Exam 2 Flashcards by Trinity Smith

L1 lumbar plexus nerves

iliohypogastric
ilioinguinal

How well did you know this?

Not at all

Perfectly

2 major arteries that the internal thoracic artery gives rise to

superior epigastric artery
musculophrenic artery

How well did you know this?

Not at all

Perfectly

external iliac artery gives rise to what 2 arteries

inferior epigastric artery
deep iliac circumflex artery

How well did you know this?

Not at all

Perfectly

which artery is the dominant supply to the anterior wall

inferior epigastric artery

How well did you know this?

Not at all

Perfectly

what are 3 branches of the inferior epigastric artery?

muscular artery
pubic artery
external spermatic/ cremasteric artery

How well did you know this?

Not at all

Perfectly

the femoral artery gives rise to what 2 arteries?

superifical epigastric
superficial external pudendal

How well did you know this?

Not at all

Perfectly

this vein is responsible for caput medusa in liver cirrhosis

paraumbilical veins

How well did you know this?

Not at all

Perfectly

lymph drainage above the umbilicus

pectoral nodes

How well did you know this?

Not at all

Perfectly

lymph drainage below the umbilicus

superficial inguinal nodes

How well did you know this?

Not at all

Perfectly

intercostal muscle nerve innervation

T7-T11

How well did you know this?

Not at all

Perfectly

subcostal muscle nerve intervation

T12

How well did you know this?

Not at all

Perfectly

iliohypogastric and ilioinguinal nerve innervation

How well did you know this?

Not at all

Perfectly

this abd muscle is the straigt muscle of the abdomen and has tendonous intersections

rectus abdominis

How well did you know this?

Not at all

Perfectly

this muscle of the abdomen forms lateral portion of inguinal canal and the cremasteric muscle

internal oblique

How well did you know this?

Not at all

Perfectly

this action of this abdominal muscle is flexion of the vertebral column

external oblique

How well did you know this?

Not at all

Perfectly

this abdominal muscle forms the inguinal ligament and superficial ring of the inguinal canal

external oblique

How well did you know this?

Not at all

Perfectly

this abdominal muscle flexes and laterally bends the trunk, supports, and increases intra-abdominal pressure

transverse abdominis

How well did you know this?

Not at all

Perfectly

this abdominal muscle forms the deep ring of the inguinal canal

transverse abdominis

How well did you know this?

Not at all

Perfectly

name the layers of the rectus sheath from superficial to deep

external oblique
internal oblique
transversus

How well did you know this?

Not at all

Perfectly

this is where the rectus sheath becomes anterior only

arcuate line

How well did you know this?

Not at all

Perfectly

what are 4 different types of abd hernias?

umbilical
incisional
linea alba
linea semilunaris

How well did you know this?

Not at all

Perfectly

this type of abdominal incision is along the linea alba and avoids arteries

midline

How well did you know this?

Not at all

Perfectly

this type of abdominal incision is a horizontal cut and avoids nerve damage

transverse

How well did you know this?

Not at all

Perfectly

this type of abdominal incision is 2.5 cm below costal margin to avoid the 7th thoracic nerve and is used for gallbladder and spleen procedures

subcostal

How well did you know this?

Not at all

Perfectly

this type of abdominal incision splits muscle fibers and is used for appendectomies

muscle splitting

what are the 3 umbilical ligaments?

median umbilical paired medial umbilical paired lateral umbilical

if this umbilical ligament fails to close it may lead to urine leakage, it is also used for landmark for laparotomy

median umbilical ligament

these umbilical ligments are remnants of the umbilical arteries

paired medial umbilical ligaments

the action of this posterior abd muscle is extension and flexion of the vertebral column

quadratus lumborum

this posterior abd muscle flexes the vertebral column and the thigh

psoas

this is a fan shaped posterior abd muscle

iliacus

this is formed by 2 posterior abd muscles and is the major flexor of the thigh

iliopsoas

this is the most important nerve of the lumbar plexus

femoral nerve

this major nerve of the lumbar plexus innervates the anterior, lateral and medial leg

femoral nerve

2 major peripheral branches of lumbar plexus

L1- ilioinguinal and iliohypogastric

this is a double layer of peritoneum connecting viscera to abd wall

mesentery

this is a double layer of peritoneum attached to the stomach

omentum

this part of the peritoneum forms a ligament and connects viscera to abd wall

peritoneal ligament

this recess is posterior to the appendix

retrocecal

this recess is the lowest point in peritoneal cavity when supine and is the recess of the greater sac to the right of the epiloic foramen

Morrison's pouch/ hepatorenal recess

these recesses are lateral to the ascending and descending colon

paracolic gutters

this recess is between the diaphragm and liver

subphrenic *subphrenic abscess

peritonitis generates sticky fluid containing _______

fibrin

greater splanchnic nerve includes....

