Exam 3 - Pelvis Flashcards
(113 cards)
1
Q
what parts of the pancreas are retroperitoneal?
A
everything except tail
2
Q
describe the exocrine functions of the pancreas (cell, secretions)
A
acinar cells (go to pancreatic duct)
- neutralizing alkaline components
- trypsin (protein), amylase (starch)
3
Q
describe the endocrine functions of the pancreas (cell, secretions)
A
islets of langerhans (go to blood)
- secrete insulin, glucagon, somatostatin, pancreatic peptide hormone, ghrelin
4
Q
what cells make insulin, glucagon, and somatostatin?
A
beta cells = insulin
alpha cells = glucagon
delta cells = somatostatin
5
Q
what stimulates secretion of the pancreas?
A
distention of stomach
acid in the duodenum
6
Q
what is the INN of the pancreas? what is the result of each? referred pain?
A
vagus -> secretion
symp T7-9 -> dilate blood vessels (via celiac plexsus)
- referred to inf. epigastric (inflammation pushes against duodenum)
7
Q
blood supply of pancreas
A
branches off of the splenic artery
8
Q
what are the three parts of the sphincter of oddi?
A
sphincter ductus choledoci (bile duct)
sphincter ductus pancreatici (pancreatic duct)
around entire ampulla
9
Q
what are the two ducts of the pancreas?
A
main pancreatic duct (Duct of Wirsung)
accessory pancreatic duct (Duct of Santorini)
10
Q
what (9) things are in the transpyloric plane?
A
L1
9th costal cartilage
sup. part of duodenum
sup. of pylorus
hili of kidneys
neck of pancreas
SMA
start of portal vein
fundus of GB
11
Q
what is the psoas sign? what organs are apart of this?
A
when contracted (flex/extend thigh) it will bulge and if an organ is inflamed it will cause pain
- kidneys, ureters, retrocecal appendix
12
Q
where does lymph from organs on the lateral and retroperitoneal side go to?
A
para-aortic nodes
13
Q
where does lymph from the midline gut go to?
A
pre-aortic nodes (along vessels)
14
Q
where does lymph from organs belwo the diaphragm go to?
A
posterior abdominal nodes
15
Q
where does all lymph drain to? describe it’s location
A
cisterna chyli
- right of aorta
- below renal artery
- L1-2
16
Q
what organs drain their lymph to the lateral aortic nodes?
A
lateral body wall
kidney
suprarenals
testis
ovary
17
Q
what nodes do the lower limbs and perineum drain their lymph to? (describe the pathway)
A
external iliac nodes
common iliac nodes
pre-aortic & lateral aortic nodes
18
Q
what do lymph nodes do?
A
makes lymphocytes be exposed to antigens in the lymph system (fluid)
- blood and lymph flow through separate compartments
- uses high endothelial venules
19
Q
what type of cells produce antigens?
A
B cells and T cells
20
Q
what does MALT do for lymphocytes?
A
expose them to antigens from outside world
- antigens from respiratory or intestinal systems
21
Q
what does the spleen do for lymphocytes?
A
expose them to antigens in the blood
22
Q
at what rib is the spleen located? intra or retro peritoneal?
A
9th-10th rib
- intraperitoneal
23
Q
what two ligaments hold the spleen?
A
splenorenal lig
gastrosplenic lig
24
Q
what is the INN of the spleen? referred pain?
A
vagus
symp T7-9 (via celiac plexsus)
- referred to left hypochondriac region
25
what are the three functions of the spleen?
expose immune cells to antigens in the blood & prevent sepsis (white pulp) -> lymphocytes
filter out defective RBCs (red pulp) -> macrophages
in infants, it helps make blood
26
what does the right suprarenal gland touch? (3)
liver, IVC, diaphragm
27
what does the left suprarenal touch? (4)
stomach, pancreas, spleen, diaphragm
28
what does the cortex of the adrenal do?
makes mineralcorticoids, glucocorticoids, sex hormones
29
what does the medulla of the adrenal do? whats an important cell here??
circulates catecholamines (adrenaline, noadrenaline)
-basophilic cells (NS tissue)
30
what is the blood supply of the adrenals?
inferior phrenic a
aorta
renal a
31
what does the right adrenal drain to? what about the left?
right = drains to IVC
left = drains to left renal v.
