Term
| What are the 5 layers of the anterior abdominal wall? |
|
Definition
Skin
Subcutaneous fascia
Muscles and sheet-like tendons
Transversalis fascia
Peritoneum |
|
|
Term
| Describe the subcutaneous fascia above the umbilicus. |
|
Definition
| A single layer of connective tissue with a variable amount of fat. |
|
|
Term
| Describe the subcutaneous fascia below the level of the umbilicus. |
|
Definition
Divided into two layers:
1) Camper's fascia- fatty, superficial layer
2) Scarpa's fascia- deep layer |
|
|
Term
| What are the four muscles in the anterior abdominal wall? |
|
Definition
Rectus abdominus
External oblique
Internal oblique
Transversus abdominus |
|
|
Term
|
Definition
| The seam on the midline of the tendons of the external oblique, internal oblique, and transversus abdominus that cover the rectus abdominus. |
|
|
Term
| What are 5 things the abdominal muscles can do when they are flexed? |
|
Definition
Flex the lumbar spine
Breathing
Increase abdominal pressure:
Urination
Defecation
Vaginal birth |
|
|
Term
| What spinal nerve innervates the skin over the xiphoid process? |
|
Definition
|
|
Term
| What spinal nerve innervates the skin around the umbilicus? |
|
Definition
|
|
Term
| What spinal nerve innervates the skin over the pubic crest? |
|
Definition
|
|
Term
| On both sides, which are the major arteries in the median region of the anterior abdominal wall? |
|
Definition
| Superior and inferior epigastric arteries |
|
|
Term
| Where do most of the anterior wall's veins drain into? |
|
Definition
| Either the inferior or superior vena cava, with the exception of the para-umbilical veins, which drain into the portal venous system. |
|
|
Term
| Where do the lymphatics of the abdominal wall drain that are above the level of the umbilicus? |
|
Definition
| Anterior group of axillary lymph nodes |
|
|
Term
| Where do the lymphatics of the abdominal wall below the level of the umbilicus drain? |
|
Definition
| Horizontal group of superficial inguinal lymph nodes |
|
|
Term
| What is the inguinal canal? |
|
Definition
| Passageway in the inguinal region through which the spermatic cord in the male and the round ligament of the uterus in the female traverse the abdominal wall. |
|
|
Term
| The formation of the inguinal canal spans what time period during fetal development? |
|
Definition
| 5-32 weeks; the development in both sexes is similar up until the 28th week. |
|
|
Term
| Where and when do the gonads begin forming? |
|
Definition
| 5th week of development in the lower region of the posterior abdominal wall sandwiched between the peritoneum and the deep fascia. |
|
|
Term
| In relation to the inferior epigastric artery, where is the deep inguinal located? |
|
Definition
| The deep inguinal ring lies immediately lateral to the origin of the inferior epigastric artery from the external iliac artery. The deep inguinal ring is the lateral or deep end of the inguinal canal. |
|
|
Term
| The internal spermatic fascia is continuous with what abdominal wall layer? |
|
Definition
|
|
Term
| The cremasteric fascia is continuous with what abdominal wall layer? |
|
Definition
| Internal oblique; the vaginal process with the internal spermatic fascia passes beneath the lower free border of the tranversus abdominis |
|
|
Term
| The external spermatic fascia is continuous with what abdominal wall layer? |
|
Definition
|
|
Term
| What is the superficial inguinal ring? |
|
Definition
| The triangular margin where the external spermatic fascia is continuous with the external oblique's tendon. |
|
|
Term
| In relation to the to the pubic tubercle, where is the superficial spermatic ring? |
|
Definition
| Immediately above and medial to the pubic tubercle. |
|
|
Term
| What forms the roof of the inguinal canal? |
|
Definition
| The lower free borders of the internal oblique and transversus abdominis. |
|
|
Term
| What forms the anterior wall of the inguinal canal? |
|
Definition
| Tendon of the external oblique |
|
|
Term
| What forms the floor of the inguinal canal? |
|
Definition
|
|
Term
| What forms the posterior wall of the inguinal canal? |
|
Definition
|
|
Term
| When does the testis begin to pass through the deep inguinal ring and into the inguinal canal? |
|
Definition
|
|
Term
| What is the tunica vaginalis? |
|
Definition
| The only postnatal, gross remnant of the vaginal process which covers all but the posterior aspect of the testis. |
|
|
Term
| What is the proximal, tapered end of a hernia called? |
|
Definition
|
|
Term
| What is an indirect inguinal hernia? |
|
Definition
| A hernia whose contents protrude into the inguinal canal through the deep inguinal ring. |
|
|
Term
| The neck of an indirect inguinal hernia always lies just lateral to what structure? |
|
Definition
| The origin of the inferior epigastric artery |
|
|
Term
| Why do indirect inguinal hernias have embryological derivations? |
|
Definition
| They occur in individuals with a patent vaginal process. |
|
|
Term
| What is a direct inguinal hernia? |
|
Definition
| A hernia whose contents protrude into the inguinal canal through a distention of its posterior wall. |
|
|
Term
| The neck of a direct inguinal hernia lies just medial to what structure? |
|
Definition
| The origin of the inferior epigastric artery |
|
|
Term
| The inguinal triangle is an area within the inguinal region bounded by what structures? |
|
Definition
1) Inferior epigastric artery laterally
2) Lateral edge of the rectus abdominus medially
3) Inguinal ligament inferiorly |
|
|
Term
| Which kind of hernia lies within the inguinal triangle? |
|
Definition
|
|
Term
| Which types of hernias are at risk for incarceration and strangulation? |
|
Definition
|
|
Term
| Which organs are intraperitoneal? |
|
Definition
|
|
Term
| Which organs are retroperitoneal? |
|
Definition
|
|
