other Flashcards
prostate secretions
- proteolytic enzymes
- PAP
- β-microseminoprotein
- PSA
- zinc
ejaculatory ducts?
formed by the union of the vas deferens with the duct of the seminal vesicle –> pass through the prostate, and open into the urethra at the Colliculus seminalis.
Ampulla of vans deferens
enlargement of the vas deferens at the fundus of the bladder.
seminal vesicle
pair of glands which open into the vas deferens near to its junction with the urethra (before prostate) and secrete many of the components of semen
failure of processus vaginalis to close –>
- indirect inguinal
2. hydrocele
fate of vitelline duct
obliteration at 7 weeks
Urachus - everything
in 3rd week the yolk sac forms the allantois –> extentds into urogenital sinus –> Allantois becomes the urachus, a duct between fetal bladder and umbilicus
Amniotic band syndrome?
congenital disorder caused by entrapment of fetal parts (usually a limb or digits) in fibrous amniotic bands while in utero.
position of uterus
50% –> anterverted
25% retroverted
25% midverted
due to uterosacral ligament –> loss of the ligament –> prolapse into vagina
fructose rich compoment of sperm, and area
area of Bulbourethral gland of Cowper
seminal vesicle (posteriolateral of bladder) seminal vesicle in ductus deferans (behind bladder) --> ejaculation duct cowper: junction between membranous + boublous urethra
epistomy - definition + types
it is an incision of the posterior wall of the vagina during labor:
- medline: extend posteriorly in the midline throught perineal body but not to the external anal sphincter (vertical)
- mediolateral: extend througth the bulbospongiosus + transcerus perineus muscle (less risk of damage fibers of external anal sphincter)
branches of internal iliac artery
- pelvic visceral branches: umbilical ar, uterine ar, ductus deferens, vaginal art, inferior vesical ar, middle rectal ar
- perineal branches: internal pubendal –> inf rectal, perineal branch, artery to bulb, deep ar of penis, dorsal ar of penis
- pelvic wall branches –> iliolumbar, lateral sacral
- lower limb branches –> superior glut, inf glut, oburator ar
pudendal nerve - branches
3 main branches –> inf rectal, perineal nerve, dorsal nerve of penis + clitoris
unresponsive to medical management postpartum hemorrhage –>
bilateral ligation of the internal iliax artery (aka as hypogasric artery)
the uterus has collateral blood flow (from ovarian art) –> sufficient to maintain uterine function
fibrinoids of uterus may located
- serosal surface (subserosal) –> IRREGULAR ENLARGED UTERUS –> bulk symptoms (eg. constipation)
- within uteral wall (intramural) –> reproductive difficulties
- below endometrium (SUBMUCOSAL) –> reproductive difficulties, bleeding
main target of kegel exercise
levator ani:
- iliococcygeus
- pubococcygeus
- puborectalis
levator ani injury –>
- urethral hypermobility
2. pelvic organ prolapse
inscision in cesarea delivery
- midline vertical sepration of the rectus abdominis muscle
- when additionally space necessary –> horizontal transection of the rectus abdominis –> risk for inferior epigastric arteries
arcuate line?
horizontal line below the umbilicus that demarcates the lower limit of the posterior rectus sheath. Above that, the rectus abdominis is sourounded by anterior + posterior sheath. Below only by anterior sheath
lymphatic system of lower extremities
- superficial lymphatic vessels (follow venous system)
- deep lymphatic vessels (follow arterial system)
the superficial lymphatic system is also divided to medial + lateral
medial bypass the popliteal nodes (like saphenus) –> inguinal area
lateral do not bypass –> popliteal AND inguinal area
gonadal arteries course
right travels in front of IVC + behind ileum + left ar behind left colic + sigmoid art + iliac colon –> cross anteror the ureter –> paraller the external iliac vessels –> inguinal canal –> testes
endometriosis in pouch of douglas
painful defecation, dyspareunia, plpable nodularity on rectpvaginal examination
perineal body?
