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MRCOG part 1 > ANATOMY > Flashcards

ANATOMY Flashcards

1
Q

Type of epitheium lining the ureters - and function

A

transitional - allows for stretch

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2
Q

type of epithelium lining the bladder - and function

A

Columnar/transitional - allows for stretch

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3
Q

type of epithelium lining the urethra (female) - and function

A

transitional - allows for stretch

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4
Q

Where is transitional epithelium found

A

bladder, ureters and urethra (female)

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5
Q

Where is pseudostratified epithelium found and what is the function?

A

trachea and upper resp trach. Absorbs and secretes mucous

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6
Q

Where is columnar epithelium found

A

uterus, uterine tubes, digestive tract, bladder, bronchi

Absorbs and secretes mucous/enzymes

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7
Q

Where is cuboid epithelium and what is function?

A

glands/ducts/kidney tubules

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8
Q

Arterial blood supply to ureters

A

renal
vaginal/uterine
gonadal
middle rectal

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9
Q

nerve supply to ureters

A

T11-L2

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10
Q

Describe the anatomy of the male urethra.

Where do the cowpers glands enter?

A

3 parts - prostatic, membranous (after the prostate and before the penis), penile (spongy, cavernous).

15-29cm long

The bulbourethral glands (Cowper’s glands) enter in the membranous portion.

The vas deferens travels from the testicles and then joins the seminal vesicle to formt he ejaculator duct. It then travels into the prostate to join the urethra

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11
Q

Which muscles make up the pelvic floor?

A

Levator ani - puborectalis, pubococcygeus, iliococcygeus

AND coccygeus muscle

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12
Q

What is the nerve supply to the pelvic floor

A

S3-S4 spinal nerves

pudendal nerve (sacral plexus)
peroneal (branch of pudendal)
inferior retal (sciatic)

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13
Q

arterial supply to the pelvic floor

A

inferior gluteal artery

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14
Q

How can the common peroneal nerve compression present in pregnancy and why?

A

Lithotomy position during delivery

Foot drop - dorsiflexors lost. Sensory loss to lateral lower leg

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15
Q

Foot drop and sensory loss to lateral lower leg

A

common peroneal

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16
Q

How can the femoral nerve compression present in pregnancy and why?

A

difficult birth.

Quads not working. extension at the knee.

loss of knee jerk

Sensory loff of knee and anterior thigh

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17
Q

loss of knee jerk caused by palsy of which nerve?

A

Femoral

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18
Q

Quads not working. extension at the knee.

loss of knee jerk

Sensory loss of knee and anterior thigh

Which nerve palsy?

A

Femoral

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19
Q

Which nerve can be affected by compression of fetal head and pelvic structures?

What symptoms could this cause?

A

Obturator nerve

Lack of adduction at the hip

Loss of sensation upper medial thigh

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20
Q

What would a lateral femoral cutaneous nerve palsy cause?

A

sensory loss of lateral thigh

No motor problems

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21
Q

What are the boundaries of the femoral canal?

A

Superior - inguial ligament

Medial - adductor longus

Lateral - sartorius

Floor - adductor longus, pectinus, iliopsoas

Roof - fascia lata

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22
Q

Describe the anatomy of the sperm tail

A

THE AXIAL FILAMENT

9+2

2 central longitudinal fibres called beta fibres

surrounded by 9 longitudinal fibres called alpha fibres

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23
Q

Blood supply to the tesicles

A

testicular artery
cremaster artery
artery to vas deferens

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24
Q

Venous drainage of testicles

A

pampiniform plexus
testicular vein

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25
Q

lymphatic drainage of testicles

A

lumbar and paraaortic nodes

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26
Q

Describe the fetal skull sutures

A

Middle one = sagital
Posterior one = lambdoid suture
Anterior one = coronal suture
Anterior continuation of sagital = anterior suture

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27
Q

Nerve supply to testis

A

spermatic plexus
T10 spinal segment

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28
Q

Which cell forms the blood-testis barrier. What happens within the sertoli cells

A

sertoli cells. They are the cells of the seminiferous tubules

Progenitor speratogonia cells differentiate gradually into sperm

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29
Q

Which cells form the seminiferous tubules

A

sertoli cells

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30
Q

What does sympathetic.parasympathetic do to the bladder?