Term
| Which organs are secondarily retroperitoneal? |
|
Definition
| Ascending and descending colon |
|
|
Term
| What are the five largest branches of the abdominal aorta which supply all the abdominal organs? |
|
Definition
Celiac artery
Superior mesenteric artery
inferior mesenteric artery
left renal artery
right renal artery |
|
|
Term
| What is the most superior branch of the abdominal aorta? |
|
Definition
|
|
Term
| Which organs do the celiac artery supply? (8) |
|
Definition
Liver
Gallbladder
Extrahepatic biliary ducts
Pancreas
Spleen
Lower third of the esophagus
Stomach
Duodenum |
|
|
Term
| Pain in the right shoulder could be referred pain from what abdominal organs? |
|
Definition
| Liver, gallbladder, extrahepatic biliary ducts |
|
|
Term
| What is the ligamentum venosum? |
|
Definition
| The postnatal, cord-like remnant of the venous ductus venosus. |
|
|
Term
| What is the legamentum teres? |
|
Definition
| The postnatal, cord-like remnant of the fetal umbilical vein. |
|
|
Term
| What stuctures form the right vertical limb of the H on the liver's visceral surface? |
|
Definition
| The inferior vena cava and the gall bladder. |
|
|
Term
| What structures form the left vertical limb of the H on the liver's visceral surface? |
|
Definition
| The ligamentum venosum and the ligamentum teres. |
|
|
Term
| What structure forms the crossbar of the H on the liver's visceral surface? |
|
Definition
|
|
Term
| What structures form the porta hepatis? |
|
Definition
| The portal vein, hepatic artery proper, and the left and right hepatic ducts. |
|
|
Term
| Which peritoneal ligament suspends the liver from the diaphragm? |
|
Definition
|
|
Term
| What is the peritoneal ligament that suspends the liver from the anterior abdominal wall? |
|
Definition
|
|
Term
| What structure forms the border between the anterior liver's left and right lobes? |
|
Definition
|
|
Term
| What structures form the borders of the caudate lobe? |
|
Definition
| The crossbar of the H (porta hepatis), the inferior vena cava on the right, and the ligamentum venosum on the left. |
|
|
Term
| What structures form the borders of the quadrate lobes? |
|
Definition
| The crossbar of the H (porta hepatis), the gallbladder on the right, and the ligamentum teres on the left. |
|
|
Term
| What is the duct that extends from the gallbladder's neck? |
|
Definition
|
|
Term
| Which ribs mark the areas where the right lung overlaps the liver? |
|
Definition
|
|
Term
| What is the structure of the extrahepatic bile ducts? |
|
Definition
| The left and right hepatic ducts emerge from the liver and combine to form the common hepatic duct; these join the cystic duct to form the common bile duct. |
|
|
Term
| Which parts of the pancreas are secondarily retroperitoneal? |
|
Definition
|
|
Term
| Which part of the pancreas are intraperitoneal? What peritoneal ligament encases it? |
|
Definition
| Tail- splenorenal ligament (travels from the left kidney to the hilum of the spleen). |
|
|
Term
| When is the tail of the pancreas specifically at risk? |
|
Definition
| When the splenorenal ligament is cut during a splenectomy. |
|
|
Term
| Where does the main pancreatic duct run? |
|
Definition
| From the tail, through the middle of the body, neck, and head. |
|
|
Term
| What is the largest lymph organ of the body? |
|
Definition
|
|
Term
| Where is the spleen's hilum? |
|
Definition
| The spleen's central anteroinferior surface. |
|
|
Term
| Is the spleen an intraperitoneal organ? |
|
Definition
|
|
Term
| What are the two peritoneal ligaments that extend from the hilum of the spleen? |
|
Definition
| Splenorenal and gastrosplenic ligaments |
|
|
Term
| What is the location of the gastrosplenic ligament? |
|
Definition
| It extends from the hilum of the spleen to the greater curvature of the stomach. |
|
|
Term
| What are the dimensions of the spleen (ribs)? |
|
Definition
|
|
Term
| Palpating the spleen below the left costal margin in an adult usually indicates what? |
|
Definition
|
|
Term
| Where is the stomach's angular notch located? |
|
Definition
| The lesser curvature is indented along its lower margin by the angular notch. |
|
|
Term
| Is the stomach a retroperitoneal organ? |
|
Definition
|
|
Term
| Where is the lesser omentum? |
|
Definition
| It extends from the liver's visceral surface to the lesser curvature of the stomach and the upper border of the proximal half of the 1st part of the duodenum. |
|
|
Term
| Where is the greater omentum? |
|
Definition
| It arises from the greater curvature of the stomach and the lower border of the proximal half of the first part of the duodenum. |
|
|
Term
| Is the duodenum intraperitoneal? |
|
Definition
| The first portion is intraperitoneal; the second, third, and fourth are secondarily retroperitoneal. |
|
|
Term
| What is the most fixed segment of the small bowel? |
|
Definition
|
|
Term
| What are the three branches of celiac artery? |
|
Definition
| Left gastric artery, splenic artery, common hepatic artery |
|
|
Term
| What are the branches of the left gastric arteries and what do they supply? |
|
Definition
Esophageal branches- lower 1/3 of the esophagus
Gastric branches- upper part of the lesser curvature of the stomach. |
|
|
Term
| What is the largest branch of the celiac artery? |
|
Definition
|
|
Term
| What are the branches of the splenic artery and what do they supply? |
|
Definition
Short gastric arteries- supply the fundus of the stomach
Splenic branches- spleen
Gastroepiploic artery- stomach along the upper part of the greater curvature. |
|
|
Term
| What are the branches of the common hepatic artery? |
|
Definition
R. gastric artery- lower part of the lesser curvature.
Gastroduodenal artery- branches include r. gastroepiploic artery, anterior superior and anterior posterior pancreaticoduodenal artery.
