Abdominal & Pelvic Anatomy Flashcards
(165 cards)
1
Q
What structures form the boundary of the femoral triangle?
A
1) Sartorius (laterally); 2) Adductor longus (medially); 3) Inguinal Ligament (superiorly); 4) Iliopsoas (lateral floor); 5) Pectineus (medial floor)
2
Q
What is the mnemonic for the borders of the femoral triangle?
A
SAIL:
S - sartorius
A - adductor longus
I - inguinal…
L - ligament
3
Q
What forms the lateral border of the femoral triangle?
A
Sartorius
4
Q
What forms the medial border of the femoral triangle?
A
Adductor longus
5
Q
What forms the superior border of the femoral triangle?
A
Inguinal ligament
6
Q
What structures form the floor of the femoral triangle?
A
Pectineus and iliopsoas
7
Q
What structures pass through the femoral triangle?
A
Femoral nerve, artery and vein
8
Q
Which nerve supplies gluteus maximus?
A
Inferior gluteal nerve
9
Q
What is the blood supply of gluteus maximus?
A
Superior and inferior gluteal artery
10
Q
What is the action of gluteus maximus?
A
Extension and external rotation of the hip
11
Q
What is the insertion of gluteus maximus?
A
Ischial tuberosity
Iliotibial band
12
Q
What is the origin of gluteus maximus?
A
Posterior gluteal line of inner upper ilium
Posterior surface of lower sacrum
Lumbodorsal fascia
Sacrotuberous ligament
13
Q
What structures form the rectus sheath?
A
Aponeurosis’s of transversus abdominis, external oblique and internal oblique
14
Q
Which is deeper, scarpa’s or camper’s fascia?
A
Scarpa’s
15
Q
What is the anatomy of rectus sheath above the arcuate line?
A
Aponeurosis’s of external oblique and the anterior lamellae of the aponeurosis of internal oblique pass anterior
The posterior lamellae of the aponeurosis of internal oblique and aponeurosis of transversalis fascia pass posterior
16
Q
What is the anatomy of the rectus sheath below the arcuate line?
A
Aponeurosis of external oblique and internal oblique pass anterior
Aponeurosis of transversalis fascia pass posterior
17
Q
What does the right ovarian vein empty into?
A
IVC
18
Q
What does the left ovarian vein empty into?
A
Left renal vein
19
Q
Which artery supplies the foregut?
A
Coeliac trunk
20
Q
Which artery supplies the midgut?
A
Superior mesenteric
21
Q
Which artery supplies the hindgut?
A
Inferior mesenteric
22
Q
What are the branches of the coeliac trunk?
A
1) L gastric artery
2) Splenic artery
3) Common hepatic artery
23
Q
What structures does the foregut form?
A
Mouth to the duodenum
24
Q
At what level does the abdominal aorta bifurcate into the common iliac vessels?
A
L4
25
What are the terminal branches of the abdominal aorta?
Right common iliac
Left common iliac
Median sacral artery
26
What structures form the perineal body?
External anal sphincter
Transverse perineal muscles
Bulbocavernosus muscle
Levator ani muscle
27
What is the anatomical location of the deep inguinal ring?
Midpoint of the inguinal ligament
28
How is the midpoint of the inguinal ligament found?
Midpoint between ASIS and the pubic tubercle
29
What is the anatomical location of the superficial inguinal ring?
Just above and just lateral to the pubic tubercle
30
What passes through the inguinal canal in females?
Round ligament
31
What passes through the inguinal canal in males?
Spermatic cord
32
What structure passes through the superficial inguinal ring only, NOT the deep inguinal ring?
Ilioinguinal nerve
33
What are the boundaries of the inguinal canal?
Anterior - aponeurosis of external oblique
Posterior - transversalis fascia
Superior - internal oblique
Inferior - inguinal ligament
34
What is the anterior boundary of the inguinal canal?
Aponeurosis of external oblique
35
What is the posterior boundary of the inguinal canal?
Transversalis fascia
36
What is the superior boundary of the inguinal canal?
Internal oblique
37
What is the inferior boundary of the inguinal canal?
Inguinal ligament
38
What is the lymphatic drainage of the vagina?
Superior - internal iliac LNs
| Inferior = superficial inguinal LNs
39
What is the transverse diameter of the pelvis?
13cm
40
Which arteries supply the ovary?
Ovarian and uterine arteries
41
What is the mediAL umbilical ligament a remnant of?
Remnant of fetal umbilical arteries
42
What is the mediAN umbilical ligament a remnant of?
Remnant of urachus
43
What innervates the testes?
T10 and spermatic plexus
44
What is the inferior border of the deep perineal pouch?
Perineal membrane
45
What is the superior border of the deep perineal pouch?
Superior fascia of the urogenital diaphragm
46
What separates the deep and superficial pouches?
