Original Anatomy Flashcards
1
Q
What structures form the boundary of the femoral triangle?
A
1) Sartorius (laterally); 2) Adductor longus (medially); 3) Inguinal Ligament (superiorly); 4) Iliac and psoas (lateral floor); 5) Pectineus (medial floor)
2
Q
What is the mnemonic for the borders of the femoral triangle?
A
SAIL:
S - sartorius
A - adductor longus
I - inguinal…
L - ligament
3
Q
What forms the lateral border of the femoral triangle?
A
Sartorius
4
Q
What forms the medial border of the femoral triangle?
A
Adductor longus
5
Q
What forms the superior border of the femoral triangle?
A
Inguinal ligament
6
Q
What structures form the floor of the femoral triangle?
A
Iliac and psoas (lateral floor)
Pectineus (medial floor)
7
Q
What structures pass through the femoral triangle?
A
Femoral nerve, artery and vein
8
Q
Which nerve supplies gluteus maximus?
A
Inferior gluteal nerve
9
Q
What is the blood supply of gluteus maximus?
A
Superior and inferior gluteal artery
10
Q
What is the action of gluteus maximus?
A
Extension and external rotation of the hip
11
Q
What is the insertion of gluteus maximus?
A
Ischial tuberosity
Iliotibial band
12
Q
What is the origin of gluteus maximus?
A
Posterior gluteal line of inner upper ilium
Posterior surface of lower sacrum
Lumbodorsal fascia
Sacrotuberous ligament
13
Q
What structures form the rectus sheath?
A
Aponeuroses of external oblique, internal oblique and transversus abdominis
14
Q
Which is deeper, scarpa’s or camper’s fascia?
A
Scarpa’s
15
Q
What is the anatomy of rectus sheath above the arcuate line?
A
Anterior: Aponeurosis’s of external oblique, and anterior lamellae of the aponeurosis of internal oblique
Posterior: Posterior lamellae of the aponeurosis of internal oblique, and aponeurosis of transversalis fascia
16
Q
What is the anatomy of the rectus sheath below the arcuate line?
A
Aponeuroses of all 3 muscles (external oblique, internal oblique, transversus abdominis) pass anterior to the rectus sheath.
Rectus sheath in contact with transversalis fascia posteriorly
17
Q
What is the path of the ureters?
A
Infero-medially along psoas
Enter pelvis at bifurcation of common iliac vessels
Pass anterior to internal iliac artery
Crossed by the uterine artery
Enter bladder at ischial spines
Pierce cardinal and broad ligaments
18
Q
What does the right ovarian vein empty into?
A
IVC
19
Q
What does the left ovarian vein empty into?
A
Left renal vein
20
Q
What nerve supplies the clitoris?
A
Dorsal nerve, arising from the pudendal nerve
21
Q
Which artery supplies the foregut?
A
Coeliac trunk
22
Q
Which artery supplies the midgut?
A
Superior mesenteric
23
Q
Which artery supplies the hindgut?
A
Inferior mesenteric
24
Q
What are the branches of the coeliac trunk?
A
1) L gastric artery
2) Splenic artery
3) Common hepatic artery
25
What structures does the foregut form?
Mouth to the duodenum
26
At what level does the abdominal aorta bifurcate into the common iliac vessels?
L4
27
What are the terminal branches of the abdominal aorta?
Right common iliac
Left common iliac
Median sacral artery
28
What structures form the perineal body?
External anal sphincter
Transverse perineal muscles
Bulbocavernosus muscle
Levator ani muscle
29
What is the anatomical location of the deep inguinal ring?
Midpoint of the inguinal ligament
30
How is the midpoint of the inguinal ligament found?
Midpoint between ASIS and the pubic tubercle
31
What is the anatomical location of the superficial inguinal ring?
Just above and just lateral to the pubic tubercle
32
What passes through the inguinal canal in females?
Round ligament
33
What passes through the inguinal canal in males?
