Pelvis and Practical #2 Review Flashcards
1
Q
Urinary bladder
A
2
Q
Broad ligament
A
3
Q
Divisions of the internal iliac artery
A
4
Q
Posterior division of the internal iliac artery
A
5
Q
Iliolumbar artery
A
6
Q
Superior gluteal artery
A
7
Q
Lateral sacaral artery
A
8
Q
Anterior division of the internal iliac artery
A
9
Q
Umbilical artery
A
10
Q
Obturator artery
A
Exits pelvic cavity to supply lower extrimity (through obturator canal)
11
Q
A
12
Q
Uterine and vaginal arteries
A
Uterine artery is larger
Inferior vesicle artery comes off of vaginal artery in females
12
Q
inferior and superior vesicle arteries
A
13
Q
Middle rectal artery
A
14
Q
Obturator internus
A
i. Attaches to bone around the obturator foramen and distally to the greater trochanter of the femur
ii. Innervation is the nerve to obturator internus (L5, S1, S2) from sacral plexus
15
Q
Piriformis muscle
A
i. attaches along the anterolateral edge of the sacrum and the greater trochanter of the femur
ii. innervation—ventral rami from S1, S2 or nerve to piriformis
16
Q
Levator ani muscles – form the pelvic floor attach
A
Puborectalis
Pubococcygeus
Iliococcygeus
Coccygeus muscle
17
Q
Iliococcygeus
A
18
Q
Muscles of the pelvic diaphragm
A
Innervated by anterior rami of S3 and S4 spinal segments
19
Q
Quadratus Lumborum
A
Flexes laterally (trunk) when unilaterally activated
Innervated by T12 (subcostal n) and L1-4 anterior rami
20
Q
Psoas major
A
Attaches to the transverse processes (superior attachement) of the lumbar spine and less trochanter of the femus (distal attachement)
Innervated by L2-4 (penetrates muscle before L2-4 forms the femoral nerve)
Major hip flexor
21
Q
Psoas minor
A
Flexes the L-spine (attaches distally to pelvis)
Innervated by L2-4 (penetrates muscle before L2-4 forms the femoral nerve)
22
Q
Iliacus
A
Innervated by the femoral nerve (L2-4)
Joins the psoas major in attaching to the trochanter of the femur to aid in hip flexion
23
Q
What drains the superficial surface of the anterior abdominal wall and thorax
A
Thoracoepigastric veins
24
Layers of IAO in regard to arcuate line
Above arcuate line - layers are split, internal layer is behind rectis abdominis, and external is in front
Below arcuate line - both layers are behind the rectis abdominis
25
What forms the deep ring
Transversalis fascia
Also forms internal spermatic fascia
26
Inferior epigastric vessel location in respect to deep and superifical rings
Inferior epigastric artery is medial to deep ring and external to superficial ring
27
Fiber types of nerves innervating the flat muscles of the abdomen
Somatic motor and sensory
Sympathetic motor and sensory
28
Important dermatomes
29
What layer of the flat muscle aponeuroses does not contribute to the coverings of the spermatic cord?
The transversus abdominis
30
Coverings of the spermatic cord and their origins
Cremaster muscle is specifically supplied by the genital n branching from the genitofemoral nerve
31
Arteries of the male urogenital system
32
Nerves of the male urogenital system
Pudendal n (S2-4) innervates the posterior scrotum or process vaginalis
Autonomics (sacral outflow) supply this area
33
Veins of testis
The pampiniform plexus of veins
## Footnote
Radiator - cools the testicle - leads to the testicular vein
Left testicular vein - drains into the left renal vein
Right testicular vein - drains into the IVC
34
Infection of testis can lead to swelling of which lymph nodes?
The para-aortic nodes and lumbar nodes
35
Coverings of the testis
Dartos (smooth muscle) just deep to epidermis
## Footnote
Cremaster m - protection
Dartos m - temperature regulation
36
Where does the testicular artery originate?
Level LV-1/2 off of the abdominal aorta
37
Dorsal vs. ventral mesentery
If it connects to the liver it is ventral mesentery
## Footnote
I.e. the greater omentum is derived from dorsal mesentery
38
Most posterior structure of the hepatoduodenal ligament
The portal vein (anterior to the epiploic foramen)
39
Peptic ulcers of the first part of the duodenum
Problems for structures in the epiploic foramen:
Portal vein
IVC
Proper hepatic artery
Common bile duct
40
Spleen is attached to posterior body wall by ______
The splenorenal ligament (dorsal mesentery that contains blood vessels)
## Footnote
Spleen is intraperitoneal
41
What vessels travel through the splenogastric ligament?
