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ENDO I exam 2 > Ketchum- Urinary tract and rectum (part of compartmentalization lecture) > Flashcards

Ketchum- Urinary tract and rectum (part of compartmentalization lecture) Flashcards

1
Q

What are the 4 surfaces of the bladder

A

superior, inferolateral (2)

inferoposterior (base of bladder)

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2
Q

where is the apex of bladder and what arises

A

apex is the junction of inferolateral and superior surfaces

the median umbilical ligament arises here

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3
Q

Where do the ureters enter the bladder

A

superior-lateral angles

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4
Q

Where is the neck of bladder and what does it surround

A

junction of inferolateral and inferoposterior surfaces

surround internal urethral opening

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5
Q

what separates bladder form pelvic contents

A

prevesical fascial space

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6
Q

What are the structures of the bladder

A

smooth m wall
submucosal layer with loose areolar tissue
mucous membrane of transitional epithelium
and the trigone

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7
Q

Where is the ducturs deferens in relation to ureter

A

anterior

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8
Q

What is the trigone of bladder

A

area between orifices of ureters superiorly and internal urethral orifice inferiorly
superior border marked by ureteric fold
inferior border marked by uvula at urethral orifice
trigonal mm smooth

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9
Q

What type of inn does trigonal m of bladder receive?

A

SAN

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10
Q

What is the major aa supply to bladder

A

superior vesical aa from umbilical

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11
Q

what aa supply bladder

A

superior vescial
vesiculodeferential aa (middle vesicle)
inferior vesical

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12
Q

what is the male homologue of uterine a

A

vesiculodeterential a

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13
Q

Where is the venous drainage from bladder

A

dense venous plexus at base and neck
prostatic in male
vesico-vaginal in female
drains into internal iliac v

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14
Q

Where do the ureters run with regards to iliac vessels

A

anteriorly

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15
Q

how is there no backflow in ureters

A

remain in wall of bladder about 2 cm before opening so when bladder contracts the ureters close by compression

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16
Q

what aa supply the pelvic ureters

A

common iliac a, internal iliac, vasiculodeferential ( uterine or inferior vesicle)

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17
Q

what are the 4 parts of the male urethra

A

intramural, prostatic, membranous and cavernous

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18
Q

Where is the prostatic urethra

A

from internal urethral orifice through prostate gland

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19
Q

where is the membranous urethra in male

A

through UG diaphragm surrounded by sphincter urethrae m

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20
Q

where is the cavernous urethra in male

A

from inferior surface of UG thorugh spongy body of penis

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21
Q

Where are the dilations in the cavernous urethra in male

A

within bulb(bulbar) and within glans (fossa navicularis)

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22
Q

what is the least extensible portion of urethra

A

the external orifice

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23
Q

what 2 glands open into cavernous urethra

A

bulbourethral gland and urethral gland

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24
Q

What are the portions of the female urethra

A

superior and membranous

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25
Q

what surrounds superior urethra in female and therse are homolog to what

A

urethral glands homologs to prostate glands

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26
Q

which part of female ureter pierces UG diaphragm

A

membranous

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27
Q

What type of inn does the detrusor mm receive

A

PAN

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28
Q

where does the rectum originate, what level

A

3rd sacral vertebra

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29
Q

what 2 morphological features distinguish rectum from sigmoid colon

A

rectum has no mesocolon (retroperitoneal)

teniae coli spread out as longitudinal mm surrounding rectum

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30
Q

where is the perineal flexure

A

sharp inferior posterior angulation near anal orifice

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31
Q

The curvatures of rectum divide it into what two portions

A

rectum proper and anal canal

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32
Q

what is the ampulla of rectum

A

dilated caudal portion of rectum proper

33
Q

describe anatomical and clinical anal canal

A

anatomical- from level of upper surface pelvic diaphragm to anus (1-1.5 in)
clinical- from pectinate line to anal verge (.5 in)

34
Q

what are the palpable structures in the male rectovesical pouch

A 
posterior surface of bladder
seminal vesicles
distal vas deferens
prostate
sacrum, coccyx and ischial spines
35
Q

what are the contents of the female rectouterine pouch

A

cervix, vagina and sacrum, coccyx ischial spines

36
Q

Describe mm of rectum

A

outer longitudinal mm (blend with fibers of levator ani)

inner circular mm( thickened to form internal sphincter

37
Q

what are the plica transversales

A

transverse rectal folds

semilunar folds of mucosa, submucosa and circular m

38
Q

How many folds are there in rectum

A

3: 2 on left and 1 on right

39
Q

what are the rectal columns

A

mucous membrane over submucosal aa and vv

40
Q

What are the anal valves

A

arch like folds of mucous membrane connecting caudal ends or rectal columns

41
Q

What do the anal valves cover

A

anal sinuses which may be opnening for anal ducts arising from anal glands

42
Q

what is the pectinate line

A

irregular circumferential line formed by anal valves and base of rectal columns

43
Q

what does the pectinate line demarcate for vv, nn, epithelium and lymph

A

vv: superior drains to middle and superior rectal
inferior drains to inferior rectal
nn: superior is autonomic
inferior is somatic
lymph: superior to pelvic nodes
inferior to inguinal nodes
epithelium is typical above and stratified squamous below

