Pelvis 5+6- Exam 4 Flashcards
The ____ is responsible for the coordination of ejaculation
sympathetic
The ____ is responsible for the erection (relaxes blood vessels of genitalia, allowing engorgement)
Parasympathetics
What is the sympathetic pathway for the pelvic region?
Anterior roots, spinal nerve, white rami communicans, paravertebral ganglia
Once the pre-ganglionic sympathetic axon arrives in the paravertebral ganglia it may:
exit without synapsing and travel to the prevertebral ganglia in the abdomen and pelvis
The greater splanchnic nerve bundle is at what levels?
T5-9
The lesser splanchnic nerves bundles are from what levels?
T10-11
The least splanchnic nerve bundle are from what level?
T12
In the abdomen, individual _______ leave the paravertebral ganglia as separate nerves that do not bundle together.
lumbar splanchnic nerves
Superior hypogastric plexus I should associate with ?
pre-vertebral ganglia in the pelvis (where post ganglionic cell bodies are found)
Left & right hypogastric nerves, I should associate with ?
pre-vertebral ganglia in the pelvis (where post ganglionic cell bodies are found)
Left & right inferior hypogastric plexuses, I should associate with ?
pre-vertebral ganglia in the pelvis (where post ganglionic cell bodies are found)
The ______ receives pre-ganglionic axons from the greater splanchnic nerve that synapse with post-ganglionic cell bodies within it.
celiac ganglion
The post-ganglionic axons follow the branches of the _____ to reach the foregut organs. These axons are now the ______.
celiac arteries
celiac plexus
Word association with greater splanchnic pathway
greater thoracic splanchnic, Celiac ganglion, celiac plexus
Word association with lesser splanchnic pathway
lesser thoracic splanchnic, superior mesenteric ganglion, superior mesenteric plexus
What kind of nerve is found in the lesser thoracic splanchnic nerve?
preganglionic sympathetic
What kind of nerve is found in the superior mesenteric plexus?
post ganglionic sympathetic
What kind of organs are the superior mesenteric plexus supplying?
midgut organs
Where are the preganglionic sympathetic nerve cell bodies located?
IML of T1-L2
Where are the post-ganglionic sympathetic nerve cell bodies located that supply the midgut?
superior mesenteric ganglia
Word association: lesser thoracic splanchnic nerve
lesser thoracic splanchnic nerve, superior mesenteric ganglion, superior mesenteric plexus
The _______ (one on each side) receives pre-ganglionic axons from the lesser and least splanchnic nerves
aorticorenal ganglia
Where do the aorticorenal ganglia receives its pre-ganglionic axons from?
lesser and least splanchnic nerves
The post-ganglionic axons of the aorticorenal ganglia innervate the _____, ______ and _____ by following the branches of the _____ arteries.
suprarenal gland, kidney and proximal ureter
renal
The______ receives pre-ganglionic axons from the lumbar splanchnic nerves that synapse with the post-ganglionic cell bodies within it.
inferior mesenteric ganglion
Word association: lumbar splanchnics
Lumbar splanchnics, inferior mesenteric ganglion, inferior mesenteric plexus then goes to hindgut
The superior hypogastric plexus receives ______ sympathetics from ____ and _____ splanchnic nerves.
pre-ganglionic
lumbar and sacral nerves
After synapsing, the post-ganglionic axons from the superior hypogastric plexus go where?
TEND TO follow branches of the iliac ARTERIES to reach the hindgut, pelvic organs, and external genitalia.
some axons can descend through the hypogastric nerves to reach the inferior hypogastric plexi
The _______ receive pre-ganglionic sympathetics from sacral splanchnic nerves.
inferior hypogastric plexi
After synapsing in the inferior hypogastric plexi, the post-ganglionic axons from the left and right inferior hypogastric plexi TEND TO ????
follow the plexi directly to pelvic organs.
The vagus nerve carries ______ to the abdomen
pre- ganglionic parasympathetics
Where do the foregut and midgut get parasympathetic innervation by ?
vagus nerve
The hindgut and pelvic organs get parasympathetics from ?
S2, S3, S4
The vagus nerves carry pre-ganglionic parasympathetic axons from the brainstem into the abdomen on either side of the esophagus as the _______
anterior and posterior vagal trunks
The ______ travels to the anterior wall of the stomach and via the ______ to reach the liver and gall bladder.
anterior vagal trunk
hepatogastric ligament
The _______ jumps off the esophagus to join celiac, superior mesenteric, aorticorenal, and gonadal plexi then follow the plexi to their target organs
posterior vagal trunk
T/F: The parasympathetics synapse in the ganglia/plexi
False, DO NOT SYNAPSE
they synapse in the wall of the organ
The descending colon, sigmoid colon and rectum receive pre-ganglionic parasympathetic axons from the ______. What are they called?