Spermatic cord
34
What structure passes through the superficial inguinal ring only, NOT the deep inguinal ring?
Ilioinguinal nerve
35
What are the boundaries of the inguinal canal?
Superior - internal oblique
Anterior - aponeurosis of external oblique
Inferior - inguinal ligament
Posterior - conjoint tendon and transversalis fascia
36
What is the anterior boundary of the inguinal canal?
Aponeurosis of external oblique
37
What is the posterior boundary of the inguinal canal?
Conjoint tendon and Transversalis fascia
38
What is the superior boundary of the inguinal canal?
Internal oblique
39
What is the inferior boundary of the inguinal canal?
Inguinal ligament
40
What does Hilton's line indicate?
White line that indicates the junction between non-keratinised stratified squamous epithelium and the keratinised stratified squamous epithelium
41
What does the pectinate line indicate?
The junction between the upper two-thirds of the lower one-third of the anus
Upper two thirds = cuboidal epithelium
Lower one third = stratified squamous epithelium (keratinised around the orifice)
42
How long is the anal canal?
3cm
43
What is the lymphatic drainage of the vagina? (Superior and Inferior, respectively)
Superior - external and internal iliac LN
Inferior = inguinal LNs
44
What is the transverse diameter of the pelvis?
13cm
45
How long are the ureters?
25cm
46
How do the ureters insert into the bladder?
Posterolaterally
47
Which arteries supply the ovary?
Ovarian and uterine arteries
48
What does POPQ (prolapse) score 1 mean?
>1cm above hymen
49
What does POPQ (prolapse) score 2 mean?
Within 1cm (distal or proximal) of hymen plane
50
What does POPQ (prolapse) score 3 mean?
>1cm below plane of hymen.
Protrudes <2cm less than length of vagina
51
What does POPQ (prolapse) score 4 mean?
Complete prolapse
52
What is the the Pelvic Organ Prolapse Quantification (POPQ) system of prolapse?
Grade 0-4
53
What is a Grade 0 prolapse?
No prolapse
54
What is a Grade 1 prolapse?
>1cm from hymen
55
What is a Grade 2 prolapse?
Within 1cm (proximal or distal) to the hymen
56
What is a Grade 3 prolapse?
>1cm below the plane of the hymen but protrudes < 2 cm less than the total length of the vagina
57
What is a Grade 4 prolapse?
Complete eversion of the vagina
58
What is the mediAL umbilical ligament a remnant of?
Remnant of fetal umbilical arteries
59
What is the mediAN umbilical ligament a remnant of?
Remnant of urachus
60
What are the 3 muscular components of levator ani?
1) Puborectalis
2) Pubococcygeus
3) Iliococcygeus muscle.
61
What innervates the testes?
T10 and spermatic plexus
62
What is the inferior border of the deep perineal pouch?
Perineal membrane
63
What is the superior border of the deep perineal pouch?
Superior fascia of the urogenital diaphragm
64
What separates the deep and superficial pouches?
Perineal membrane
65
What is the contents of the deep perineal pouch?
Deep transverse perineal muscle
External sphincter muscle of urethra:
Compressor Urethrae Muscle
Urethrovaginal Sphincter
Proximal portion of urethra
Male: Membranous portion of the urethra and bulbourethral gland
66
What are the layers of the bladder wall?
1) Mucosa
2) Submucosa
3) Detrusor
4) Adventitia
67
Is bladder voiding parasympathetic or sympathetic?
Parasympathetic - S2-S4
68
Is bladder storage parasympathetic or sympathetic?
Sympathetic - T10-L2
69
Where in the brain is the hypothalamus located?
Diencephalon
70
How many lobules are in each testis?
250-400
71
How many seminiferous tubules are found in each testis lobule?
1-3
72
Is contraction of the internal anal sphincter sympathetic or parasympathetic?
Sympathetic. Pelvic splanchnic nerves, S4
73
Is relaxation of the internal anal sphincter sympathetic or parasympathetic?
