Abdomen, pelvis and perineum Flashcards

1
Q

Wall layers of the anterior abdomen (8)

A

Skin
Superficial fascia (camper-fatty; and Scarpa-fibrous)
External oblique
Internal oblique
Transversus abdominis
Trasnversalis fascia
Extraperitoneal connective tissue
Parietal peritoneum

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2
Q

three flat abdominal muscles (superficial to deepest)

A

External abdominal oblique muscle
Internal abdominal oblique muscle
Transversus abdominis muscle

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3
Q

from which abdominal layer comes the gonad?

A

Extraperitoneal connective tissue

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4
Q

Layers of spermatic fasciae (external to deepest)

A

External spermatic fascia
Cremaster muscle and fascia
Internal spermatic fascia

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5
Q

External spermatic fascia comes from

A

External oblique fascia

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6
Q

Cremaster muscle and fascia come from

A

Internal oblique fascia

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7
Q

Internal spermatic fascia

A

Transversalis fascia

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8
Q

Innervation of the anterior abdominal wall

A

ventral primary rami of the Lower 6 thoracic spinal nerves + iliphfpogastric + ilioinguinal branches of L1

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9
Q

Arterial blood supply of the anterior wall

A

superior epigastric branch of the internal thoracic artery + inferior epigastric + deep circumflex iliac branches

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10
Q

The testicular artery is branch of the..

A

Abdominal aorta

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11
Q

What assists in the regulation of the temperature of the testis?

A

Pampiniform venus plexus

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12
Q

3 fascial components that surround the spermatic cord

A
  1. External spermatic fascia (external oblique)
  2. Middle or cremasteric muscle and fascia (internal oblique)
  3. Internal spermatic fascia (trasversali fascia)
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13
Q

Which muscle helps regulate the thermal environment of the testis?

A

Cremasteric muscle

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14
Q

Lymphatic drainage of the testis

A

aortic nodes

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15
Q

Superior border of inguinal canal

A

External abdominal oblique muscle +
Transversus abdominis muscle

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16
Q

anterior border of inguinal canal

A

Aponeurosis of the external abdominal oblique + internal oblique

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17
Q

Inferior border of inguinal canal

A

Inguinal ligament + lacunar ligament

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18
Q

Posterior border of inguinal canal

A

Trasversalis fascia + conjoint tendon

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19
Q

Hernia lateral to the inferior epigastric vessels

A

Indirect

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20
Q

Hernia medial to the inferior epigastric vessels

A

Direct

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21
Q

Hernia found within the spermatic cord

A

Indirect

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22
Q

Hernia found on the surface of spermatic cord

A

direct

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23
Q

layers of the indirect hernia

A

3 spermatic layers (external, cremaster, and internal)

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24
Q

layers of the direct hernia

A

external layer of the spermatic fascia

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25
Q

Components of the Inguinal Triangle (Hesselbach)

A
  1. Inguinal ligament (inferior border)
  2. Rectus abdominis muscle (medial border)
  3. Inferior epigastric vessels (lateral border)
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26
Q

What causes a congenital indirect inguinal hernia?

A

Persistent process vaginalis

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27
Q

What causes hydrocele in a new born?

A

A persistent process vaginalis - liquid from the perineum enters the scrotum

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28
Q

Lymphatic nodes of the penis and scrotum

A

Superficial Inguinal lymph nodes

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29
Q

What causes varicocele?

A

Blood collects in the pampiniform venous plexus

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30
Q

Which one disappears when the patient lays down? Varicocele or hydrocele?

A

Varicocele

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31
Q

Artery from the foregut

A

Celiac

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32
Q

Artery from the midgut

A

Superior mesenteric

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33
Q

Artery from the hindgut

A

inferior mesenteric

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34
Q

Parasympatic innervation of the foregut

A

Vagus nerves

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35
Q

Parasympathetic innervation of midgut

A

Vagus Nerves

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36
Q

Parasympathetic innervation of hindgut

A

Pelvic splanchnic nerves

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37
Q

sympathetic innervation of the foregut

A

Preganglionic: thoracic splanchnic nerves t5-t9
Postanglionic : celiac ganglion

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38
Q

sympathetic innervation of the midgut

A

Preganglionic: thoracic splanchnic nerves t9-t12
Postganglionic: superior mesenteric ganglion

