Term
intra-peritoneal what? ex? |
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Definition
Stomach, First part of the duodenum [5 cm], jejunum, ileum, Cecum, appendix, structures completely surrounded by visceral peritoneum
transverse colon, sigmoid colon, Rectum, Spleen, Uterus, Fallopian tubes, ovaries |
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Term
retroperitoneal (primary) what examples |
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Definition
structures that develop behind the peritoneum and stay there
kidneys, ureters, suprarenal glands, aorta, IVC, post wall o nerves, nerve plexuses |
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Term
retroperitoneal (secondary) what? ex? |
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Definition
structures who develop interperitoneally but end up fusing (partial/whole) to the posterior abdominal wall
3/4 duodenum, ascending/descending colon, pancreas |
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Term
kidneys location (vert) which one higher? |
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Definition
- lie on posterior aspect of abdominal wall, T12 - L3. Behind peritoneum
- upper kidney protected by two floating ribs
-right kidney lower than left. liver pushes it down (a few inches) |
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Term
layers of kidney inside to outside |
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Definition
renal medulla renal cortex renal capsule (tough fibrous) perinephric fat (or "perirenal fat") renal fascia paranephric fat (or "pararenal fat")
peritoneum (anteriorly), and transversalis fascia (posteriorly). |
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Term
Hilum of kidney points in what direction what's there, what orientation? |
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Definition
points medially
renal artery/vein and renal pelvis
VEIN MOST ANTERIOR, THEN artery then pelvis |
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Term
quick kidney function run though |
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Definition
cortex (nephrons) - medulla, collecting duct pyramids - apex of pyramid/ renal papilla - minor calyx - major calyx - renal pelvis - ureter
cortex has nephrons/tubules
medulla has collecting ducts (renal pyramids)
[image] |
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Term
when renal artery reaches hilum it branches into how many segments? |
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Definition
5 END ARTERIES
superior, anterosuperior, anteroinferior, inferior and posterio |
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Term
variation of renal arteries why? in what % of people what should end up with |
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Definition
should have 1 renal artery/kidney. they ascend from pelvis and continuously re-establish/lose blood supply as they go. failure of fetal blood supply to degenerate results in accessory vessels. |
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Term
hydronephrosis what is what caused looks like? |
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Definition
distention/dilation of renal pelvis caused by obstructed urine flow.
large bags in pelvis
can be caused by accessory renal artery that hardens/compresses the ureter |
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Term
three anatomical narrowing sites of ureter
what gets lodged? |
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Definition
urtero-pelvic junction (ureter - pelv) mid ureter (where iliac art crosses) utero-vesicle junction (ureter-bladd)
kidney stones (calculi) |
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Term
symptom of kidney stone where? |
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Definition
severe pain in scrotum in spinal cord segments that innervate T11-L2 lumbar to groin |
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Term
treatment of kidney stones surgical? special precaution another? |
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Definition
surgically enter posterior lithotripsy (focused shockwave) |
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Term
Embryological development of kidney -from where? -what happens? - from what embryonic layer? - gland growth? - what's fetal kidney look like? |
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Definition
from pelvis ascend and rotate so ureters face medially mesoderm adrenal glands originally as big as kidney and shrink as kidney grows fetal kid is lobulated |
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Term
fusion misformations types (2) |
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Definition
horseshoe (fusing at pelvic brim) sigmoid (S shaped) |
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Term
horseshoe kidney -ascend until where? -orientaton of ureters |
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Definition
until inferior mesenteric artery anterior instead of medial |
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Term
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Definition
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Term
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Definition
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Term
vert location of celiac trunk |
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Definition
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Term
vert location of aortic bifurcation |
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Definition
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Term
suprarenel/adrenal glands -shape of left and right surrounded by? how regulate stress response blood supply? |
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Definition
left: crescent right: pyramidal perirenal fat regulate by synthesis of catecholamines BS: superior suprarenal middle suprarenal inferior suprarenal |
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Term
suprarenal arteries superior middle inferior
all from where?