Splenic a. branches to and from the stomach
42
End of the foregut
Second part of the duodenum
## Footnote
Derived foregut structure - esophagus, stomach, and duodenum
Foregut outpocketings - Liver, pancreas, and gallbladder
43
Three types of abdominal arteries off of the aorta
Ventral splanchnics - Celiac/SMA/IMA
Lateral Splanchnics - Renal/Gonadal
Lateral segmental - Arteries that supply the body wall
44
Celiac trunk
| Level and general destination
Off abdominal aorta at TV12 supplying foregut
45
Superior mesenteric artery
| Level and general destination
Off abdominal aorta at LV1 supplying midgut
46
Inferior mesenteric artery
| Level and general destination
Off abdominal aorta at LV3 supplying hindgut
47
Superior mesenteric artery syndrome
Nutcracker
Left renal vein becomes compressed - Left testicular a./Left suprarenal a./Left renal a cannot drain
In males - their are no anastomotic connections with the testicle, there are for the ovary
## Footnote
Extreme weight loss causes mesentery to pull down on intestines
48
Left gastric a.
49
Splenic a.
50
Gastroduodenal a.
Branches from the common hepatic, which branches from the celiac trunk
51
Branches of the common hepatic a.
52
What lobes are part of the "functional left side" of the liver?
The quadrate/caudate/ and left lobes
53
Where is the bare area of the liver?
The posterior aspect of the right lobe
54
The paraumbilical vein is part of what structure?
The falciform ligament (not the round ligament)
55
Impressions of the liver
Right renal/right colic (ascending) and gastric impression (on the posterior aspect of the left lobe)
56
What does a tumor of the head of the pancreas compress?
The common bile duct
57
Ducts you need to know
## Footnote
Ampulla of vater (main pacreactic duct) at second portion of duodenum - even small gallstones can become stuck here
58
Tumor in the tail of the pancrease can compress what vessels?
Vessels of the stomach and spleen
## Footnote
Tail of pancrease lives right inside splenorenal ligament
59
Anterior edge of spleen
Weird edges
60
What surrounds the head of the pancreas?
The first, second, and third portions of the duodenum
61
Characeristics of the ileum
Peyer's patches (visible to the naked eye)
Absence on interintestinal folds
Lots of fat in mesentery surrounding vasarecta/arcardes
Shorter vasa recta than the jejunum
62
Characteristics of the large intestines
Epiploic appendages
Huastra (sacculations)
Tinea coli
63
What portion(s) of the large intestines have an anterior mesentery?
The transverse and sigmoid colons
64
What forms the interconnections between all of the atrial branches of the large intestines?
65
What organ that drains into the portal system is not gut-derived?
The spleen (derived from mesoderm)
66
What abdominal organs do not drain into the portal system?
The kidneys/adrenals/gonads
67
How does the stomach drain into the portal system?
The L/R gastric veins drain directly into the portal vein
68
Portal system anastomoses
Retrograde venous blood flow tracing:
Left portal vein -> paraumbilical veins -> thoracoepigastric veins -> L axilla or L femoral -> caval system
Superior rectal v -> Middle/inferior rectal veins -> internal iliac vv. -> IVC
Esophageal vv below diaphragm -> esophageal veins above diaphragm -> azygos v. -> vena cava
69
Parasympathetic innervation of abdomen
Foregut - Vagus (CN X)
Midgut - Vagus (CN X)
Hindgut - S2-4 (pelvic splanchnic)
70
Sympathetic innervation of abdomen
Foregut - greater splanchnic (T5-9) synapses at celiac ganglia
Midgut - lesser splanchnic (T10-11) synapses at superior mesenteric ganglia
Kidney and adrenals - sympathetic innervation by least splanchnic (T12)
Hindgut - lumbar splanchnic (L1-4) synapse on inferior mesenteric ganglia
Hindgut - also pelvic splanchnic (S2-4)
71
Location of adrenal gland if Pt has pevlic kidney
Adrenal glands develop separately from kidney and will be where they normally are
72
Renal structures that arise from the metanephric blastema
73
Ligaments and foramina of the pelvis
74
The pelvic diaphragm
75
The broad ligament
76
Anastomoses of the urterovaginal canal
77
At the height of pregnancy, ~40% of all maternal cardiac output goes through ________ artery
The uterine artery
78
The urogenital triangle
The ischiocavernosus and bulbospongious muscles rhythmically contract during the orgasmic platform
## Footnote
Innervated by the perineal branch of the pudendal nerve (S2-4 somatic)
79
# ian
Anatomy of the penis
## Footnote
Supplied by the dorsal branch of the pudendal nerve (purely sensory fibers)
80
Pudendal nerve
Somatic nerve S2-3 - supplies the structures of the perineum, and sensory to the posterior scrotum.
81
What supplies sensory innervation to the posterior aspect of the scrotum
Branch of the pudendal nerfve