Parasympathetic. Pelvic splanchnic nerves, S4
74
How is the external anal sphincter innervated?
Inferior rectal branch of pudendal nerve
(and perineal branch of S4)
75
What is meralgia paraesthetica?
Entrapment of the lateral cutaneous nerve of the thigh
76
How are the ureters innervated?
T11-L2
77
What are the 3 layers of the ureter?
1) Adventitia
2) Smooth Muscle
3) Transitional Epithelium
78
How does the round ligament leave the pelvis?
Deep inguinal ring
79
What reinforces the inguinal canal posteriorly?
Conjoint tendon
80
What are the 3 cells types that make up the juxtaglomerular apparatus (JGA)?
1) Macula dense
2) Juxtaglomerular cells
3) Extraglomerular mesangial cells
81
What is the pelvic inlet angle?
60 degrees
82
Which vessels exit the pelvis via the greater sciatic foramen?
Superior gluteal artery
Inferior gluteal artery
Internal pudendal artery
83
Which vessel exits the pelvis via the greater foramen and then re-enters through the lesser sciatic foramen?
Internal pudendal artery
84
What causes entrapment of the femoral nerve in pregnancy?
Fetal pressure in a difficult birth
85
What are the consequences of femoral nerve entrapment?
Sensory loss to the anterior thigh and knee
Quariceps weakness, loss of knee jerk
86
What causes entrapment of the lateral femoral cutaneous in pregnancy?
Pregnancy (in general)
87
What are the consequences of lateral femoral cutaneous nerve entrapment?
Sensory loss to the lateral thigh
88
What causes entrapment of the common peroneal nerve nerve in pregnancy?
Due to compression to the lateral head of fibula - occurs in leg bars
89
What are the consequences of common peroneal nerve nerve entrapment?
Sensory loss to the foot and anterolateral leg
Foot-drop
90
What causes entrapment of the obturator nerve in pregnancy?
Compression between the head of the fetus and the bony structures of the pelvis
91
What are the consequences of obturator nerve entrapment?
Sensory loss to the upper medial thigh
Weakness to leg adduction
92
What separates the true and false pelvis?
Pelvic brim
93
What divides the pelvis into anterior and posterior compartments?
Vagina
94
How many lobules in each testes?
250-400
95
Which ligaments attach the vagina and cervix to the pelvic wall?
Cardinal and uterosacral ligaments
96
What are the layers of detrusor?
Inner and outer layers of longitudinal smooth muscle with a middle circular smooth muscle layer
97
What is the contents of the superficial perineal pouch?
Ischiocavernosus muscle
Bulbospongiosus muscle
Superficial transverse perineal muscle
Crura of penis (males) / Crura of clitoris (females)
Bulb of penis (males) / Vestibular bulbs (females)
Greater vestibular glands (female)
98
What in another name for the conjoint tendon which reinforces the superficial inguinal ring posteriorly?
Falx inguinalis
99
If a urethra ruptures due to vigerous inflation of an incorrectly placed catheter, what space would the urine leak into?
Anterior abdominal wall and mons pubis
100
What are the 3 important branches of the pudendal nerve?
Perineal nerve
Dorsal clitoral nerve
Inferior rectal nerve
101
What are the nerve root origins of the inferior hypogastric plexus?
T10-12, L1-2
102
What are the superficial muscles of the perineum?
Bulbospongiosus
Superficial transverse perineal muscle
Ischiocavernous
103
What is the nerve supply of the bladder?
Sympathetic - T10-L2
Parasympathetic - S2-S4
104
Which artery supplies the ureter?
Inferior vesical artery
105
What cells are located outside the blood-testis barrier?
Leydig
106
What type of cells are Sertoli cells?
Tall columnar
107
What is the size of a resting follicle?
0.02mm
108
What is the size of a follicle ready to ovulate?
20mm
109
What is the main muscle being tested during urodynamic testing?