44
Q

What is the pecten of rectum

A

area immediately below pectinate line

characterized by lots of CT blue/white appearance

45
Q

What is the anal verge

A

caudal portion of anal canal with sweat glands and hair follicles

46
Q

What aa supply rectum

A

superior rectal, middle rectal and inferior rectal

47
Q

Where do superior rectal aa come from

A

inferior mesenteric a
divides into R and L
DOES NOT supply upper 1/5 1/4 rectum

48
Q

Where do middle rectal comr from

A

internal iliac or other pelvic aa

49
Q

where do inferior rectal come from

A

internal pudendal aa, supply external anal sphincter and perianal portion of levator ani m

50
Q

What drains the rectum

A

submucosal plexus superior rectal v above line, inferior rectal v below
perimuscular plexus to middle rectal v

51
Q

Which vessels in pelvis are not derived from internal iliac a and v

A

middle sacral, superior rectal and obturator aa

52
Q

Which branch of common iliac a is smaller

A

internal

53
Q

What is the internal iliac split into

A

anterior and posterior trunks

54
Q

What aa come off posterior trunk of internal iliac

A

iliolumbar

lateral sacral and superior gluteal

55
Q

what does iliolumbar turn into and supply

A

iliac branch supplies iliacus m

lubar branch supplies psoas and quadratus lumborum

56
Q

what do the lateral sacral aa supply

A

structures of vertebral canal, skin an mm over dorsum of sacrum
anastomoses with branches of superior gluteal a

57
Q

what are the 2 paths of lateral sacral a

A

first enters anterior sacral foramen

second descendes along sacrum medial to anterior foraminae

58
Q

Where does superior gluteal a leave pelvis and what does it supply

A

leaves thru greater sciatic foramen above piriformis
sometimes divides into superior gluteal and inferior gluteal a
may give rise to obturator a

59
Q

What branches come off anterior trunk of internal iliac a

A 
umbilical (superior vesical)
middle rectal
inferior rectal
obturator a
internal pudendal a
inferior gluteal a
uterine and vaginal aa
vesiculodeferential a
60
Q

Where does the middle sacral a originate from

A

aorta along anterior surface of sacrum

61
Q

Where does the superior rectal a branch from

A

inferior mesenteric

62
Q

Describe venous drainage of pelvis

A

internal iliac and iliolumbar v

63
Q

What are the cruciate anastomosis in pelvic viscera

A

gluteal aa to perforating branch of profunda femoris a

64
Q

what does obturator a anastomose with

A

medial femoral circumflex

65
Q

what does iliac branch of iliolumbar anastomose with

A

deep circumflex a

66
Q

what do the lumbar branches of iliolumbar anastomose with

A

lumbar branches of aorta

67
Q

what do the internal pudendal aa anastamose with

A

external pudendal a

68
Q

what do the lateral sacral aa anastomose with

A

middle sacral a

69
Q

what do the superior recta a anastomose with

A

middle and inferior rectal a

70
Q

What nn are in the lumbar plexus

A

ventral rami of T12-L5
formed in substance of psoas major
both ant and post leave pelvis on anterior aspect of thigh

71
Q

what nn are in the sacral plexus

A

ventral rami of S1-S3
formed within pelvis on anterior surface and lateral borders of sacrum
both ant and post leave pelvis posteriorly entering buttocks

72
Q

What do the ant divisions of lumbosacral plexus inn

post divisions?

A

ant: original flexor mm
post: original extensor

73
Q

What are the anterior branches of lumbar plexus

A 
iliohypogastric
ilioinguinal
genitofemoral
obturator
L4 contribution to sacral plexus
74
Q

what are the posterior branches of lumbar plexus

A

lateral femoral cutaneous
femoral
accessory obturator

75
Q

What 3 main nn come from ant division lumbosacral plexus

A 
obturator n
medial plantar (tibial)
lateral planta (tibial)
76
Q

What 2 main nn come from post division lumbosacral plexus

A

femoral

common fibular

77
Q

What are the nn that come from ant division sacral plexus

A

tibial portion sciatic
n to quadratus femoris
n to obturator internus
pudendal n

78
Q

what nn come from post division of sacral plexus

A 
superior gluteal
inferior gluteal
common peroneal portion of sciatic
n to piriformis
posterior femoral cuteaneous

ENDO I exam 2 (11 decks)

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