S2-S4 spinal cord
pelvic splanchnic nerves
Where do the pelvic splanchnic nerves exit?
anterior sacral foramina
pelvic splanchnic nerves are _____
parasympathetic
Sacral splanchnic nerves are _____
sympathetic
The gut has its own brain, post- ganglionic cells scattered throughout the organs are known as:
What are they influenced by?
enteric nervous system
myenteric (Auerbach’s plexus)
submucosal (Meissner’s plexus)
parasympathetic inputs and hormonal signals
Post-ganglionic parasympathetic ganglia come from what kind of cells?
neural crest cells
What is Hirschsprung’s disease?
Failure of post-ganglionic parasympathetic ganglia to migrate into the colon results in Hirschsprung’s congenital megacolon
De-innervation makes the affected area hyper-contracted and the regions proximal to the problem become distended with feces
Hirschsprung’s congenital megacolon usually effects ____ and _____
rectum and sigmoid colon
_____ also cause smaller glands in the area to secrete fluid that lubricates the UG tract
Parasympathetic inputs
_______ also contract the internal urethral sphincter to prevent retrograde ejaculation into the bladder
Sympathetics
______ signaling at orgasm causes the smooth muscles in the vagina to contract.
Sympathetic
Visceral non-pain stimuli follow the ______ nerves backwards to reach the central nervous system.
parasympathetic
The vagus nerve carries parasympathetics inputs to the caudal region of the _____ – the cardiorespiratory center.
solitary nucleus
Where is the cardiorespiratory center located next to ?
dorsal vagal motor nucleus
What does the dorsal vagal motor nucleus control?
the heartbeat and respiration
rate of peristalsis and secretion in the foregut and midgut
Visceral pain follows what pathway?
sympathetic pathway
Draw in the pelvic pain line.
What organs does the pelvic pain line transect?
top of the bladder, utero-cervical junction and midpoint of the sigmoid colon
Superior to the pain line: Visceral pain axons follow ______ innervation (sacral and lumbar splanchnics) to spinal cord
sympathetic
Superior to the pain line: Non-pain afferents follow _______ innervation to (pelvic splanchnics) to spinal cord
parasympathetic
Inferior to the pain line: All visceral afferents follow ______ innervation (pelvic splanchnics) to spinal cord (S2-S4)
parasympathetic
In the perineum, somatic afferent fibers run with the ____ nerve to the spinal cord
pudendal
Draw out the visceral pain pathway from the lower pelvis.
Where does the referred pain from the gallbladder present as ?
Right shoulder (C4) and right upper abdomen (T5-9)
Where does the referred pain from the stomach localize to ?
upper left abdomen T5-9
Where does the referred pain from the pancreas localize to ? What levels?
upper abdomen and upper back pain
T5-T11
Referred pain from the small intestine presents as ? What levels?
mid abdomen pain
T9-11
Referred pain from the large intestine presents as ? What levels?
lower abdominal pain (T8-L2)
Adrenal glands receive pre-ganglionic sympathetic axons from ______
thoracic splanchnic nerves
The adrenal gland sympathetics synapse where?
at the adrenal medulla because the suprarenal medulla essentially IS a prevertebral ganglion.
Post-ganglionic cell bodies within the medulla (chromaffin cells) do not have axons, they simply dump epinephrine/norepinephrine into the suprarenal vein.
_____ inputs stimulate the internal urethral sphincter, keeping it contracted at other times
Sympathetic
______ produces the kidneys and gonads
intermediate mesoderm
Intermediate mesoderm gives rise to the ______ and the ______ that is in contact with the intraembryonic cavity.
nephrogenic region
genital ridge
_____ is the precursor to the human functional kidney
Metanephros
Drainage from the the three early kidneys the _____, _____ and _____ drain into the _____.