A

Sympathetic is STORAGE
Parasympathetic is PEEING

T10-L2 for sympathetic
S2-S4 for parasympathetic

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31
Q

Arterial supply to bladder?

A

INTERNAL ILIAC:

Superior vesicle
Vaginal
Gluteal/obturator

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32
Q

Venous drainage of bladder?

A

vesical plexus

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33
Q

Lymphatic drainage of bladder?

A

common iliac nodes
internal iliac nodes
external iliac nodes

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34
Q

Layers of bladder

A

mucosa - columanar epithelium, lamina proprial
submucosa
detrusor
adventicia

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35
Q

Describe the full structure of sperm

A

HEAD = acrosome at the front and then nucleus containing genetic material

NECK = contains the centrioles (proximal and distal, which are necessary to initiate zygotic division

Mid piece = contain mitochondria which generate energy for swimming

Tail = longitudinal fibres (2x beta centrally) (9x alpha peripherally)

END PIECE

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36
Q

Describe the degrees of prolapse

A

0 - no prolapse
1 - >1cm in from the hymen
2 - <1cm in from the hymen - proximal or distal
3 - prolapsed beyond the hymen >1cm but <2cm past the hymen
4 - complete eversion of the vagina

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37
Q

What is the linea terminalis made of

A

It is basically the inlet of the pelvis (minus the sacral bit). It is made from the arcuate line (medial border or ileum), the pectinial line and the pubic crest (from the pubic symphsis to the pubic tubercles)

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38
Q

Descibe the inferior border of the pelvic inlet

A

pubic symphsis –> inferior ischiopubic rami –> ishial tuberosity (the large ligament that covers here is the sacrotuberous ligament

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39
Q

What does the sacrospinous ligament link to

A

ischial spine and the sacrum

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40
Q

What does the sacrotuberous ligament link to

A

sacrum and ischeal tuberosity

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41
Q

What do sertoli and leydig cells secrete?

Which receptors do they have?

A

Sertoli = secrete inhibin. FSH receptors

Leydig = secrete testosterone, LH receptors

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42
Q

What angle is the pelvic inlet at in anatomical position in comparison to the horizontal

A

50-60 degrees

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43
Q

Venous drainage of uterus, ovaries, vagina, fallopian tubes, cervix

A

uterine veins, ovarian vein, vaginal venous plexus, uterine and ovarian veins, uterine veins

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44
Q

Venous drainage of small bowel and large bowel

A

small = superior mesenteric vein and hepatic portal vein

large = superior and inferior mesenteric veins and

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45
Q

Venous drainage of kidneys, bladder, ureters

A

renal veins - drain into IVC, vesical venous plexus, renal veins and superior/inferior vesical veins

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46
Q

Venous drainage of spleen, pancreas, stomach

A

splenic vein, pancreaticoduodenal veins and pancreatic veins, gastric veins and gastroepiplioc veins and short gastric veins

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47
Q

Where do each ovarian vein drain into

A

left - renal vein
right - IVC

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48
Q

What is the hepatic portal vein made of?

A

SMA and splenic (IMA drains into this)

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49
Q

What makes up the pudendal nerve?

Branches?

Which muscles does it innervate?

A

S2-4

Innervates levtor ani, bulbospongiosus, ischiospongiosus, external urethral spincter (women), external anal sphincter,

Branches - inferior rectal, perineal, dorsal nerve of the clitoris

NOT INTERNAL ANAL SPHINCTER - innervated by pelvic splanchnic nerves

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50
Q

What are the layers of an oocyte?

A

Outer most layer - corona radiata.

Then zona pellucida - for acrosome reaction

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51
Q

Innervation of the anal sphincters

A

Internal = pelvic splanchnic (S4). Involuntary. Sympathetic is contraction

External = inferior rectal branch of pudendal (S2-4)

52
Q

What is meralgia paresthstica?

A

Another name for lateral cutaneous femoral nerve entrapment.

