The Abdomen 2 Flashcards
Extends from the ___________________to the level of inferior border of _______.
At inferior border of L1 spinal cord ends in ‘pointed’ extremity called ______________.
From that, a fine fibrous ligament, the ______________, extends inferiorly and attaches to posterior body of the 1st coccygeal vertebra.
Surrounding vertebra provide a shelter for the enclosed spinal cord, and__________________________ provide additional protection.
Spinal cord is roughly cylindrical but flattened slightly in its AP dimension.
Adult spinal cord does not extend the entire length of the vertebral column as the vertebral column continues to grow.
Length of adult spinal cord = __________. Diameter= ____________, mid-thoracic region (larger in the lower cervical and mid-lumbar regions and smallest at the inferior tip.)
i.e. reason why lumbar punctures are done below L2(?) – inferior to spinal cord and provides relatively safe access.
Extends from the Upper border of C1 to the level of inferior border of L1.
At inferior border of L1 spinal cord ends in ‘pointed’ extremity called Conus medullaris.
From that, a fine fibrous ligament, the filum terminale, extends inferiorly and attaches to posterior body of the 1st coccygeal vertebra.
Surrounding vertebra provide a shelter for the enclosed spinal cord, and vertebral ligaments, meninges and CSF provide additional protection.
Spinal cord is roughly cylindrical but flattened slightly in its AP dimension.
Adult spinal cord does not extend the entire length of the vertebral column as the vertebral column continues to grow.
Length of adult spinal cord = 42-45cm. Diameter= approx 2cm, mid-thoracic region (larger in the lower cervical and mid-lumbar regions and smallest at the inferior tip.)
i.e. reason why lumbar punctures are done below L2(?) – inferior to spinal cord and provides relatively safe access.
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What is the size of an average adult kidney?
- The average size of a kidney in a human adult is:
- 10-12 cm long
- 5-7.5 cm wide
- 2.5 cm thick
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- Renal pyramid
- Efferent artery
- Renal artery
- Renal vein
- Renal hilum
- Renal pelvis
- Ureter
- Minor calyx
- Renal capsule
- Inferior renal capsule
- Superior renal capsule
- Afferent vein
- Nephron
- Minor calyx
- Major calyx
- Renal papilla
- Renal column
What are the two internal regions of the kidney?
Internal Anatomy of the Kidney (two regions:)
- The renal cortex – outer layer which extends inwards between the renal pyramids forming the renal columns
- The renal medulla – inner layer containing the renal pyramids
What’s the Renal Parenchyma?
The Renal Parenchyma
- Includes cortex and renal pyramids
- The renal parenchyma contain around one million nephrons (functional units of kidney)
How many calyces does each kidney have?
Each kidney has 8 to 18 minor calyces and 2 or 3 major calyces.
Where does urine go from the nephrons?
•Urine formed by the nephrons drains into large ducts (papillary ducts) of one renal pyramid and delivers urine to a major calyx. From the major calyces the urine drains into a large cavity (renal pelvis) and out through the ureter to the urinary bladder.
Label this left kidney with:
Renal pyramid in the medulla
Renal pelvis
Ureter
Renal cortex
Renal column
Capsule
Major calyx
Minor calyx
What does the ureter connect?
Transport?
Length?
Width?
Position?
Protection?
Renal pelvis to bladder
Urine from kidneys to bladder
25-30cm in adults
Approx 5mm
Retroperitoneal
•The inner lining of the ureters (& bladder) secrete mucous which protect the ureter from urine
Why protect cells from urine?
1.Urine contains waste products that the body wants to eliminate
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2.The pH and solute concentration of urine is potentially damaging to cells
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3.prevents cell composition being adversely affected + so maintains homeostasis
What is the urinary bladder?
Where?
Shape?
- Hollow, muscular organ, capable of expansion and relaxation
- Situated in the pelvic cavity
- Is held loosely in position by folds of peritoneum
- In the male – is directly anterior to the rectum
- In the female – is anterior to the vagina and inferior to the uterus
- The shape depends on the volume of urine within it
What is the trigone?
The Trigone
- The trigone is a triangular region situated at the base of the urinary bladder
- There are no rugae in this region
- At the base of the trigone the urinary bladder opens into the urethra
- The ureters enter the urinary bladder, one at each of the two remaining corners of the triangle
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What are the adrenal glands?
Size?
Weight?
2 parts?
Function?
A pair of glands located immediately superior to the kidneys
3-5cm in height, 2-3cm wide, and less than 1cm thick
Weigh 3 ½ to 5 grams.