Detrusor
110
Which type of injury is reduced in frequency by open (Hasson) technique compared to closed (Verress needle) technique in laparoscopic surgery?
Major vessel injury
111
What muscles make up the pelvic floor?
Levator ani and coccygeus
112
The inferior epigastric artery is a branch of what artery?
External iliac artery
113
The pudendal nerve is derived from what spinal segments?
S2-S4
114
What artery is contained within the infundibulopelvic (aka suspensory) ligament?
Ovarian artery
115
How many lobules does each breast contain?
20
116
What type of joint is the symphysis pubis?
Cartilagenous (secondary)
117
What brings about the closure of the ductus arteriosus following lung inflation?
Bradykinin
118
What is the arrangement of axial filaments in a sperm?
9+2
119
What is the contents of the femoral triangle?
Femoral nerve
Femoral sheath:
- Femoral artery
- Femoral vein & sapheno-femoral junction
- Canal
Deep inguinal LN and lymphatic vessels
120
How long is the female urethra?
4cm
121
How long is the male urethra?
15-29cm
122
What is the normal bladder capacity?
400-600ml
123
At what bladder volume does the urge to void occur?
150ml
124
What makes up the roof of the femoral triangle?
Fascia lata
125
How much cooler is the scrotum compared to core body temperature?
2-2.5 degrees cooler
126
What is the arterial supply of the bladder?
Superior vesical artery
Vaginal artery
Minor branches Gluteal & Obturator arteries
127
What is the venous return from the bladder?
Vesicle venous plexus
128
From what points on the chest wall does the base of the breasts extend?
2nd rib to 6th rib
129
How many lobules in each breast?
20, each of which contain and lactiferous duct
130
What is the purpose of the areolar glands of the breast?
Secretion of an oily protective lubricant
131
What separates the lobules of the breast from one another?
Suspensory ligaments, extending from the deep fascia of pec major to the dermis of the skin
132
What is the blood supply to the breast?
The lateral or medial mammary branches:
- Axillary A --> lateral thoracic A --> Lateral mammary
- Posterior intercostal A --> lateral cutaneous --> lateral mammary
- Subclavian A --> internal thoracic A --> medial mammary
133
Which structures pass through the diaphragm?
Azygous vein
IVC
Oesophagus
Thoracic duct (lymph)
Aorta
Phrenic nerve
134
At what level does the IVC and phrenic nerve pass through the diaphragm?
T8
135
At what level does the oesophagus pass though the diaphragm?
T10
136
At what level does the aorta, thoracic duct and azygous vein pass through the diaphragm?
T12
137
What is the nerve root of the ilioinguinal nerve?
L1
138
Describe an anthropoid pelvis:
Ape like, AP diameter long, transverse diameter short
139
Describe a platypelloid pelvis:
Flat female type
140
Describe an android pelvis:
Male type, pelvic inlet triangular or heart shaped
141
Describe a gynaecoid pelvis:
Normal female type. Suprapubic angle 90-100 degrees
142
What is the suprapubic angle of a normal gynaecoid pelvis?
90-100 degrees
143
What nerve is pyramidalis supplied by?
Subcostal nerve, a branch of T12
144
What proportion of the population HAS pyramidalis?
80%
145
What muscles allow flexion of the hip joint?
Iliacus, psoas
146
Which muscles forms part of the inguinal ligament?
External oblique
147
What is the terminal branch of the internal thoracic artery?
Superior epigastric artery
148
What are the three branches of the posterior division of the internal iliac artery?
1. Superior gluteal artery
2. Lateral sacral artery
3. Iliolumbar artery
149
What are the nerve root/s of the lateral cutaneous nerve of the thigh (entrapment of which causes meralgia parasthetica)?
L2-L3
150
What is the contents of the ischiorectal fossa?
1. Inferior rectal nerve and vessels
2. Pudendal canal and its contents
3. Fat pad
4. Perforating cutaneous branch of S2 and S3
5. Perineal branch of S4
6. Labial nerve and vein
151
What is the contents of the pudendal canal?