Causes tingling or sensory change of lateral thigh with no muscle weakness

53
Q

Sensory nerve supply to the external femal genitalia

A

Anterior labia - ilioinguinal nerve (branches into anterior labial nerves)

Posterior labia - perineal nerve from the pudendal nerve

Mons pubis - genital branch from genitofemoral nerve

54
Q

Describe the degrees of perineal tear following birth

A

1st - vaginal mucosa or frenulum of labia minora

2nd - into perineal muscle but sparing the anal sphincter

3 - extends to anal sphincter
A - partial external anal sphincter tear with <50% thickness
B - partial external anal sphincter tear with >50% thickness
C - involves internal anal sphincter

4 - involves rectal mucosa

55
Q

How many lobules are within each testi

What is a lobule

A

250-400

Functional unit of the tesis. Contains about 3 seminiferous tubules. Lobules are separated by fibroud septa which are extensions of the tunica albuginea

56
Q

What is the boundary of the true pelvis

A

The pelvic brim.

57
Q

What divides the pelvis into anterior and posterior

A

the vagina

58
Q

What part of the nephron does ADH act on and what does it do?

A

The collecting duct. It increases the number of aquaporins which reabsorb water

59
Q

Origins of the following arteries: uterine, vaginal, ovarian

A

Uterine - anterior division of the internal iliac artery

Vaginal - internal iliac

Ovarian - aorta

60
Q

Describe the course of the pudendal nerve

A

Forms from S2-4 and exits the pelvis via the greater sciatic foramen. Travels along the border of the sacrospinous ligament and re-ernters the pelvis by the lesser sciatic foramen

61
Q

What are the contents of the greater sciatic foramen

A

Nerves = Sciatic nerve, pudendal nerve, superior and inferior gluteal nerves, posterior femoral cutenous nerve, nerve to quadratis femoria and nerve to obturator internus

Vessels = superior and inferior gluteal artery and vein, internal pudendal artery and vein

Muscles = piriformis

62
Q

What are the average measurements of the pelvic inlet: oblique, anteroposterior, transverse

A

oblique = 12cm
anteroposterior = 11cm
transverse = 13cm

63
Q

What does the femoral canal contain?

A

Femoral artery (branches into common and deep)
Femoral vein (branches the great saphenous vein = the saphenofemoral junction)
Femoral nerve and terminal branches
Femoral sheath
Deep inguinal nodes

Genital branch of genito-femoral nerve not in this

64
Q

What are antigen presenting cells?

A

They find antigens and present them to the T cells. However, most cells can do this via major histocompatability compex (MHC) type 1 and are called non-professional APCs.

Macrophages are professional APCs and present using MHC1 and MHC2 which means they can recruit CD4 (t helper cells) and CD8 (cytotoxic t cells)

65
Q

Give examples of APCs

A

macrophages
dendritic cells
B cells

66
Q

Where do macrophages develop from

A

monocytes

67
Q

Describe the anatomy of the inguinal fossa

A

The inguinal fossa is located on the peritoneal surface of the anterior abdominal wall.

It has 3 thicker areas which are:
- lateral umbilical fold - contains the inferior epigastric artery
- medial umbilical ligament: remnant of the umbilical artery
- median umbilical ligament: remnant of urachus

68
Q

What does urachus become?

What is it?

A

Fibroud structure in the midline attaching the bladder to the belly button.

It becomes the MEDIAN umbilical ligament

69
Q

What is the MEDIAL umbilical ligament a remnant of?

A

umbilical arteries

70
Q

What is the lateral umbilical?

What does it contain?

A

Contains the inferior epigastric arteries

71
Q

Describe the boundaries of the inguinal canal

A

Anterior = aponeurosis of the external oblique - laterally reinforced by the internal oblique apneurosis

Posterior = conjoint tendon (medial) and transversal is fascia

Floor = inguinal ligament and lacunar ligament

Roof = internal oblique and transverse abdominis

72
Q

What does the inguinal canal contain?