Made of 2 parts – Outer = Adrenal cortexandInner=Adrenal medulla
Function
Works interactively with hypothalamus & pituitary gland
- Produces steroid hormones essential
- Loss of adrenocortical hormones – death due to dehydration and electrolyte imbalances, also norepinephrine and epinephrine –
- Highly vascularised gland.
What does the adrenal cortex do?
Produces?
Outer = adrenal cortex – secretes hormones affecting body metabolism, some chemicals in the blood and certain body characteristics - produces
– hydrocortisone (controls body’s use of fats, proteins & carbohydrates)
- corticosterone (with hydrocortisone suppresses inflammatory reactions & also affects the immune response)
- aldosterone (inhibits level of sodium excreted into urine, maintaining blood volume & blood pressure)
- androgenic steroids (have a minimal affect on development of male characteristics)
What does the adrenal medulla do?
Produces?
Inner = Adrenal medulla – not essential to life but helps in coping with physical & emotional stress – produces
- epinephrine/adrenaline (increases heart rate & force of contractions, facilitates blood flow to muscle & brain, relaxes smooth muscle & helps with conversion of glycogen to glucose in liver)
- norepinephrine/noradrenaline (has strong vasoconstrictive effects and so increases blood pressure, but little effect on smooth muscle, metabolic processes or cardiac output)
What does hydrocortisone do?
– hydrocortisone (controls body’s use of fats, proteins & carbohydrates)
What does corticosterone do?
- corticosterone (with hydrocortisone suppresses inflammatory reactions & also affects the immune response)
What does aldosterone do?
- aldosterone (inhibits level of sodium excreted into urine, maintaining blood volume & blood pressure)
What do androgenic steroids do?
- androgenic steroids (have a minimal affect on development of male characteristics)
What does epinephrine do?
- epinephrine/adrenaline (increases heart rate & force of contractions, facilitates blood flow to muscle & brain, relaxes smooth muscle & helps with conversion of glycogen to glucose in liver)
What does norepinephrine do?
- norepinephrine/noradrenaline (has strong vasoconstrictive effects and so increases blood pressure, but little effect on smooth muscle, metabolic processes or cardiac output)
What is shown here?
Pheochromocytoma
What is Pheochromocytoma?
Pheochromocytoma is a rare tumor of adrenal gland tissue. It results in the release of too much epinephrine and norepinephrine, hormones that control heart rate, metabolism, and blood pressure.
Label the pancreas
What is the dual role of the pancreas?
Accessory organ of the digestive system
▪99% acini cells
Endocrine gland
▪1% Islets of Langerhans
What is the length of the pancreas?
12 ½ - 15 cm in length
What do the acini cells of the pancreas do?
99% of pancreatic cells are arranged in clusters (acini) – produce digsetive enzymes which flow into the gi tract through a network of ducts
What are the 4 types of hormone secreting cells of each pancreatic islet (langerhans cell)?
Each pancreatic islet includes four types of hormone-secreting cells:
Alpha or A cells constitute about 17% of pancreatic islet cells and secrete glucagon
Beta or B cells constitute about 70% of pancreatic islet cells and secrete insulin
Delta or D cells constitute about 7% of pancreatic islet cells and secrete somatostatin
F cells constitute the remainder of pancreatic islet cells and secrete pancreatic polypeptide.
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What is the urethra?
What does it do?
Length?
The Function of the Urethra
- The urethra is the ‘end’ of the urinary system and is a small tube leading from the urinary bladder to the exterior of the body
- Urine passes through the urethra when it is expelled from the body
- In females the urethra is approximately 3.5 cm long and only transports urine
- In males, the urethra is approximately 20 cm in length, passes through the penis and also acts as the passageway for semen
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What does this image show?
Normal testes
What are the seminal vesicles?
Where?
The Seminal Vesicles
- 2 sacs, about 5 cm long
- Lie on the posterior aspect of the base of the bladder
- Composed of a single coiled tube which gives rise to several diverticula
- Combines with the seminal duct to form the ejaculatory duct
What are the 3 coats of the seminal vesicles?
Where does most of the seminal fluid come from?
Composed of three coats:
- Outer areolar coat
- Middle smooth muscle layer
- Inner mucous layer which is lined with columnar epithelium
- The diverticula contain goblet cells which secrete most of the seminal fluid
What are the ejaculatory ducts:
Length?
Formed where what unite?
Travels where?