Hepatic artery proper- cystic artery, common hepatic artery then branches right hepatic artery and left hepatic artery. |
|
|
Term
| What are two veins that come together to form the portal vein? |
|
Definition
| Superior mesenteric and splenic veins |
|
|
Term
| What are the branches of the gastroduodenal artery? |
|
Definition
| R. gastroepiploic, superior anterior pancreaticoduodenal artery, and superior posterior pancreaticoduodeal artery. |
|
|
Term
| What represents the functional left side of the liver? |
|
Definition
| Left lobe, quadrate lobe, and part of the caudate lobe |
|
|
Term
| What represents the functional right side of the liver? |
|
Definition
| Right lobe plus part of the caudate lobe |
|
|
Term
| What vessels unite for form the inferior vena cava? |
|
Definition
| Left, middle, and right hepatic veins |
|
|
Term
| The superior mesenteric artery supplies what organs? |
|
Definition
| Pancreas, duodenum, jejunum, ileum, cecum, vermiform appendix, ascending colon, and the proximal 2/3 of the transverse colon. |
|
|
Term
| Injury to the organs supplied by the superior mesenteric artery produces what kind of pain, and where? |
|
Definition
| Visceral pain around the umbilicus; may cause referred pain to the T8-T12 dermatomes. |
|
|
Term
| The inferior mesenteric artery supplies what organs? |
|
Definition
| Distal 2/3 of the transverse colon, descending colon, sigmoid colon, rectum, and upper half of the anal canal. |
|
|
Term
| Injury to the organs supplied by the inferior mesenteric artery causes what kind of pain, and where? |
|
Definition
| Visceral pain, usually in the hypogastric region; may cause referred pain to the L1, L2, S2, S3, and S4 dermatomes. |
|
|
Term
| The jejunum and ileum are suspended from the posterior abdominal wall by what peritoneal ligament? |
|
Definition
| Mesentery of the small intestine |
|
|
Term
| Are the jejunum and ileum intraperitoneal organs? |
|
Definition
|
|
Term
| The mucosal folds of the small bowel coils are thicker and more numerous where? |
|
Definition
| Jejunum (folds also called plicae circulares, valvulae conniventes, or the valves of Kerckring) |
|
|
Term
| Peyer's patches are found primarily where? |
|
Definition
|
|
Term
| What is the peritoneal ligament that suspends the appendix from the mesentery of the small intestine? |
|
Definition
|
|
Term
| The appendix lies in a retrocecal position in what portion of people? |
|
Definition
|
|
Term
| What is the common initial symptom of acute appendicitis? |
|
Definition
| Visceral pain in the umbilical region. |
|
|
Term
| The transverse colon is suspended from the posterior abdominal wall by what peritoneal ligament? |
|
Definition
|
|
Term
| The sigmoid colon is suspended from the posterior abdominal wall by what peritoneal ligament? |
|
Definition
|
|
Term
| What are appendices epiploicae? |
|
Definition
| Small masses of fat that are scattered over the exposed surfaces of the large colon. |
|
|
Term
| What are the teniae coli? |
|
Definition
| 3 longitudinal bands made up of smooth muscle gathered around the circumference of the large colon. |
|
|
Term
|
Definition
| Sacculations that are made up of circumferential gatherings of large intestine wall. |
|
|
Term
| What are the branches of the superior mesenteric artery? |
|
Definition
| Inferior pancreatoduodenal artery, 12-20 jejunal and ileal branches, middle colic artery, right colic artery, and the iliocolic artery. |
|
|
Term
| What are the branches of the ileocolic artery? |
|
Definition
| Colic branch, ileal branch, anterior cecal artery, posterior cecal artery, appendicular artery. |
|
|
Term
| Which artery anastomoses with the terminal end of the superior mesenteric artery? |
|
Definition
| Ileal branch of the ileocolic artery. |
|
|
Term
| Which artery supplies the transverse colon? |
|
Definition
| Middle colic artery- a branch of the superior mesenteric artery. |
|
|
Term
| Which artery supplies the ascending colon? |
|
Definition
| Right colic artery- a branch of the superior mesenteric artery. |
|
|
Term
| Which artery supplies the cecum? |
|
Definition
| Anterior and posterior cecal arteries- branches of the superior mesenteric artery |
|
|
Term
| Where are two locations that functionally inadequate anastomoses are often encountered? |
|
Definition
1) The anastomoses near the ileocecal junction between the descending branch of the right colic artery and the colic branch of the ileocolic artery.