T5-T9

lesser splanchnic nerve includes...

T10 and T11

least splanchnic nerve includes...

T12

lumbar splanchnic nerve includes....

L1-L3

where does the greater splanchnic nerve synapse?

celiac ganglia

where does the lesser splanchnic nerve synapse?

superior mesenteric ganglia

where does the least splanchnic nerve synapse?

superior mesenteric ganglia

where does the lumbar splanchnic nerve synapse?

inferior mesenteric ganglia

PS innervation of the abdomen includes what 2 major nerves?

vagus pelvic splanchnic nerve (S2-S4)

what 2 plexuses does the vagus nerve utilize to innervate the GI tract?

celiac plexus superior mesenteric plexus

what plexus does the pelvic splanchnic nerve utilize to innervate the gut?

inferior mesenteric plexus

what 3 arteries does the celiac trunk give rise to?

L gastric splenic common hepatic * proper hepatic * gastroduodenal- superior pancreaticoduodenal * R gastric

branches of SMA

inferior pacreaticoduodenal middle colic R colic iliocolic

branches of IMA

L colic sigmoid branches superior rectal artery

this is the junction between squamous epithelium and gastric columnar epithelium at the stomach

Z line

where is the MC site of gastric ulcers?

lesser curvature

if gastric ulcers are found here, they are considered cancerous until proven otherwise

greater curvature

rugae are almost absent along which stomach curvature

lesser

this is the 1st section of the small intestine

duodenum

this section of the small intestine has thick walls, more prominent plicae circulares and the mesentary has less fat, allowing branches of the emsenteric artery to be more clear

jejunum

this part of the small intestine has peyer's patches and more arcades

ileum

these veins combine to form the portal vein

superior mesenteric splenic (inferior mesenteric flows into splenic)

where is diverticulosis most of the time?

sigmoid colon

where is the appendix usually located?

retrocecal

what are 4 signs that can indicate appendicitis

1. McBurney's point 2. Rovsing sign 3. Psoaas sign 4. Obturator sign

this branch of the SMA supplies the cecum and appendix

ileocolic artery

this artery connects the SMA (middle colic) and IMA (L colic)

marginal artery

what are the 4 lobes of the liver?

1. L lobe 2. R lobe 3. caudate 4. quadrate

liver HTN/ cirrhosis leads to ____________ anastomoses

portosystemic

what 3 types of varicies can liver HTN lead to?

1. esophageal 2. caput medusa (paraumbilical veins) 3. hemorrhoids

gallbladder arterial supply

cystic artery

what do you have to cut for a cholecystectomy?

cystic duct

this duct comes from the liver

hepatic duct

this duct comes from the gallbaldder

cystic duct

this duct is formed by the cystic and hepatic ducts

common bile duct

where do bile ducts empty?

duodenum

pancreas arterial supply

splenic superior and inferior pancreaticoduodenal

this part of the spleen produces lymphocytes

white pulp

this part of the spleen filters blood and contains phagocytes

red pulp

what 3 vaccines must be obtained after splenectomy

1. h flu 2. strep pneumoniae 3. n meningitis

where do the lower 6 thoracic nerves lie

between internal oblique and transversalis muscle

what 3 muscles form the inguinal canal

1. external oblique 2. transversalis fascia 3. internal oblique

what part(s) of the inguinal canal does the external oblique form?

* superficial inguinal ring * inguinal ligament * anterior wall

what part of the inguinal canal does the transversalis fascia form?

* deep ring * posterior wall

what part of the inguinal canal does the internal oblique form?

roof

if an inguinal hernia passes through the ____ ring, it may travel to the scrotum or labia

superficial

this area contains the depression through which ________ inguinal hernias protude

Hasselbach triangle direct hernias

what marks the borders of Hasselbach's triangle?

rectus abdominis inferior epigastric vessels inguinal ligament

origin of indirect inguinal hernias

deep inguinal ring lateral to inferior epigastric vessels

origin of direct inguinal hernias

posterior wall of inguinal canal medial to inferior epigastric

list the cause, age, and location of indirect hernias

cause- congenital age- children and young adults location- unilateral, R side MC

list the cause, age and location of direct hernias

cause- acquired--> weak abd muscles (lifting) age- older adults (men) location- bilateral

this is an outpouching of peritoneum that occurs at the 12th week of fetal life

processus vaginalis

if this structure fails to obliterate at birth, congenital inguinal hernia is more likely

processus vaginalis

this is excessive fluid in the scrotum

hydrocele

what part of the testis produce sperm?

