral wall
4) Piriformis – posterior wall

196
Q

What two main nerves are formed by the sacral plexus? What does each innervate?

A

1) Sciatic n.– posterior thigh and leg below knee
2) Pudendal n. – nerve to perineum

197
Q

Besides the two main nerves of the sacral plexus, what else does it form? What does each innervate?

A

1) Superior gluteal n. – glut min, medius, TFL
2) Inferior gluteal n.– glut max

198
Q

1) Where does the pudendal nerve come from? What is the it main nerves of?
2) Where does it enter?

A

1) S2-S4, main nerve to the perineum and chief sensory nerve of the external genitalia
2) Enters perineum via lesser sciatic foramen

199
Q

1) Where does the obturator nerve come from?
2) Where does it pass through?
3) What is it the primary nerve to?

A

1) L2-L4
2) Passes thru the pelvis BUT is not a pelvic nerve
3) Medial (adductor group) thigh

200
Q

1) What do structures do at the greater sciatic foramen?
2) What muscle is located here?
3) What 4 nerves are here?
4) What else is located here?

A

1) Exit pelvis
2) Piriformis m. to femur
3) Sciatic nerve, pudendal nerve, superior/inferior gluteal n.
4) Vessels

201
Q

What does sympathetic innervation of the pelvis do? (3 things)

A

1) Vasomotion
2) Inhibit peristalsis of rectum
3) Stimulates contraction of genital organs during orgasm (ejaculation in males)

202
Q

What does parasympathetic innervation of the pelvis do? (2 things)

A

1) Stimulate contraction of bladder and rectum
2) Supply erectile bodies of genitalia resulting in erection

203
Q

What are the 3 main parts of pelvic autonomics?

A

1) Sympathetic
2) Parasympathetic
3) Periarterial plexuses

204
Q

What structures pass through the pelvic diaphragm to reach the perineal compartment? (3)

A

Rectum
Vagina
Urethra

205
Q

1) Where is the rectum found?
2) Where are the vagina and urethra found?

A

1) Posterior triangle
2) Anterior urogenital triangle

206
Q

1) What is the urinary bladder inferior to?
2) Where does it rest?
3) Where is the apex of the urinary bladder?

A

1) Peritoneum (subperitoneal)
2) Rests on pelvic floor
3) Anterior toward pubis

207
Q

1) What innervates the bladder parasympathetically? (what fibers and plexus?)
2) What do they provide motor innervation to? What do they do in males?
3) When visceral afferent fibers stimulated by stretching, what happens in males? What suppresses this reflex?

A

1) Parasympathetic fibers from S2-3-4 via pelvic splanchnic n. to inferior hypogastric plexus
2) Motor to detrusor muscle & inhibitor to internal urethral sphincter in males
3) Detrusor m. contracts & the internal urethral sphincter relaxes and urine flows into the urethra; toilet training suppresses this reflex (along with external urethral sphincter)

208
Q

Urethral glands homolog to ______________, common paraurethral duct bilaterally near external urethral orifice.

A

prostate

209
Q

1) What part of the male urethra is surrounded by external urethral sphincter?
2) What primarily controls continence?

A

1) Intermediate (membranous)
2) Tonic and phasic contraction of external urethra sphincter

210
Q

What are the 4 parts of the male urethra?

A

1) Intramural
2) Prostatic urethra
3) Intermediate (membranous)
4) Spongy urethra

211
Q

1) What does parasympathetic stimulation do during micturition?
2) The _______________________ is under somatic control and is inhibited during micturition

A

1) Causes the detrusor muscle to contract & inhibits the internal urethral sphincter.
2) external urethral sphincter

212
Q

To gain voluntary control over micturition, infants must learn to suppress and stimulate what?

A

1) Suppress: the visceral afferent urge to void
2) Stimulate: the somatic motor of external urethral sphincter

213
Q

1) What muscle is in the wall of the bladder and is involved in micturition?
2) What form the “involuntary” internal urethral sphincter?
3) What is the “voluntary” (Somatic) sphincter and where is it?