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39
Q

sympathetic innervation of the hindgut

A

Preganglionic: Lumbar splanchnic nerves L1-L2
Postganglionic: inferior mesenteric ganglion

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40
Q

Referred pain of the foregut

A

Epigastrium

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41
Q

Referred pain of the midgut

A

Umbilical

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42
Q

Referred pain of the hindgut

A

Hypogastrium

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43
Q

The esophagus comes from which division of the primitive gut tube

A

foregut

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44
Q

The stomach comes from which division of the primitive gut tube

A

foregut

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45
Q

The duodenum (first and second parts) comes from which division of the primitive gut tube

A

foregut

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46
Q

The liver comes from which division of the primitive gut tube

A

foregut

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47
Q

The pancreas comes from which division of the primitive gut tube

A

foregut

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48
Q

The Biliary apparatus comes from which division of the primitive gut tube

A

foregut

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49
Q

The gallbladder comes from which division of the primitive gut tube

A

foregut

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50
Q

The duodenum (second, third and fourth parts) comes from which division of the primitive gut tube

A

midgut

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51
Q

The jejunum comes from which division of the primitive gut tube

A

midgut

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52
Q

The ileum comes from which division of the primitive gut tube

A

midgut

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53
Q

The cecum comes from which division of the primitive gut tube

A

midgut

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54
Q

The appendix comes from which division of the primitive gut tube

A

midgut

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55
Q

The ascending colon comes from which division of the primitive gut tube

A

midgut

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56
Q

The transverse colon (proximal two thirds) comes from which division of the primitive gut tube

A

midgut

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57
Q

The transverse colon (distal third) comes from which division of the primitive gut tube

A

hindgut

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58
Q

The descending colon comes from which division of the primitive gut tube

A

hindgut

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59
Q

The sigmoid colon comes from which division of the primitive gut tube

A

hindgut

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60
Q

The rectum comes from which division of the primitive gut tube

A

hindgut

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61
Q

The anal canal (above pectinate line) comes from which division of the primitive gut tube

A

hindgut

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62
Q

Is the stomach major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major intraperitoneal organ

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63
Q

Are the liver and gallbladder major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major intraperitoneal organs

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64
Q

Is the duodenum (1st part) major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major intraperitoneal organ

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65
Q

Is the spleen major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major intraperitoneal organ

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66
Q

Is the tail of pancreas major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major intraperitoneal organ

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67
Q

Is the jejunum major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major intraperitoneal organ

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68
Q

Is the ileum major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major intraperitoneal organ

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69
Q

Is the appendix major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major intraperitoneal organ

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70
Q

Is the transverse colon major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major intraperitoneal organ

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71
Q

Is the sigmoid colon major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major intraperitoneal organ

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72
Q

Is the duodenum (2nd and 3rd parts) major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major secondary retroperitoneal organ

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73
Q

Is the head, neck and body of the pancreas major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major secondary retroperitoneal organ

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74
Q

Is the ascending colon major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major secondary retroperitoneal organ

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75
Q

Is the descending colon major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major secondary retroperitoneal organ

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76
Q

Is the upper rectum major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major secondary retroperitoneal organ

77
Q

are the kidneys major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major primary retroperitoneal organ

78
Q

are the adrenal glands major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major primary retroperitoneal organ

79
Q

are the ureters major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major primary retroperitoneal organ

80
Q

Is the aorta major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major primary retroperitoneal organ

81
Q

Is the inferior vena cava major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major primary retroperitoneal organ

82
Q

Is the Lower rectum major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major primary retroperitoneal organ

83
Q

Is the anal canal major inter peritoneal organ, major secondary retroperitoneal organ or major primary retroperitoneal organ?

A

major primary retroperitoneal organ

84
Q

Is the lesser omentum between the liver and the gut tube, or between the liver and the ventral body wall?

A

between the liver and the gut tube

85
Q

Is the falciform ligament between the liver and the gut tube, or between the liver and the ventral body wall?