A

Females = round ligament of the uterus, ilioinguinal nerve, genital branch of genitofemoral nerve

Males = spermatic cord, ilioinguinal nerve, genital branch of genitofemoral nerve

73
Q

What contributes to the lumbar plexus

A

T12-L4

74
Q

Which nerves come from the lumbar plexus and which spinal roots are they from?

A

TOTAL PLEXUS = T12-L4

Iliohypogastric - T12/L1
Ilionguinal - L1
Genitofemoral - L1/L2
Lateral cutaneous femoral - L2/L3
Femoral - L2-L4
Accessory obturator - L2/3
Obturator - L2-L4
Lumbosacral trunk

75
Q

Where does the ilioingiunal nerve come from ?

What does it inneravate?

A

L1

MOTOR: internal oblique, transversus abdominis

SENSORY: anterior labia, anterior scrotum

76
Q

Where does the iliohypogastric nerve come from ?

What does it inneravate?

A

T12/L1

MOTOR: internal oblique, transversus abdominis

SENSORY: mons pubis, upper buttock

77
Q

Where does the genitofemoral nerve come from?

What does it inneravate?

A

L1/L2

MOTOR: cremaster muscle

SENSORY: (femoral branch) upper medial thigh, scrotum (genital branch)

78
Q

Where does the lateral femoral cutaneous nerve come from?

What does it inneravate?

A

L2/L3

NO MOTOR.

SENSORY: lateral thigh

79
Q

Where does the femoral nerve come from?

What does it inneravate?

A

L2-L4

MOTOR: QUADS - quadriceps femoris, pectinius, sartorius, iliopsoas

SENSORY: anterior medial thigh (anterior femoral), medial lower leg (saphenous)

80
Q

Where does the obturator nerve come from?

What does it inneravate?

A

L2-L4

MOTOR: ADDUCTORS (magnus, longus, brevis), pectinius, gracilis, obturator externus

SENSORY: medial upper thigh

81
Q

Which is the narrowest portion of the male urethra

A

membranous. Contains the external urethral sphincter

82
Q

Boundaries of the pelvic outlet

A

POSTERIOR = tip of coccyx

POSTEROLATERAL = sacrotuberous ligaments

LATERAL = ischial tuberosities

ANTERIOR = pubic arch

83
Q

What supplies the sympathetic nerves to the uterus and cervix

A

inferior hypogastric plexus.

T10-L1.

During labour the pain is therefore referred here.

84
Q

What supplies the PARAsympathetic nerves to the uterus and cervix

A

mainly the pudendal nerve from S2-4.

Also contributing - branch of the femoral nerve and the genitofemoral nerve

85
Q

Where doe sthe vagina drain lymph to?

A

UPPER vagina = internal and external iliac nodes

LOWER vagina = inguinal nodes

86
Q

Name the drainage of the different parts of the female reproductive tract into the lymph system: breast, ovary, tubes, uterus, cervix, vagina

A

breast - axillary and parasternal

ovary - para-aortic

tubes - paraaortic

cervix - external iliac

uterus - internal iliac but fundus para-aortic

vagina - lower to inguinal, upper to I/E iliac nodes

87
Q

Which bone forms the arcuate line

A

internal border of the ilium.

88
Q

What are the contents of the broad ligament

A

2 TUBES, 2 OVARY, 2 UTERUS

fallopian tubes (as in we have two tubes)

ovarian artery, ovarian ligament

uterine artery, round ligament of uterus

89
Q

Layers of the testis

A

INNER TO OUTER:

Tunical vascularis
Tunica albuginea
tunical vaginalis (visceral)
tunical vaginalis (parietal)
fascia
dartos muscle
Skin

90
Q

lymph drainage of the scrotum

A

superficial inguinal nodes

91
Q

artery to scrotum

A

anterior scrotal artery
posterior scrotal artery

92
Q

vein to scrotum

A

testicular vein

93
Q

nerves to scrotum

A

anterior scrotal nerve
posterior scrotal nerve
genital branch of genitofemoral
posterior femoral cutaneous

94
Q

What is the function of piriformis muscle

A

external rotation of the hip

inserts onto greater trochanter.

originates from the sacrum

innervated by nerve to piriformis L5-S2

95
Q

parasympathetic innervation of bladder

A

pelvic splanchnic nerves - S2-4

96
Q

What is the superficial inguinal ring a hole in

A

external oblique anoneurosis

97
Q

Describe the rectus sheath above and below the arcuate line

A

ABOVE = the rectus abdominis lies in the internal oblique aponeurosis.

