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Flashcards in anatomy Deck (136):
1

gonadal - venous drainage

Left ovary/testis --> left gonadal vein --> left renal vein
--> IVC
Right ovary/testes --> right gonadal vein --> IVC

2

left vs right gonadal vein

Left --> left renal --> IVC
right --> IVC

3

gonadal vein - female vs male

female --> ovarian vein
male --> testicular vein (or spermatic vein)

4

clinical significance of speramatic vein

Because left spermatic vein enters the left renal vein at 90 degrees, flow flow is less laminar on left than right
--> more pressure on left vein --> varicocelle more common in left

5

varicocelle is more common in left or right side

left

6

Cervical, hilar, Mediastinal, Axillary lymph node cluster drains ... (area)

cervical --> head and neck
hilar --> lungs
mediastinal --> Trachea and esophagus
axiallary --> Upper limb, breast, skin above umbilicus

7

Celiac lymph node cluster drains ... (area)

liver, stomach, spleen, pancreas, upper duodenum

8

Superior mesenteric lymph node cluster drains ... (area)

lower duodenum, jejunum, ilieum, colon to splenic fructure

9

Inferior mesenteric lymph node cluster drains ... (area)

colon from splenic flexure to upper rectum

10

Para-aortic lymph node cluster drains ... (area)

1. Testes
2. ovaries
3. kidneys
4. uterus

11

internal iliac nodes drain

1. lower rectum to anal canal (above the line)
2. cervix
3. corpus carvenosum
4. vagina (middle third)
5. prostate

12

superficial inguinal drain

1. anal canal (below the line)
2. skin below umbilicus (except popliteal area)
3. scrotum
4. vulva
5. vagina (lower third)

13

deep inguinal nodes

glans penis

14

external iliac nodes

1. body of uterus
2. cervix (and upper third of vagina)
3. superior bladder

15

cervix lymph drainage

external and internal iliac nodes

16

uterus lymph drainage

Para-aortic
external iliac (body)

17

lymph drainage - uterus, cervix, vagina

para-aortic uterus --> uterus
external iliac --> body of uterus, cervix, upper third vagina
internal iliac --> cervix, middle third vagina
superficial inguinal --> lower third vagina

18

Lymphatic drainage of the vagina is generally to the

external iliac nodes (upper third of the vagina), internal iliac nodes (middle third), and the superficial inguinal nodes (lower third).

19

Fenale reproductive system - ligaments

1. infundibulopelvic ligament (suspensory ligament of the ovary)
2. Cardinal ligament
3. Round ligament of uterus
4. Broad ligament
5. Ovarian ligament
6. uterosacral

20

Fenale reproductive system - ligaments an what they connect

1. infundibulopelvic (suspensory ligament of the ovary) --> ovaries to lateral pelvic
2. Cardinal --> cervix to side wall of pelvis
3. Round ligament of uterus --> uterine fundus to labia major
4. Broad --> uterus, fallopianm tuves and ovaries to pelvic side wall
5. Ovarian --> madian pole of ovary to lateral uterus
6. uterosacral --> uterus to the anterior aspect of the sacrum

21

infundibulopelvic ligament is AKA

suspensory ligament of the ovary

22

infundibulopelvic (suspensory ligament of the ovary) connects

ovaries to lateral pelvic

23

infundibulopelvic (suspensory ligament of the ovary) contains

ovarian vessels

24

cardinal ligament connects

cervix to side wall of pelvis

25

cardinal ligament contains

uterine vessels

26

Round ligament of the uterus connects

uterine fundus to labia majora

27

Round ligament of the uterus contains

nothing

28

Broad ligament connects

uterine, fallopian tubes and ovaries to pelvic side wall

29

Broad ligament contains

ovaries, fallopian tuves, round ligaments of uterus

30

uterosacral ligament connects

uterus to the anterior aspect of the sacrum

31

ovarian ligament connects

medial pole of ovary to lateral uterus

32

ovarian ligament contains

nothing

33

Derivatives of gubernaculum in females

1. ovarian ligament
2. round ligament of the uterus

34

course of round ligmament of the uterus

travels along inguinal canal, in the broad ligament, above the artery of Sampson

35

Sampson artery

- runs under the round ligament of uterus.
- is anastomosis of the uterine artery and ovarian artery

36

Broad ligament - structure

Fold of peritoneum that comprises the
1. mesosalpinx
2. mesometrium
3. mesovarium (suspends the ovaries)

37

ureter course in females

retroperotoneally, close to gonadal vessels (risk at injury during ligation of ovarian vessels) and under uterine artery)
(risk at injury during ligation of ovarian or uterine vessels)

38

an operation with uterine vessels ligation

hysterectomy

39

clinical correlation of infundibulopelvic ligament

1. very close to ureter --> risk of injury during ligation
2. ligate vessels during oophorectomy to avoid bleeding

40

vagina histology

stratified squamous epithelium, nonkeratinized

41

ectocervix histology

stratified squamous epithelium, nonkeratinized

42

transformation zone (female reproductive) histology

Squamocolumnar junction (ectocervic-endocervix)

43

endocervix histology

simple columnar epithelium

44

uterus histology

simple columnar epithelium with long tubular glands in proliferative phase
coiled glands in secretory phase

45

fallopian tube histology

simple columnar epithelium, ciliated

46

ovary, outer surface histology

simple cuboidal epithelium (germinal epithelium covering surface of ovary

47

uterus walls

inside --> endometrium
middle --> myometrium
outside --> Perimetrium

48

perimetrium?