A

between the liver and the ventral body wall

86
Q

Parts of the pancreas that develop from the ventral bud

A

Head and major pancreatic duct

87
Q

Parts of the pancreas that develop from the dorsal bud

A

Neck, body, tail, and minor pancreatic duct

88
Q

Congenital abnormality of gut tube:
The musculares externa hypertrophies (narrow pyloric lumen) + polyhydramnios + non bilious vomiting

A

hypertrophic pyloric stenosis

89
Q

Congenital abnormality of gut tube:
Lumen of the biliary ducts is occluded + jaundice + white-colored stool + dark-colored urine

A

Extrahepatic biliary atresia

90
Q

Congenital abnormality of gut tube:
Ventral and dorsal pancreatic buds form a ring around the duodenum

A

Annular pancreas

91
Q

Congenital abnormality of gut tube:
lumen of the duodenum occluded + polyhydramnios + bile-containing vomitus + distended stomach

A

Duodenal atresia

92
Q

Congenital abnormality of gut tube:
viscera herniate through the umbilical ring contained in a shiny sac

A

Omphalocele

93
Q

Congenital abnormality of gut tube:
viscera herniate through the body wall not enclosed in a sac

A

gastroschisis

94
Q

Congenital abnormality of gut tube:
Remnant of the vitelline duct forming a blind pounch on the anti mesenteric borer of the ileum

A

Ileal - Meckel - diverticulum

95
Q

Rule of 2 of the Meckel diverticulum

A

2 feet from the ileocecal junction
2 inches long
in 2% of the population

96
Q

Congenital abnormality of gut tube:
Loss of peristalsis + immobility of the hindgut + fecal retention + abdominal distention of the transverse colon (megacolon)

A

Colonic aganglionosis - Hirschsprung disease

97
Q

Blood supply to the liver

A

arterial blood: hepatic artery
venous blood: portal vein

98
Q

Structures of the portal triad

A

common bile duct
hepatic artery
hepatic portal vein (returns to the IVC)

99
Q

location of the portal triad

A

hepatoduodenal ligament - the right border of the lesser omentum

100
Q

Structures of the common bile duct

A

Cystic duct + common hepatic duct

101
Q

Common bile duct information

A

Descends in the hepatoduodenal ligament, passes posterior to the 1st part of the duodenum and penetrates the head of the pancreas

102
Q

Structures of the hepatopancreatic ampulla

A

Common bile duct + main pancreatic duct

103
Q

hepatopancreatic ampulla drains into

A

2nd part of the duodenum, at the major duodenal papilla - sphincter of oddi

104
Q

only part of the pancreas that is intraperitoneal

A

tail

105
Q

Blood supply of the head of the pancreas

A

Superior and inferior pancreatic duodenal branches of the gastroduodenal and superior mesenteric arteries

106
Q

Where does commonly carcinoma occurs

A

Head of the pancreas, constructing the main pancreatic dict and common bile duct, causing jaundice

107
Q

Blood supply of the neck, body and tail of the pancreas

A

Splenic artery

108
Q

Blood supply of the liver and how they reach the liver

A

splenic artery and vein by the splenorenal ligament

109
Q

Internal anal sphincter

A

circular smooth muscle
Sympathetics: lumbar splanchnics - increase tone
Parasympathetic: pelvic splanchnics - relax tone during defecation

110
Q

External anal sphincter

A

voluntary skeletal muscle controled by rectal branches of the pudendal nerve

111
Q

layers of the GI system

A
  1. Mucosa (inner) -
  2. Submucosa
  3. Muscularis externa
  4. Serosa
112
Q

In which GI layer are larger vessels

A

submucosa

113
Q

Muscle type of the muscularis externa

A

Striated in the upper third of the esophagus and smooth elsewhere

114
Q

serous cells secrete..

