SUGER anatomy Flashcards

1
Q

The inguinal canal

A
  • a passage through the muscles of the anterior abdominal wall
  • deep inguinal ring
    • invagination of transversalis fascia that covers the contents of the inguinal ligament
    • above the midpoint of the inguinal canal
  • superficial inguinal ring
    • lies just superior to the pubic tubercle
    • invagination of the external oblique aponeurosis
    • this also covers the contents of the canal
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2
Q

the inguinal ligament

A

runs from the asis to the pubic tubercle

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3
Q

what does the inguinal canal contain in males

A

the spermatic cord

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4
Q

what does the inguinal canal contain in females?

A

the round ligament of the uterus

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5
Q

spermatic cord structures

A

rule of 3

  • 3 coverings
    • external, cremasteric and internal spermatic fascia
  • 3 arteries
    • testicular, artery of the vas, cremasteric artery
  • 3 veins
    • testicular, vein of the vas, cremasteric artery
  • 3 nerves
    • ilio-inguinal (skin sensation anterior 1/3 of genetalia)
    • genitofemoral (to cremaster muscle)
    • sympathetic (vas and testicular pain)
  • 3 others
    • vas deferens, lymphatics and tunica vaginalis
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6
Q

spermatic cord fascia

A
  • acquires a layer of fascia from each of the three abdominal wall layers
  • leaves the superficial ring with three layers of covering
  • most internal is from transversalis
  • most externalis from ext oblique
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7
Q

Tunica vaginalis

A
  • a sac covering the testis
  • derived from the peritoneum
  • works like peritoneum allowing friction free movement
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8
Q

epididymis

A
  • very coiled duct at the back of the testis - along which sperm travels to the vas deferens
  • there’s a head that’s superior and highly coiled
  • then there’s a posterior body
  • then there’s a tail that turns back on itself and communicates with the vas deferens
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9
Q

cremaster muscle

A

a muscle of the spermatic cord by which the testicle can be partially raised

it runs in the inguinal canal

it is derived from muscle of the internal oblique

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10
Q

inferior epigastric artery

A
  • arises from external iliac
  • hernias medial to this vessel are direct hernias
  • hernias lateral to this vessel are indirect
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11
Q

dartos muscle

A

a sheet of smooth muscle, situated immediately underneath the skin. It acts to help regulate the temperature of the scrotum, by wrinkling the skin – this decreases surface area, reducing heat loss.

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12
Q

tunica albuginea

A

a fibrous capsule that encloses the testes. It penetrates into the parenchyma of each testicle with diaphragms, dividing it into lobules.

these lobules contain the seminiferous tubules

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13
Q

prepuce

A

foreskin

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14
Q

suprarenal glands

A

adrenal glands

at top of kidney

embedded in perinephric fat

Right: tetrahedral and lies behind the liver and IVC

Left: crescent shaped and lies behind the stomach and pancreas

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15
Q

divisions of arteries once they have entered the kidney

A
  • renal artery divides into segmental branches
  • segmental branches divide to form interlobar arteries
    • interlobars are either side of each pyramid
  • interlobar arteries divide to form arcuate arteries
  • arcuate arteries (in cortex) divide to form afferent arterioles
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16
Q

arterial blood supply to kidneys

A
  • renal arteries which come off aorta just inferior to the sup mesenteric
  • aorta lies slightly left of midline
  • for this reason right renal artery is longer than the left and passes the IVC posteriorly
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17
Q

blood supply to adrenal glands

A
  • superior adrenal artery (arises from inf phrenic artery)
  • middle adrenal artery (arises from the abdominal aorta)
  • inferior adrenal artery (arises from the renal arteries)
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18
Q

venous drainage of adrenal glands

A
  • right and left adrenal veins
  • right drains straight into the IVC
  • left first drains into the left renal vein
19
Q

layers of the adrenal glands

A

Cortex - derived from embryonic mesoderm

  • Zona glomerulosa - mineralocorticoids (e.g. aldosterone)
  • Zona fasciculata - corticosteroids (e.g. cortisol)
  • Zona reticularis - androgens (e.g. DHEA)

Medulla - derived from the ectodermal neural crest cells

  • secretes catecholamines (such as adrenaline) from chromaffin cells in response to stress
20
Q

what is the surface marking for the aortic bifurcation

A

the umbilicus

NB it bifurcates into the common iliac arteries

21
Q

3 common spots for renal caliculi

A
  • where the pelvis of the kidney becomes the ureter
  • at the pelvic brim
  • where the ureter passes through the bladder wall
22
Q

psoas muscle

A
  • arises from the sides of the lumbar vertebra
  • passes almost vertically down under the inguinal ligament
  • attaches to the lesser trochanter of the femur
  • converges with the iliacus to form the iliopsoas
23
Q