Perineal membrane
47
What is the contents of the deep perineal pouch?
Deep transverse perineal muscle
External sphincter muscle of urethra
Compressor Urethrae Muscle (female)
Urethrovaginal Sphincter (female)
Membranous portion of the urethra (males)
Proximal portion of urethra (females)
Bulbourethral gland (males)
48
Where in the brain is the hypothalamus located?
Diencephalon
49
What is meralgia paraesthetica?
Entrapment of the lateral cutaneous nerve of the thigh
50
How does the round ligament leave the pelvis?
Deep inguinal ring
51
What reinforces the inguinal canal posteriorly?
Conjoint tendon
52
Which vessels exit the pelvis via the greater sciatic foramen?
Superior gluteal artery
Inferior gluteal artery
Internal pudendal artery
53
Which vessel exits the pelvis via the greater foramen and then re-enters through the lesser sciatic foramen?
Internal pudendal artery
54
What causes entrapment of the femoral nerve in pregnancy?
Fetal pressure in a difficult birth
55
What are the consequences of femoral nerve entrapment?
Sensory loss to the anterior thigh and knee
| Quariceps weakness, loss of knee jerk
56
What causes entrapment of the lateral femoral cutaneous in pregnancy?
Pregnancy (in general)
57
What are the consequences of lateral femoral cutaneous nerve entrapment?
Sensory loss to the lateral thigh
58
What causes entrapment of the common peroneal nerve nerve in pregnancy?
Due to compression to the lateral head of fibula - occurs in leg bars
59
What are the consequences of common peroneal nerve nerve entrapment?
Sensory loss to the foot and anterolateral leg
| Foot-drop
60
What causes entrapment of the obturator nerve in pregnancy?
Compression between the head of the fetus and the bony structures of the pelvis
61
What are the consequences of obturator nerve entrapment?
Sensory loss to the upper medial thigh
| Weakness to leg adduction
62
What is the True (lesser) pelvis?
Inferior to the pelvic brim, contains the bladder, colon and reproductive organs
63
What is the False (greater) pelvis?
Superior to the pelvic brim, supports organs of the lower abdomen and the gravid uterus
64
What separates the true and false pelvis?
Pelvic brim
65
What divides the pelvis into anterior and posterior compartments?
Vagina
66
How many lobules in each testes?
250-400
67
How many seminiferous tubules are found in each testis lobule?
1-3
68
Which ligaments attach the vagina and cervix to the pelvic wall?
Cardinal and uterosacral ligaments
69
What is the contents of the superficial perineal pouch?
Ischiocavernosus muscle
Bulbospongiosus muscle
Superficial transverse perineal muscle
Crura of penis (males) / Crura of clitoris (females)
Bulb of penis (males) / Vestibular bulbs (females)
Greater vestibular glands (female)
70
What in another name for the conjoint tendon which reinforces the superficial inguinal ring posteriorly?
Falx inguinalis
71
What are the 3 important branches of the pudendal nerve?
Perineal nerve
Dorsal clitoral nerve
Inferior rectal nerve
72
What are the superficial muscles of the perineum?
Bulbospongiosus
Superficial transverse perineal muscle
Ischiocavernous
73
What type of cells are Sertoli cells?
Tall columnar
74
What is the size of a resting follicle?
0.02mm
75
What is the size of a follicle ready to ovulate?
20mm
76
Which type of injury is reduced in frequency by open (Hasson) technique compared to closed (Verress needle) technique in laparoscopic surgery?
Major vessel injury
77
The inferior epigastric artery is a branch of what artery?
External iliac artery
78
What artery is contained within the infundibulopelvic ligament?
Ovarian artery (as well as the vein; nerve plexus; lymphatics)
79
What is another name for the infundibulopelvic ligament?
Also known as the suspensory ligament
80
What type of joint is the symphysis pubis?
Cartilagenous
81
What is the arrangement of axial filaments in a sperm?
9+2
82
What is the contents of the femoral triangle?
Femoral nerve
Femoral sheath
Femoral artery
Femoral vein and sapheno-femoral junction
Deep inguinal lymph nodes and lymphatic vessels
83
What makes up the roof of the femoral triangle?
Fascia lata
84
How much cooler is the scrotum compared to core body temperature?
2-2.5 degrees cooler
85
What is the nerve root of the ilioinguinal nerve?
L1
86
Describe an anthropoid pelvis:
Ape like, AP diameter long, transverse diameter short
87
Describe a platypelloid pelvis:
Flat female type
88
Describe an android pelvis:
Male type, pelvic inlet triangular or heart shaped
89
Describe a gynaecoid pelvis:
Normal female type. Suprapubic angle 90-100 degrees
90
What is the suprapubic angle of a normal gynaecoid pelvis?
90-100 degrees
91
Which muscles forms part of the inguinal ligament?
