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Jemima Flash Cards > GENITOURINARY > Flashcards

GENITOURINARY Flashcards

1
Q

what makes up the glomerular filtration barrier

A

fenestrated endothelium, Glomerular basement membrane (double thickness), podocyte foot processes

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2
Q

how much of the cardiac output does the kidney receive

A

20 % - 1L

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3
Q

what size of molecule can pass through the filtration barrier

A

10kDa or smaller

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4
Q

is the glomerular basement membrane positively or negatively charged

A

it is negatively charged - through heparin sulphate

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5
Q

what can pass through the glomerular filtration barrier

A

glucose, amino acids, creatinine, sodium, potassium, urea, bicarbonate disulphide and chloride

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6
Q

what are mesangial cells

A

they are modified smooth muscle cells - for support

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7
Q

what factors effect glomerular filtration

A

hydrostatic pressure out the capillary
hydrostatic pressure out of bowman’s capsule
oncotic pressure in the capillary
together they make the net filtration pressure

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8
Q

what is the only protein that should be found in urine

A

Tamm Horsfall

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9
Q

how do you calculate the GFR

A

NFP X kF (filtration coefficient)

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10
Q

what is the average GFR

A

125ml/min

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11
Q

what substance is used to measure GFR in clinic

A

creatinine

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12
Q

why is creatinine used to measure GFR

A

it isnt metabolised, it isnt secreted or absorbed by the tubules and it is freely filtered

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13
Q

how much plasma is filtered in 24 hours

A

180L in 24 hours (3L of plasma at 125ml every minute)

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14
Q

what is renal clearance

A

it is a measure of how much a substance is secreted/absorbed
how long a particular substance is removed from the plasma by the kidney and excreted in the urine

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15
Q

what happens to arterioles to increase the GFR

A

dilate the afferent arteriole and constrict the efferent arteriole. it increases the blood at the renal capsule

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16
Q

what happens to the arterioles to decrease the GFR

A

constrict the afferent arteriole and dilate the efferent arteriole. it decreases blood in the renal capsule

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17
Q

what cells are involved in tubuloglomerular feedback

A

the juxtagloerular apparatus

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18
Q

what cells detect a decrease in NaCl

A

the macula densa cells - in the distal convoluted tubule

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19
Q

what cells detect a decrease in the blood pressure

A

the granular cells of the afferent arteriole

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20
Q

what happens when there is a decrease in sodium and blood pressure in the kidney

A

then renin is secreted from the glomerular cells which acts in the RAA system

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21
Q

what is reabsorbed in the proximal convoluted tubule

A

glucose, amino acids, lactate, sodium, phosphate, bicarbonate, hydrogen ions, water and chloride

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22
Q

what is secreted in the proximal convoluted tubule

A

organic ions

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23
Q

what is the main driver of reabsorption of sodium ions

A

the Na/K ATPase basolaterally - builds up the concentration of sodium

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24
Q

what molecules do sodium cotransport

A

glucose, amino acids and lactate

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25
Q

what is sodium antiported with in the proximal convoluted tubule

A

it is antiported with H+ (maintains electrical charge)

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26
Q

how is HCO3- reabsorbed

A

tubular sodium/hydrogen antiporter. H+ and HCO3- in the lumen forms H2CO3 (via carbonic anhydrase) which then dissociated to H20 and CO2. CO2 diffuses into the RCT cell and H2O moves in via aquaporins. in the cell CO2 and H2O combine (carbonic anhydrase) to H2CO3 and this dissociates to H+ and HCO3-.
H+ is antiported into lumen
HCO3- basolaterally absorbed into capillary

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27
Q

what are the two sections of the loop of henle

A

the thin descending and the thick ascending

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28
Q

where in the loop of henle is water reabsorbed

A

in the thin descending loop

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29
Q

where in the loop of henle are ions reabsorbed

A

in the thick ascending loop

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30
Q

how does the concentration gradients cause reabsorption in the loop of henle

A

the descending limb loses H2O and ions remain. Therefore there is an increased concentration. In the ascending limb you lose Na and Cl with water remaining. therefore the concentration descreases

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31
Q

what channel transports Na+, K+ and 2CL- from the lumen into the LOH cell

A

the NKCC2 channel

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32
Q

what part of the RAA system acts on the NKCC2

A

aldosterone

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33
Q

what happens in the distal convoluted tubule

A

there is fine regulation of sodium, chlorine phosphate and water reabsorption

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34
Q

where are the macula densa cells found

A

in the distal convoluted tubule

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35
Q

what happens in the collecting duct of the kidney

A

there is water reabsorption and acid/HCO3- regulation

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36
Q

what are the two cell types found in the collecting ducts

A

the principal cells and intercalated cells

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37
Q

what are the features of the principal cells of the collecting duct

A

there are aquaporin 2 channels - responds to ADH action which increases water absorption
there are ENaC channels which is acted on by aldosterone. the result is more sodium reabsorption and potassium secretion