1. Internal pudendal artery
2. Internal pudendal veins
3. Pudendal nerve
152
What is another name for the pudendal canal?
Alcock's canal
153
What does the pectinate line embryologically represent?
The junction between the hindgut and the protodeum
154
Where would you find the pudendal canal (for the sake of delivering a pudendal block)?
Lateral wall of the ischiorectal fossa, above the sacrotuberous ligament
155
What is the arterial and nerve supply of rectus abdominis
Inferior epigastric artery, T7-T12
156
What is a glucagonoma?
A tumour of the alpha cells of the pancreas, resulting in hyperglycaemia
157
Which prostanoid inhibits platelet aggregation?
PG12
158
From what is the prostate derived embryologically?
Urogenital sinus
159
What are the umbilical vessels contained within in the umbilical cord?
Wharton's jelly
160
What is the mean length/width of the umbilical cord?
Length - 50cm
Width - 2cm
161
What is velamentous cord insertion associated with?
Vasa praevia
162
What is the contents of the umbilical cord?
x2 arteries - umbilical arteries derived from the internal iliac artery
x1 vein - umbilical vein which drains (in the majority) to the IVC via the ductus venosus - 80%, and then 20% into the hepatic vein
163
What proportion of umbilical cords have only one artery?
1%
164
In the perineum what dose the deep scarpa's fascia become?
Colles' fascia
165
What is the origin and insertion of rectus abdominis?
Origin - 5th-7th costal cartilages
Insertion - pubic crest
166
What is the origin and insertion of external oblique?
Origin - Lower 8 ribs
Insertion - pubic crest, xiphoid, linea alba, pubic tubercle, iliac crest
167
What is the origin, insertion and innervation of the internal oblique?
Origin - lumbar fasciae, iliac crest, inguinal ligament
Insertion - lower 6 costal cartilages, linea alba, pubic crest
Innervation - T7-T12
168
What is the origin, insertion and innervation of transversus abdominis?
Origin - lower 6 costal cartilages, lumbar fasciae, iliac crest, inguinal ligament
Insertion - lina alba, pubic crest
Innervation - T7-T12
169
How long is the inguinal canal?
3.8cm
170
What are the characteristics of the internal and external inguinal ring?
Internal ring = lies in the transversalis fascia
External ring = in external oblique aponeurosis, v-shaped
171
What makes up the conjoint tendon?
Internal oblique and transversus abdominis
Inserts into the pubic crest and pectineal line
172
What is the contents of the spermatic cord?
Arteries - testicular, vas, cremasteric
Nerves - ilioinguinal, cremasteric, sympathetic
Other - vas deferens, lymphatics, pampiniform plexus of veins
173
What does adductors canal contain?
Femoral vessels
Saphenous nerve
174
What is the usual site of a direct inguinal hernia?
Hasselbach's triangle
175
What is the epiploic foramen/foramen of Winslow?
Entrance to the lesser omental sac
176
What type of joint is symphysis pubis?
Cartilagenous joint
177
What are the boundaries of the pelvic outlet?
Pubic symphysis
Ischial tuberosities
Sacrotuberous/sacrospinous ligament
Coccyx
178
What is the spinal level of the dimples just above the buttocks?
S2
179
What are the boundaries of the greater sciatic foramen?
SUPERIOR - sacroiliac ligament
POSTEROMEDIAL - sacrotuberous ligament
INFERIOR - sacrospinous ligament
ANTEROLATERAL = greater sciatic notch
(from top going clockwise)
180
What are the boundaries of the lesser sciatic foramen?
ANTERIOR - ischial tuberosity
LATERAL - lesser sciatic notch
POSTERIOR - sacrotuberous ligament
SUPERIOR - sacrospinous ligament
181
What are the measurements of the pelvic inlet?