External oblique
92
What are the three branches of the posterior division of the internal iliac artery?
1. Superior gluteal artery
2. Lateral sacral artery
3. Iliolumbar artery
93
What are the nerve root/s of the lateral cutaneous nerve of the thigh (entrapment of which causes meralgia parasthetica)?
L2-L3
94
What is the contents of the ischiorectal fossa?
1. Inferior rectal nerve and vessels
2. Pudendal canal and its contents
3. Fat pad
4. Perforating cutaneous branch of S2 and S3
5. Perineal branch of S4
6. Labial nerve and vein
95
What is the contents of the pudendal canal?
1. Internal pudendal artery
2. Internal pudendal veins
3. Pudendal nerve
96
What is another name for the pudendal canal?
Alcock's canal
97
What does the pectinate line embryologically represent?
The junction between the hindgut and the protodeum
98
Where would you find the pudendal canal (for the sake of delivering a pudendal block)?
Lateral wall of the ischiorectal fossa, above the sacrotuberous ligament
99
What is the nerve supply of rectus abdominus?
Inferior epigastric artery, T7-T12
100
In the perineum what dose the deep scarpa's fascia become?
Colles' fascia
101
What is the origin and insertion of rectus abdominis?
Origin - 5th-7th costal cartilages
Insertion - pubic crest
102
What is the origin and insertion of external oblique?
Origin - Lower 8 ribs
Insertion - pubic crest, xiphoid, linea alba, pubic tubercle, iliac crest
103
What is the origin, insertion and innervation of the internal oblique?
Origin - lumbar fasciae, iliac crest, inguinal ligament
Insertion - lower 6 costal cartilages, linea alba, pubic crest
Innervation - T7-T12
104
What is the origin, insertion and innervation of transversus abdominis?
Origin - lower 6 costal cartilages, lumbar fasciae, iliac crest, inguinal ligament
Insertion - lina alba, pubic crest
Innervation - T7-T12
105
How long is the inguinal canal?
3.8cm
106
What are the characteristics of the internal and external inguinal ring?
Internal ring = lies in the transversalis fascia
| External ring = in external oblique aponeurosis, v-shaped
107
What makes up the conjoint tendon?
Internal oblique and transversus abdominis
| Inserts into the pubic crest and pectineal line
108
What is the contents of the spermatic cord?
Arteries - testicular, vas, cremasteric
Nerves - ilioinguinal, cremasteric, sympathetic
Other - vas deferens, lymphatics, pampiniform plexus of veins
109
What does adductor canal contain?
Femoral vessels
| Saphenous nerve
110
What is the usual site of a direct inguinal hernia?
Hasselbach's triangle
111
What is the epiploic foramen/foramen of Winslow?
Entrance to the lesser omental sac
112
What are the boundaries of the pelvic outlet?
Pubic arch
x2 sciatic notch
Coccyx
113
What are the boundaries of the greater sciatic foramen?
SUPERIOR - sacroiliac ligament
POSTEROMEDIAL - sacrotuberous ligament
INFERIOR - sacrospinous ligament
ANTEROLATERAL = greater sciatic notch
114
What are the boundaries of the lesser sciatic foramen?
ANTERIOR - ischial tuberosity
LATERAL - lesser sciatic notch
POSTERIOR - sacrotuberous ligament
SUPERIOR - sacrospinous ligament
115
What are the measurements of the pelvic inlet?
Transverse - 12.7
Oblique - 11.5
Anteroposterior - 10
116
What are the measurements of the pelvic outlet?
Transverse - 10
Oblique - 11.5
Anteroposterior - 12.7
117
What are the branches of the coeliac trunk?
Left gastric artery
Splenic artery - short gastric artery, left gastroepiploic artery
Hepatic artery - right gastric artery, cystic artery, gastroduodenal artery
118
What is appendix testes a remnant of?
The paramesonephric duct
119
What is the appendix epididymis a remnant of?
The mesonephric duct
120
What are arbour vitae?
Folds of endothelium in the vagina
121
Where are Doderlein's bacilli found?
The vagina, converting glycogen to lactic acid
122
How long are the fallopian tubes?
10cm
123
What type of epithelium line the fallopian tubes?
Secretory cells (most abundant)
Ciliated simple columnar epithelium
Peg cells (least abundant)
124
What is the blood flow through a non-parous uterus?
45ml/min
125
What are the uterine ligaments?
Broad ligament
Round ligament - cornua to labia majora
Cardinal ligament - cervix to lateral wall of pelvis
Uterosacral ligament - cervic to sacrum
Pubocervical ligament - cervix to pubic bone
126
What are the layers of the ovary?
Germinal epithelium
Tunica albuginia
Cortex - containing ovarian follicles
Medulla - containing ovarian vessels
127
What are the ovarian support ligaments?