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38
Q

what are the intercalated cells in the collecting ducts for

A

it is involved in reabsorbing HCO3- and secreting H+

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39
Q

What is the distribution of fluid in the ICF and the ECF

A

42L

  • 28L in ICF
  • 14L in ECF - 11L in IF and 3L in plasma
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40
Q

what is plasma osmolarity

A

300 mOsm

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41
Q

what is fluid volume regulated by in the long term

A

RAA and ADH

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42
Q

what are the factors controlling potassium

A

diet and aldosterone

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43
Q

where is most of the potassium absorbed in the renal tubule

A

in the proximal convoluted tubule

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44
Q

where is ADH/vasopressin made in the body

A

it is manufactures in the hypothalamus

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45
Q

where is ADH /vasopressin secreted from

A

the posterior pituitary

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46
Q

what is ADH/vasopressin affected by

A

osmoreceptors (a small change activates ADH) and baroreceptors (these arent as sensitive so need a large change to activate)

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47
Q

what happens in the body when you drink a lot of water

A

there is a decrease in fluid mOsm which causes an inhibition of ADH release. this means there is less plasma AQDH and therefore there is an increase water excretion at the loop of henle and the collecting ducts

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48
Q

what happens if there is a decrease in the extracellular fluid in the body

A

there is an increase in baroreceptor firing, which cases stimulation of ADH release. this causes an increase in plasma ADH. and therefore there is a decrease in excretion of water at the LOH and CD

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49
Q

what is the RAA system

A

renin converts angiotensinogen to angiotensin 1. ACE (from the lungs) then converts angiotensin 1 to angiotensin2. angiotensin 2 causes release of aldosterone, as well as increased ADH stimulation and increased blood pressure (acts as a vasoconstrictor)

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50
Q

what is the main ECF ion

A

sodium - sodium determines blood pressure

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51
Q

where is aldosterone made

A

from the zona glomerulosa of the adrenal cortex

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52
Q

what is ANP

A

it is produced by cardia atrial myocytes when there is an increased blood pressure in response to atrial stretch. it is an antagonist to ENaC, aldosterone and increases GFRand increases sodium excretion.

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53
Q

what is the link between the parathyroid hormone and the kidney

A

parathyroid hormone is released from the parathyroid gland, when there is decreased calcium in the plasma. this directly increases calcium reabsorption. it stimulates the active form of vitamin D in the body as well (also involved in calcium absorption)

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54
Q

what is the average pH of the body

A

7.35 - 7.45

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55
Q

what is acidemia

A

when the environment is more acidic but it is still in the normal range

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56
Q

what is alkalemia

A

when the environment is more alkaline but still in the normal

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57
Q

what is the equation to calculate the anion gap

A

[[Na+]+[K+]] - [[Cl-]+[HCO3-]]

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58
Q

what is the main urinary buffer

A

HCO3-

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59
Q

what does the concentration of buffer molecules in acid/alkalosis depend on

A

the driving factor - the thing causing the change (acidosis/alkalosis)
compensation - trying to restore the normal

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60
Q

what is the kidneys endocrine function

A
  1. EOP (erythropoietin) which stimulates RBC maturation in the bone marrow, it is produced in the peritubular cells of the renal cortical interstitium
  2. activation of vitamin D
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61
Q

what causes an increase of EPO in the body

A

anaemia, altitude, cardiopulmonary disorders

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62
Q

what causes a decrease in EPO in the body

A

polycythemia (increased Hb abnormally in blood), renal failure

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63
Q

how does activation of vitamin D occur

A

calcediol (25-DeH VitD3) in the liver is transported to the kidney where it is activated to calcitriol (1,25 - vitaminD3). this then worked in the intestines, bone, kidney and parathyroid

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64
Q

what is the action of active vitamin D in the body

A

intestines - increased PO4 absorption and increase calcium
bone - increased reabsorption
Kidney - increased PO4 reabsorption and increased calcium reabsorption
parathyroid - decreased parathyroid hormone (low PTH inhibits bone resorption)

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65
Q

what is present in the walls of the bladder

A

detrusor muscles

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66
Q

what sort of muscle is present in the internal urethral sphincter

A

smooth muscle

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67
Q

what nerve stimulates the internal urethral sphincter

A

syplathetic nerve - hypogastric T1-L2

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68
Q

what muscle is present in the external urethral sphincter

A

skeletal muscle

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69
Q

what nerve innervates the external urethral sphincter

A

somatic pudendal nerve - s2, s3, s4

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70
Q

what happens during bladder filling

A

the detrusor relaxes, the internal and external urethral sphincter is shut = contracted (shut)

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71
Q

what happens to the bladder during micturition/pee

A

the detrusor muscle contracts (increased sympathetic tone) and the internal and external urethral sphincter relaxes (opens), due to a reduced sympathetic tone

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72
Q

what is the primitive bladder stretch reflex

A

when there is peeing (until childhood) due to a spinal reflex to a increased bladder filling.

