SUGER Flashcards
What 3 changes to the uterus does oestrogen have during the menstrual cycle?
1) Proliferation of endo and myo metrium
2) Increase no. of receptors for progesterone at endometrium
3) Watery, abundant cervical mucus
What 3 changes to the uterus does progesterone have during the menstrual cycle?
1) Development of the secretory endometrium - coiled glands, glycogen and increased no. of blood vessels
2) Inhibition of myometrium contractions
3) Thick mucus (prevents bacteria)
What is the corpus albicans?
The remnant of the corpus luteum (fibrous structure)
Name the pituitary hormone that stimulates leydig cells to secrete testosterone
LH
Describe the endothelium of the capillaries at the glomerular tuft
Fenestrated
State the GFR
125mL/min
180L/day
What effect on GFR does constriction of the afferent arterioles have?
Decreased GFR due to decreased hydrostatic pressure
What effect on GFR does constriction of the effect arterioles have?
Increased GFR due to increased hydrostatic pressure
State the equation for net filtration pressure at the renal corpuscle in terms of starlings forces
PGC - (PBS + πGC)
Describe the proportions of Na (and therefore water) reabsorbed at each part of the renal tubule
PCT - 65%
Loop of Henle - 25%
DCT - 5%
Collecting duct - 4%
In which part of the kidneys are renal corpuscles of all neprhons found?
Cortex
Describe juxtamudullary nephrons
15%
Renal corpuscle in the cortex but close to medullary-cortex junction
Long loop of henle - responsible for creating an osmotic gradient for the reabsorption of water
Where are macula densa cells found?
DCT walls
Which limb of the loop of Henle does water reabsorption take place
Descending
Which limb of the loop of Henle is impermeable to water
Ascending
What 3 factors determin the GFR
Membrane permeability
SA
Filtration (starling pressures)
What force favours glomerular filtration?
Pressure in the glomerular capillary
Why does πGC oppose filtration?
Presence of proteins in GC, lower water potential than in bowmans space. Water froms out of BS to GC
From where are substances secreted into the tubule (PCT)
Peritubular capillary
What percentage of the plasma is filtered at the renal corpuscle (ultrafiltration)
20%
What two capillary beds arise from the efferent arteriole?
Peritubular capillary
Vasa recta
State the eq for filtered load
Plasma conc of substance x GFR
Was is the role of the Vasa recta
Maintain gradient of counter current system
Where is ANP (atrial natriuretic peptide) synthesised and in response to what?
Atrial myocytes
High blood pressure/distention
What is the action of ANP?
Inhibits Na reabsorption Increased GFR (renal vasodilator Inhibits Aldosterone (closes ENaC channels)
Other than stimulating the secretion of aldosterone from the adrenal medulla what other actions does angiotensin II have?
Increases sympathetic activity
Arteriolar vasoconstriction (selective to efferent arteriole)
ADH release form the posterior pituitary
Direct Na reabsorption/K secretion
Where does the inguinal ligament run?
ASIS to pubic tubule
Where does the inguinal canal run?
Mid inguinal point to pubic tubule
What forms the floor of the inguinal canal?
Inguinal ligament
Reinforced medially by the lacunar ligament
What forms the deep inguinal ring?
Transversalis fascia
What forms the superficial inguinal ring?
External oblique
What form the superior border of the inguinal canal?
Transversalis fascia, tranversus abdominis, internal oblique
What form the anterior border of the inguinal canal?
Aponeurosis of the external oblique
What forms the posterior wall of the inguinal canal?
Transversalis fascia
What are the 3 covering of the spermatic cord?
Internal spermatic
External spermatic
Cremasteric
What are the 3 arteries/veins that run in the spermatic cord?
Artery/vein of Vas
Testicular a/v
Cremasteric a/v
What are the 3 nerves that run in the inguinal canal?
Ilioinguinal
Genitofemoral
Autonomic(sym)
What 3 others things can be found in the spermatic cord?
Vas Deferens
Lymphatics
Tunica vaginalis
(Pampiniform plexus)
What are the roots of the lumbar plexus?
L1-L4
What are the nerves of the lumbar plexus?
Iliohypogastric Ilioinguinal Genitofemoral Lateral cutaneous Femoral Obturator
What are the roots of the iliohypogastric?
L1 (&T12)
What are roots of the ilioinguinal?
L1
What are the roots of the genitofemoral?
L1 and L2
What are the roots of the lateral cutaneous?
L2 and L3
What are the roots of the femoral nerve?
L2,3,4
What are the roots of the obturator nerve?
L2,3,4
What does the genital branch of the genitofemoral supply?
Motor - Cremasteric muscle
Sensory - Scrotum (M), Mons pubis/labia majora (F)
What does the lateral cutaneous nerve supply?
Skin over the lateral part of the thigh
What does the femoral nerve supply?
Anterior compartment of the thigh (motor and sensory)
What does the obturator nerve supply?
Medial compartment of the thigh (motor and sensory)
What is the action of the quadratus laborum?
Extension and lateral flexion of the vertebral column
What are the actions of the psoas major?
FLEXION of the thigh at the hip
Lateral flexion of the vertebral column
What is the action of the iliacus
FLEXION of the thigh at the hip
Where do the iliacus and psoas major insert?
Lesser trochanter of the femur (iliacus joins with psoas)
Describe the relationship between the ureter and uterine artery (in females)
Ureter passed behind the uterine artery (water under bridge)
The bladder receives its blood supply from a branch of which artery?
Internal iliac
What is the parasympathetic nerve supply to the bladder?
Pelvic S234
What is the sympathetic nerve supply to the bladder?
Hypogastric
What is the somatic nerve supply to the external sphincter of the bladder?
Pudendal S234
What is the effect on the bladder if a spinal cord injury occurs above S2?
Reflex bladder
No awareness of filling
External sphincter constantly relaxed
What is the effect on the bladder if a spinal cord injury occurs between s2-4?
Flaccid bladder
Fills uncontrollably until overflow
What ligament forms the greater sciatic foramen?
Sacrospinous ligament
What ligament forms the lesser sciatic foramen?
Sacrotuberous ligament
Describe the adaptations of the female pelvis for childbirth
1) Wider and broader but lighter
2) Oval inlet
3) Less prominent ischial spines
4) Shorter move curved sacrum
5) Greater angled sub-pubic arch
What is the anatomical position of the uterus?
Anteverted
Anteflexed
Which ligament is responsible for the anverted position of the uterus?
Round
Where does the cardinal ligament run?
Base of broad ligament, lateral walls of cervix to pelvic walls
What does the cardinal ligament contain?
Uterine artery and vein