Serous layer of visceral peritonium. It covers the outer surface of the uterus

49

ovarian artery arises from

abdominal aorta (above L2)

50

uterine artery arises from

anterior division of the internal iliac artery

51

ovarian and uterine anastomosis

Sampson artery

52

portions of cervix

1. endocervix
2. transitional zone
3. ectocervix

53

cervical os?

1. external os: the external opening into the vagina
2. internal os: theinternal opening into the endometrial cavity

54

Vaginal fornix (fornices of the vagina)

superior portions of the vagina, extending into the recesses created by the vaginal portion of cervix
1. posterior - behind the cervix (largest)
2. anterior
3. twο lateral

55

infundibulopelic - course according to Fallopian tube

it goes under

56

regions of Fallopian tube (from inner to outer)

uterine --> isthmus --> ampula --> infundibulum --> Fimbriae (ostium)

57

parts of male urethra (and direction)

(AFTER bladder and bladder neck) preprostatic urethra --> prostatic --> membranous urethra (through pelvic floor) --> spongy (penile) within the bulb and corpus sponsgiosum

58

spongy (penile urethra) is sometimes further divided to

bulbar and penile urethra

59

suspect urethreal injury in males if

blood seen at urethral meatus

60

male urethral injury - division according to location

posterior urethra - membranous
anterior urethra - bulbar and penile urethra

61

posterior urethra (membranous) trauma

prone to injury from pelvic fracture --> injury can cause urine to leak into retropubic space

62

Retropubic space is the

extraperitoneal space between the pubic symphysis and urinary bladder

63

anterior urethra bulbar and penile trauma

at risk of damage due to perineal straddle injury --> urine leak beneath deep fascia of Buck --> if fascia is torn, urine escapes into superficial perineal space

64

straddle injury

perineal trauma

65

Buck's fascia?

or fascia of the penis --> is a layer of deep fascia covering the three erectile bodies of the penis

66

Pathway of sperm during ejaculation

mnemonic: SEVEN UP
Seminiferous tubules --> Epidedidymis --> Vas deferens
--> Ejaculation ducts --> urethra --> penis

67

histology of testis and epdidemis

seminiferous tubules (Leyding cells between them, separated by septa) and covered by tunica albuginea --> concentrate in Rete testis --> head of epididymis (efferent ductule) --> tale of epididymis --> vas deferens

68

Prepuce?

- Clitoral hood, skin surrounding and protecting the head of the clitoris
- Foreskin, skin surrounding and protecting the head of the penis in humans

69

Corpus cavernosum vs corpus spongiosum
according to anatomy

corpus spongiosum --> mass of spongy tissue surrounding the male urethra within the penis (ventral)
Corpus cavernosum --> 2 sponge like regions on erectile tissue of penis (dorsal)

70

erection is control by

parasympathetic nervous system (pelvic nerve)

71

erection mechanism

NO --> increased cGMP --> SMCs relaxation --> vasodilation -> proerectile

72

norepinephrine in erection

norepinephrine increases Ca2+ concentration in in SMCs --> vasoconstriction --> antierectile

73

emission definition/controled by

phase when sperm moves from testes upto prostatic urethra. It is controlled by sympathetic nervous systme (hypogastric nerve)

74

ejaculation definition/controled by

phase when sperm moves from prostatic urethra to the outside. It is controlled by visceral and somatic nerves (The pudendal nerve)

75

emission vs ejaculation according to definition

emission --> phase when sperm moves from testes upto prostatic urethra
ejaculation --> phase when sperm moves from prostatic urethra to the outside

76

Seminiferous tubules - cells

1. spermatogonia (germ cells)
2. sertoli cells (non germ cells)
3. Leyding cells (endocrine cells)

77

Seminiferous tubules - cells/location

1. spermatogonia (germ cells) --> line seminiferous tubules
2. sertoli cells (non germ cells) --> line seminiferous tubules
3. Leyding cells (endocrine cells) --> intersitium (outside the tubule)