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73
Q

what happens if the primitive bladder stretch reflex persists

A

you get an incontinence syndrome

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74
Q

what is the bladder and urinary tract function

A

store urine at a low pressure, fill to a comfortable volume (receptive relaxation). there is a voluntary initiation to peeing

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75
Q

when does the primordial germ cell migrate to the urogenital ridges

A

6 weeks

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76
Q

what causes female sex differentiation

A

when there is no SRY it means there are no leydig or sertoli cells meaning no testosterone and AMH (wolffian ducts regress). the Mullerian ducts develops, and with the action of oestrogen, the vagina, citerus, ovaries and ova is made

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77
Q

what causes male sex development

A

there is the presence of SRY, causing development of leydig and sertoli cells meaning there is testosterone and AMH present. this causes the development of wolffian ducts, testes and sperm

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78
Q

what do sertoli cells produce

A

AMH

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79
Q

what do leydig cells produce

A

testosterone

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80
Q

what does the external genitalia respond to in males

A

dehydroxytesterone

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81
Q

what coverts testosterone to DHT

A

5 alpha reductase

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82
Q

what occurs in gametogenesis (male)

A
  1. mitosis occurs at puberty onwards making spermatogonia type A and B
  2. meiosis then occurs - M1 makes the primary to secondary spermatocyte, M2 makes the secondary spermatocyte to the spermatid (M2 continuous after pruberty)
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83
Q

where do the spermatids mature in the males

A

they mature in the epididymis to spermatozoa

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84
Q

how long does the spermatids mature in the epididymis

A

64 days

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85
Q

what is the maturation process of spermatogonia to spermatozoa

A

spermatogonia B develops into primary spermatocyte. these then undergo M1 to make two secondary spermatocyte. M2 then happens and it makes 4x spermatids. these then develop into spermatozoa

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86
Q

what is the process of spermatids called spermatozoa called

A

spermiogenesis

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87
Q

what is the process of spermatogonia to spermatid called

A

spermatogenesis

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88
Q

what is the process of gametogenesis in females

A
  1. mitosis occurs at prebirth in the foetus to make primary oocytes.
  2. mitosis 1 then occurs to make secondary oocytes, and then M2 occurs to make oogonia.
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89
Q

in females when is M1 arrested until

A

until menarche - the 1st period

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90
Q

when does M2 occur in women

A

it occurs after fertilisation

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91
Q

what is the development from primary oocyte to oogonia

A

the primary oocyte undergoes M1 which becomes secondary oocyte and a polar body. the secondary oocyte M2 to produce oogonia and 3 polar bodies

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92
Q

what happens in puberty in women

A

primary development is by FHS and LH stimulating gonadotropins. secondary development is then caused by adrenal androgens

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93
Q

what is the path that sperm takes in the male reproductive system

A 
Seminiferous tubules (spermatogenesis) - rete testis - efferent ducts - epididymis - vas deferens - ejaculation duct (joined by seminal vesicles) - (nothing) - urethra - penile urethra 
SREEVENUP
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94
Q

what is the pathway that the testes descends through

A

it descends through the inguinal canal by the processes vaginalis. It is covered in tunica vaginalis and fibrous capsule tunica albuginea

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95
Q

why are the testis found outside the body cavity

A

cooler - pampiniform plexus descends to exchange heat with the environment and cooler arterial blood to the testis

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96
Q

what makes up the blood testis barrier

A

sertioli cell tight junctions

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97
Q

what is the function of the blood testis barrier

A

to prevent an immune response to sperm and sperm movement into the systemic circulation

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98
Q

what is the female HPG axis

A

the hypothalamus releases GnRH, which then acts on the anterior pituitary to release FSH. this acts on the granulosa cells of the follicle and causes egg maturation.
Inhibitin inhibits FHS release. Oestrogen release acts to increase LH until it reaches threshold and there is an LH surge causing ovulation. The granulosa cells then become the corpus luteum and makes progesterone

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99
Q

what is the male HPG axis

A

GnRH from the hypothalamus then stimulates the anterior pituitary to make FSH and LH. FHS works on sertoli cells to make AMH, and LH works on the leydig cells to make testosterone. Sertoli cells make inhibin which acts on the anterior pituitary to reduce FSH.
testosterone acts on the sertoli cells to make sperm
testosterone is acted on by 5 alpha reductase to make DHT

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100
Q

what is DHT needed for in male development

A

external genitalia

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101
Q

where are androgens made in the adrenal glands

A

in the zona reticularis

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102
Q

what are the two stages of the menstrual cycle

A

follicular/proliferative and the luteal/secretory phases

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103
Q

what happens during the follicular phase of the menstrual cycle

A

there is follicular development and the womb lining proliferates

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104
Q

what happens during the luteal phase of the menstrual cycle

A

the oocyte is released and the follicle becomes the corpus luteum, in the womb lining there are large gaps in the structure with skinnier irregular tubes seen on H+E

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105
Q

where is GnRH made in the body

A

made in the hypothalamus

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106
Q

what are the effects of oestrogen production

A

increased LH (positive feedback), inhibition of FSH and it thickens the endometrium to prepare for ovulation

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107
Q

what happens to hormone levels if the oocyte is fertilised

A

then there is hCG produces as well as progesterone continually produced from the corpus luteum. oestogen also stays high

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108
Q

what happens if there is no fertilisation

A

then the corpus luteum breaks down and progesterone levels drop. this causes the womb lining to shed and the cycle then repeats

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109
Q

where does fertilisation occur

A

in the ampulla of the fallopian tube

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110
Q

what are the layers of the uterus

A

the endo, myo and perimetrium

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111
Q

what happens during labour

A

relaxin and oestrogen causes relaxation of the cervix. oxytosin then stimulates the uterine wall to contract

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112
Q

what happens on day 1 of fertilisation

A

there is the sperm acrosomal reaction at the zona pellucida which causes a calcium influx. this allows the sperm to fertilise the egg and the male and female pronuclei form. Syngamy occurs and the two nuclei combine to make a 2n nucleus
- fertilisation

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113
Q

what happens on day 2-3 after fertilisation

A

there is mitotic division 1-2-4-8 (these cells are totipotent)
- cleavage

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114
Q

what happens on day 4 after fertilisation

A

this is the 16 cell stage called a morula.

