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RCPSC > anatomy & physiology > Flashcards

anatomy & physiology Flashcards

1
Q

femoral artery gives rise to

A

1) superficial epigastric
2) superficial circumflex iliac
3) superficial external pudendal

just below inguinal ligament within the femoral triangle

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2
Q

inferior/deep epigastric vessels are branches of

A

external iliac vessels

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3
Q

inferior epigastric vessels supply

A

anterior abdominal wall muscles and fascia

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4
Q

inferior epigastric vessels: anatomical course

A

above arcuate line:
- ventral to posterior rectus sheath
- between sheath and posterior surface of rectus muscles

(ventral to transversus abdominis muscle aponeurosis)

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5
Q

superior epigastric vessels are branches of

A

internal thoracic vessels

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6
Q

pyramidal muscles originate from and insert into

A

from pubic crest into linea alba

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7
Q

hesselbach triangle boundaries

A
  1. lateral = inferior epigastric
  2. inferior = inguinal ligament
  3. medial = lateral border rectus abdominis

hernia through this triangle are direct

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8
Q

abdominal wall is innervated by

A
  1. intercostal nerves T7-11
  2. Subcostal nerve T12
  3. Iliohypogastric + ilioinguinal L1
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9
Q

transversus abdominis plane

A

space between transverses abdominis and internal oblique muscles

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10
Q

which nerves can become severed during a low transverse incision or entrapped during closure

A

ilioinguinal and iliohypogastric

especially if incisions extend beyond the lateral borders or the rectus abdominis muscle

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11
Q

average size of labia majora

A

7-8cm long
2-3cm wide
1-1.5cm thick

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12
Q

round ligament terminates at

A

upper border of labia majora

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13
Q

what type of glands are present in labia majora

A
  1. apocrine
  2. eccrine
  3. sebaceous
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14
Q

what type of glands are present in labia minora

A

sebaceous glands only

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15
Q

Hart line

A

demarcating line on labia minor separating keratinised (lateral) and non-keratinised epithelium (medial)

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16
Q

clitoral blood supply stems from

A

branches of the internal pudendal artery

  • deep artery = body
  • dorsal artery = glans + prepuce
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17
Q

vestibule borders

A
  1. Lateral = hart line
  2. Medial = external surface of hymen
  3. anterior = clitoral frenulum
  4. posterior = fourchette
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18
Q

openings in the vestibule

A
  1. urethral
  2. vagina
  3. bartholin glands ducts x2
  4. skene glands ducts x2
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19
Q

ducts of bartholin glands open:

A

distal to hymenal ring, at 5 and 7 o’clock

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20
Q

vaginal lining is composed of

A

nonkeratinized stratified squamous epithelium

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21
Q

blood supply to proximal portion of vagina:

A

cervical branch of uterine artery
+
vaginal artery (may arise directly from internal iliac)

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22
Q

blood supply to posterior vaginal walls contributed by

A

middle rectal artery

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23
Q

blood supply to distal vaginal walls by

A

internal pudendal artery

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24
Q

lymphatics from lower third of vagina + vulva drain into

A

inguinal nodes

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25
Q

lymphatics from middle third vagina drain into

A

internal iliac nodes

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26
Q

lymphatics from upper third vagina drain into

A

external, internal, and common iliac nodes

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27
Q

muscles forming perineal body

A
  • bulbospongiosus
  • superficial transverse perineal
  • EAS

more deeply, perineal membrane, pubococcyegous, and IAS contribute

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28
Q

colles fascia is

A

the continuation of Scarpa fascia onto perineum

superficially binds the space of the anterior triangle

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29
Q

pudendal nerve roots

A

S2-4

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30
Q

EAS blood supply

A

inferior rectal artery

branch of internal pudendal

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31
Q

EAS innervation

A

somatic motor fibres from
inferior rectal branch of pudendal nerve

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32
Q

IAS innervation

A

primarily PARASYMPATHETIC fibers via pelvic splanchnic nerves

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33
Q

IAS blood supply

A

superior, middle, and inferior rectal arteries

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34
Q

bulk of anal canal resting pressure supplied by

A

IAS

35
Q

IAS dimensions

A

3-4 cm in length,
overlaps EAS by 1-2cm

36
Q

cervical stroma composed mainly of

A
  • collagen
  • elastin
  • proteoglycans
37
Q

blue tint of cx with pregnancy

A

Chadwick sign

38
Q

cervical edema and softening in pregnancy

A

Goodell sign

39
Q

Isthmic softening in pregnancy

A

Hegar sign

40
Q

uterine artery branches from

A

internal iliac
(aka hypogastric)

41
Q

right ovarian vein empties into

A

vena cava

42
Q

left ovarian vein empties into

A

left renal vein

43
Q

from proximal to lateral - portions of the fallopian tube

A
  1. interstitial
  2. isthmus
  3. ampulla
  4. infundibulum
44
Q

origin of the internal branch of the common iliac artery

A

proximal to the iliolumbar artery

45
Q

obstetrical conjugate

A

shortest distance between sacral promontory and symphysis pubis

normally measures >=10cm but cannot be measured manually

46
Q

which bones is pelvis composed of?