A

proteins and enzymes

115
Q

mucous cells secrete

A

glycosylated mucins

116
Q

Which salivary gland is?
* Lies on the master muscles in the lateral face
* Entirely serous
* Drain inside each cheek through Stensen’s duct
* Contribute to 25% of the saliva

A

Parotid glands

117
Q

Which salivary gland is?
* Lies inside the lower edge of the mandible
* Mixed serous and mucus - predominante serous
* Drain in the floor of the tongue through Wharton’s ducts
* Contribute to 70% of the saliva

A

Submandibular glands

118
Q

Which salivary gland is?
* Lies at the base og the tongue
* Mixed serous and mucus - predominante mucus
* Drain into the mouth through small ducts
* Contribute to 5% of the saliva

A

Sublingual glands

119
Q

What are Ito Cells

A

liver cells involved in storage of fat-soluble vitamins (mainly vitamin A)

120
Q

histological layers of gallbladder

A
  1. Mucosa
  2. Tunica muscularis
  3. Serosa
121
Q

Level of the aortic hiatus in the diaphragm

A

T12

122
Q

where does the abdominal aorta bifurcates

A

L4

123
Q

Branches of the abdominal aorta

A

3 unpaired visceral branches,
3 paired visceral branches
Several parietal branches

124
Q

Unpaired visceral branches of the abdominal aorta

A

Celiac
Superior mesenteric
Inferior mesenteric

125
Q

Paired visceral branches of the abdominal aorta

A

middle suprarenals
Renals
Gonads

126
Q

Unpaired parietal branches of the abdominal aorta

A

medial sacral

127
Q

Paired parietal branches of the abdominal aorta

A

Inferior phrenic
Lumbars
Common iliac

128
Q

Branches of the celiac artery (trunk)

A
  1. Left gastric artery
  2. Splenic Artery
  3. Common hepatic artery
129
Q

Most common site for an abdominal aneurysm

A

between renal arteries and the bifurcation of the abdominal aorta

130
Q

Most common site of atherosclerotic plaque

A

Bifurcation of the abdominal aorta

131
Q

Branches of the common hepatic artery

A
  • Proper hepatic artery
  • Gastroduodenal artery
132
Q

Branches of the gastroduodenal artery

A
  • Right gastroepiploic artery
  • Superior pancreaticduodenal arteries
133
Q

Branches of the superior mesenteryc artery

A
  • Inferior pancreaticduodenal arteries
  • Intestinal arteries
  • Ileocolic artery
  • Right colic artery
  • Middle colic artery
134
Q

The intestinal arteries supply…

A

jejunum and ileum

135
Q

The ileocolic arteries supply

A

distal ileum and cecum

136
Q

Right colic arteries

A

ascending colon

137
Q

The middle arteries supply

A

Proximal two-thirds of the transverse colon

138
Q

most common site for bowel ischemia

A

splenic flexure

139
Q

Branches of the inferior mesenteric artery

A
  • Left colic artery
  • Sigmoid arteries
  • Superior rectar arteries
140
Q

The left colic artery supplies..

A

distarl third of the transverse colon and the descending colon

141
Q

Location of the caval hiatus

A

T8

142
Q

the ureorectal septum divides the hindgut into

A

anorectal canal and urogenital sinus

143
Q

Potter sequence (3)

A

Clubbed feet
Pulomonary hypoplasia
Craniofacial anomalies

144
Q

Horseshoe kidney

A

fusion of both kidneys at their ends

145
Q

Location of the kidneys

A

T12 - L3

146
Q

Ureters are are retroperitoneal o peritoneal?

A

Retroperitoneal

147
Q

common sites of ureteral constriction to blockage by renal canulli

A
  • Where the renal pelvis joins the ureter
  • Where the ureter crosses the pelvic inlet
  • Where the ureter enters the wall of the urinary bladder
148
Q

Blood supply of the bladder

A

branches of the internal iliac arteries and umbilical arteries

149
Q

the venus plexus of the bladder drains to

A

Internal iliac veins

150
Q

Lymohatics of the bladder drains to

A

external and internal iliac nodes

151
Q

Innervation of the bladder

A

Parasympathetic: S2, S3 and S4 -> preganglionic fibers travel in pelvic splanchnic nerves to reach the detrusor muscle

Sympathetic: L1 and L2 (lumbar splanchnics) -> supply the trigone muscle and the internal urethral sphincter

152
Q

Bladder muscles

A

Detrusor muscle
Internal urethral sphincter
external urethral sphincter

153
Q

smooth muscle that contracts during emptying of the bladder

A

Detrusor muscle

154
Q

Internal urethral sphincter

A

Smooth muscle, activated during the filling phase to prevent leakage

155
Q

External urethral sphincter

A

Voluntary skeletal muscle; relaxed during mucturition; innerved by perineal branches of the pudendal nerve

156
Q

spastic bladder

A

lesions of spinal cord above the sacral spinal cord levels -> loss of inhibition of the parasympathetic of the detrusor muscle causing urge incontinence

157
Q

Atonic bladder

A

lesions to the sacral spinal cord segments; loss of contraction of the detrusor muscle

158
Q

renal cortex and medullary fibrous produce..?