2) The anastomses near the splenic flexure between the left branch of the middle colic artery and the ascending branch of the left colic artery. |
|
|
Term
| Where does the inferior mesenteric vein end? |
|
Definition
| Where it joins the splenic vein. |
|
|
Term
| What are portal-caval anastomoses? Where are they located and why are they important? |
|
Definition
| These are found in 'border regions' in the esophagus and the anal canal. Some of the veins in these regions which drain toward the portal vein anastomose with veins draining towards the superior or inferior vena cava. These are important because portal hypertension can cause these to rupture. |
|
|
Term
| Where does injury to the kidney produce pain? |
|
Definition
| Costovertebral angle and posterior subcostal region. |
|
|
Term
| Kidney and ureter pain can refer to which dermatomal regions? |
|
Definition
Kidney: T10-L1
Ureter: T10-L2 |
|
|
Term
| What does loin-to-groin pain refer to? |
|
Definition
| Acute distention of an upper ureter due to a renal calculus produces pain that extends from the loin or flank region of the abdomen to the ipsilateral groin area. |
|
|
Term
| How do the left and right adrenal veins end? |
|
Definition
Left- ends when it joins the left renal vein.
Right- ends when it joins the inferior vena cava. |
|
|
Term
| What vessels supply the adrenal glands? |
|
Definition
Superior adrenal arteries- branches of the inferior phrenic artery (branch of the abdominal aorta).
Middle adrenal artery- branch of the abdominal aorta.
Inferior adrenal artery- branch of the renal artery. |
|
|
Term
| Which kidney usually lies higher than the other? |
|
Definition
| Left lies at a slightly higher level than the right. In a supine patient, the left kidney's upper pole extends above the posterior segment of the 11th rib, while the right kidney's upper pole extends above the posterior segment of the 12th rib. |
|
|
Term
| How can one estimate the length of the kidney? |
|
Definition
| 3.7 x the thickness of the body of the 2nd lumbar vertebrae. |
|
|
Term
| The kidneys move downward during what two movements? |
|
Definition
| Inspiration and sitting up |
|
|
Term
| The fascia about the right kidney is in direct contact with what three organs? |
|
Definition
1) Right adrenal gland
2) Second portion of the duodenum
3) Hepatic flexure |
|
|
Term
| The fascia about the left kidney is in direct contact with what three organs? |
|
Definition
1) Left adrenal gland
2) Pancreas
3) Splenic flexure |
|
|
Term
|
Definition
| The apices of the medullary renal pyramids. Project toward the renal sinus. |
|
|
Term
|
Definition
| Cortical regions that descend between the medullary pyramids towards the renal sinus. |
|
|
Term
| What are the minor calyces? |
|
Definition
| Vessels that envelop the renal papillae and collect the urine released from the collecting tubules. |
|
|
Term
| What does a lobe of a kidney consist of? |
|
Definition
| Each renal pyramid and the cortical region that lies at its base. The kidney has 5-18 lobes. |
|
|
Term
| The renal arteries arise from the abdominal aorta at what vertebral level? |
|
Definition
| 1st or 2nd lumbar vertebra |
|
|
Term
| As each renal artery extends through the renal hilum, they divide into what? |
|
Definition
| Anterior and posterior rami, which each give rise to one or more segmental arteries (anatomic end arteries). |
|
|
Term
| What is in the pelvic cavity? |
|
Definition
Rectum
Urinary bladder
Reproductive viscera |
|
|
Term
| The floor of the pelvic cavity consists of what? |
|
Definition
| The left and right levator ani muscles. The floor of the pelvic cavity is also called the pelvic diaphragm. |
|
|
Term
|
Definition
| Consists of the external genitalia and the anal canal. |
|
|
Term
| What type of joint is the sacroiliac joint? |
|
Definition
|
|
Term
| What type of joint is the sacrococcygeal joint? |
|
Definition
|
|
Term
| What type of joint is the pubic symphysis? |
|
Definition
|
|
Term
| What does the bony pelvis consist of? |
|
Definition
| The left and right coxal bones, the sacrum, and the coccyx come together to form a bowl-shaped ring. The joints include the pubic symphysis, the sacroiliac joint, and the sacrococcygeal joint. |
|
|
Term
| What are the major ligaments of the bony pelvis? |
|
Definition
Sacrotuberous ligament- bilaterally bind the ischial tuberosity to the sacrum and coccyx.
Sacrospinous ligament- bilaterally binds the ischial spine to the sacrum and coccyx. |
|
|
Term
| The border of the pelvic inlet is called what? |
|
Definition
|
|
Term
| What makes up the pelvic brim? |
|
Definition
1) Anteriorly- pubic crests of the coxal bones.
2) Laterally- iliopectineal lines of the coxal bones.
3) Posteriorly- sacral promontory of the first sacral vertebra. |
|
|
Term
| What makes up the pelvic outlet? |
|
Definition
1) Anteriorly- pubic arch
2) Laterally- ischial tuberosities
3) Posteriorly- sacrotuberous ligaments and tip of the coccyx. |
|
|
Term
| How is a female's pelvis different from a male's pelvis? |
|
Definition
1) The pelvic cavity in a female is shallower and more cylindrical than in a male.
2) The subpubic angle is more rounded and 20-30 degrees greater in a female.
