Term
Where is the inguinal region located? |
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Definition
Between the anterior superior iliac spine and the pubic tubercle |
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Term
The inguinal canal is formed by what process during development? |
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Definition
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Term
Define Deep/Internal Inguinal Ring |
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Definition
The hole in the transversalis fascia through which the spermatic cord (round ligament (f)) pass through
- deep aspect of the abdominal wall |
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Term
Define Superficial/External Inguinal Ring |
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Definition
The point at which the spermatic cord (round ligament) crosses the medial defect of the external oblique aponeurosis |
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Term
Boundaries of the Inguinal Canal |
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Definition
anterior: external oblique aponeurosis & internal oblique M (more lateral)
posterior: transversus abdominis M and transversali fascia
Superior: internal oblique M and transversus abdominis M and aponeurosis
Inferior: inguinal ligament and lacunar ligament |
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Term
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Definition
- Anterior superior iliac spine
- Pubic symphysis
- Deep inguinal ring
- Superficial inguinal ring
- Inguinal canal
- Obturator foramen
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Term
What is Poupart's Ligament? |
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Definition
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Term
Describe the Inguinal Ligament |
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Definition
- comprised of inferior fibers of the external oblique aponeurosis
- streches from the ASIS to the pubic tubercle
- forms the inferior floor of the inguinal canal |
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Term
Cooper's Ligament is another name for what ligament? |
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Definition
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Term
Describe the Pectineal Ligament |
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Definition
- lateral portion of the lacunar ligament
- fused to the pubic tubercle
- may include fibers from the transversus abdominis, iliopubic tract, internal oblique, and rectus abdominis |
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Term
Describe the Illiopubic Tract |
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Definition
- on deep side of inguinal ligament (looking from inside out)
- begins at ASIS and inserts into the pectineal lig.
- helps form the inferior margin of the deep (internal) inguinal ring
- continues as the anterior and medial border of the femoral canal |
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Term
Gimbernat's Ligament is also known as what? |
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Definition
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Term
Describe the Lacunar Ligament |
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Definition
- triangular fanning out of the inguinal ligament as it joins the pubic tubercle
- lateral edge forms medial border of femoral canal |
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Term
What is another name for Conjoined Tendon? |
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Definition
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Term
Describe the Conjoined Tendon |
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Definition
- fusion of the inferior fibers of the internal oblique and transversus abdominis aponeurosis, where they insert on the pubic tubercle |
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Term
Describe the Deep (Internal) Inguinal Ring
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Definition
- entrance to inguinal canal for spermatic cord (round ligament)
- entrance for genital branch of genitofemoral N
- lateral to the inferior epigastric A
- starts as an invagination of the transversalis fascia that forms an opening for the spermatic cord to enter the inguinal canal
- inferior border formed by iliopubic tract |
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Term
Describe the Superficial (external) inguinal ring
- Do things enter or exit?
- What goes through this ring?
-What is its position?
- what does it split to form? |
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Definition
- exit for the spermatic cord (round ligament), genitofemoral N, and ilioinguinal N from inguinal canal
- superior and lateral to pubic tubercle
- splits to form the medial and lateral crus (portion of the external oblique aponeurosis |
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Term
Define the Intercural Fibers |
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Definition
- formed from the superficial layer of deep fascia overlying the external oblique M and aponeurosis
- runs perpendicular to the fibers of the aponeurosis to help prevent the crura from opening
- runs perpendicular to the medial and lateral crus to prevent the opening of the superficial inguinal ring |
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Term
Describe the Gubernaculum
what does it do?
