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GSSE > KUB, pelvis and repro > Flashcards

KUB, pelvis and repro Flashcards

1
Q

how big is a normal kidney?

A

12 x 6 x 3

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2
Q

which kidney is lower?

A

the right is lower

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3
Q

the surface marking of the hilum of the kidney is ?

A

the transpyloric plane 5 cm from the midline

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4
Q

immediate posterior relation of the kidneys is? (4)

A

the costodiaphragmatic recess of the pleura
the ileohypogastric and ileoinjoinal nerves
psoas muscle
the subcostal artery nerve and vein after emerging through the lateral arcuate ligament

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5
Q

the shape of the right suprarenal gland is?

A

pyramidal

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6
Q

the location of the right suprarenal gland ?

A

upper pole of right kidney, behind the IVC and in front of the right crus of the diaphragm, and bare area of the liver

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7
Q

what shape is the left suprarenal gland?

A

cresentric shape

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8
Q

where can the left suprarenal gland be located

A

is applied to the medial border of the left kidney , above the hilum behind the peritoneum of the posterior wall of the lesser sac.

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9
Q

the transverslis fascia splits retroperitoneally into an anterior and posterior layer to form what?

A

gerotas fascia, ‘pre and retrorenal fascia’, fuses at the upper pole but ober inferiorly and medially.

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10
Q

how many minor calyces are there in a typical kidney ?

A

7-14

and 2- 3 major calyses

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11
Q

the anterior relations of the right kidney are (4)?

A

the right lobe of the liver, anteriroly
the hepatic flexure
the duodenum medially

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12
Q

what are the anterior relations of the left kidney ? (5)

A

tip of left lobe of liver anteriorly as well as fundus of stomach
tail of pancreas medially and anterirly
splenic flexure ant but infeorly
spleen laterally

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13
Q

how many degrees posterirly are the kidneys rotated ?

A

30 degrees

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14
Q

what are the names of the 4 anteriro renal arteries?

A

apical, upper, middle and lower (segmental branches) 70% f renal blodo flow

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15
Q

how many posterior segmental arteries are there in the kidney?

A

1

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16
Q

which is more anteriro? the renal artery or vein?

A

the vein

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17
Q

pus in the renal fascia can burst and track where?

A

retroperitoneally into the pelvis

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18
Q

how much blood does the kidney recieve every minute?

A

1L

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19
Q

the lymphatic drainage of the kidney is?

A

to the paraaortic nodes at the level of origin of the renal arteries. the surface fo the upper pole may drain through the diaphragm into nodes in the posterior mediastinum

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20
Q

how long is the ureter?

A

25 cm long

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21
Q

the 3 points of narrowing of the ureter are?

A

PUJ
crossign the pelvic rim
and the JUV termination in the bladder mucosa

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22
Q

on the psoas musle what is the orientation of these three structures? genitofemoral berve, ureter adn gonadal vessels.

A

the gonadal vessels are most anterior followed by the ureter then the genitofemoral nerve.
All under peritoneum
the root of the mesently ont he roght does cross it later downthe way

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23
Q

the left ureter is in what relation to the inferior mesenteric vessels?

A

to the left (lateral)

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24
Q

which vessel crosses the left ureter ?

And which part of the bowel just before entering the pelvis?

A

the left colic left lateral side

and the apex of the sigmoid

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25
Q

when does the ureter leave the psoas muscle?

A

at the bifurcation of the common iliac artery over the sacroiliac joint
on the left the apex of the sigmoid colon is the guide to then it eter the pelvis

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26
Q

the radiological marker of the ureter is the lumbar area is?

A

just medial to the tips of the transverse processes of the lumbar vertebrae

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27
Q

the blood supply to the ureter?

A

the upper end is supplied by the ureteric branch of the renal artery
the middle by gonadal and common iliac
and the lower end by branches from the inferior and superiro vesical and middle rectal arteries and uterine arteries.
all make anastomoses with eachother in the adventitia

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28
Q

the venous drainage of the ureter?

A

drains into the renal, gonadal and internal iliac veins.

29
Q

the nerve supply to the ureter is?

A

sympathetic supply from celiac and hypogastric plexi pain fibres, PNS also unsure of significance

30
Q

the transitional epithelium of the ureter is lined with muscularis mucosae (T/F?)

A

false

31
Q

the blood supply to the adrenal gland?

A

3 arteries.
superior: inferior phrenic
renal
aorta

  1. vein drains into renal vein on the left and IVC on the right.
32
Q

nerve supply to the adrenal glands

A

pre ganglionic myelinated from splanchnic nerves via the aortic and renal plexus, fibres synapse directly with the medullary cells. .
blood vessels have usual post ganglionic sympathetic supply although cortical contrl is not neural but by ACTH and the anterior pituitary.

33
Q

the layer beneath the connective tissue capsule around the adrenal gland is called?

A

the zona glomerulosa

34
Q

the second layer of the adrenal gland is called?