Transverse - 12.7
Oblique - 11.5
Anteroposterior - 10
182
What are the measurements of the pelvic outlet?
Transverse - 10
Oblique - 11.5
Anteroposterior - 12.7
183
What pierces the cardinal ligaments?
Ureters
184
What are the branches of the coeliac trunk?
Left gastric artery
Splenic artery - short gastric artery, left gastroepiploic artery
Hepatic artery - right gastric artery, cystic artery, gastroduodenal artery
185
Which kidney is lower than the other?
R kidney = lower
186
How long are the ureters?
25.4cm
187
What structures cross the ureters?
Ovarian/testicular vessels
On the right, colic vessels and ileocolic vessels
On the left , colic vessels
Uterine vessels
188
What are the common sites of urethral injury in surgery?
Lateral to the uterine vessel
In the tunnel of the cardinal ligament
Base of the infundibulopelvic ligament
Lateral pelvic wall
189
What is appendix testes a remnant of?
The paramesonephric duct
190
What is the appendix epididymis a remnant of?
The mesonephric duct
191
What are arbour vitae?
Folds of endothelium in the vagina
192
Where are Doderlein's bacilli found?
The vagina, converting glycogen to lactic acid
193
What is the degree of flexion of the uterus (anteflexion/retroflexion)?
Flexion at the level of the internal os, usually 170 degrees
axes = line of : uterine body / cervix
compare with version
vagina / cervix (90 degrees)
194
What is the degree of version (anteversion/retroversion) of the uterus?
Version in axis of cervix on vagina, usually 90 degrees
195
From when can Braxton-Hicks contractions occur?
Week 8
196
What is the uterine pressure required to cause cervical dilatation?
25mmHg
197
How long are the fallopian tubes?
10cm
198
What are the uterine ligaments?
Broad ligament
Round ligament - cornua to labia majora
Cardinal ligament - cervix to lateral wall of pelvis
Uterosacral ligament - cervic to sacrum
Pubocervical ligament - cervix to pubic bone
199
What are the layers of the ovary?
Germinal epithelium
Tunica albuginia
Cortex - containing ovarian follicles
Medulla - containing ovarian vessels
200
What are the ovarian support ligaments?
Infundibulopelvic (suspensory) ligament
Broad ligament
Ovarian ligament
201
What is the nerve supply of the ovary?
T10
202
What is another name for the ovarian fossa?
Waldeyer's fossa
203
What are the boundaries of the ovarian fossa?
Superior - External iliac vessel
Posterior - Internal iliac vessels, ureter
Anterior - Obliterated umbilical artery
204
What are the ligaments of Cooper of the breast?
Separate the lobules of the breast
205
What are the Glands of Montgomery of the breast?
Lubrication of the areola
206
What is the nerve supply of the breast?
T4-T6
207
What is the nerve supply of the nipple?
T4
208
How many fetal fontanelles are there?
6
209
When does the anterior (Bregma) fontanelle close?
Closes at 18 months
210
When does the posterior fontanelle close?
Closes at 2 years
211
What are the following diameters of the fetal skull: Biparietal and Bitemporal
Biparietal - 9.5cm
Bitemporal - 8.5cm
212
What is the ideal birthing presentation and posistion?
Vertex, OA
213
Which two nerves provide the primary cutaneous sensory innervation to the labia majora?
Ilioinguinal and pudendal
214
Which part of the kidney does the juxtaglomerular apparatus sit in?
Renal cortex
215
In the male urethra which is the narrowest part?
Membranous urethra
216
What is the mnemonic for bladder innervation?
Storage is Sympathetic
Peeing is Parasympathetic
217
Where are the proximal and distal centriole located in a spermatozoa?
Neck
218
Why can a karyotype not be gained from RBCs?
Because they don't have a nucleus
219
What is the contents of the femoral ring?
Cloquet's node and lymphatics
220
What are the boundaries of the femoral ring?