central tendon of the perineum –> lies in the midline between urogenital + anal triangle
the following structures are anchored to it:
1. bulbospongiosus muscle
2. external anal sphincter
3. superficial + deep transverse perinal muscle
4. fibers from external urethral sphincter, levator ani + muscular coat of rectum
prostatic plexus - lies … / origin /
- lies within the fascia of prostate
- origin: inferior hypogastric plexus
- gives rise to lesser + greater carvenous nerves
risk for injury in prostatectomy –> erectile dysfunctin
vesicouterine vs rectovesical pouch
females –> peritoneum onto anterior aspect of uterus (between uterus + bladder) –> vesicouterine pouch
males –> peritoneum onto anterior aspect of the rectum (between rectum + uterus –> rectovesical pouch
ext iliac artery branches
- inf epigastric
2. deep circumflex iliac
inf epigastric artery - course
branch of ext iliac immediately proximal to inguinal ligament –> supply to lower anterior abdominal wall as it rans superiorlu + and medially up to abdomen
hypospandias - association
- inguinal hernia
2. cryptorhidism
endometrial carcinoma - risk factors
- prolong use of estrogen without progestins
- obesity
- diabetes
- hypertension
- nulliparity
- late menopause
- Lynch syndrome
Medulary carcinoma mimics … in mammograpy
fibroadenona
Male female genital homologs - everything (embriogenic structure, derivatives - right for estrogen and left for dihydrotestosterone
- glans penis - genital tubercle - glans clitoris (ESG)
- Corpus cavernosum and spongiosum - genital tubercle - vestibular bulbs
- Balboulerthral glands of Cowper - urogenital sinus - greater vestibular glands of Bartholin
- Prostate gland - urogenital sinus - Urethral and paraourethral glands of skene
- ventral shaft of penis (penile urethra) - urogenital folds - labia minora
- scrotum - Labioscrotal swelling - Labia majora
carpal tunnel contains
- tendos of flexor digitorum profandus, superficialis, pollicis longus (thumb flexor)
- median nerve
major muscles responsible for hip motion
- flexion: ilipsoas, rectus femoris, tensor fascia lata
- extension: gluteus maximus, semitendinosus, semimembranosus, long head of biceps
- abduction medius/minimus
- adduction: adductor brevis/longus/magnus
piriformis location / action / clinical significance
passes through the greater sciatic foramen + is involved with external rotation –> muscle injury or hypertrophy –> compress sciatic nerve in the foramen –> PIRIFORMIS SYNDROME –> tender muscle in deep palpation or on adduction + internal location
structure passing above piriformis: superior gluteal vessels + nerves
structure passing below piriformis: inferior gluteal vessels, internal pupendal vessels, multiple nerves (esp sciatic)
sciatic foramen is divided to … by
greater + lesser foramen by sacrospinous ligament
liver - posterior ribs
renal - posterior rbs
Spleen
8-11
11-12
9-11
Kidney location
- T12-L3
- right is lower (because of the liver)
- left is slightly larger
Alkaline sperm secretions - from
Prostate
The larger volume of secretions in sperm - from
Seminal vesicles
Cleft lip - mechanism/presentation
failure of fusion of the maxillary and medial nasal process (formation of 1ry palate) –> split in the upper lip on one or both sides of the centre
Cleft palate - mechanism
failure of fusion of the 2 lateral palatine shelves or failure of fusion of lateral palatine shelves with the nasal septum and/or median palatine shelf (formation of 2ry palate)
- Cleft lip - when
2. Cleft palate - when
- 5-6 weeks
2. 7-8 weeks
Peak height velocity (when)
1 year after initiation of breast development (turner 3)
also in fetal alcohol manifestation
low ear
increased space between eyes
tamoxifen - lipid profile
decreases LDL
no change in HDL
increases TG in some patients
pregnancy - hair
high estrogen + progest -> increased hair growth
topical only minimal
absolute contraindication for OCPs
- prior hostory of thromboembolic event or stroke
- History of estrogen-dep tumor
- women over 35 who smoke heavily
- Hypertriglyceredimea
- Pregnancy
- decompresated or active liver disease (would impair steroid metabolism)
clonidine, β-blockers, thiazides - in pregnancy
clonidine - safe but 2nd line
β-blockers - safe
thiazides - fetal thrombocytopenia + jundice, but safe (you can continue, but not start)
phenytoin vs valproic acid according to teratogenesis
phenytoin –> hydantoid syndrome
valproic acid –> spina bifida
women whoo benefits extend extend the risk of tamoxifen
patients B –> women more than 50 with hysterctomy
medications used for pregnancy termination
- misoprostol (PGL E1 agonist) –> cervical softening and uterine contraction
- Mifepristome (prog antagonist –> necrosis of uterine decidua, glucocortic antag)
- Methotrexate
actin of progestins in contraception
- if local (noethndrone pill or levnorgestrel IUD) –> thickness of cervial mucus –> impair sperm penetration
- systemic -(impant/injection, pill, patch, vaginal ring) –> suppresses axon