- compaction

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115
Q

what happens day 5 after fertilisation

A

the 32 cell stage, and the formation of the blastocyst. there is an inner cell mass formed called the epiblast, and an outer ring of cells called the trophoblast. the cells are pluripotent at this stage
- cantation

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116
Q

what happens day 6 after fertilisation

A

the zona pellucida is discarded which is key for fertilisation
- hatching

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117
Q

what happens 7 days after fertilisation

A

implantation of the blastocyst

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118
Q

what are the three stages of implantation

A 
apposition = unstable binding 
attachment = stronger adhesion 
invasion = lacunar flow: uteroplacental circulation is established by the syncytotrophoblast and maternal sinusoids
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119
Q

what is the cell type found in the epididymis and the vas deferens

A

pseudostratified columnal with stereocilia

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120
Q

where is urothelium found

A

renal, pelvis, ureters, bladder and urethra (except penile)

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121
Q

what are the different layers of the skin

A

epidermis, dermis and subcutaneous tissue

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122
Q

what are the layers found in the epidermis of the skin

A 
the stratum basale (deepest) 
the stratum spinosum 
the stratum granulosum 
the stratum lucidum 
the stratum corneum
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123
Q

what are the functions of the skin

A

barrier to infection, thermoregulation, protection against trauma, protection against UV, vitamin D synthesis and regulation of H2O loss

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124
Q

what are the membranes of the renal corpuscle like

A

they are fenestrated and negatively charged

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125
Q

what are the two layers of the bowmans capsule in the renal corpuscle

A

the basement membrane and the parietal epithelial cells

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126
Q

what are the 3 layers of the glomerulus in the renal corpuscle

A

endothelial cells - fenestrated
basement membrane - fusion of 2, negatively charged
podocytes - foot processes act as a filtrate barrier

127
Q

in the female what is the three structures found in the inguinal canal

A
  1. round ligament of the uterus
  2. ilioinguinal nerve
  3. Genital branch of the genitofemoral nerve
128
Q

in males what are the contents of the inguinal canal contained in

A

the spermatic cord

129
Q

what are the 3 nerves found in the spermatic cord

A

the ilioinguinal nerve, the genital branch of the genitofemoral nerve, the sympathetic nerve fibres

130
Q

what are the 3 arteries found in the spermatic cord

A

testicular artery, cremasteric artery and the artery to the vas deferens

131
Q

what are the three fascial layers of the spermatic cord

A

the external spermatic fascia (from external oblique aponeurosis)
cremasteric muscle and fascia (internal oblique muscle)
internal spermatic fascia (transversalis fascia)

132
Q

what are the 4 other structures found in the spermatic cord

A

pampiniform venous plexus
lymphatics
vas deferens
processes vaginalis

133
Q

what is a hernia

A

abnormal protrusion of tissue through an opening

134
Q

what is an inguinal hernia

A

abdominal contents protrude through the anterior abdominal wall via the inguinal canal

135
Q

what is an indirect inguinal hernia

A

intra-abdominal contents are forces through the feel inguinal ring and into the canal itself

136
Q

what is a direct inguinal hernia

A

the intra abdominal contents are forced directly through the posterior wall of the inguinal canal and subsequently through the superficial ring.

137
Q

what are the testes covered with

A

three layers of spermatic fascia that cover the spermatic cord. as well as a sac derived from the peritoneum called the tunica vaginalis

138
Q

where is sperm stored

A

epididymis

139
Q

where do the testicular arteries arise from

A

the abdominal aorta

140
Q

what is the venous drainage of the testis/epididymis

A

pampiniform venous plexus

141
Q

what are the two types of erectile tissue

A

corpora cavernosa and corpus spongiosum

142
Q

where is the penile urethra

A

within the corpus spongiosum

143
Q

what is the arterial supply to the penis

A

penile arteries

144
Q

what is the nervous supply to penis

A

sympathetic from the dorsal nerve of the penis (branch of pudendal nerve) and parasympathetics from the peri-prostatic nerve plexus

145
Q

what is primarily responsible for the male erection

A

the corpus cavernosa - increase in size and rigidity

146
Q

what is the main role of the corpus spongiosum during an erection

A

to prevent the urethra from being compressed which would prevent ejaculation

147
Q

what is the corpus spongiosum and cavernosa covered in

A

covered in tunica albuginea and deep fascia (bucks fascia)

148
Q

what is the adrenal gland embedded in

A

perinephric fat

149
Q

what are the arteries that supply the adrenal glands

A

superior, middle and inferior adrenal artery

150
Q

what is the superior renal artery a branch of

A

the inferior phrenic artery

151
Q

what is the middle adrenal artery a branch of

A

the abdominal aorta

152
Q

what is the inferior renal artery a branch of

A

the renal artery

153
Q

where does the right adrenal vein drain into

A

it drains directly into the inferior vena cava

154
Q

where does the left adrenal vein drain into

A

it drains first into the left renal vein and then this drains into the inferior vena cava

155
Q

what are the two parts of the adrenal gland

A

the cortex (outer) and the medulla (inner)

156
Q

what is a phaeochromocytoma

A

a hormone producing tumor of the adrenal medulla which can secrete excess adrenaline

157
Q

are the kidneys retroperitoneal or intraperitoneal

A

retroperitoneal

158
Q

what are the layers found round the kidney

A

immediately covered in perinephric fat, then by renal fascia. then by paranephric fat.