venous drainage into what? |
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Definition
superior: inf. phrenic middle: AA inferior: renal artery
suprarenal vein |
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Term
Where does aorta pass behind diaphragm? (aortic hiatus) where aorta pops out of diaphragm |
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Definition
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Term
arteries of posterior wall (5) locations from where? |
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Definition
inferior phrenic (A) (T12) middle suprarenal (A) (L1) renal arteries (L1) (opposite SMA) testicular/overian (A) (L2) Common iliac (L4/5) |
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Term
inferior phrenic supplies what? |
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Definition
inferior diaphragm, adrenal glands |
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Term
IVC what side of aorta enters diaphragm at what vert lvl |
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Definition
right of aorta IVC hiatus at T8 |
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Term
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Definition
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Term
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Definition
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Term
common iliac veins converge to form IVC at what vert lvl |
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Definition
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Term
Right side veins drain to what vein?
Left side veins drain where? |
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Definition
Right to IVC Left to Renal V |
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Term
what runs between aorta and SMA? |
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Definition
pancreas, left renal artery, 3rd part of duodenum |
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Term
issue that could arise with Left renal vein running under SMA? other name forSMA |
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Definition
anatomical nutcracker
SMA gets pulled down by weight of intestines. could compress vein leading to varicoele in LEFT testicle. testicular/ovarian vein drains into left renal vein |
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Term
why is left testicle more prone to varicoele than right? |
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Definition
right testicular v drains straight to IVC
left testicular v drains to L renal vein |
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Term
what forms superior border of abdominal cavity? |
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Definition
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Term
diaphragm innervated what what two nerves? |
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Definition
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Term
phrenic nerve responsible for what in diaphragm
what else does phrenic innervate?? |
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Definition
motor and sensory
The PPPs (phram) pericardium, pleura, peritoneal cavity |
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Term
lower thoracic nerve resposnsible for what in diaphragm? |
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Definition
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Term
damage of either side of phrenic n. results in what? |
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Definition
HEMIDIAPHRAGM - paralysis of a side of diaphragm |
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Term
three parts of skeletal muscle of diaphragm |
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Definition
vertebral/lumber costal sternal |
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Term
Diaphragm vertebral skeletal muscle. attach where? by what? |
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Definition
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Term
Diaphragm skeletal costal muscle form what attaches where? |
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Definition
form the domes attach to ribs 6-12 |
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Term
diaphragm skeletal sternal muscle attaches where? |
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Definition
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Term
what joins aorta in aortic hiatus where again? |
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Definition
T12. azygos, thoracic duct |
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Term
I eight 10 Eggs At 12, where the structures pop out of diaphragm |
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Definition
IVC T8 Esophagus T10 Aorta T12 |
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Term
Afferent nerves -also called? -do what -where are cell bodies |
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Definition
sensory neurons carry impluses TOWARDS CNS dorsal root ganglia Afferent Arives Efferent Exits |
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Term
Efferent neurons -also called? -do what -where are cell bodies |
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Definition
motor neurons carry signal AWAY from CNS grey matter of spinal cord |
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Term
three paths of sympathetic efferent nerves... |
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Definition
preganglionic fibers exit ventral root, go through white rami into sympathetic trunk. Then..
1. synapse at same level with postganglionic neuron and exit thorugh grey rami and then posterior or anterior rami to target
2. synapse at different level though grey rami, then anti or post rami, to target
3. dont synapse with splanchnic n, and go synapse at a prevertebral ganglia ( a ganglion between sympathetic trunk and organ) |
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Term
preverterbral gangion what? examples |
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Definition
ganglion located between the sympathetic trunk and an organ.