A

erythropoietin

159
Q

components of the renal corpuscle

A

Bowman’s capsule + glommerullus

160
Q

The uro rectarl septum divides the cloaca into

A

Anorectarl canal and urogenital sinus

161
Q

which forms the permanent kidney: pronephros, mesonephros or metanephros

A

Metanephros

162
Q

Mesangial cells of the kidney

A

Palkissen or Lacis cells

163
Q

male and female differentiation of gonads

A

Female: ovary, follicle, rate ovary
Male: Testes, seminiferous tubules and rate testes (Testes-determining factor+)

164
Q

male and female differentiation of paramesonephric ducts

A

Female: uterine tubes, uterus, cervix, upper vagina
Male: appendix of testes (MIF-)

165
Q

male and female differentiation of mesonephric ducts

A

Female: duct of gartner
Male: Epididymis, ductus deferens, seminal vesicle, ejaculatory duct (testosterone+)

166
Q

male and female differentiation of genital tubercle

A

Female: clitories
Nale: Glands and body of penis

167
Q

male and female differentiation of Urogenital folds

A

Female: labia minora
Male: ventral aspect of penis

168
Q

male and female differentiation of labioscrotal swellings

A

Female: labia mejora
Male: Scrotum

169
Q

Most common cause of female pseudointersexuality

A

Congenital adrenal hyperplasia - excess of androgens

170
Q

Congenital anomalie:
46 xx, ovarian (but no testicular) tissue and masculinization of the female external genitalia

A

Female pseudointersexuality

171
Q

Congenital anomalie:
46 xx, testicular (but no ovarian) tissue and stunted development of the male external genitalia

A

Male pseudointersexuality

172
Q

Most common cause of Male pseudointersexuality

A

inadequate productionn of dihydrotestosterone due to 5a-reductase deficiency

173
Q

cause of hypospadias

A

urethral folds fail to fuse completely, resulting in the urethral orifice opening onto the ventral surface

174
Q

Cause of epispadias

A

external urethral orifice opens onto the dorsal surface of the penis

175
Q

pelvic diaphragm muscles

A

Levator ani and coccygeus

176
Q

urogenital diaphragms muscles

A

sphincter urethrae and deep transverse perineus

177
Q

support for pelvic viscera in females (6 ligaments)

A
  • Ovarian ligament
  • transverse cervical ligament
  • Uterosacral ligament
  • Suspesonsory ligament of ovary
  • Borad ligament
  • Round ligaments of uterus
178
Q

Sensory and motor innervation of perineum

A

Pudendal nerve (S2-S4) of the sacral plexus

179
Q

what does the SRY secretes?

A
  • testosterone (leydig)
  • MIF (sertoli)
180
Q

Genital tubercle gives rise to

A
  • Female: clitoris
  • Male: penis
181
Q

Urogenital folds give rise to

A
  • Female: lamina minora
  • Male: penile urethra
182
Q

Urogenital swellings give rise to

A
  • Female: labia mejora
  • Male: scrotum
183
Q

Paramesonephric ducts give rise to

A

Fallopian tubes, uterus, cervix, 1/3 upper vagina

184
Q

What differentiates internal genitalia in female

A

Paramesonephric (mullerian) ducts

185
Q

What differentiates internal genitalia in male

A

Testosterone

186
Q

What differentiates external genitalia in male

A

DHT

187
Q

Sertoli cells secrete..? to male differentiation

A

MIF

188
Q

Leydig cells secrete..? to male differentiation

A

Testosterone

189
Q

Components of the spermatic cord (5)

A
  1. Testicular artery
  2. Panpiniforme venus plexus
  3. Vas deferens
  4. Autonomic nerves
  5. Lymphatics