159
Q

what are contained within the hilum of the kidney

A

renal vessels, nerves, lymphatics and ureter

160
Q

what are the right and left renal arteries branches of

A

the abdominal aorta

161
Q

what is the internal aspect of the kidney composed of

A

cortex, medulla and the calyces

162
Q

what is the function of the nephrons

A

filter blood, reabsorb water and solutes, secreting and excreting waste products

163
Q

what part of the nephron is found in the cortex of the kidney

A

the glomerulus, bowmans capsule, proximal and distal tubules and part of the collecting duct

164
Q

what parts of the nephron are found in the medulla of the kidney

A

loop of Henle and the rest of the collecting duct

165
Q

as urine is produced in the kidney where does it go

A

as its made in the collecting ducts it travels down the pyramid towards the renal papilla (apex of pyramid). here is enters the minor calyx, which then merges with other calyces to form the major calyces. these merge to form the renal pelvis which then becomes the ureter

166
Q

how does the ureter move urine to the bladder

A

via peristaltic contractions

167
Q

what are kidney stones most often made from

A

calcium oxalate

168
Q

what are the risk factors for kidney stones

A

high urine calcium, dehydration, obesity and certain medication

169
Q

what are the classic signs for kidney stones

A

sharp pulsatile pain felt from loin to groin - pain fibers supplying the ureter, originate from T12 to L2 so pain is referred.

170
Q

where are the three narrowings in the ureter were stones are most likely to get stuck

A

the pelvi-ureteric junction
pelvic brim
vesico-ureteric junction

171
Q

what causes a UTI

A

bacteria entering the urinary bladder via the urethra. this is most common in females as the urethra is much shorter.

172
Q

what are the three main types of kidney cancer

A

renal cell carcinomas, transitional cell carcinoma and Wilms tumours

173
Q

what does the posterior abdominal wall consist of

A

the lumbar spine together with the psoas and quadratus lumborum muscles

174
Q

what structures run along the posterior abdominal wall

A

the inferior vena cava, the aorta with its associated structures and autonomic plexus, lymphatics and sympathetic trunks either side of the lumbar spine

175
Q

what lumbar spinal nerves form the lumbar plexus

A

L1-4

176
Q

what are the notable nerve branches that come off of the lumbar plexus

A 
iliohypogastric and iliolinguinal nerves 
genitofemoral nerve 
lateral femoral cutaneous nerve 
femoral nerve 
obturator nerve
177
Q

what does the iliohypogastric and ilioinginal nerves supply

A

anterior abdominal wall muscles and the skin of the external genitalia

178
Q

what does the genitofemoral nerve supply

A

the skin of the external genitalia

179
Q

what does the lateral femoral cuneatus nerve supple

A

supplies the skin over the lateral thigh

180
Q

what does the femoral nerve supply

A

the skin and muscle of the anterior thigh

181
Q

what does the obturator nerve supply

A

the muscles and skin of the medial thigh

182
Q

what spinal level does the abdominal aorta divide

A

L4

183
Q

what are the paired branches of the abdominal aorta

A

the adrenal, renal, gonadal and lumbar arteries

184
Q

what are the functions of the bony pelvis

A

supports the spine, tors and upper body, locomotion and housing and protecting pelvic viscera

185
Q

what is the hip bone made up of

A

the ilium, the ischium and the pubis

186
Q

what are the 5 articulations of the bony pelvis

A

hip joint, sacroiliac joint, pubic symphysis, lumbosacral joint, sacrococcygeal joint

187
Q

what are the surface landmarks of the pelvis

A 
the iliac crest
the anterior superior iliac spine 
the iliac tubercle 
the pubic tubercle 
inguinal ligament
mid-inguinal point 
McBurneys point - 1/3 distance from the anterior superior iliac spine to the umbilicus
188
Q

what are the differences between male and female pelvic anatomy

A

in females the pelvis has wider, circular pelvic inlets, in men these are narrower. in females there is an obtuse angle formed by the inferior pubic rami (acute in males) and there is wider and shorter sacrum in females compared to men

189
Q

what is the arterial supply to the pelvis

A

the right and the left iliac arteries

190
Q

what are the key branches of the iliac arteries

A 
visceral arteries - bladder in both sexes (prostate and seminal vesicles in men) 
uterine and vaginal arteries in females 
middle rectal artery 
internal pudendal artery 
superior and inferior gluteal arteries
191
Q

what are the nerves that supply the pelvis

A

the pelvis splanchnic nerves made up of parasympathetics from S2-4 to the pelvic viscera. Also have the superior and inferior gluteal neves