what does it become? |
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Definition
- fibrous tract connecting the primordial testes to the anterolateral abdominal wall at the site of the deep inguinal ring
- fibrous cord connecting the ovary and uterus to the developing labium majus
- becomes ovarian ligament and the round ligament |
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Term
Define Processus Vaginalis |
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Definition
- the peritoneal diverticulum (outpouching) that crosses the developing inguinal canal carrying the muscular and fascial layers of the anterolateral abdominal wall into the scrotum |
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Term
Describe the Myopectineal Orifice [image] |
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Definition
-passageway for the great vessels to the lower extremity, and for the testicle to reach the scrotum
- Site for many different hernias to occur
Borders
Superior: arch of the int. oblique M and transversus abdominis M
Lateral: iliopsoas M
Medial: lateral edge of the rectus abdominis and pubic pectin
- Iliopubic tract divides orifice into superior portion (spermatic cord) and inferior portion (iliac vessels)
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Term
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Definition
- space bordered by iliopubic tract (superior) and gonadal vessels (lateral)
- contains lateral femoral cutaneous N, femoral branch of the genitofemoral N, and femoral N
[image]
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Term
Define Triangle of Doom
- borders
- what runs through it
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Definition
- space bordered by vas deferens and spermatic cord vessels
- contains external iliacs, deep circumflex iliac V, femoral N, genital branch of genitofemoral N
- cut thru the vessels in this region and pt can bleed to death
[image] |
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Term
Define the Circle of Death |
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Definition
- vascular continuation formed by the common iliac, internal iliac, obturator, inferior epigastric, and external iliacs |
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Term
Compare direct and indirect hernias |
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Definition
- Direct Hernias
- go through the Hesselbach triangle
- protrude medial to the inferior epigastrics
- Indirect Hernias
- DO NOT go through Hesselbach's triangle
- protrude laterally to inferior epigastrics
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Term
Define Hesselbach's Triangle
- borders |
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Definition
- superior/lateral border: inferior epigastrics
- medial border: lateral edge of rectus abdominis
- inferior border: inguinal ligament |
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Term
What is the scrotal ligament a remenant of? |
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Definition
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Term
What forms the Tunica Vaginalis?
and what does it cover?
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Definition
- distal part of the processus vaginalis (the stalk degenerates)
- covers the testis and epididymis |
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Term
In females, how does the Gubernaculum function? |
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Definition
- the gubernaculum is a fibrous cord that connects the ovary and the primordial uterus to the developing labium majus |
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Term
Do the ovaries descend into the inguinal region?
How about the round ligament? |
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Definition
- No, the ovaries do not descend into the inguinal region because the ovarian ligament holds the ovaries up
- The round ligament however does enter the inguinal region |
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Term
What does the spermatic cord contain? (11 items) |
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Definition
vas deferens A/V
cremasteric A/V
testicular A/V
vas deferens
pampiniform venous plexus
genital branch of genitofemoral N
sympathetic N
lymphatic vessels
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Term
What are the 3 fascial layers of the spermatic cord?
- include the layers origin |
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Definition
- external spermatic fascia - external oblique aponeurosis
- cremaster fascia - internal oblique M
- internal spermatic fascia - transversalis fascia |
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Term
What are the layers of the scrotum? |
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Definition
2 layers - skin and dartos fascia |
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Term
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Definition
- layer of smooth muscle fibers responsible for wrinkled appearance of scrotum
- superior dartos fascia has no fat
- continuous anteriorly with Scarpa's fascia
-continous posteriorly with Colle's fascia
- attaches to skin and causes scrotum to contract and bring testis closer to abdominal cavity to keep warm and sperm alive |
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Term
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Definition
- lies on posterior surface of the testis
- is covered by tunica vaginalis
- has 3 parts head, body, tail |
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Term
Explain the relationship between the efferent ductules, rete testis, and epididymis |
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Definition
- the rete testis = network of canals at the termination of the seminiferous tubules
- the efferent ductules transport sperm from the rete testis to the epididymis where sperm is stored
- seminiferous tubules in testes -> rete testis -> efferent ductules -> epididymis |
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Term
Name the layers covering the Testis
(from most superficial to deep) |
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Definition
Outer to Inner layers
- skin
- dartos fascia
- external spermatic fascia
- cremaster fascia
- internal spermatic fascia
- tunica vaginalis (parietal layer)
- tunica vaginalis (visceral layer)
- tunica albuginea |
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Term
Describe the Vas Deferens |
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Definition
- aka ductus deferens
- continuation of the tail of the epididymis
- muscular tube that conveys sperm from the epididymis to the ejaculatory duct
- meets with seminal vesicle duct to form ejaculatory duct |
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Term
Describe the Seminal Vesicles
- where is located
- what does it do
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Definition
- located in between the fundus of the bladder and rectum
- DOES NOT STORE SPERM
- secretes thick alkaline fluid that mixes with sperm as they pass into the ejaculatory ducts and urethra |
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Term
Describe the Iliohypogastric N |
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Definition
- superior terminal branch of the anterior ramus (L1)
-pierces transversus abdominis to course b/t 2nd and 3rd layers of abdominal M (in between transversus abdominis and internal oblique M)
- branches into lateral and anterior cut. branches, pierce internal and external oblique M above superficial inguinal ring
- innervates skin overlying iliac crest, upper inguinal and hypogastric regions, internal oblique, and transversus abdominis M
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Term
Describe the Ilioinguinal N |
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Definition
- inferior terminal branch of anterior ramus of L1
- passes between 2nd and 3rd layer of abdominal M.