3) The pelvic outlet has a greater circumference in a female because the ischial tuberosities are more everted. |
|
|
Term
| What is the narrowest diameter near the pelvic inlet? |
|
Definition
| Obstetric conjugate diameter- it is an anteroposterior diameter; it is the distance between the midpoint of the sacral promontory to the closest point on the posterior surface of the pubic symphysis. Cannot be measured directly. |
|
|
Term
| The obstetric conjugate diameter can be estimated how? |
|
Definition
| By measuring the diagonal conjugate diameter, which is the distance from the midpoint of the sacral promontory to the inferior margin of the pubic symphysis. Subtract 1/5cm from this measurement to estimate the obstetric conjugate diameter. |
|
|
Term
| What is the narrowest diameter in the bony pelvis? |
|
Definition
| Interspinous diameter- transverse diameter that lies at the midlevel of the bony pelvis between the two ischial spines. Lies on the plane of least pelvic dimensions. |
|
|
Term
| What are the six cardinal movements of labor? |
|
Definition
Engagement
Flexion
Descent
Internal rotation
Extension
External rotation |
|
|
Term
| Describe the fetus during engagement. |
|
Definition
| The face of the fetus is ideally facing directly to the right or to the left side of the mother. |
|
|
Term
| Describe the fetus during internal rotation. |
|
Definition
| The face of the fetus ideally faces directly posterior relative to the mother. |
|
|
Term
| Which phase of birth involves the cervix being completely dilated? |
|
Definition
|
|
Term
| What nerve fibers innervate the levator ani muscles? |
|
Definition
| Nerve fibers that originate from the anterior ramus of S4 and from the pudendal nerve. |
|
|
Term
| What are the most posterior muscles of the pelvic floor? |
|
Definition
| Left and right coccygeus. |
|
|
Term
| The left and right coccygeus are innervated by fibers arising from what vertebrae? |
|
Definition
|
|
Term
| What are the origins and insertions of the coccygeus muscles? |
|
Definition
Origin: pelvic sides of the ischial spines and sacrospinous ligaments
Insertion: coccyx |
|
|
Term
| What are the origins of the piriformis? |
|
Definition
| 2nd, 3rd, and 4th sacral vertebrae |
|
|
Term
| Why is the sacral plexus important? |
|
Definition
| Gives rise to almost all the nerves that innervate the pelvic wall muscles and the muscles of the perineum. |
|
|
Term
| What is the sacral plexus? |
|
Definition
| Arises from the lumbosacral trunk (anterior rami of L4 and L5) and the anterior rami of S1, S2, S3, and part of S4 |
|
|
Term
| The pudendal nerve arises from where? |
|
Definition
| Sacral plexus, receiving fibers from S2, S3, and S4. |
|
|
Term
| Describe the pathway of the pudendal nerve. |
|
Definition
The pudendal nerve extends from the pelvis into the gluteal region through the greater sciatic foramen.
It extends inferiorly through the gluteal region by coursing past the lateral side of the sacrospinous ligament.
It then extends from the gluteal region into the posterior part of the perineum by passing through the lesser sciatic foramen. |
|
|
Term
| What is another name for the internal iliac artery? |
|
Definition
|
|
Term
| The internal iliac artery divides forming what two arteries? |
|
Definition
| The anterior and posterior trunks of the internal iliac artery. |
|
|
Term
| What does the anterior division of the internal iliac artery supply? |
|
Definition
| Pelvic and perineal viscera. Also gives rise to the obturator and inferior gluteal arteries. |
|
|
Term
| What does the posterior division of the internal iliac supply? |
|
Definition
| The sacral vertebrae, posterior abdominal wall muscles, and gluteal regions. |
|
|
Term
| Which surface of the bladder is covered with peritoneum? |
|
Definition
|
|
Term
| Which portion of the bladder is the most 'fixed.' |
|
Definition
|
|
Term
| As the bladder fills with urine, which part primarily becomes distended? |
|
Definition
| The superior surface bulges upwards (can elevate above the pelvic inlet). |
|
|
Term
| What is a procedure called that is used to drain urine from a swollen bladder? |
|
Definition
|
|
Term
|
Definition
| The triangular posterior region that is defined by the entrance of the two ureters superiorly and the neck of the bladder inferiorly. |
|
|
Term
| The pelvic splanchnic nerves provide what kind of innervation to the smooth muscle of the bladder and the internal sphincter? |
|
Definition
Detrusor muscle- preganglionic parasympathetic motor innervation.