192
Q

what is the 3 main functions of the pelvic floor

A
  1. prevent herniation of the pelvic organs inferiorly
  2. control continence of urine and faeces by providing a sphincter action
  3. aids in increasing intra-abdominal pressure
193
Q

what are the two muscles that make up the pelvic floor

A

the levator ani and the coccygeus

194
Q

what are the three muscles that makes up the levator ani

A

the puborectalis, the pubococcygeus and the iliococcygeus

195
Q

what is the function of the puborectalis muscle

A

it is a U shaped muscle and maintains its tone until defecation. it attached to the pubic bone anteriorly and forms a sling around the rectum. it pulls on the rectum so that a sharp angle is formed between the rectum and anal canal. when it relaxes the path from the rectum to the anal canal straightens and faeces can pass through

196
Q

what arteries supply the perineum

A

the internal pudendal artery

197
Q

what can the perineum be divided into

A

the anal triangle (posterior) and the urogenital triangle

198
Q

what are the layers found in the urogenital triangle

A

the skin, perineal fascia, the superficial perineal pouch , the perineal membrane and the deep perineal pouch

199
Q

what is contained within the superficial perineal pouch

A

it contains the majority of the erectile tissue that unites to form either the clitoris or the penis

200
Q

what is the function of the corpora cavernosa

A

it forms a strong foundation for the clitoris or the penis

201
Q

what is the function of the corpus spongiosum

A

in the males it has a proximal expansion which is the bulb of the penis. in women it splits into two parts to flank the vaginal opening

202
Q

what is the function of the ischiocavernosus muscle

A

it helps to stabilise the erect penis and clitoris

203
Q

in males what does the bulbospongiosus muscle do

A

it maintains an erection by compressing the veins that drain the erectile tissues

204
Q

what is the function of the vas deferens

A

carries sperm from the epididymis up the spermatic cord and through the inguinal canal into the pelvis. it passes by the bladder and terminates by joining the seminal vesicle duct to form the ejaculatory duct

205
Q

what is the function of the seminal vesicles

A

they secrete thick alkaline fluid which forms the bulk of the seminal fluid

206
Q

what artery supplies the vas deferens, prostate and seminal vesicle

A

the internal iliac artery

207
Q

what structure(s) passes through the prostate

A

the urethra and the ejaculatory duct

208
Q

what ligament is the ovary attached to

A

the broad ligament - via a short mesentery (mesovarium)

209
Q

what is the blood supply to the ovary

A

the ovarian artery

210
Q

in females what does the internal iliac artery supply

A

the vagina, cervix, uterine tubes, and uterus

211
Q

what is the term vulva used for

A

all parts of the female external genitalia

212
Q

what is the main blood supply to the vulva

A

the internal pudendal arteries

213
Q

what is the innervation of the vulva

A

the ilioinguinal nerve, the genital branch of the genitofemoral nerve, the pudendal nerve, and the posterior cutaneous nerve

214
Q

what are the parts of the vulva

A

the mons pubis, the labia majora, the labia minora, the clitoris, the vestibule, the vaginal opening, the hymen, the urinary meatus and the vestibular glands (greater and lesser)

215
Q

what arteries is the bladder supplied by

A

the vesical arteries

216
Q

what is the bladder stretch reflex

A

as the bladder fills, stretching of the bladder wall is detected, and info sent via visceral afferent fibres. in the sacral spine these fibres synapse onto motor neurons that directly send information back to the bladder, to contract.
- bladder filling initiates bladder emptying

217
Q

if a patient suffers a spinal injury above the sacral level what are the two pathways that will be interrupted

A
  1. ascending pathways that convey sensation of bladder filling to the brain
  2. descending pathway that exert voluntary, inhibitory control over the external urethral sphincter
218
Q

what is the pectinate line

A

it divides the superior part of the anal canal from the inferior part - marks where endoderm and the hindgut transition to ectoderm

219
Q

what is the foramen between the pubis and the ischium

A

the obturator foramen

220
Q

what passes through the obturator foramen

A

the obturator nerves and vessels

221
Q

what is the blood supply to the thyroid

A

the superior thyroid artery, from the external carotid

the inferior thyroid artery, from the subclavian

222
Q

what is the action of glucose on beta cells in the pancreas

A

glucose moves into the cell via GLUT2. ATP is made and there is closure of the ATP sensitive potassium channels. There is opening on voltage gated calcium channels and this makes vesicles containing insulin fuse with the membrane and the insulin is released

223
Q

what is the action of insulin on cells

A

it mobilises GLUT4 containing vesicles to the cell membrane allowing glucose to be absorbed

224
Q

what stimulates the release of ACTH

A

CRH from the hypothalamus

225
Q

what is the cell type that releases ACTH

A

corticotrophs

226
Q

what is the action of ACTH

A

it causes cortisol release from the zona reticularis #

227
Q

what does cortisol do in the body

A

it causes gluconeogenesis and carbohydrate motabolism, decreases inflammation and causes proteolysis and lipolysis

228
Q

what is the action of FHS and LH in males

A

LH causes leydig cells to release testosterone

FSH causes sertoli cells to produce MIF, as well as inducing spermatogenesis

229
Q

what pituitary cells produce FSH and LH

A

gonadotrophs

230
Q

what regulates prolactin release from the anterior pituitary

A

dopamine - it inhibits it

231
Q

the pubic bones joining is an example of what kind of joint

A

a secondary cartilage joint

232
Q

what is the sacroiliac joint an example of

A

a specialised synovial joint

233
Q

what protein is produced by follicular cells in the thyroid gland

A

thyroglobulin

234
Q

what is found within the female urogenital triangle

A

The female urogenital triangle contains the mons pubis, labia majora and labia minora, the clitoris, and the vaginal and urethral orifices