78

spermatogonia (germ cells) - function

maintain germ pool and produce primary spermatocytes

79

spermatogonia to sprmatozoon (only the cells)

spermatogonium --> sprmatocytes (1ry and 2ry) --> speramtides --> spermatozoon (spermatozoon in the lumen of seminiferous tubule) (SPERMATOGENESIS)

80

sertoli cells (non-germ cells) - location

line of seminiferous tubules

81

sertoli cells (non-germ cells) - action

1. secrete inhibin B (inhibits FSH)
2. secrete androgen-binding protein (maintain local levels of testosterone --> stimulate spermatogenesis)
3. produce MIF (suppress development of paramesonephric ducts)
4. form the blood-testis barrier --> isolate gametes from autoimmune attack
5. sapport and nourish developing spermatozoa
6. Regulate spermatogenesis
7. convert testosterone and androstenedione to estrogens via aromatase

82

sertoli cells (non-germ cells) are sensitive to

temperature

83

sertoli cells (non-germ cells) are sensitive to ... (explain)

temperature:
increased Q --> low sperm production and low inhibin B

84

situations that increases temperature in seminiferous tubules

1. Varicocele
2. crytorchidism

85

Blood-testis barrier - structure and function

structure: tight junction between Sertoli cells
function: a. isolates gametes from autoimmune attack
b. prevent cytotoxic agents

86

sertoli cells - homolog of female

granulosa cells

87

Leyding cells (endocrine cells) - function

secrete testosterone in the presence of LH

88

Leyding cells (endocrine cells) vs temperature

testosterone production unaffected by temperature

89

Leyding cells - area

interstitium of Seminiferous tubules

90

Leyding cells - homolg of female

theca interna cells

91

which ligaments of the female reproductive system contain nothing

the derivatives of gubernaculum
1. Round ligaments of the uterus
2. ovarian ligament

92

which ligaments of the female reproductive system contain tha major vessels of the area

1. infundibulopelvic ligament --> ovarian vesses
2. cardinal vessels --> uterine vessels

93

Female reproductive epithelial histology - MC area of cervical cancer

transformation zone

94

breast - suspensory ligaments - aka and course

aka: Cooper
course: separate the the lobes + attach the skin

95

breast - arterial supply

branches of:
1. internal thoracic (sublavian)
2. lateral thoracic (axillary)
3. anterior + posterior intercoastal

96

breast - lymph nodes

1. most: axillary
2. part of medial quadrants: parasternal

97

radial mastectomy?

breast is removed along with pectoralis major and minor, axillary nodes and vessels, and tributaries of axillary vein

98

SA node location

in the sinus venarum of the RA near the entrance of the SVC

99

AV node location

interatrial septum - RA near TV and the orifice of coronary sinus

100

inf epigastric artery - course

branch of ext iliac immediately proximal to inguinal ligament --> supply to lower anterior abdominal wall as it rans superiorlu + and medially up to abdomen

101

superior gluteal artery - course

the continuation of internal iliac artery --> post/inf to supply gluterus and a portion of hip

102

obturator artery - course

branch of internal iliac --> inf to supply pelvic organs

103

ext iliac artery branches

1. inf epigastric
2. deep circumflex iliac

104

great saphenous course

medial side of food --> anterior to medial malleolus --> medial aspect of leg + tight --> drains into demoral in the femoral tirangle (inferolateral to pupitubercle)

105

small saphenous vein course

lateral foot --> posteriorly --> into popliteal vein

106

perineal body?

central tendon of the perineum --> lies in the midline between urogenital + anal triangle
the following structures are anchored to it:
1. bulbospongiosus muscle
2. external anal sphincter
3. superficial + deep transverse perinal muscle
4. fibers from external urethral sphincter, levator ani + muscular coat of rectum

107

hip bone is consists by

3 bones: ilium, ischium, pubis

108

pelvis diaphragm weakness -->

prolapse of uteros, bladder or rectum into vagina

109

vesicouterine vs rectovesical pouch

females --> peritoneum onto anterior aspect of uterus (between uterus + bladder) --> vesicouterine pouch
males --> peritoneum onto anterior aspect of the rectum (between rectum + uterus --> rectovesical pouch

110

position of uterus

50% --> anterverted
25% retroverted
25% midverted
due to uterosacral ligament --> loss of the ligament --> prolapse into vagina

111

fructose rich compoment of sperm, and area
area of Bulbourethral gland of Cowper

seminal vesicle (posteriolateral of bladder)
seminal vesicle in ductus deferans (behind bladder) --> ejaculation duct
cowper: junction between membranous + boublous urethra

112

The recto-uterine pouch( pouch of Douglas)?

extension of the peritoneal cavity between the rectum and the posterior wall of the uterus in the female human body

113

epistomy - definition + types

it is an incision of the posterior wall of the vagina during labor:
1. medline: extend posteriorly in the midline throught perineal body (vertical)
2. mediolateral: extend througth the bulbospongiosus + transcerus perineus muscle (less risk of damage fibers of external anal sphincter)