celiac ganglia, superior mesenteric ganglia, inferior mesenteric ganglia |
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Term
SAME DAVE
paths of somatic afferent/efferents |
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Definition
sensory afferent motor efferent
dorsal afferent ventral efferent |
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Term
summary of somatic nerve function |
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Definition
impulse carried by afferent neuron (sensory) -> dorsal root -> posterior horn -> interneuron -> efferent cell body in anterior (lateral) horn -> ventral root -> body
somatic efferent/afferent 1,2
[image] |
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Term
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Definition
sensory impluse -> dorsal root -> spinal cord -> cell body of preganglionic neuron -> ventral root -> white rami -> sympathetic ganglion then, if heads straight to organ sympathetic ganglion -> gray rami -> anterior/posterior rami -> body
sympathetic efferent 3,4,5
[image] |
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Term
preganglionic cell bodies in lateral horns of spinal cord between what and what vert locations? |
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Definition
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Term
somatic nerves to abdominal wall |
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Definition
Phrenic (C3-5) -diaphragm
Lower thoracic nerves (T7-12) intercostal nerves, rectus abdominus
Subcostal nerve (anti rami of T12) EO and skin of anterolateral abd wall - not lumbar plexus nerve *palpate 12 rib to find |
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Term
cutaneous branches of lower thoracic nerves |
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Definition
CB around Xiphoid (T7)
CB around umbilicus (T10)
CB just above pubic bone T12
CB just above inguinal region (L1)
[image] |
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Term
sympathetic nerves/ structures |
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Definition
sympathetic trunk, greater/lesser/least splancnic |
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Term
parasympathetic nerves
origin of pre-parasympathetic neurons? |
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Definition
cranio-sacral:
cranial derived, come off spinal cord
in sacral region
vagus CNX, pelvic splancnic (S2-S4) |
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Term
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Definition
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Term
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Definition
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Term
iliohypgastric
ilioinguinal
vert location?
location?
finish where? |
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Definition
both L1, cross quadratus lumborum.
iliohypogastric superior to ilioinguinal
end up as superficial nerves on abdominal wall |
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Term
genitofemoral
vert location?
location
what reflex a part of? |
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Definition
L1-L2
on top of Psoas muscle
both sensory/motor components
femoral part -> cutaneous over femoral triangle
genito part -> innervs cretmaster muscle
*part of cremaster reflex |
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Term
lateral femoral cutaneous
location, end point?
associated syndrome?
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Definition
crosses across illiacus muscle, under inguinal ligament, ends on anterior lateral part of thigh (sensory)
myalgia parenthetica
-tight, low pants compress nerve causing parestheia over lateral anterior thigh |
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Term
femoral nerve
vet location?
location? |
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Definition
L2-L4
between illiacus and psoas muscles |
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Term
Obturator
vert location?
location |
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Definition
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Term
lumbosacral trunk
(lumbar plexus)
vert location
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Definition
L4-L5
from spinal hole to pelvis
connects lumbar plexus to sacral plexus |
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Term
sympathetic thoracolumbar region
what (nerves)?
what through what?
includes what chains? |
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Definition
where preganglionic ganglia reside.
T1-L2
sympathetic, thoracic splanchnic, lumbar splanchnic |
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Term
autonomic aortic plexus
what means?
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Definition
sympathetic/parasympathetic neurons running in it
ganglia = postganglionic sympathetic masses
[image]
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Term
celiac plexus
components
also called |
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Definition
2 celiac ganglia, 1 superior mesenteric ganglion
solar plexus |
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Term
greater splanchnic nerves
path |
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Definition
from posterior thorax, through diaphragm
greater splan = preganglionic symathetic nerve heading to synpase at post ganglionic sympathetic neurons at celiac ganglion |
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Term
lesser/least splanchnic nerves
path |
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Definition
pierces diaphragm, go to other ganglia |
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Term
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Definition
nerves coming off are pre-gangilionic sympathetic looking for post ganglionic neurons to synapse with
*post ganglionic nerves are those that actually cause reponses. |
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Term
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Definition
intermediallateral cell column: where sympathetics cell bodies are located T1-L2
impluse from column heads to sympathetic ganglia and can do 1 of 4 things
-synapse to postganglionic neuron ->grey -> spinal nerve going out(venral primary ramus, in this case) to some muscle/organ
-move to superior ganglion in chain
- move to ganglion below
-synapase with postganglionic neuron in sympathetic gangion and move out into abdomen
-look for a more peripheral post ganglionic sympathetic neuron (eg. greater splanchnic to celiac ganglion) then to a target tissue by way of blood vessel
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Term
what are post ganglionic fibers doing in a somatic nerve (ventral rami)? |
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Definition
use somatic nerves to get to where they wanna go
-control sweat, erector pilli muscles, smooth muscles - all sympathetically controlled |
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Term
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Definition
blue structure = vagus nerve
preganglionic goes though plexus, does NOT synapse and goes straight to target tissue.