Internal sphincter- inhibitory |
|
|
Term
| The lumbar splanchnic nerves provide what kind of innervation to the bladder's internal sphincter? |
|
Definition
| Preganglionic motor sympathetic fibers. |
|
|
Term
| Where do the pelvic splanchnic nerves arise from? |
|
Definition
|
|
Term
| Where do the lumbar splanchnic nerves arise from? |
|
Definition
| Lumbar ganglia of L1 and L2. |
|
|
Term
| The sensory fibers that innervate the bladder enter the spinal cord at what levels? |
|
Definition
|
|
Term
| What are the three muscles involved in timing of defecation? |
|
Definition
Internal anal sphincter- smooth muscle
External anal sphincter- skeletal muscle
Puborectalis part of the levator ani |
|
|
Term
| How does the puborectalis group of muscles within the levator ani work? |
|
Definition
| They form a U-shaped muscular sling around the posterior and lateral surfaces of the anorectal junction. Tonic contraction of the puborectalis draws the anorectal junction forward and thus increases the curvature at the anorectal junction-> helps prevent unwanted passage of feces from the rectum into the anal canal. |
|
|
Term
| The puborectalis interdigitate extensively with the muscle fibers of the deepest part of the external anal sphincter to form what prominant muscular ring? |
|
Definition
|
|
Term
| what are the arteries that supply that rectum and anal canal? |
|
Definition
Superior rectal artery
Paired middle rectal arteries
Paired inferior rectal arteries
Middle sacral artery |
|
|
Term
| What does the superior rectal artery supply? |
|
Definition
| The mucosa of the rectum and upper half of the anal canal. |
|
|
Term
| What do the middle rectal arteries supply? Where do they originate? |
|
Definition
| The muscularis externa of the rectum and anal canal. They originate from the anterior division of the internal iliac artery. |
|
|
Term
| What do the inferior rectal arteries supply? Where do they originate? |
|
Definition
| They supply the lower half of the anal canal, internal sphincter, external sphincter. They arise from the internal pudendal artery. |
|
|
Term
| What does the middle sacral artery supply? Where does it originate? |
|
Definition
| It supplies the posterior parts of the anorectal junction and the anal canal. It arises from the abdominal aorta above its terminal bifurcation. |
|
|
Term
| The mucosa of the rectum and upper half of the anal canal is drained by what venous system? |
|
Definition
| Internal rectal venous plexus->superior rectal vein->portal vein |
|
|
Term
| The mucosa of the lower half of the anal canal is drained by what venous system? |
|
Definition
| External rectal venous plexus->inferior rectal vein->inferior vena cava |
|
|
Term
| What is the pectineal line? |
|
Definition
| The anal valves collectively form this transverse fold which encircles the anal canal at the border between its upper and lower halves. |
|
|
Term
| Where does the lymph from the rectum and anal canal drain? |
|
Definition
Upper half of the rectum- inferior mesenteric nodes
Lower half of the rectum and upper half of the anal canal- internal iliac nodes
Lower half of the anal canal- horizontal group of superficial inguinal nodes |
|
|
Term
| Describe the innervation to the rectum and anal canal. |
|
Definition
| The pelvic splanchnic nerves provide preganglionic parasympathetic innervation and the lumbar splanchnic nerves provide preganglionic sympathetic innervation for the rectum and upper half of the anal canal. Sensory fibers from the rectum and upper half of the anal canal enter the spinal cord at L1, L2, S2, S3, and S4. The left and right pudendal nerves provide sensory innervation for the lower half of the anal canal. |
|
|
Term
| The superficial perineal space lies between what two layers of fascia? |
|
Definition
| A deep fascial layer called the perineal membrane and a superficial fascial layer called the superficial perineal fascia, or Colles fascia (continuous with scarpa's fascia of the anterior abdominal wall). |
|
|
Term
| What does the term vulva represent? |
|
Definition
| The female's external genitalia: mons pubis, labia majora, labia minora, clitoris, vestibule, external urethral orifice, and vaginal orifice. |
|
|
Term
| Where do the round ligaments of the uterus end? |
|
Definition
|
|
Term
| What are the four bodies of erectile tissue associated with the clitoris? |
|
Definition
The paired vestibular bulbs
The paired corpora cavernosa |
|
|
Term
| The secretion of what glands contribute to vaginal lubrication during sexual arousal? |
|
Definition
| Bartholin's glands- lie immediately posterior to the vestibular glands, the ducts open into the vaginal orifice. |
|
|
Term
| The left and right crura of the clitoris are the proximal portions of what? |
|
Definition
|
|
Term
| What are the three muscles associated with the vulva? |
|
Definition
Pair of bulbospongiosus muscles- overlie the vestibular bulbs and greater vestibular glands.
Pair of ischiocavernosus muscles- superficially cover the cruris of the clitoris.
Pair of superficial transverse perineal muscles- originates from the ischia tuberosities, extend medially behind the vagina and insert onto the perineal body->stabilizes perineal body. |
|
|
Term
| The muscles of the vulva are innervated by what nerves? |
|
Definition
|
|
Term
| Where is the deep perineal space? |
|
Definition
| Between the perineal fascia and the anterior parts of the levator ani. |
|
|
Term
| What muscles of the deep perineal space control the timing of micturition in the female? |
|
Definition
| The external urethral sphincter, the urethrovaginal sphincter, and the compressor urethrae. |
|
|
Term
| What are the muscles of the deep perineal space in the female? |
|
Definition
| The external urethral sphincter, the compressor urethrae, the urethrovaginal sphincter, and the paired deep transverse perineal muscles. All are innervated by the paired pudendal nerves. |
|
|
Term
| What does the compressor urethrae muscle do? |
|
Definition
| It compresses the urethra posteriorly against the vagina. |
|
|
Term
| Posteriorly, the vagina is in direct contact with what structures? |
|
Definition
| The perineal body and the lower third of the rectum. |