32
what is the arterial blood flow of the kidney?
renal a
segmental a
interlobar a
arcuate a
inerlobular a
superficial glomeruli OR juxtamedullary glomeruli
- afferent a
- glomerulus
- efferent a.
- peritubular capillary bed OR vasa recta
33
how is blood filtered in bowman's space?
using fenestrated capillaries with podocytes
- uses transport mechanisms to only allow certain molecules in
34
what is an important cell type in the juxtaglomerular aparatus? what does it secrete?
macula densa
-secretes renin
35
what is the function of lacis cells? describe the pathway this starts
reads BP in afferent arteriole
- LOW = triggers macula densa to release renin
- renin induces liver to produce angiotensin 1 -> angio 2
- constricts vessels, increases aldosterone (adrenal), and increases water retention (kidneys)
36
what things lead to renal failure?
drop in pH, hematocrit, calcium
rise in K+, phosphate, urea, BP
37
what is the blood supply of the ureters? (4)
renal a
testicular / ovarian a
common iliac
internal iliac
38
what are the three constriction areas in the ureters? (areas for kidney stones)
ureteropelvic junction (ureter / kidney)
pelvic inlet (over iliac a.)
entrance to bladder
39
what is the pathway of urine after the collecting duct?
ducts of bellini
area cribrosa at apex of papilla
minor calyx
major calyx
renal pelvix
ureter
40
what is the INN of the kidney & ureter?
parasymp
- vagus = kidney, upper ureter
- pelvic splanchnic = lower ureter, bladder
symp T10-L1 (along aorta & thru sacrum)
41
describe the effect of parasympathetic activity on the bladder
nerve of empty!!
- contracts detrusor muscle (+)
- relaxes internal urethral sphincter (-)
- pudendal nerve constricts external sphincter (somatic)
42
describe the effect of sympathetic activity on the bladder?
nerve of full!!
- relaxes detrusor muscle (-)
- constricts internal urethral sphincter (-)
43
describe what occurs in the process of micturation
1. pelvic splanchnic nerve
2. spinobulbospinal reflex
3. pontine micturation center (PMC)
- inhibits sympathetic & Onuf's nucleus
- activates parasymp (empty)
44
what are the three pelvic bones? where do they all meet?
illium
ischium
pubis
- meet at acetabulum (VINEGAR BOWL)
45
what are the three palpable bony points?
pubic symphysis
ischial tuberosity
coccyx
46
what does the genital tubercle become in males and females?
F = clit, corpora cavernosa
M = penis, corpora cavernosa
47
what does the labioscrotal swellings become in males and females?
F = labia majora
M = scrotum
48
what does the urogenital fold become in males and females?
F = labia minor, bulbs of vestibule
M = penile urethra, corpus spongiosum
49
where is the superficial perineal pouch?
between colle's fascia and perineal MB
50
where is the deep perineal pouch?
between pelvic diaphragm and perineal MB
51
where is the ischio-anal fossae?
fat filled areas on the sides of the deep pouch and below the pelvic diaphragm, on the posterior side of the body!!
52
what is the order of the pelvic diaphragm muscles? (back -> front) what is the INN of these muscles?
coccygeus
iliococcygeus
pubococcygeus
puborectalis (contains posterior part of rectum)
- pudendal S2-4
53
what arteries branch off of the internal iliac?
lateral sacral
superior gluteal
umbilical -> superior vesicle
obturator
inferior vesicle
middle rectal
vaginal
uterine / vas deferens
inferior gluteal
internal pudendal
54
what artery goes outside of the pelvis (above piriformis)?
superior gluteal
55
what artery and main nerve goes inside the pelvis by the piriformis (below piriformis)?