- enters the inguinal canal b/t the internal and external oblique M
- exits through the superficial inguinal ring
- innervates the skin of lower inguinal region, upper and medial thigh, inferiormost internal oblique M, transversus abdominis M, penis and upper scrotum (males), mons pubis and labium majus (female) |
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Term
Describe the Genitofemoral N |
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Definition
- arises from L1-2
- emerges on the ant. aspect of the psoas
- divides into the genital and femoral branches
- genital branch remains ventral to the iliac vessels and the iliopubic tract, as it enters the superficial inguinal canal (just lateral to inferior epigastric vessels)
- supplies the scrotum and cremaster M (males)
- supplies mons pubic and labia majora (females)
- femoral branch courses along the femoral sheath |
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Term
Describe the Lateral Femoral Cut. N |
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Definition
- arises from L2-3, emerges from lateral border of psoas M at level of L4
- crosses iliacus M obliquely
- passes inferiorly to the inguinal ligament where it divides to supply the lateral aspect of the thigh |
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Term
Name the different types of hernias (9) |
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Definition
- Femoral : found in the femoral canal
- Obturator: protrude through obturator canal, more common in elderly women, present w/ Howship-Romberg sign
- Umbilical: protrude thru' umbilical ring
- Spigelian: abdominal wall hernia thru' transversus abdominis aponeurosis, b/t semilunar line and the semicircular line at the lateral edge of the rectus M
- Lumbar (Petit): protrudes thru' inferior lumbar triangle (posterior)
- Grynfelt: protrudes thru' superior lumbar triangle (posterior and superior)
- Sliding: portion of hernia sac contains an intrabdominal organ
- Pantaloon: has both direct and indirect hernia ocurring simultaneously
- Epigastric: due to congenital or acquired weakness of the linea alba above the umbilicus |
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Term
Suprarenal Glands
-where are they located
- what are the measurements?
- name the fascia covering them
- describe the differences b/t the rt and lt gland |
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Definition
- located superiorly and medial to the kidneys at level of rib 11
- measures 5 x 3 x 1 and weights 4-5g
-Gerota's fascia covers the adrenal glands
- rt gland is more pyramid shaped, lt is more semilunar shape
- rt gland is close to liver and IVC
-lt gland is associated with aorta, spleen, and tail of pancreas |
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Term
Suprarenal Cortex
- what are the 3 zones? and what do they produce? |
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Definition
- Glomerulosa: mineralocorticoids
- Fasciculata: glucocorticoids
- Reticularis: androgens |
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Term
Suprarenal Medulla
- what % of the gland does it make up?
- Is it endodermal, mesodermal or ectodermal in nature?
- what does it produce? |
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Definition
- 20% of the gland (cortex makes up 80%)
- it is ectodermal in nature
- produces norepinephrine and epinephrine |
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Term
Describe the blood supply to the Suprarenal Glands
(include where the A branched from) |
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Definition
- Suprior adrenal A : from inferior phrenic A
- Middle adrenal A: from aorta
- Inferior adrenal A: from renal A |
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Term
Describe the different b/t the Rt and Lt Adrenal V |
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Definition
- the Rt adrenal V is shorter b/c IVC is on the right
- rt. adrenal V drains into IVC
- the left adrenal V is longer b/c it has to travel farther
-**the left adrenal V joins the inferior phrenic V and empties into the left renal V |
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Term
Which zones of the suprarenal cortex are present at birth and which one is not present until 3 years of age? |
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Definition
- at birth: glomerularis and fasciculata
- 3yo : reticularis |
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Term
Fetal adrenals are 10-20 times larger than adult glands due to extensive size of the cortex.