|
|
Term
| What portion of the vagina is covered with peritoneum? |
|
Definition
| The upper quarter of the posterior surface. |
|
|
Term
| Where is the round ligament of the ovary? |
|
Definition
| It extends from the medial pole of the ovary to the side of the uterus. |
|
|
Term
| What is the pouch of douglas? |
|
Definition
| The peritoneal reflection from the rectum onto the vagina- creates a 'pouch.' |
|
|
Term
| What is the vesicouterine pouch? |
|
Definition
| The peritoneal reflection from the uterus onto the bladder. |
|
|
Term
| Describe the broad ligament of the uterus. |
|
Definition
| On each side of the uterus, a broad layer of peritoneum extending from the side of the uterus to the lateral pelvic wall ascends from the floor of the pelvis, drapes over the uterine tubes, and then descends onto the floor of the pelvis; the ascending and descending layers of peritoneum together are called the broad ligament of the uterus. The round ligament of the ovary and the round ligament of the uterus extend through the extraperitoneal space sandwiched between the ascending and descending layers. |
|
|
Term
| What structures extend through the extraperitoneal space sanwiched between the ascending and descending layers of the broad ligament of the uterus? |
|
Definition
| Round ligament of the ovary and round ligament of the uterus. |
|
|
Term
| Each ovary is attached by what peritoneal ligament to the posterior peritoneal layer of the broad ligament of the uterus. |
|
Definition
|
|
Term
| Is the ovary covered with peritoneum? |
|
Definition
|
|
Term
| What are the dimensions of the mesosalpinx? |
|
Definition
| The part of each broad ligament which lies below the uterine tube but above the mesovarium and the round ligament of the ovary. |
|
|
Term
| What is the portion of the broad ligament that extends from the ovary to the lateral pelvic wall? |
|
Definition
| Suspensory ligament of the ovary |
|
|
Term
| Where are the cardinal ligaments? What does it do? |
|
Definition
| They extend from the lateral pelvic walls to the cervix and vagina along the lowest margin of the extraperitoneal space within the broad ligaments of the uterus. They help to stabilize the midline position of the cervix and the upper end of the vagina. |
|
|
Term
| What is another name for the cardinal ligaments? |
|
Definition
| Transverse cervical ligaments |
|
|
Term
| Where are the uterosacral ligaments? What do they do? |
|
Definition
| They arise from the lower end of the sacrum and extend anteriorly around the rectum to attach to the cervix and vagina. Contains a muscle called the rectouterine muscle->forms a fascial shelf that is covered by a fold of peritoneum called a rectouterine fold. The uterosacral ligaments securely tether the cervix to the sacrum and help stabilize the anterior 90 degree angle between the longitudinal axes of the vagina and uterus. |
|
|
Term
| What are the four pairs of arteries that supply that vagina, uterus, uterine tubes, and ovaries? |
|
Definition
Ovarian arteries
Uterine arteries
Vaginal arteries
Internal pudendal arteries |
|
|
Term
| What is the origin of the ovarian arteries? |
|
Definition
| Abdominal aorta below the renal arteries. As it descends into the pelvis, it is closely associated with the uteter. |
|
|
Term
| What does the ovarian artery supply? |
|
Definition
->mesovarium to supply the ovaries
->medially through the broad ligament to supply the uterine tube and fundus of the uterus. |
|
|
Term
| What is the origin of the uterine arteries? |
|
Definition
| The anterior division of the internal iliac artery; it extends medially within the cardinal ligament to reach the side of the uterus. |
|
|
Term
| Which artery supplies the uterine tubes and fundus of the uterus? |
|
Definition
|
|
Term
| Which artery travels medially within the cardinal ligament? |
|
Definition
|
|
Term
| The uterine artery branches anastomose with what vessels? |
|
Definition
| The uterine branches that ascend the uterus to supply the body of the uterus and to anastomose with the uterine branches of the ovarian artery near the entrance of the uterine tube into the uterus. |
|
|
Term
| What does the uterine artery supply? |
|
Definition
| The body of the uterus and the upper part of the vagina via the vaginal branches. |
|
|
Term
| Vaginal branches of the vaginal artery anastomose with what other vessels? |
|
Definition
| The vaginal branches of the uterine arteries that descend to supply the upper portions of the vagina. |
|
|
Term
| Lymph from the lower third of the vagina drains where? |
|
Definition
| The horizontal group of superficial inguinal lymph nodes. |
|
|
Term
| Lymph from the middle third of the vagina drains where? |
|
Definition
|
|
Term
| Lymph from the upper third of the vagina drains where? |
|
Definition
| External and internal iliac nodes |
|
|
Term
| Lymph from the middle third of the vagina drains where? |
|
Definition
|
|
Term
| Lymph from the cervix and body of the uterus drains where? |
|
Definition
|
|
Term
| Lymph from the fundus of the uterus, the uterine tubes, and the ovaries drains where? |
|
Definition
| Aortic nodes at the level of the body of the 1st lumbar vertebra. |
|
|
Term
| The sensory fibers innervating the body of the uterus enters the spinal cord at what level? |
|
Definition
| T11-L1- *sympathetic innervation |
|
|
Term
| The sensory fibers innervating the cervix and the upper part of the vagina enter the spinal cord at what level? |
|
Definition
| S2-S4; *parasympathetic innervation. |
|
|
Term
| Disease or injury to the uterus will cause what kind of pain? |
|
Definition
| Visceral pain that is poorly localized to the hypogastric region. |
|
|
Term
| Disease or injury to the cervix or upper part of the vagina cause what kind of pain? |
|
Definition
| Visceral pain that is poorly localized to the lumbosacral region. |
|
|
Term
| What nerves provide sensory innervation to the lowest part of the vagina? |
|
Definition
| Right and left pudendal nerves |
|
|
Term
| What are the posterior and lateral attachments for Colle's fascia? |
|
Definition
Posteriorly- attached to the posterior margin of the perineal membrane.