A

1) Detrusor muscle in wall of bladder
2) Neck of bladder muscles
3) External urethral sphincter; above perineal membrane

214
Q

1) Where are the seminal glands (vesicles)?
2) What fluid do they secrete? What does it do?
3) What part of the seminal glands is covered in peritoneum?

A

1) Lie obliquely between the fundus of bladder and rectum
2) Alkaline fluid, mixes with sperm, major contributor to volume of semen ~ 75%
3) Superior aspect

215
Q

1) What are ejaculatory ducts?
2) Where do they pass through?
3) Where do they open and how?

A

1) Tube arising from union of vas deferens and seminal gland duct
2) Posterior prostate
3) By slit like apertures on or within the prostatic utricle

216
Q

What are the two divisions of the prostate? Define each.

Which one incorporates the prostatic plexus?

A

1) Glandular part 2/3
2) Fibromuscular 1/3: dense fibromuscular capsule
-Incorporates the prostatic plexus of nerves and veins

217
Q

1) How many prostatic ducts open into prostatic sinuses?
2) Where are the prostatic sinuses?

A

1) 20+
2) On either side of seminal colliculus on posterior wall of the prostatic urethra

218
Q

1) Prostatic fluid accounts for ~____% of volume of semen
2) Where are the Bulbourethral glands (Cowper’s glands)?
3) Where do the Bulbourethral glands open to?

A

1) ~25%
2) Lie posterolateral to the intermediate part of the urethra embedded in external urethral sphincter
3) Proximal spongy urethra

219
Q

What are the 2 categories of LUTS (lower urinary tract symptoms)? List what’s in each

A

1) Irritative symptoms
-Frequency
2) Obstructive symptoms
-Dribbling
-Push harder
-Nocturia
-Repeat voiding

220
Q

What are the 4 female internal genital organs?

A

1) Uterus
2) Uterine tubes
3) Ovary
4) Vagina

221
Q

List and define the 3 parts of the body of the uterus

A

1) Fundus: rounded part superior to orifices of uterine tubes
2) Isthmus: just superior to the cervix
3) Uterine horns: where uterine tubes enter

222
Q

1) What part of the wall of the uterus is actively involved in the menstrual cycle? What does it do?
2) Where does implantation occur with conception?

A

1) Endometrium differs in structure with each stage of cycle, inner surface is shed during menstruation
2) Endometrium (within fundus of uterus)

223
Q

1) What does the ligament of the ovary do? Where?
2) What does the the round ligament of the uterus attach?
3) What does the round ligament enter and where does it end?

A

1) Connects the ovary to the uterus; near the uterotubal jct.
2) Attaches close to above, vestiges of the ovarian gubernaculum related to decent of ovary from the posterior abdominal wall
3) The internal/deep inguinal ring and ends within the inguinal canal

224
Q

What 3 things make up the broad ligament?

A

1) Mesovarium
2) Mesosalpinx
3) Mesometrium

225
Q

What 4 things are found between layers of the broad ligament bilaterally?

A

1) Uterine tubes
2) Ligament of the ovary
3) Round ligament of the uterus
4) Suspensory ligament of the ovary

226
Q

1) What extend laterally and open into the peritoneal cavity near the ovaries?
2) What part of this is intramural?

A

1) Oviducts or fallopian tubes
2) Uterine part

227
Q

1) Is the vagina retroperitoneal, intraperitoneal, or something else?
2) Where does it extend from and to?

A

1) Mostly subperitoneal
2) From posterior fornix to the vestibule of the vagina

228
Q

1) Where is lymph drained from female pelvic viscera to?
2) Where is it drained from the female perineum to?

A

1) Internal, external, common iliac nodes & sacral node
2) Perineum to superficial inguinal nodes

229
Q

1) Where is the rectum?
2) What shape is it in lateral views?
3) What can be seen in A-P view?

A

1) Sigmoid colon to anal canal
2) S-shaped
3) 3 lateral flexures

230
Q

1) What veins are involved in internal hemorrhoids?
2) What veins are involved in external hemorrhoids?

A

1) Veins of internal rectal venous plexus
2) External rectal venous plexus

231
Q

1) What do internal hemorrhoids do?
2) What do external hemorrhoids do?