sciatic nerve
inferior gluteal artery & vein
56
what artery goes on the inside of the piriformis but outside of the sacrospinous ligament? (lesser sciatic foramen)
internal pudendal
- this nerve also follows this pathway
57
what are the branches off of the internal pudendal artery?
inferior rectal
perineal -> transverse perineal -> post. scrotal / labial
artery of the bulb
deep artery of penis / clitoris
dorsal artery of penis / clitoris
58
where does fluid fill if the membranous urethra is broken?
fills up deep perineal space surrounding bladder and prostate
59
where does fluid fill if the spongy / penile urethra is broken?
fills in the superficial perineal pouch along colle's fascia
60
what is the dermatome of mons pubis?
L1-2
61
what is the dermatome of the phallus, scrotum, and anterior labia?
S3
62
what is the dermatome of the posterior scrotum and labia?
S4
63
what is the dermatome of the skin around anus?
S5
64
what are the (4) muscles of the superficial perineal pouch?
ischiocavernosus (along sides of perineum)
bulbopongiosus (ontop of scrotum OR along labia)
superficial transverse perineal (splits urogential & anal triangle)
levator ani (pelvic diaphragm)
65
what is in the deep perineal pouch in men?
deep transverse perineal muscle
bulbourethral gland
membranous urethra
external sphincter
66
what are the tissues of the genitalia under the muscle fascia?
corpus cavernosum (crus)
corpus spongiosum
67
what are the erectile tissue of the male genitalia?
corpus cavernosum (VERY)
glans
bulb of penis
68
what are the four main arteries of the male genitalia? what are their branches? which artery are they coming from?
(int. pud) dorsal artery of penis
(int. pud) arteries of bulb -> bulbourethral arteries
(int. pud) deep arteries of penis -> cavernous a. & helical a.
(ex. pud) superficial dorsal
69
which artery is responsible for erection?
deep artery of penis / clitoris
70
what are the three main veins in the male genitalia? where do they drain to?
deep dorsal v -> circumflex v -> prostatic plexsus
post. scrotal, cavernous, bulbar -> int. pudendal
superficial dorsal v -> ex. pudendal)
71
what is the venous drainage pathway from the external pudendal?
saphenous -> femoral -> ex. iliac -> IVC
72
where does the testicular vein drain to?
pampiniform plexsus
73
what is the INN pathway of the male genitalia?
pudendal -> inferior rectal , perineal , dorsal of penis
74
what is the area b/w the penis and pubic bone called?
infrapubic aperture
- deep dorsal v. goes through here!
75
what is the pathway of sperm?
seminiferous tubules
straight tubules
rete testis
efferent ductules
epididymis (head -> body -> tail)
vas deferens
ampulla of vas deferens
ejaculatory duct
urethra
76
what are the four parts of the male urethra? (go in order)
prostatic
membranous
bulbar
spongy / penile
77
what are the two main cell types in the seminiferous tubules? what do they do?
leydig (OUTSIDE) = testosterone, androgens
sertoli (INSIDE) = support & nourish sperm
78
what 6 things are in the spermatic cord?
genital branch of genitofermoral nerve
visceral nerve to testis
testicular artery
afferent of vas deferens
pampiniform plexsus of veins
lymphatics
79
what are the three glands of the male reproductive tract? what are their main secretions?
seminal gland = prostaglandin hormones
prostate gland = buffers
bulbourethral gland = mucus
80
what is the fascia b/w the prostate and rectum called?
denoviller fascia
81
what are the tissue layers of the penis (outer first)? b/w what layers are the veins squeezed during erection?
skin
superficial fascia
bucks fascia
SQUEEEEEEEZE
tunica albuginea surrounds corpa cavernosa
82
what type of NT allows for erection?