seminiferous tubules

the gubernaculum becomes what?

scrotal ligament

the distal part of the processus vaginalis becomes what?

tunica vaginalis

if a testis is undescended, does it produce sperm?

where is mature sperm stored?

epididymis

what part of the epididymis becomes continuous with the ductus deferns?

tail

in this reflex, you strok the internal medial thigh and the testicles retract

cremastic reflex

the cremastic reflex assumes what is intact?

genitofemoral nerve

what abdominal muscle forms the cremasteric muscle?

internal oblique

this scrotal muscle is smooth involuntary muscle that responds to temperature

dartos

this fasica of the testis is continuous with membranous layers of abd wall and is responsible for the scrotal septum

scarpa's fascia

what are the major pelvic bones?

sacrum coccyx os coxae (hip bones)

this divides the true and the false pelvis

pelvic brim

what does the true pelvis contain?

bladder and reproductive organs

what is in the false pelvis

ileum and sigmoid colon

these pelvic ligaments divide the greater and lesser sciatic foramen

sacrospinous and sacrotuberous

what structures go through the greater sciatic foramen?

* superior and inferior gluteal nerves and arteries * piriformis muscle * sciatic nerve

what structures go through the lesser sciatic foramen?

* internal pudendal artery and vein * obturator tendon * nerve to obturator

what nerve leaves the pelvis via the greater sciatic foramen, then re-enters via the lesser sciatic foramen?

pudendal nerve

what levels is the sacral nerve plexus?

L4-S3

what 2 major nerves make up the sacral plexus and what levels are they?

sciatic- L4-S3 pudendal- S2-S4

lumbosacral plexus includes what spinal nerves?

L4-S4

what 3 structures form the pelvic floor?

levator ani small coccygeus muscles covering fascia

what are the 3 parts of the levator ani muscle?

puborectalis pubococcygeus iliococcygeus

this pelvic muscle supports and flexes the coccyx

coccygeus

what 2 things can lead to levator ani/ pelvic floor dysfunction

pudendal nerve lumbosacral plexus

this pelvic muscle rotates the thigh laterally, is innervated by the internal pudendal and gluteal arteries, and the fibers pass through the lesser sciatic foramen

obturator internus

this pelvic muscle passes through the sciatic foramen and is a lateral rotator when the hip is extended and an abductor when hip is flexed

piriformis

anterior pelvic ligaments

puboprostatic pubovesicle

this ligament of the pelvis can be found posteriorly and connects the sacrum around one side of the rectum to the prostate or vagina

sacrogenital ligament

this subperitoneal ligament is passive support of the uterus

cardinal ligament

this subparitoneal ligament is for stability of the uterus and cervix

retrouterine

this subperitoneal fascia is for the passage of nerves and vessels

hypogastric sheath

this is located between the anal canal and the perineal membrane

perineal body

this is where ureteric orifices are in the bladder

trigone

this is the muscle that tightens with bladder contraction

detrusor

what are the 4 parts of the male urethra?

intramural/ preprostatic prostatic intermediate/ membranous spongy

this structure carries sperm from the testis to ejaculatory duct

ductus deferens

this is the junction of the vas deferns and the duct of the seminal vesical

ejaculatory duct

this is attached to the bladder and does not store sperm

seminal vesical

this gland produces mucus like secretions that enter the urethra during sexual arousal to protect the sperm from acidic urine

bulbo-urethral gland

this ligament attaches the uterus to the side walls of the pelvis

broad ligament

this ligament attaches the ovary to the uterus just below the point where uterine tube enters the uterus

ovarian ligament

this ligament holds the uterus forward

round ligament

this ligament covers neurovascular supply of the uterus

suspensory ligaments

this ligament connects the isthmus of the uterus to the sacrum

uterosacral ligament

this is the open end of the fallopian tube that surrounds portion of ovary

ostium

what are the parts of the fallopian tube?

infundibulum ampulla isthmus

this part of the anus/ rectum can be a site for infection that spreads quickly

ischio-anal fossae

this is a horizontal passageway through the obturator fascia from the lesser sciatic notch to the posterior edge of the perineal membrane that contains the pudendal nerve, artery, and vein

Alcock's canal

what spinal nerve controls the external anal sphnicter?

this is where the anal cell type changes and squamous metaplasia are found

pectinate line/ anal transformation zone (ATZ)

what are the 2 major portions of the penile body?

corpora cavernosa corpus spongiosum

what 2 major nerves are responsible for erection?

pudendal nerve S2-S4 pelvic splanchnic nerve S2,3,4 * S2, 3, 4 keeps the penis off the floor