235
Q

does the vagina pierce the superficial or deep perineal pouch

A

it pierced both of them

236
Q

where is the perineal body found in women

A

between the vagina and the anus

237
Q

what does the perineal body attach in women

A

the perineal muscles, the pubo-vaginalis, the bulbospongiosus and the superficial external anal sphincter

238
Q

what cell type produces growth hormone

A

somatotrophs

239
Q

what does growth hormone do in the body

A

causes skeletal growth, muscle strength, protein synthesis, glycogenolysis and lypolysis

240
Q

what inhibits growth hormone

A

somatostatin

241
Q

what are the contents of the pelvis

A

the small intestine, the sigmoid colon and rectum, the ureters and bladder, ovaries, fallopian tubes, ureters, vagina, vas deferens, seminal vesicles, prostate, lumbosacral trunk, obturator nerve, sympathetic trunk, sacral plexus, iliac arteries, gonadal and superior rectal arteries

242
Q

what structure suspends the penis from the pubic synthesis

A

the suspensory ligament of the penis

243
Q

what is the root of the penis

A

the bulb of the penis plus the right and left crura

244
Q

what does the crura become in the shaft of the penis

A

the corpora cavernosa

245
Q

what does the bulb of the penis become

A

the corpus spongiosum

246
Q

what is the corpus cavernosa surrounded by

A

tunica albunginea

247
Q

what is bucks fascia

A

it is the deep fascia of the penis

248
Q

what is the blood supply to the rectum

A

the superior, middle and inferior rectal arteries

  • superior from inferior mesenteric
  • other two from the internal iliac
249
Q

what is the nervous supply to the rectum

A

the hypogastric plexus and the pelvic splanchnic nerves

250
Q

what are the bones of the pelvis

A

ischium, iliac and pubic bone

251
Q

where do the bones of the pelvis join

A

they join at the acetabulum

252
Q

what are the layers of the scrotum

A

skin, superficial facia, external spermatic fascia, cremasteric fascia, internal spermatic facia and parietal layer of the tunica vaginalis

253
Q

what is the nervous and blood supply to the scrotum

A

the anterior and posterior scrotal arteries

the genitofemoral, ilioinguinal and the pudendal nerves

254
Q

what is the nervous supply to the bladder

A 
sympathetic = hypogastric (T12-T2)
parasympathetic = pelvic splanchnic nerve (S2-4) 
somatic = pudendal nerves
255
Q

where is the inguinal canal found

A

at the lower edge of the aponeurosis of the external oblique

256
Q

where is the inguinal ligament found

A

ASIS to the pubic tubercle

257
Q

what is found in the inguinal canal

A

spermatic cord, round ligament and genitofemoral nerve pass through DIR. Ilioinguinal nerve also found but doesnt pass through DIR

258
Q

in the urogenital triangle what does the deep perineal space contain

A

the deep transverse perineal muscles, the urethral sphincter, the membranous urethra, the bulbourethral glands, the pudendal vessels and the dorsal nerve of the penis

259
Q

what connects the pelvis to the uterus

A

the broad ligament

260
Q

what does the broad ligament contain

A

the ovarian and uterine arteries, the ovarian ligament and the round ligament of the uterus

261
Q

where is the function of the round ligament of the uterus

A

it connects the body of the uterus through the inguinal canal to the labia majora

262
Q

what vertebral level does the thyroid gland sit

A

C1-5

263
Q

what two muscle does the thymus sit inbetween

A

the sternohyoid and the sternothyroid

264
Q

what is the blood supply to the prostate

A

the inferior vesical and the middle rectal arteries

265
Q

what is the nervous supply to the prostate

A 
parasympathetic = pelvic splanchnic nerve 
sympathetic = hypogastric
266
Q

what are the nerves of the pelvis

A

the obturator, the sacral plexus, the sacral sympathetics, the inferior hypogastric plexus

267
Q

what is the function of the obturator nerve

A

supplies the abbductor compartments of the thigh and skin

268
Q

what is the function of the inferior hypogastric plexus

A

micturition, defaecation, erection, ejaculation and orgasm

269
Q

what is the perineal body

A

it is the midline fibromuscular tissue that splits the anal and urogenital triangles

270
Q

what attaches to the perineal body

A

the levator ani, bulbospongiosus, external anal sphincter, deep transverse perineal muscle

271
Q

what are the structures in the external female genitalia

A

mons pubis, labia majora, labia minora, clitoris, vestibule, bulb of vestibule, greater vestibular glands, vagina and urethral orifice

272
Q

what is the structure of the clitoris

A

there are two erectile crura attached to the perineal membrane

273
Q

what is the nervous supply of the female external genitalia

A

internal pudendal, ilioinguinal, labial branch of the pudendal nerve and the femoral cutaneous nerve

274
Q

what are the vessels of the pelvis

A

the main branch is the common iliac that divides into the internal and external iliac.
- this divides into the iliolumbar, the lateral sacra, the obturator, the superior and inferior gluteal, the superior and inferior vesical, the uterine, the vaginal and the middle rectal

275
Q

what is the perineum made up of

A

the anterior urogenital triangle and the posterior anal triangle

276
Q

what is found in the anal triangle

A

iscioanal fossae, anal canal, internal and external anal sphincters, anococcygeal ligament