A
  • sacrum
  • coccyx
  • Inominate x2
    (pubis, ischium, ilium)
47
Q

which is the only measurement of the pelvis that can be obtained clinically?

A

diagonal conjugate

subtract 1.5cm to get obstetrical conjugate

48
Q

vessels of the anterior division internal iliac

A
  1. inferior gluteal
  2. internal pudendal
  3. middle rectal
  4. vaginal
  5. uterine
  6. obturator
  7. umbilical/superior vesical
49
Q

vessels of the posterior division internal iliac

A
  1. superior gluteal
  2. lateral sacral
  3. iliolumbar
50
Q

early urinary system develops from

A

mesonephros and paired mesonephric ducts

mesonephric ducts aka wolffian ducts

51
Q

final kidney grows from

A

metanephros
(which originates from ureteric bud from mesonephric duct)

mesonephros degenerates near end of first trimester

52
Q

cloaca divides by which week

A

7th

53
Q

mullerian ducts form

A
  • fallopian tubes
  • uterus
  • upper vagina

aka paramesonephric ducts

54
Q

uterus is formed by

A

10th week,
by union of two Müllerian ducts

55
Q

anomalies most frequently associates with renal defects

A
  • unicornuate uterus
  • uterine didelphys
  • agenesis syndromes
56
Q

persistent remnants of mesonephric of wolffian vestiges can persist as

A

Gartner duct cysts

typically located in proximal anterolateral vaginal wall

57
Q

MRKH findings

A
  1. upper vaginal agenesis
  2. +/- uterine hypoplasia or agenesis
  3. +/- renal, skeletal, auditory abnormalities
58
Q

obstetric risks of unicornuate uterus

A
  • misc/ loss
  • malpresentation
  • FGR
  • IUFD
  • PPROM
  • PTB
59
Q

mechanisms underlying risks of unicornuate uterus

A
  • abnormal blood flow
  • cervical incompetency
  • diminished cavity size
60
Q

what category of unicornuate uterus poses the greatest risk for ectopic pregnancy

A

noncommunicating cavitary rudimentary horn

61
Q

blood flow to uterus at term

A

500-750ml/min
at 36 weeks

62
Q

intensity of Braxton hicks contractions

A

5-25mmHG

63
Q

maternal plasma osmolality

A

decreases early in pregnancy;

induced by reset of osmotic thresholds for thirst and vasopressin secretion

64
Q

maternal basal metabolic rate

A

rises by 20% by third trimester

+ extra 10% in twins

65
Q

carbohydrate metabolism: normal pregnancy is characterised by

A
  1. mild fasting hypoglycemia
  2. postprandial hyperglycemia
  3. hyperinsulinemia
66
Q

total serum calcium levels in pregnancy

A

decrease

NB: serum ionised calcium levels remain unchanged

67
Q

total blood volume in pregnancy

A

increases by ~40% by term

68
Q

oxygen dissociation curve shifts to the

A

left

69
Q

bicarbonate in pregnancy

A

decreases
from 26 –> 22

70
Q

respiratory changes in pregnancy

A

TV and resting minute ventilation increase, PEF rises

functional residual capacity (including residual volume) decreases

71
Q

pituitary enlargement in pregnancy caused by

A
  1. estrogen stimulated hypertrophy
  2. hyperplasia of lactotrophs

enlarge by ~135%

72
Q

hormones released from posterior pituitary gland

A

ADH, oxytocin

73
Q

fetal skeleton mineralization requires

A

~30g of calcium,
usually third trimester

(3% of total maternal calcium stores)

74
Q

aldosterone in pregnancy

A

increases

75
Q

which pulmonary volumes increase in pregnancy

A
  • TV
  • O2 carrying capacity
  • inspiratory capacity
76
Q

which pulmonary volumes decrease in pregnancy

A
  • RV
  • ERV
  • FRC
77
Q

which pulmonary volumes stay the same in pregnancy

A
  • VC
  • RR
  • FEV1
78
Q

which hormones increase in pregnancy

A
  • ATH
  • CRF
  • oxytocin
  • PRL
  • cortisol
  • PTH
79
Q

which hormones stay the same in pregnancy

A
  • vasopressin
  • TSH
  • GH
80
Q

which hormones decrease in pregnancy

A
  • FSH
  • LH
81
Q

which Rheum factors increase in pregnancy

A
  • ESR
  • Immunoglobulins
  • immune complexes
  • complement levels
82
Q

which rheum factors stay the same in pregnancy

A
  • antibodies
83
Q

which rheum factors decrease in pregnancy

A
  • cell mediated immunity
  • inflammatory response

RCPSC (17 decks)

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