ANTERIOR - inguinal ligament
MEDIAL - lacunar ligament
LATERAL - medial border of femoral vein
POSTERIOR - pectineal ligament and pectineus muscle
221
What nerve root mediates the cremasteric reflex?
L1
222
What nerve root mediates the abdominal reflex?
T7-T12
223
What is the embryological origin of the thymus?
Endoderm of the third pharyngeal pouch.
224
What is the dermatomal level of the anus?
S5
225
What is the blood supply to the lateral surface of the brain?
Middle cerebral artery
226
What is the blood supply to the anterior and superior surface of the brain?
Anterior cerebral artery
227
What are the branches of the superior mesenteric artery?
Intestinal arteries
(i.e.ileocolic)
Middle colic and
Right colic
228
What is the average length of a newborn int he UK?
50cm
229
What is the umbilical artery a branch of?
Internal iliac artery
230
What does the inguinal canal contain in women?
Round ligament
Ilioinguinal nerve
231
What is the position of the deep inguinal ring?
Midway between the ASIS and the symphysis pubis, and about 1.25 cm superior to the midpoint of the inguinal ligament
232
What is the position of the superficial inguinal ring?
Just above lateral to the pubic tubercle
233
What are the nerve roots of obturator nerve?
L2-L4
234
On which side is hydroureter and hydronephrosis seen in pregnancy?
Right
235
Does urinary protein excretion decrease or increase in pregnancy?
Increase
236
Why do triglyceride levels increase in pregnancy?
The increase in triglycerides results from increased hepatic lipase activity and decreased lipoprotein lipase activity
237
How does pregnancy influence lipolysis?
Insulin resistance and the relative hypoglycaemia in pregnancy leads to increased lipolysis
238
What best describes glycogen storage and glucose utilisation in pregnancy?
There is increased glycogen storage and increased utilisation of peripheral glucose
239
What is the daily calcium requirement of the fetus?
200mg
240
What changes occur int he diaphragm and thorax of the fetus?
The diaphragm is elevated and the thoracic diameter is increased
241
Which hormone is responsible for the initiation and progression of puberty?
Leptin
242
Which paired structures contain the uterine arteries and veins?
Cardinal ligaments
243
What does oxytocin have a similar structure to?
ADH
244
How do total cholesterol and triglyceride levels change during pregnancy?
Increased total cholesterol and triglyceride levels
245
How does the fallopian tube propel the ovum along it?
Peristalsis of the tube AND cilia
246
Where is the muscular layer found in the fallopian tube?
Isthmus
247
What is the lymphatic drainage of the cervix?
External iliac nodes
Para-aortic nodes
248
Are the ovary and fallopian tube covered by peritoneum?
Ovary ISN'T
Fallopian tube IS covered by peritoneum (mostly)
249
What is the spinal level of the umbilicus, and then what is its dermatomal level
Spinal level = L3-L5 (varies)
Dermatomal level = T10
250
Where may the thyroid gland have an accessory lobe?
Tongue
251
How much does the accessory lobe weigh?
25g
252
From what does the thyroid gland develop?
The thyroid gland develops from the endoderm between the first and second pharyngeal pouches
253
Describe the epidural space:
Starts at foramen magnum, ends at S2, and is triangular in shape
254
What does the epidural space contain?
1. Fat
2. Epidural veins (Batson's plexus)
3. Small arteries
4. Lymphatics
5. Spinal nerve roots
255
How long is the rectum?
10-15cm
256
Where does the lymph from the medial side of the breast drain?
Parasternal lymph nodes (the rest drains the axillary nodes)
257
What is the innervation of the diaphragm?
C3, C4, C5
258
How does the thyroid gland internalise iodine?
Active transport
259
From what does the diaphragm develop?
It develops mainly from septum transversum (central tendon) and cervical myotomes (muscular component)
260
What are the branches of the anterior trunk of the internal iliac artery?