Opens where?
The Ejaculatory Ducts
- About 2 cm long
- Formed where the seminal duct (vas deferens) and the seminal vesicle unite
- Travels inferiorly and anteriorly and enters the prostate gland
- Opens into the prostatic part of the urethra
Label the seminal vesicle and ejaculatory duct?
How was this image taken?
Seminal vesiculography – u/s transrectal probe direct needle puncture of seminal vesicle and contrast injected shows up ducts etc.
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Where does the prostate gland lie?
Structure?
The Prostate Gland
- Lies at the base of the bladder
- Surrounds the first part of the urethra
- Outer capsule of fibrous tissue
- Mixture of muscular and glandular (exocrine) tissue
- Ducts from the glandular portion of the prostate open into the prostatic urethra
What is the function of the prostate gland?
Function of the Prostate Gland
- Secretes a slightly alkaline fluid – protective localised environment for sperm (vagina is acidic)
- Contains a clotting enzyme – thickens the semen in the vagina, increasing the likelihood of semen being retained in the region of the cervix
- Milky fluid that constitutes about 33% of semen
Label this image
What is it an image of?
Micturating cystogram (voiding cystourethrogram (VCUG))
What is a Micturating cystogram?
Why is it used?
Micturating cystogram
A technique for visualizing a person’s urethra and urinary bladder while the person urinates (voids). The technique consists of catheterizing the person in order to fill the bladder with a radiocontrast agent, typically diatrizoic acid. Under fluoroscopy (real time x-rays) the radiologist watches the contrast enter the bladder and looks at the anatomy of the patient.
The male urethra provides the outflow for both urine and seminal fluid.
If the prostate gland becomes enlarged it compresses the prostatic portion of the urethra and results either in frequency of micturition or poor flow or both – treatment = TURP. Transurethral resection of the prostate.
- Core out inside section of prostate via urethra (using laser)
What is shown here?
Ovary size, shape and position?
Where?
What holds them in position?
Position size and shape vary greatly often imaged as transvaginal ultrasound scan.
In superior portion of pelvic cavity, one on each side.
Ligaments hold them in position.
Where do the fallopian tubes lie?
Length?
What does it do?
The Fallopian (Uterine) Tubes
- Lie in the upper margins of the broad ligaments of the uterus
- About 10 cm long
- Transmit the ovum from the ovary to the uterus
What 4 parts are the fallopian tubes divided up into?
•Divided for descriptive purposes into 4 parts: the infundibulum, ampulla, isthmus, uterine portion
What are the 3 coats to the fallopian tubes?
The Structure of the Fallopian Tubes
Composed of three coats:
- Outer serous coat which is provided by the peritoneum
- Middle smooth muscle coat – outer longitudinal and inner circular fibres (moves ova by peristalsis)
- Inner mucous membrane – lies in longitudinal folds and is covered by ciliated epithelium (assists with moving the ova)
•
Label the parts of the fallopian tubes
Label the parts of the uterus
What is the vagina?
What 3 coats is it comprised of?
The Vagina
- A fibromuscular canal
- Composed of three coats:
- Outer loose areolar layer containing vessels and nerves
- Middle smooth muscle layer
- Inner mucous membrane layer arranged in rugae and containing stratified squamous epithelium
Label this image with:
Mucous
Bladder
Pubis
Myometrium
Endometrium
The cervix
Vagina
What is the peritoneum?
When’s it typically visualised?
The Peritoneum
•Serous membrane (largest within the body)
Typically only visualised in disease e.g.
▪Ascites- a gastroenterological term for an accumulation of fluid in the peritoneal cavity that exceeds 25 mL- most caused by cirrhosis, severe liver disease or metastic cancer
What are the layers to the peritoneum?
What does it contain?
- The parietal peritoneum lines the wall of the abdominal – pelvic cavity
- The visceral peritoneum covers certain organs within the abdomen
- The peritoneal cavity is the space between these two regions of the peritoneum and contains peritoneal fluid
- Contains large folds that bind the organs to each other
- Contains the vessels and nerves that supply the organs of the abdomen and pelvis.
What mnemonic aids recollection of abdominal retroperitoneal viscera?
S = Suprarenal glands (aka the adrenal glands)
A = Aorta/IVC
D = Duodenum (second and third segments [some also include the fourth segment] )
P = Pancreas (tail is intraperitoneal)
U = Ureters
C = Colon (only the ascending and descending branches)
K = Kidneys
E = Esophagus
R = Rectum