Infundibulopelvic ligament
Broad ligament
Ovarian ligament
128
What is the nerve supply of the ovary?
T10
129
What is another name for the ovarian fossa?
Waldeyer's fossa
130
What are the boundaries of the ovarian fossa?
Superior - External iliac vessel
Posterior - Internal iliac vessels, ureter
Anterior - Obliterated umbilical artery
131
Which two nerves provide the primary cutaneous sensory innervation to the labia majora?
Ilioinguinal and pudendal
132
Where are the proximal and distal centriole located in a spermatozoa?
Neck
133
What is the contents of the femoral ring?
Cloquet's node and lymphatics
134
What are the boundaries of the femoral ring?
ANTERIOR - inguinal ligament
MEDIAL - lacunar ligament
LATERAL - medial border of femoral vein
POSTERIOR - pectineal ligament and pectineus muscle
135
What nerve root mediates the cremasteric reflex?
L1
136
What nerve root mediates the abdominal reflex?
T7-T12
137
What are the branches of the superior mesenteric artery?
Intestinal arteries
Middle colic and
Right colic
138
What is the umbilical artery a branch of?
Internal iliac artery
139
What does the inguinal canal contain in women?
Round ligament
| Ilioinguinal nerve
140
What is the position of the deep inguinal ring?
Midway between the ASIS and the symphysis pubis, and about 1.25 cm superior to the midpoint of the inguinal ligament
141
What is the position of the superficial inguinal ring?
Just above lateral to the pubic tubercle
142
What are the nerve roots of obturator nerve?
L2-L4
143
Which paired structures contain the uterine arteries and veins?
Cardinal ligaments
144
Where is the muscular layer found in the fallopian tube?
Isthmus
145
What is the blood supply to the fallopian tubes?
Uterine and ovarian arteries
146
What is the venous drainage from the fallopian tubes?
Uterine and ovarian veins
147
What is the lymphatic drainage from the fallopian tubes?
Iliac, sacral and aortic lymph nodes
148
What is the lymphatic drainage of the cervix?
Internal iliac, external iliac, obturator AND para-aortic nodes
149
Are the ovary and fallopian tube covered by peritoneum?
Ovary ISN'T
| Fallopian tube IS covered by peritoneum (mostly)
150
What is the spinal level of the umbilicus, and then what is its dermatomal level
Spinal level = L3-L5 (varies)
| Dermatomal level = T10
151
What are the branches of the anterior trunk of the internal iliac artery?
Obturator artery
Superior vesicle (umbilical) artery
Uterine artery
Vaginal artery
Inferior vesical artery
Middle rectal artery
(Internal) pudendal artery - Inferior rectal artery
152
What are the branches of the posterior trunk of the internal iliac artery?
Iliolumbar artery
Lateral sacral arteries
Superior gluteal artery
153
What is the cervix made up of?
Fibrous and elastic tissue
154
Where may pain from an ovarian tumour be referred to and why?
The ureter descends in the posterior boundary of the fossa while the obturator nerve and vessels cross its floor. Therefore, ovarian disease which involves the parietal peritoneum at this site may produce pain referred via the nerve to the medial side of the thigh
155
What are the branches of the femoral artery?
1. Descending genicular artery
2. Profunda femoris
3. Superficial and deep external pudendal artery
4. Superficial epigastric
5. Superficial circumflex iliac arteries
156
In terms of its peritoneal covering, what does the POD represent?
It represents the caudal most part of the parietal peritoneum
157
What is the biologic homologue of the fallopian tubes in the male?
Appendix of the testis
158
What are the 4 layers of the vagina?
Stratified squamous epithelium
Elastic lamina propria
Fibromuscular layer ( 2 layers of smooth muscle - inner circular and outer longitudinal)
Adventitia
159
What is the arterial supply to the vagina?
Uterine and vaginal arteries
160
What is the lymphatic drainage of the vagina?
Upper 1/3rd - external iliac
Middle 1/3rd - common and internal iliac
Lower 1/3rd - superficial inguinal and peri-rectal lymph nodes
161
How is the vagina innervated?
Parasympathetic and sympathetic = uterovaginal nerve plexus (of the inferior hypogastric plexus) - suplying smooth muscle and vessels
Somatic innervation = the deep perineal nerve (from the pudendal nerve) - supplies inferior 1/5th, i.e. lowest 2-3cm
162
Where do the lymph nodes of the vulva drain?
Superficial inguinal nodes
163
What is the blood supply to the vulva?
Internal pudendal artery (supplies majority)
External pudendal artery = perineal and labial skin
164
What is the venous drainage of the vulva?
Pudendal veins
165
What is the nerve supply to the vulva?
Anterior = ilioinguinal and genital branch of genitofemoral nerve
Posterior = pudendal nerve and posterior cutaneous nerve of the thigh