post ganglionic neurons inside the target tissue itself
(parasympaetheic)
post ganglionic parasympathetic fibers are very short,
preganglionic fibers are very long |
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Term
LENGTH
pre ganglionic sympathetic fibers
post ganglionic sympathetic fibers |
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Definition
pre: short
post: long
post are long becuase they dont lie in target tissue but in ganglionic masses |
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Term
what kinds of neurons run along SMA? |
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Definition
sympathetic
parasympathetic
sensory |
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Term
what kinds of neurons run along IMA? |
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Definition
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Term
vagus nerve travels down what blood vessel? |
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Definition
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Term
how much of gut is innervated by vagus parasympatheic fibers? |
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Definition
about 2/3rds of the transverse colon
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Term
how does the rest of gut get innervated by parasympathetic neurons if vagus only goes 2/3rd of way down transverse colon?
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Definition
pelvic splanchnic n
S2,3,4 keeps penis off the floo
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Term
how does pelvic splanchnic run innervations along gut?
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Definition
uses superior rectal artery to ascend then spreads to hind gut using other blood vessels of IMA, but not IMA itself
[image] |
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Term
general function of autonomic in GI track?
sympathetic
parasym |
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Definition
sympathetic: vaso constrictive of gut vessels
parasymp: gland secretion (muscous/digestive juices), peristalsis - digestive processes |
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Term
visceral afferents
where are cell bodies |
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Definition
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Term
what provides sensory information to pareital peritoneum?
where would cell bodies be? |
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Definition
somatic nerves:
lower thoracic (CB at xiphoid T7, CB at umbilicus T10)
upper lumbar (CB atpubic bone T12, CB at inguinal region L1)
dorsal root ganglia |
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Term
visceral afferents
where are cell bodies?
involve what kind of receptors? |
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Definition
like somatic afferents, have cell bodies in dorsal root ganglia
stretch (visceral stretch) receptors felt as referred pain, according to spinal cord level of sensory cell bodies)
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Term
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Definition
green: incomign afferent somatic sensory fibers, with cell bodies in dorsal root, |
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Term
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Definition
visceral afferents (black)
comign from gut (eg. distended), through sympathetic ganglia -> white rami >spinal nerve >bodies in DRoot then do other stuff.
somatic/visceral afferents both enter at same place, through same root - REFERRED pain with afferents. |
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Term
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Definition
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Term
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Definition
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Term
referred pain (due to stretch, distention, ischemia)
Hollow tube organs
where is pain referred for:
forgut (stomache - mid DD)
midgut (mid DD to 2/3 Tcolon)
hindgut
kind of pain?
solid organs? |
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Definition
along midline
forgut superior to umbilicus,
midgut at umbilicus
hind at lower abdomen
dull achey pain
solid organs usually will have pain over the organ itself |
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Term
when will visceral referred pain become localized?
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Definition
when the organ irritates the parietal peritoneum (somatic) |
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Term
visceral pain is:
somatic pain is:
both can abe referred |
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Definition
dull, achy
poorly localized
the opposite
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Term
lymph drainage of testes/scrot/abdomen |
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Definition
lymph usually follows vessels.