T/F |
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Definition
True - adrenals become smaller as ther cortex regresses during 1st year of life |
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Term
Name the 2 layers of fat and the fascia covering the kidneys |
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Definition
- Renal fascia (Gerota's fascia)
- Perirenal fat (inside the renal fascia)
Pararenal fat (outside renal fascia)
pararenal fat ->renal fascia -> perirenal fat |
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Term
Kidneys
- Measurements of kidneys
- Heavier in M or F? |
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Definition
- length: 10-14cm
- width: 5-6cm
-thickness: 2.5-3cm
- heavier in males |
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Term
What are the surfaces, borders, and poles of the kidneys? |
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Definition
surface : ant and post
borders: lateral and medial
poles: superior and inferior |
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Term
Kidneys have anastomotic arterial flow and are not prone to infarction when vessels are interrupted
True or False |
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Definition
False : Kidneys DO NOT have anastomotic flow --> prone to infarction when renal vessels interrupted |
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Term
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Definition
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Term
Describe the pathway of urine starting from nephron to ureter |
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Definition
bowman's capsule -> proximal convoluted tubule -> descending loop of henle -> ascending loop of henle -> distal convoluted tubule -> macula densa -> collecting ducts (located in renal papilla) -> minor calyces -> major calyces -> renal pelvis -> ureter |
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Term
Compare the rt and lt renal A |
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Definition
- Left renal A is shorter than right, since aorta is on left side
- Rt renal A passes posterior to IVC |
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Term
Describe renal A pathway/branching |
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Definition
Renal A -> segmental A -> interlobar A -> arcuate A -> afferent arterioles |
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Term
Renal Veins
- describe the differences
- location
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Definition
- renal V drain into IVC
- rt renal V is shorter than lt
- lt renal V passes anteriorly to aorta, but posteriorly to SMA (can be compressed)
- Lt renal V passes ant. to lt renal A
- Lt renal V is in continuity with the lt gonadal V, lt inferior adrenal V, and lumbar V |
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Term
What are the 3 excretory organs in development? |
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Definition
pronephros, mesonephros, metanephros |
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Term
Mesonephric duct becomes the Wolffian duct --> form male reproductive system
T/F |
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Definition
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Term
Which of the 3 excretory organs during development will become the adult kidney? Pronephros, mesonephros, metanephros ? |
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Definition
Metanephros - will become adult kidneys
- give rise to collecting tubules, minor and major calices, renal pelvis, and ureters |
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Term
During the kidneys ascent, they add segmental vessels cranially and lose them caudally as thye go up toward the suprarenal glands.
True or false |
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Definition
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Term
Where are the ureters located in relation to the renal vessels? |
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Definition
posterior to the renal vessels |
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Term
The ureter crosses anteriorly to the obliterated umbilical A.
True or False |
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Definition
False, the obliterated umbilical A passes anterior to the ureter |
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Term
The left ureter passes behind the sigmoid colon.
True or False? |
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Definition
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Term
What are the parts of the bladder? |
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Definition
- apex : anterior end that points toward pubic symphysis
- body: part b/t fundus and apex
- Fundus base of bladder formed by posterior wall
- Neck
- Uvula : slight projection of trigone |
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Term
Describe the Trigone of the bladder |
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Definition
- smooth area within the base of the bladder
- bounded by 3 orifices : right and left ureterovesical orifices and the internal urethral meatus |
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Term
Describe the position of the bladder as it relates to male and females |
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Definition
males - bladder is anterior to rectum
females - bladder is anterior to vagina and uterus (bladder -> uterus & vagina -> rectum) |
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Term
Define Median Umbilical Ligament |
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Definition
connects dome of bladder to the umbilicus |
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Term
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Definition
connects lateral wall of the bladder to the tendinous arch of the pelvic fascia |
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Term
Define Puboprostatic ligament |
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Definition
connects the pelvic wall to the prostate gland |
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Term
Define Pubovesical ligament |
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Definition
connects the pelvic wall to bladder neck |
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Term
Define Paracolpium ligament |
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Definition
- lateral attachment of the vagina to the tendinous arch of the pelvic fascia |
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Term
Describe the Cloaca as it relates to development |
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Definition
- divided by the urorectal septum -> doral rectum and ventral urogenital sinus
- recieves the allantois and mesonephric ducts |
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Term
Name the 3 parts the urogenital sinus divides into |
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Definition
- Vesical (cranial) - forms most of the urinary bladder
- Pelvic (middle) - becomes urethra in the neck of the bladder and produces prostatic and membranous portions of the uretha in the male
- Phallic (caudal) - forms penile urethra in male and vestibule of the vagina in the female
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