277
Q

what separates the upper and lower sections of the anus

A

the dentate line

278
Q

what epithelia is found in the upper 2/3 of the anal canal

A

simple columnar

279
Q

what epithelia is found in the lower 1/3 of the anal canal

A

stratified squamous

280
Q

what is the nervous supply to the vagina

A 
upper = hypogastric 
lower = pudendal and ilioinguinal nerves
281
Q

what are the layers in the uterus lining

A

outer serosa, myometrium (smooth muscle) and endometrium

282
Q

what are the 4 sections of the male urethra

A

pre-prostatic, prostatic, membranous and spongy

283
Q

what attaches to the apex of the bladder to the umbilicus

A

the medial umbilical ligament

284
Q

what are the layers found in the bladder wall

A

the outer serosa, the detrusor muscles and a second circular smooth muscle layer

285
Q

what is the blood supply to the bulb and spongiosum of the penis

A

the bulbourethral artery

286
Q

what nerves supply the penis

A

The penis is supplied by S2-S4 spinal cord segments and spinal ganglia.
Sensory and sympathetic innervation to the skin and glans penis is supplied by the dorsal nerve of the penis, a branch of the pudendal nerve.
Parasympathetic innervation is carried by cavernous nerves from the peri-prostatic nerve plexus, and is responsible for the vascular changes which cause erection.

287
Q

what are the three layers of the vagina

A

the outer fibrous layer which attaches to pelvic viscera, the muscular layer (longitudinal and circular) and the internal surface of stratified squamous epithelia

288
Q

what are the sections of the uterine tube

A

infundibulum (fibrae found here), ampulla and isthmus

289
Q

where does the uterine artery come from

A

the internal iliac artery

290
Q

where do the ureters cross the pelvic brim

A

at the bifurcation of the common iliac vessels

291
Q

what is the ovarian blood supply

A

the ovarian artery, which is a branch of the abdominal aorta

292
Q

what is the nervous innervation of the ovaries

A

the ovarian plexus

293
Q

what are the layers of the spermatic cord

A

the external spermatic fascia (form external oblique), the cremasteric fascia (from internal oblique) and internal spermatic fascia (from transversalis)

294
Q

what are the contents of the spermatic cord

A

the vas deferens, the testicular artery the vas deferens artery, the cremasteric artery, the veins, lymphatics, genitofemoral nerves and sympathetics, processes vaginalis

295
Q

what are the boundaries of the inguinal canal

A 
anterior = external oblique aponeurosis 
floor = lower edge of inguinal ligament 
roof = lower edge of the internal oblique and transversus muscle 
posterior = conjoint tendon and transversalis fascia
296
Q

what makes up the lumbar plexus

A

L1-L4 spinal nerves

297
Q

what are the branches of the lumbar plexus

A

the lateral cutaneous nerve of the thigh, the femoral nerve, the genitofemoral nerve, the iliohipogastric and the obturator

298
Q

where is oxytocin made

A

in the paraventricular nucleus of the hypothalamus

299
Q

where is ADH made

A

the supraoptic nucleus of the hypothalamus

300
Q

what is the nervous supply to the internal and external sphincter of the rectum

A 
internal = smooth muscle and innervated by the hypogastric and pelvic plexus 
external = striated and under S4 voluntary control and the inferior rectal nerve
301
Q

what is the anatomical course of the spermatic cord

A

begins from the inferior abdomen and ends in the scrotum

302
Q

where is the spermatic cord formed

A

at the opening of the inguinal canal (deep inguinal ring)

303
Q

what are the blood vessels found within the spermatic cord

A

the testicular artery, the cremasteric artery and vein, the artery to the vas deferens and the testicular veins

304
Q

what are the nerves found within the spermatic cord

A

the genital branch of the genitofemoral nerve and the autonomic nerves

305
Q

what other structures (not nerves or vessels) are found in the spermatic cord

A

vas deferens, processus vaginalis and lymph vessels

306
Q

what is the Processus vaginalis

A

projection of peritoneum that forms the pathway of descent for testis during embryonic development

307
Q

what is the pampiniform plexus

A

network of veins responsible for venous drainage of the testes

308
Q

where do the right and left testicular veins drain into

A

right drains into the inferior vena cava, and the left into the left renal vein

309
Q

what do the walls of the vas deferens consist of

A 
inner = longitudinal smooth muscle 
intermediate = circular smooth muscle 
outer = longitudinal smooth muscle
310
Q

what do the walls of the vas deferens consist of

A 
inner = longitudinal smooth muscle 
intermediate = circular smooth muscle 
outer = longitudinal smooth muscle
311
Q

when do Leydig cells start producing testosterone

A

at week 8

312
Q

where is the bladder and the urethra derived from

A

Bladder and urethra ultimately derived from the cloaca (hindgut structure)

313
Q

what are the three divisions of the anterior urogenital sinus

A
  • Upper part forms bladder
  • Pelvic part forms urethra and some of the reproductive tract in females, the prostatic and membranous urethra in males
  • Phallic/caudal part forms part of the female reproductive tract and the spongy urethra in males
314
Q

what does the posterior urogenital sinus become

A

the anal canal

Jemima Flash Cards (9 decks)

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