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Term
cisterna chyli
what? where?
gets lymph from where |
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Definition
bag right behind diaphragm where aorta comes in. receives lymph from lower parts of body and drains to thoracic duct
form aortic lymphatic areas
preaorta - lie on top of aorta, drain intestines (particularly unpair arteries)
para-aortic/lumbar - drain deeper structures; two chains
from feet up
para aortic -> pre aortic - cisterna chyli - thoracic duct |
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Term
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Definition
development in abdominal cavity, lymph vessels and blood vessels form up there
different from kidney which looses/reestablishes blood supply as develops, the testes pull their blood supply down with them AND LYMPH DRAINAGE
so lymph goes up testicular vessels and wind up in lumbar/para-aortic lymph nodes
then
across intestinal nodes to cisternal chyli |
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Term
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Definition
scrotum is an outpocketing of anterior abdominal wall
lymph first to inguinal nodes (superficial inguinal nodes) then to deep ones > follow iliac vessels and end in lumbar/para aortic nodes |
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Term
when do major organ systems form in the embryo? what is important about this period? |
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Definition
4-10 weeks, embryonic period.
also time in which embryo most susceptible to outside influences |
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Term
primitive gut
from what embryonic layer? into how many layers does it branch, names? how is it suspended? |
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Definition
endoderm, tube in a tube.
3 segments: foregut: esophago - mid duodenum midgut: mid duodenum - 2/3 Tcolon hindgut: 1/3 Tcolon to 1/2 anus
suspended by ventral/dorsal mesentary |
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Term
Weeks 6-9 what major thing happens (digestive) what main misformations could happen? |
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Definition
hollow primitive tube forms from folding/enlongating of embryo.
if endoderm fails to properly recanalize: stenosis, atresia, duplication |
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Term
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Definition
causes esophagus to end as a blind pouch. will usually attach to trachea distally |
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Term
what nerve flanks developing stomach? |
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Definition
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Term
in formation of stomach curves, why is one bigger than other? |
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Definition
greater curvature resulted from the dorsal wall of stomach growing faster then the ventral wall. at this point in embryo, "greater curve" was posterior and "lesser curve" anterior |
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Term
after curves of stomach established what happens? |
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Definition
stomach rotates 90 degrees clockwise, forming a lesser sac (OMENTAL BURSA) posterior
now greater curve/dorsal side facing left |
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Term
after rotation what is orientation of vagus nerves? |
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Definition
left become anterior, right posterior
originally on right and left sides of hollow tube, tube distends dorsally then rotates. nerves left on their side of thinner tube just anterior and posterior |
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Term
which vagus nerve is anterior? |
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Definition
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Term
so, distenstion, rotation then what? |
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Definition
stomach pushed up, moving clockwise when taking a lateral view from left side (dorsal ventral axis) and given a backwards C shape
post natal orientation of duodenum /stomach attained
dorsal mesentary gets stretched as stomach moves forming greater omentum
ventral mesentary attached to developing liver now the lesser omentum |
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Term
greater omentum forms from what side of growing mesentary? |
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Definition
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Term
during stomach rotating/bending what is prone to atresia/stenosis?
artresia in this case mean?
major cause of stenosis |
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Definition
pyloric canal/sphincter
part of duodenum has no lumen and shut tight.
hypertrophy of muscles in pyloric region |
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Term
what is epiploic foramen very close to |
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Definition
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Term
formation of midgut begins as? what happens next: |
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Definition
primary intestinal loop
due to lack of space, midgut gets forced to herniate through umbilicus into umbilical cord
as it does this it undergoes 90 degree counterclockwise rotation (looks like string twisted) around SMA (chillin in body but attached via branches) |
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Term
during week 10 when more space is made available in body cavity how does midgut get incorportated back into body?
which first, cecum, Tcolon, intestines?