Laterally- ischiopubic rami
*In males, Colle's fascia extends inferiorly into the penis and scrotum. |
|
|
Term
| Where does Scarpa's fascia fuse with the fascia lata? |
|
Definition
| Just below the inguinal ligament in the thigh. |
|
|
Term
| In the case of a traumatic rupture of the penile urethra, why can the blood and urine NOT pass into the anal region of the perineum? |
|
Definition
| Because of the attachment of Colle's fascia to the posterior margin of the perineal membrane. |
|
|
Term
| In the case of a traumatic rupture of the penile urethra, why can the blood and urine NOT extend into the thigh? |
|
Definition
| Because of the fusion of Scarpa's fascia on each side to the fascia lata of the thigh just below the inguinal ligament, AND the attachment of Colle's fascia on each side to the ischiopubic rami. |
|
|
Term
| What are the 5 tissue layers of the scrotum? |
|
Definition
Skin
Superficial fascia
External spermatic fascia
Cremasteric fascia
Internal spermatic fascia |
|
|
Term
| Where can the dartos muscle be found? |
|
Definition
| Within the superficial fascial layer of the scrotum. |
|
|
Term
| What does the cremaster muscle do? |
|
Definition
| Acts to raise the testeis. |
|
|
Term
| Explain the cremaster reflex. |
|
Definition
| If a fingernail is stroked along the upper medial surface of the thigh, the cremaster muscle reflexively contracts cause the muscle to raise the testes. This happens because the genitofemoral nerve (from the lumbar plexus, L1 and L2) has a genital branch to the cremaster muscle, and a sensory femoral branch. |
|
|
Term
| What is the white, fibrous capsule the surrounds the testis? |
|
Definition
|
|
Term
| What is included within the spermatic cord? |
|
Definition
Vas deferens
Testicular cremasteric
Vas deferens arteries
Pampiniform plexus
Lymphatics
Nerves
*passes from the scrotum to the abdomen via the inguinal canal. |
|
|
Term
| What is the origin of the testicular artery? |
|
Definition
|
|
Term
| Where is the origin of the cremasteric artery? |
|
Definition
| Inferior epigastric artery |
|
|
Term
| What is the pampiniform plexus? |
|
Definition
| Highly anastomotic venous plexus that drains the testes->eventually forms the testicular vein. |
|
|
Term
| How does the right testicular vein end? |
|
Definition
| Joins the inferior vena cava. |
|
|
Term
| How does the left testicular vein end? |
|
Definition
| By joining the left renal vein. |
|
|
Term
| The lymphatics that drain the testes drain where? |
|
Definition
| Aortic or lumbar nodes; the lymphatics that drain the skin of the scrotal sac drain into the horizontal group of the superficial inguinal lymph nodes. |
|
|
Term
| Where does the vas deferens end? |
|
Definition
| At its union with the duct of the seminal vesicle to form the ejaculatory duct. |
|
|
Term
| Where are the seminal vesicles? |
|
Definition
|
|
Term
| What does the deep perineal space contain in the male? |
|
Definition
Urethra
External urethral sphincter
Compressor urethrae
Deep transverse perineal muscles
Bulbourethral glands |
|
|
Term
| What two muscles work together to control the timing of micturition in the male? |
|
Definition
| External urethral sphincter (which surrounds the membranous urethra) and the compressor urethrae (compresses the anterior aspect of the membranous urethra). |
|
|
Term
| The compressor urethrae and the external urethral sphincter are innervated by what nerve in the male? |
|
Definition
|
|
Term
| What muscles originates from the ischial rami and inserts on the perineal body; it stabilizes the position of the perineal body? |
|
Definition
| Paired deep transverse perineal muscles |
|
|
Term
| The erectile tissues and associated skeletal muscles in the male are all located in what space? |
|
Definition
| The superficial perineal space |
|
|
Term
| What transmits the terminal part of the male urethra/penile urethra? |
|
Definition
|
|
Term
| What proximally enlarges to form the bulb of the penis? |
|
Definition
|
|
Term
| What is the narrowest part of the male urethra? |
|
Definition
| The urethra adjacent to the eternal urethral orifice. |
|
|
Term
| What is the least distensible part of the male urethra? |
|
Definition
|
|
Term
| What constitutes the left and right cura of the penis? |
|
Definition
| The proximal portions of the corpora cavernosa- attached to the sides of the pubic arch. |
|
|
Term
| Distally, the corpora cavernosa unite to form what? |
|
Definition
| Most of the pendant part of the penis. |
|
|
Term
| What is the pair of muscles that contracts at the termination of micturition to empty the penile urethra of urine? |
|
Definition
| Bulbospongiosus muscles. Innervated by the pudendal nerve. It superficially covers the bulb of the penis. |
|
|
Term
| The rhythmic contraction of what muscles are responsible for the propulsion of semen through the penile urethra during ejaculation? |
|
Definition
|
|
Term
| What muscles superficially cover the crura of the penis? |
|
Definition
|
|
Term
| Which pair of superficial muscles help to stabilize the position of the perineal body? |
|
Definition
| Superficial transverse perineal muscles |
|
|
Term
| What arteries supply the prostate? |
|
Definition
| Inferior vesical and the middle rectal arteries. |
|
|
Term
| Most lymph collected from the prostate drains where? |
|
Definition
|
|
Term
| What are the three locations that the prostatic venous plexus drains its blood? |
|
Definition
Internal iliac veins
Vesical plexus
Vertebral venous plexuses |
|
|
Term
| The pudendal nerve provides sensory supply to the penis by what other nerve? |
|
Definition
| Dorsal nerve of the penis |
|
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