114

urogenital dipahragm is transverse by / contains

urethra in both sexes + by vagina
contains deep transversus perineus muscles + sphincter urethrae (external sphincter)

115

branches of internal iliac artery

1. pelvic visceral branches: umbilical ar, uterine ar, ductus deferens, vaginal art, inferior vesical ar, middle rectal ar
2. perineal branches: internal pubendal --> inf rectal, perineal branch, artery to bulb, deep ar of penis, dorsal ar of penis
3. pelvic wall branches --> iliolumbar, lateral sacral
4. lower limb branches --> superior glut, inf glut, oburator ar

116

pudendal nerve - branches

3 main branches --> inf rectal, perineal nerve, dorsal nerve of penis + clitoris

117

unresponsive to medical management postpartum hemorrhage -->

bilateral ligation of the internal iliax artery (aka as hypogasric artery)
the uterus has collateral blood flow (from ovarian art) --> sufficient to maintain uterine function

118

internal pupendal artery course

branch of anterior trunck of internal iliac --> runs througth the schiatic foramina --> supply the perineum

119

main risk of ovarian torsion

large ovarian mass

120

pampiform plexus

receive venous blood from testis, epididymis, ductus deferans --> drains into testicular veins

121

pelvic innervation

1. pudendal (S2-4) --> sensory: perineum, motor: urethral+anal sphincter
2. Lateral femoral cutaneous (L2-3) --> sensroy: anter + lateral tight (injury during hyperflexion of the thighs for pelvic surgery or vaginal delivery
3. inferior gluteal
4. Genitofemoral (L1-2) --> sensory: scrotum/labia majora, medial thigh (anterior to psoas, injury during laparotomy), motor to parts of genitalia (eg. cremasteric reflex)
5. Obturator
6. Iliohypogastric (T12-L1) --> sensory hypogastric (injury due to Pfnannestiel skin incisions, like cesarean, appendidectomy), motor to anterolateral abdom walls
7. ilioinguinal (L1) --> sensory from skin of the upper + medial thigh, the root of penis + upper scrotal, labia major

122

pupendal nerve - landamark

ischial spine + sacrospinous ligament
(other important structures: internal pupendal ar + inf gluteal ar - run medial to nerve

123

prostatic plexus - lies ... / origin /

- lies within the fascia of prostate
- origin: inferior hypogastric plexus
- gives rise to lesser + greater carvenous nerves
risk for injury in prostatectomy --> erectile dysfunctin

124

fibrinoids of uterus may located

1. serosal surface (subserosal) --> IRREGULAR ENLARGED UTERUS --> bulk symptoms (eg. constipation)
2. within uteral wall (intramural) --> reproductive difficulties
3. below endometrium (SUBMUCOSAL) --> reproductive difficulties, bleeding

125

imperforate hymen

by incomplete degeneration of the central portion of fibrous tissue band connecting the wall vagina --> priamary amenorrhea, normal secondary sexal, cyclic pelvic pain due to accumulation of blood in vagina + uterus (hematocopos), palbable mass anterior to rectum, difficulties in defecation

126

endometriosis in pouch of douglas

painful defecation, dyspareunia, plpable nodularity on rectpvaginal examination

127

main target of kegel exercise

levator ani:
1. iliococcygeus
2. pubococcygeus
3. puborectalis

128

levator ani injury -->

1. urethral hypermobility
2. pelvic organ prolapse

129

gonadal arteries course

right travels in front of IVC + behind ileum + left ar behind left colic + sigmoid art + iliac colon --> cross anteror the ureter --> paraller the external iliac vessels --> inguinal canal --> testes

130

prostate location
types of obstruction in BPH

between pubic symphisis + + anal canal
1. static obstriction (androgen-mediated)
2. dynamic obstriction (α adrenoreceptor mediated)

131

penile venous outflow anomalies

eg. leakflow of vein --> erectile dysfunction

132

vasectomy?

remove of ductures deferens (vas deferens) --> birth control

133

lymphatic system of lower extremities

1. superficial lymphatic vessels (follow venous system)
2. deep lymphatic vessels (follow arterial system)
the superficial lymphatic system is also divided to medial + lateral
medial bypass the popliteal nodes (like saphenus) --> inguinal area
lateral do not bypass --> popliteal AND inguinal area

134

bladder lymph drainage

superior: external iliac
inferior: internal iliac

135

arcuate line?

horizontal line below the umbilicus that demarcates the lower limit of the posterior rectus sheath. Above that, the rectus abdominis is sourounded by anterior + posterior sheath. Below only by anterior sheath

136

inscision in cesarea delivery

1. midline vertical sepration of the rectus abdominis muscle
2. when additionally space necessary --> horizontal transection of the rectus abdominis --> risk for inferior epigastric arteries