iliacus muscle

A
  • fills the iliac fossa
  • thigh flexor
  • passes under inguinal ligament
  • arises frominterior side of hip bone and also AIIS
  • converves with psoas as the iliopsoas
  • inserts on the lesser trochanter of the femur
24
Q

obturator foramen

A
25
Q

surfaces of the bladder

A
  • superior
  • two lateral
  • base
  • apex
  • bladder neck
26
Q

interior surface of the bladder

A

rugose

27
Q

prostate

A
  • completely encircles the urethra
  • with progressing age it enlarges
  • this may cause complete blockage of the urethra and the inability to pass urine
  • venous drainage of the prostate is closely related to the vertebra
    • prostatic metastases can often end up in the vertebra
28
Q

three components of control of micturation

A
  • brain
  • spinal cord
  • sensory from bladder
29
Q

loss of brain control of micturation

A
  • bladder fills but brain does not realise
  • spinal cord asks for permission to empty
  • brain does not reply
  • spinal cord controls a complete normal emptying of the bladder
  • low pressure in bladder - so no renal failure risk
30
Q

loss of spinal cord motor control of micturation

A
  • patient can sense that the bladder is full but cannot empty it
  • high pressure and renal failure
31
Q

loss of sensation of need for micturation

A
  • spinal cord and brain do not recieve info that bladder is full
  • the patient contiunuously dribbles urine
  • there’s high pressure in the bladder and this may rapidly progress to kidney failure
32
Q

three parts of the uterus

A

fundus, body and cervix

33
Q

the positions of the uterus and which one is normal

A

ante-flexion is the normal one

the -verted ones refer to when the bend is at the cervix whereas the flexion ones are when the bend is in the uterus itself

34
Q

tissue layers of the uterus

A
  • Peritoneum - double layer that’s continuous with abdominal peritoneum
  • Myometrium - thick smooth muscle layer
  • Endometrium - inner mucous membrane of uterus (two parts)
    • deep stratum basalis
      • not shed
    • superficial stratum functionalis
      • proliferates in response to oestrogen
      • secretory in response to progesterone
      • shed during menstruation
35
Q

ligaments of the uterus

A
  • Broad ligament
    • double layer of peritoneum attaching uterus to the pelvis
  • Round ligament
    • extends from the uterine horns to the labia majora
    • goes through inguinal canal
  • Ovarian ligament
    • joins the ovaries to the uterus
  • Cardinal ligament
    • located in the base of the broad ligament
    • extends from cervix to the lateral pelvic walls
    • contains the uterine artery and vein
  • Uterosacral ligament
    • extends from cervix to the sacrum
    • provides support to the uterus
36
Q

parts of the uterine tube

A
37
Q

arterial supply tothe uterus, fallopian tubes and the vagina?

A
  • Uterine and vaginal come off the internal iliac
  • The ovarian artery comes off the abdominal aorta just below the renal artery
  • the uterine artery and the ovarian artery anastamose and so the fallopian tube is supplied by both
38
Q

relate the seminal vesicle, vas deferens and ejaculatory duct

A
  • from the deep inguinal ring, the ductus deferens passes across the side wall of the pelvis
  • then turns medially onto the back of the bladder
  • here, a dilated portion called the ampulla lies medial to the seminal vesicle
  • the ductus deferens terminates by joining the duct of the seminal vesicle to form the ejaculatory duct
39
Q

Seminal Vesicle

A
  • there’s one on each side
  • they don’t store sperm
  • they secrete thick alkaline fluid tht forms the bulk of seminal fluid
  • on each side the duct of the seminal vesicle terminates in an ejaculatory duct which enters the prostate
  • this duct runs through the prostate to enter the prostatic urethra
40
Q

the prostate

A
  • about the size of a walnut
  • secretions of the prostate are added to the seminal fluid during ejaculation
  • has two ejaculatory ducts entering it (from eminal vesicles and ductus deferens)
  • urethra passes through it (collecting secretions from the ejaculatory ducts)
41
Q

the erectile cylinders of the penis

A
  • one corpus spongiosum
    • through which the urethra travels
    • forms bulb at the root
  • two corpus cavernosa
    • form crura at the root
42
Q

Male Urogenital Embryology

A
  • Presence of Y chromosome
  • Encodes SRY gene for testis determining factor
  • TDF causes genital ridge to develop into testis
  • Leydig cells secrete testosterone
  • Testis cause Mesonephric duct to develop
  • Sertoli cells secrete Müllerian inhibiting factor
  • Paramesonephric duct degenerates

NB paramesonephric duct is AKA Müllerian duct

43
Q

Female urogenital embryology

A
  • Absense of Y chromosome
  • No SRY gene so no TDF
  • Genital ridge develops into ovaries by default
  • Absense of testosterone causes mesonephric duct to degenerate
  • Absense of Müllerian-inhibiting factor allows the paramesonephric ducts to develop