A

the zona fasiculata

35
Q

the innermost layer of the adrenal gland is called the?

A

zona reticularis

36
Q

what does the adrenal medulla secrete?

A

catecholamines: adrenaline 80% and noradrenaline (20%) and soem dopamine

37
Q

what is the embryological origin of the adrenal gland?KIB

A

the medulla is derived from the neural creat and is ectodermal and the cortex is derived in situ from the mesoderm of the intermediate cell mass.

38
Q

the emerging sacral nerves lie in what relation to the piriformis muscle in and out fo the pelvis?

A

int he pelvis the nerves are anterior to the pirifirmis, once throught the greater sciatic foramen you find the sciatic nerve under the piroformis

39
Q

the pubic muscle below piroformis is?

A

ischiococcygeus (also just known as coccygeus)

nerve supply is S4 and S5

40
Q

what are the two parts of levator ani?

A

ileococcygeus and pubococcogeus
their fibres run in continuity from the ischeal spine to the body of the pubis
they cross the obturator fascia

41
Q

what two muscles can be found in order lower than coccygeus? (ischiococcygeus)

A

ileococcygeus and pubococcygeus (levator ani muscles)

42
Q

what is the name of the muscle which is a U shaped sling which holds the anorectal junction angled forward ?

A

pubo rectalis

43
Q

what is the name of the muscle which is a U shaped sling passes behind the prostate and and into the perineal body?

A

levator prostate

in the woman levator vaginalis

44
Q

the pelvic floor is innervated by which nerves?

A

the perineal branche of S 3 and S4
S2 does the external sphincter not levator ani
S4 does not do the sphincter

45
Q

regarding the pelvic wall fascia, the vessesls and nerves are above or below the fascia?

A

nerve are above and vessels are in . the sacral plexus however is within the fascia between it and piriformis
the vessels to the buttock do have to pierce the fascia to get to the muscle.

46
Q

in the male the trigone overlies which part of the prostate?

A

the median lobe

47
Q

what is the blood supply to the bladder?

A

the sup adn inf vesicular arteries

smaller contributions from the obturator, inferior gluteal, uterine and vaginal arteries

48
Q

the venous drainage of the bladder?

A

the vesicoprostatic plexus, drains backwards towards the internal iliac

49
Q

the main motor innervation of the bladder is?

A

PNS: the pelvic sphlancic nerves

sympathetic fibres - superior hypogastric and pelvic plexus. comes from L1 and L2 segments (inhibitory)

50
Q

the innerveation of the internal schincger fo the bladder is?

A

sympathetic superior hypogastric and pelvic slexi L1 and L2

51
Q

sensation of bladder filling is via what nerves to what tract?

A

paraympathitic fibres and in the spinal cord along the gracile tract

52
Q

bladder pain is transmitted by what nerves adn what tract inthe spine?

A

PNS and SNS, spinothalamic tract.

53
Q

the histology of the bladder is?

A

MM is thick and lax, lined by transitional epithelium, no glands, mucus comes from urethral galnds, there is no muscularis mucosae

54
Q

the ureter runs over or under the iliac vessels?

A

over

55
Q

does the ureter run over or under the ovary?

A

under

56
Q

in the male the ductus differens crosses the ureter in what way?

A

superficially crosses then runs medial to it

57
Q

the upper end of the seminal vesicle is in what relation to the ureter?

A

lies just below where the ureter enters the bladder

58
Q

the uterine artery passes the ureter in what location?

A

the artery is superficial to the ureter.

59
Q

the ureter enters the bladder in the woman in what relation to the cervix?

A

penetrates the condensed tissue which is the cervical ligament , crossing the lateral vaginal fornix 1 - 2 cm away from the cervix before entering the bladder in front of the fornix.

60
Q

where can the prostatic plexus ov veins be located?

A

between the prostate capsule and the pelvic fascia

61
Q

the histology of the prostate can be discribes as?

A

fibromuscular stroma with acini glands , a mixture fo CT and smooth muscle , numerous small ducts open up intot he prostatic urethra.

62
Q

what is the prostate lobe anterior to the urethra called?

A

anterior lobe

63
Q

which lobe is lokely to enlarge and obstruct the urethra in BPH?

A

the middle lobe

64
Q

which lobes in the prostate are most susceptible to cancerous change?

A

the posterior and lateral lobes

65
Q

where do the ejaculatory ducts open?

A

on the urethral crest

66
Q

the blood supply to the prostate?

A

prostatic branch of the inferior vesical artery with some small branches from the middle rectal and internal pudendal vessels.

67
Q

the lymph drainage of the prostate?

A

to the internal iliac adn sacral plexus , some may reack external iliac.

68
Q

the nerve supply to the prostate?

A

the acini are under PNC cholinergic control but ejacultion is muscle fibres fromt he stroma contract to empty the glands during ejaculation which are SNS controlled (adrenergic controlled) from the inferior hypogastric plexus.

GSSE (9 decks)

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