A

1) Strangulate, ulcerate, bleed
2) Increase portal or abdominal pressure

232
Q

1) Are external hemorrhoids painful or painless? Why?
2) What innervation is responsible in this area?

A

1) Painful, b/c they’re below pectinate line
2) Somatic fibers from inferior rectal nerves

233
Q

What are the 3 layers preventing the abdomen/ pelvis from the outside?

A

1) Pelvic floor
2) Pelvic compartment
3) Perineal body

234
Q

1) What triangle does the perineal membrane cover?
2) What part of the pelvic outlet does it cover?
3) What perforates it in males and females?

A

1) Covers UG triangle
2) Covers anterior part of pelvic outlet
3) Urethra and vagina in females, urethra in males

235
Q

What muscle of the perineum is NOT involved in the perineal body?

A

Ischiovernosus muscle

236
Q

List 2 perineal muscles that meet at the midline

A

1) Bulbopspongiosus m.
2) Ischiocavernosus m.

237
Q

1) What is the ischo-anal fossa?
2) Where is it?
3) What 2 things is it filled with?

A

1) Fascia lined wedge-shaped space between the skin of the anal region and the pelvic diaphragm
2) Around the wall of the anal canal
3) Fat and loose connective tissue

238
Q

1) Is the external anal sphincter voluntary? What does it surround and what does it blend with?
2) What innervates it?

A

1) Voluntary; surrounds inferior 2/3 of anal canal, blends superiorly with puborectalis
2) S4 via inferior anal (rectal) nerves (from pudendal nerve)

239
Q

1) What makes up the internal anal sphincter? What does it surround?
2) What stimulates its tone?
3) What inhibits (relaxes) it?

A

1) Smooth muscle; superior 2/3 of anal canal
2) Sympathetic fibers from hypogastric plexus
3) Parasympathetic fibers

240
Q

1) What do anal valves join?
2) What do they form?
3) What do these do when compressed?

A

1) Inferior ends of anal columns
2) Anal sinuses
3) Exude mucous (anal glands in dogs)

241
Q

1) What is the mons?
2) What is the labia majora? What is it bound to?
3) What does the labia major protect?

A

1) Fatty eminence anterior to pubic symphysis, fat increases at puberty and covered in hair
2) Prominent folds of skin, bound the pudendal cleft (between labia majora)
3) Urethral and vaginal orifice

242
Q

The labia minor anteriorly form 2 lamina; what are they? What do they each unite to form?

A

1) Medial laminae unite to form frenulum of the clitoris
2) Lateral laminae unite to form the prepuce of the clitoris

243
Q

List and define the two types of vestibular glands

A

1) Greater (Bartholin gland): each side of vestibule, open on each side of the vaginal orifice, secrete mucous during sexual arousal
2) Lessor glands: smaller, bilateral, between urethral and vaginal orifice, secrete mucous

244
Q

List and describe the 3 cylinders of erectile tissue (corpora) of the penis

A

1+2) Paired corpora cavernosa: Fused in median plane, except posteriorly where they separate and form crura of penis
3) Single corpora spongiosum ventrally: Contains spongy urethra

245
Q

1) What is the glans of the penis?
2) What is a distinct structure of the glans? Describe this structure
3) What does the neck of the glans delineate?

A

1) Expanded corpus spongiosum
2) Corona; projects beyond end of corpora cavernosa and over hangs the neck of the glans
3) Glands from body

246
Q

What opening does the glans of the penis contain?

A

External urethral opening of spongy urethra

247
Q

What make up the perineal body? (4 groups of things)

A

1) Superficial and deep transverse perineal m
2) Ext anal sphincter
3) Bulbospongiosis
4) Slips of muscle

248
Q

1) What is the landmark for local infiltration of anesthetic for the perineal region?
2) What part wouldn’t be blocked from this type of nerve block? Why?

A

1) Ischial spine
2) Anterior perineum; innervated by ilioinguinal nerve

249
Q

What 3 things cause ejaculation?

A

1) Sympathetic stimulation closes the internal urethral sphincter
2) Parasympathetic stimulation contracts urethral muscles
3) Pudendal n. stimulation contracts the bulbospongiosus muscles

(PA school) Gross Anatomy (52 decks)

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