TCOLOn in relation to SMA |
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Definition
180 degree counterclockwise rotation and RETRACTION
cecal bud acts as knot on rope and stays in umbilicus, allowing intestines to go first which go and get settled on the LEFT, then Tcolon then cecum
SMA posterior to Tcolon |
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Term
what happens once intestines are back in cavity?
last step in this development? |
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Definition
ascending colon elongates and pushes cecum/appendix down inferiorly to it's usual spot
ascending/descending colon's mesentaries fuse with posterior wall to become secondary retroperitoneal VIA MESOCOLON |
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Term
difference betweet:
LIGAMENT MESO - (SOMETHING) OMENTUM |
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Definition
LIGAMENT = no vessels
MESO = has vessels
OMENTUM = attaches organs |
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Term
Omphalocele what? how corrected? |
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Definition
when abdominal cavity too small is doesnt permit return of instestines from umbilicus.
place elastic tube over the omphalocele and gradually twist organs into place |
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Term
Meckle's diverticulum
2s!!!!!! |
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Definition
portion of yolk stalk that doesnt degenerate. hangs of ilieum.
-can become inflammed -attached to umbilicus by a ligament. - this ligament may be PATENT, some poop comes out umbilicus
2 in long, 2 ft from ileocecal junt, 2x more in males, 2% of pop |
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Term
left sided colon results from? |
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Definition
failure of 180 degree rotation when returns to cavity. Large intestine on LEFT, small instestine on RIGHT |
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Term
reversed rotation caused by? what enters cavity first? tcolon in relation to SMA problem that could encounter? |
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Definition
when rotating 180 before coming back in cavity, intestines rotate clockwise instead of counterclockwise.
cecum/Tcolon enter first
SMA anterior to tcolon -tcolon could get compressed by SMA/pinned under duodenem when attaches to posterior wall
tcolon could get |
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Term
in normal development where is Tcolon, duodenum, small instestine, sma? |
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Definition
duodenum/small intestine posterior to Tcolon. SMA posterior to Tcolon |
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Term
subheptaic/fetal cecum what is? when becomes a problem? |
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Definition
ascending colon doesnt elongate and cecum remains undescended.
problem when appendicitis happens, mistaken for cholecystisis |
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Term
point fixation with volvulus what is? |
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Definition
portion of intestine gets fixed to body wall while other portions are still mobile. twist upon themselves = volvulus
twisted portion can become ischemic |
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Term
% people with malformed midgut |
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Definition
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Term
situs inversus what? results in? |
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Definition
reversal of all body organs!
left sided appendix |
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Term
formation of diaphragm what 4 structures must fuse? |
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Definition
pleuroperitoneal mem mesentary of esophagus thoracic wall covering septum transversum
[image] |
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Term
septum transversum (part of diaphram formation)
ends up becoming whaat of diaphram?
forms into what outside diaphragm? |
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Definition
in diaphragm: central tendon (attaches to xiphoid) houses the hiatus of IVC
outside diaphram: ventral mesentary of foregut (becomes lesser omentum) |
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Term
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Definition
IVC in central tendon
esophageal hiatus
aortic hiatus (formed byt cruras) |
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Term
by what week is diaphram innervated by phrenic n? |
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Definition
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Term
diaphragm descends to L1 by what week? |
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Definition
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Term
malformations when structures do not fuse correctly to form diaphragm: |
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Definition
foramen of morgagni Pleuroperitoneal mem abscense esophageal hiatus foramen of bochdalek |
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Term
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Definition
caused by loose connection between esophagus/diaphragm which allows esophag/stomach to slip upwards - pushing esophageal sphincter upwards |
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Term
foramen of morgagni (hernia /sternal slip)
foramen of bochdalek (lumbocostal trigone)
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Definition
[image]
morgagni: hernia close to sternum (anterior)
bochdalek: hernia at lumbar/costal trigone (poserior) |
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Term
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Definition
[image]
develops from two buds:
dorsal and ventral (from liver bud)
grow more dorsal than ventral. dorsal then rotates towards posteriorly to join dorsal bud.
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