Pronephros
Mesonephros
Metanephros
drains into the cloaca
The cloaca is the major drainage for what three main organ systems
digestive
urinary
reproductive
The _____ forms in the cervical region and rescinds
pronephos
The _____ and ______ duct form in the thoracic/lumbar regions and begin filtration
mesonephros
mesonephric
The _____ itself rescinds but the _____ duct remains connected to the cloaca
mesonephros
mesonephric
The _____forms in the pelvic region and ascends to form the true kidney in humans.
metanephros
An outgrowth of the mesonephric duct, the _____, extends into the intermediate mesoderm
ureteric bud
**What induces the formation of the metanephros?
the outgrowth of the ureteric bud
Where do metanephric kidneys form? Where do they go?
form in the pelvis
ascend
Mesonephric ducts move _____ and carry ____ with them
inferiorly
indifferent gonads
What is the artery called when it goes into the kidney NOT at the hilum?
polar renal artery (can be superior or inferior)
If no ureter develops what happens?
no kidney will form
NOT compatible with further life
**What is the major requirement needed in kidney development
outgrowth of the ureteric bud
What is a horseshoe kidney? What artery stops their ascend?
when the kidneys will sometimes fuse in the pelvis prior to ascent.
the inferior mesenteric artery
_____ originate very early within the embryo but migrate to the yolk sac
Primordial germ cells
During the 4th week, primordial germ cells migrate back to reach the _____ of the indifferent gonad.
genital ridge
What are two duct systems located near the indifferent gonad?
mesonephric duct and paramesonephric duct
What does the Y chromosome produce?
SRY (previously called testes-determining factor)
_____ development will occur by default if this signal if SRY is not received.
Female
In males: Testes associate with the ______ duct. The ______ duct rescinds.
mesonephric
paramesonephric
In females: Ovaries associate with the _____ duct. The ______ duct rescinds.
paramesonephric
mesonephric
The urogenital sinus meets the fused ______ ducts and connects the female reproductive tract to the outside. What is the remnant of this process?
paramesonephric
hymen
the gonad is attached to the anterior body wall by the ______
gubernaculum
As the embryo lengthens, the gubernaculum tethers the gonad to the _______.
labioscrotal swellings
The testes descend parallel to (NOT within) an out-pouching of peritoneum, the ______
processus vaginalis
A remnant of the processus vaginalis remains in the scrotum in contact with the testes, the _____
tunica vaginalis.
In females, the gubernaculum pulls the ovary inferiorly but is stopped by the uterus. The ______ and ______ are its remnants.
round ligament of the ovary
round ligament of the uterus
“Cysts” can remain if the processus vaginalis leaves cavities behind. These are called _____.
hydroceles
Partitioning of the cloaca occurs when the urorectal septum, divides the _____ from the _____.
rectum
urogenital sinus
The urogenital sinus receives _____ ducts & the ______
mesonephric
allantois
The urogenital sinus becomes: _____, _____ and ______
urinary bladder, urethra & vagina
The allantois diminishes and eventually forms a fibrous cord, the ____.
urachus
the median umbilical ligament extending from the _____ to the _____
urinary bladder
umbilicus
A uracheal fistula will present as ?
urine coming from the belly button
What does a ectopic ureter present as?
constant dripple of urine
may connect the vagina or urethra instead of the bladder
What are the 3 external genitalia starting structures?
genital tubercle, urethra folds and genital swellings
What is the midline fusion of the penis called?
raphe of penis
_____ fuse, forming the scrotum
Labioscrotal swellings
In women, urethral folds remain separate, forming the _____ on either side of the vestibule
labia minora
In women, labioscrotal swellings remain separate, making the _____
labia majora.
In both sexes, genital tubercles form the ______
glans clitoris/penis
Failure of the URETHRAL FOLDS to close appropriately is called ____, results in the opening being on the underside of the penis
hypospadias
_____ where the urethra opens onto the dorsal surface of the penile shaft.
epispadias
bifid penis, BODY WALL did not grow together as it should have
The testes-determining factor on the Y chromosome activates testosterone production by _____ in the testes between days 50-150 of development
Leydig cells
Testosterone is converted into DHT by what enzyme?
5-α-reductase
What kick-starts the formation of male internal and external genitalia?
spike in DHT
A second ____ spike at puberty causes further development of male sexual characteristics.
testosterone (but NOT DHT)
What enzyme converts testosterone into estrogen?
aromatase
What will happen to a male who has reduced exposure to DHT?
develop more feminine characteristics at a child until puberty then will start developing as a man
What happens to girls who lack aromatase?
develop more masculine characteristics
What happens to boys who lack aromatase?
hyper masculine characteristics
Male hermaphrodites are genetically XY with ???
an androgen insensitivity (non-functional testosterone receptor)