Obturator artery
Superior vesicle (umbilical) artery
Uterine artery
Vaginal artery
Inferior vesical artery
Middle rectal artery
(Internal) pudendal artery - Inferior rectal artery
261
What are the branches of the posterior trunk of the internal iliac artery?
Iliolumbar artery
Lateral sacral arteries
Superior gluteal artery
262
What is the cervix made up of?
Fibrous and elastic tissue
263
Where may pain from an ovarian tumour be referred to and why?
The ureter descends in the posterior boundary of the fossa while the obturator nerve and vessels cross its floor. Therefore, ovarian disease which involves the parietal peritoneum at this site may produce pain referred via the nerve to the medial side of the thigh
264
What are the branches of the femoral artery?
1. Descending genicular artery
2. Profunda femoris
3. Superficial and deep external pudendal artery
4. Superficial epigastric
5. Superficial circumflex iliac arteries
265
Which set of lymph nodes does the rectum drain to?
Internal iliac
266
What are the groups of axillary lymph nodes? And to which group does the majority of lymph drain initially?
Apical
Central
Subscapular
Pectoral - where the majority of lymph drains initially
Lateral
267
Where is the majority of glucose reabsorbed?
PCT
268
Where do the lymph nodes of the vulva drain?
Superficial inguinal nodes
269
What are the different types of ossification, and where do they take place?
1. Intramembranous ossification - the skull cranial vault (which encloses the brain)
2. Endochondral ossification - bones of the base of the skull
270
In whom are primary cartilaginous joints seen?
Children ONLY. All cartilaginous joints in adults are SECONDARY
271
What are the 6 layers of the testis from outside to inside?
(apart from skin)
Dartos muscle
Fascia layer
Tunica vaginalis (parietal)
Tunica vaginalis (visceral)
Tunica albuginea
Tunica vascularis
272
What 3 nerves innervate levator ani? What nerve root?
Pudendal nerve
Perineal nerve
Inferior rectal nerve.
These nerves arise from S3/S4 spinal nerves (mainly S4).
273
What LN do the ovaries and Fallopian tubes drain to?
The para-aortic nodes
274
What LN does the body of the uterus drain to
Internal Iliac
275
What lymph nodes do the fundus of the uterus drain to?
Para-aortic LN
Lumbar LN
Superficial inguinal LN
276
What is the lymph drainage of the bladder?
Internal Iliac nodes
External Iliac nodes
Common Iliac nodes
277
What is the blood supply of the:
Rectum upper 2/3
Rectum lower 1/3
Anal canal
Rectum upper 2/3 - Superior rectal (IMA)
Rectum lower 1/3 - Middle rectal (int. iliac)
Anal canal - Inferior rectal (int. pudendal)
278
What vein does the inferior mesenteric vein (IMV) drain into?
The splenic vein
279
What is the arterial supply of the scrotum?
anterior scrotal (external pudendal)
posterior scrotal (internal pudendal)
280
What is the innervation of the scrotum?
Posterior and anterior scrotal nerves
Genitofemoral nerve
Posterior femoral cutaneous nerve
281
What is the arterial supply of the testicle?
Testicular Arteries
Cremasteric Artery
Artery to Vas Deferens
282
How is the testicle innervated - plexus and spinal segment?
Spermatic plexus
T10 spinal segment
283
How is the internal anal sphincter innervated?
Pelvic splanchnic nerves (S4)
284
What is the innervation (trunks) of the
Foregut
Midgut
Hindgut
Foregut: T5-T9
Midgut: T10 & T11
Hindgut: T12 & L1
285
What *dermatomes* are related to labour pain?
First stage: T10, T11, T12, L1
(hypogastric/pelvic plexus)
Second stage: S2, S3, S4 (pudendal nerve)
286
Nerves of the Lumbar Plexus
Ileohypogastric (T12, L1)
Ileoinguinal (L1) --> ant labial nerve
Genitofemoral (L1, L2)
Lateral femoral cutaneous (L2, L3)
Femoral (L2, L4)
Obturator (L2, L4)