BELOW = the rectus pierces the transversalis and travels behind it

98
Q

Where is the arcuate line

A

1/3 from the belly button to the pubis

99
Q

In early labour which deramtome is pain referred to?

A

T11-T12

100
Q

What type of joint is the sacroiliac

A

synovial

101
Q

What type of joint is the pubic symphsis

A

secondary cartilaginous

102
Q

What is the normal functional bladder capacity of a human?

A

400-600ml

103
Q

Describe the structure of the detrusor muscle

A

3 layers

2x outer longitudinal smooth muscle layers with one circular muscle layer

104
Q

Which cells secrete renin in the kidneys

A

juxtaglomerular cells

105
Q

What is the juxtoglomerular apparatus made of?

A
  1. juxtoglomerular cells - secrete renin
  2. macula densa - measures changes in NaCl
  3. extraglomerular mesangial cells
106
Q

What is the rectus sheath made of

A

aponeurosis of internal, external oblique and transversalis

107
Q

Arterial supply to: ascending colon, proximal 2/3 of transverse colon, distal 1/3 of transverse colon, descending colon, sigmoid, upper 2/3 rectum, bottom 1/3 rectum, anus

A

ascending colon = SMA (right colic)
proximal 2/3 of transverse colon = SMA (middle colic)
distal 1/3 of transverse colon = IMA (left colic)
descending colon = IMA (left colic)
sigmoid = sigmoid (IMA)
upper 2/3 rectum = superior rectal (IMA)
bottom 1/3 rectum = middle rectal (internal iliac)
anus = inferior rectal (pudendal)

108
Q

Which muscles are in the superficial peroneal pouch?

A

Ischiocavernosus, bulbospongiosus, superficial transver peroneal

109
Q

What does the round ligament of the uterus originate from?

A

The gubernaculum

110
Q

Where do the bladder arteries come from

A

internal iliac

111
Q

Which part of the kidney are the functional units (nephrons)

A

In the renal cortex.

112
Q

Which nucleus in the hypothalamus releases oxytocin, vasopressin, somatostatin, TRH and CRH

A

paraventricular nucleus

113
Q

Superior and inferior borders of the deep peroneal pouch?

A

superior = urogenital diaphragm
inferior = peroneal membrane

Contents = external urethral sphincter, deep transverse peroneal muscle, urethrovaginal sphincter, compressor urethrae muscle

114
Q

Which nerve innervates the testis

A

T10, spermatic plexus

115
Q

Artery to: foregut, midgut, hindgut

A

Foregut = Coeliac Trunk
Midgut = Superior Mesenteric
Hindgut = Inferior Mesenteric

116
Q

When can the urge to void first be felt

A

150ml

117
Q

Which parts of the urethra are found within the deep perineal pouch

A

women - proximal
men - membranous

118
Q

How does the epithelium in the male urethra change

A

proximal - transitional
middle - stratified columnar
distal - stratified squamous

119
Q

What is the posterior scrotal artery a branch of?

A

internal pudendal

120
Q

How much colder is the scrotum than the body

A

2 degs

121
Q

Where does the vaginal artery arise from

A

usually internal iliac but can come from uterine

122
Q

What is the anterior scrotal artery a branch of?

A

internal pudendal

123
Q

Where does glucose reabsorption occur in the nephron

A

proximal convoluted tubule

124
Q

Describe the breast anatomy

A

15-20 lobes

each lobe contains lobules

each lobule contains a group of alveoli

alveoli are milk-secreting cuboidal cells surrounded by myoepithelial cells

125
Q

how many nephrons does the average kidney contain

A

1,000,000

126
Q

Where does the pituitary gland sit?

A

sella turcica. This is an impression in the sphenoid bone

127
Q

Where in the brain is the hypothalamus located?

A

In the diencephalon

MRCOG part 1 (3 decks)

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