ACh
83
what two things are dialated / relaxed during erection?
arteries
trabeculae
84
what allows for veno-occulsion? (besides NT activity)
somatic stimulation of the perineal muscles
85
what happens during the secretion portion of erection?
parasymp stimulates glands to release semen fluids
86
what happens during the emission (semen -> urethra) portion of erection?
symp stimulates muscles of epididymis, vas deferenes, prostate, and seminal glands to move fluid along
- also constricts internal urethral sphincter (no pee, ew)
87
what happens during the expulsion portion of erection?
visceral = contract smooth muscle of glands, vas def., and epididymis
somatic = contract striated muscle of ex. sphincter, bulbospongiosus
88
what are Bartholin's Glands?
the bulbourethral glands but in women
- secrete mucus
89
what are the muscles of the deep perineal pouch in women? what INN these?
TOP: external urethral sphincter
deep transverse perineal (stabilizes perineal MB)
MIDDLE: compressor urethrae (help close urethra)
BOTTOM: sphincter urethrovaginalis (close vagina & urethra)
* pudendal S2-4
90
what is the INN pathway of the female genitalia?
pudendal -> inferior rectal , perineal , dorsal of clit
91
what is the arteriole blood supply of the female genitalia?
int. pudendal
- artery of bulb
- deep a. of clit
- dorsal a. of clit
ext. pudendal
- branch of femoral
- superficial dorsal a. (anastomoses w/ int. pudendal)
92
what is the vein drainage of the female genitalia?
dorsal v. of clit -> venous plexus -> int. iliac
deep v. of clit -> int. pudendal -> int. iliac
superficial dorsal -> ex. pudendal
93
what is the pathway of the female reproductive tract?
ovary
fallopian tube
uterus
cervix
vagina
vulva
94
what is the blood supply of the superficial tissues in the female genitalia?
perineal -> transverse perineal a. & posterior labia
95
what is the lowest point in peritoneal sac?
Pouch of Dougless
- front gap of uterus
96
describe the development of the germ cells
at the 4-6th week it migrates from yolk sac to germinal ridge
- mitosis & meiosis (stop at prophase 1)
- sit in primordial follicles surrounded by celomic mesothelium until FSH increases
97
what is primary follicle?
cells are more cuboidal (granulosa cells) due to increase FSH from pituitary
98
what is secondary follicle?
multiple layers of granulosum (makes zona pellucida)
- theca folliculi derived from stroma
99
what is tertiary follicle?
creates an antrium (fluid), theca produces estrogen & progesterone
- proliferative phase
- granulosum cells + oocyte = cumulus oophorus
100
what is a graffian follicle?
prior to ovulation, radiating crown of granulosum, secondary oocyte (now metaphase 2)
101
what happens when the egg breaks out of the follicle?
the follicle turns into a corpus luteum
- secretes progesterone
102
what does the follicle become if the egg isn't fertilized and progesterone secretion stops?
corpus albicans
103
what are the three types of cells in the fallopian tube?
ciliated
non-ciliated secretory cells
intercalated cells
104
what is the difference between a follicular cyst and luteual cyst?
follicular does not rupture and just fills with fluid
luteum does not fill w/ stroma cells and the invagination fills w/ fluid
105
what are the two hormones that impact the endometrium? what do they do?
estrogen = vascular, grow
progesterone = stop growth
* once theres a decrease in prog., the layer sheds
106
what is the blood supply pathway of the uterus?
uterine
arcuate
radial
spiral
107
what is endometriosis?
endometrial tissue growing in the wrong spot
- will still proliferate adn shed each cycle
108
what type of risk is a hysterectomy? why?
Iatrogenic Risk
- ligation of uterine artery occurs where it passes over ureter
109
what two ligaments attach uterus to body wall and elongate & widen during pregnancy?
round ligament
uterosacral iigament
110
what occurs during the four stages of labor?
1 = cervix effaced (thins), dilates
2 = birth
3 = placenta
4 = recovery (constriction of vessels)
111
what is a pudendal nerve block? at what sensory region gets numb?
injection at sacrospinous ligament through vagina
- numbs S2-4 & lower 1/4 of vagina
- perineal region! = S2-4 pudendal
112
what is an epidural block? at what sensory region gets numb?
injection at L2-3
- numbs entrie sacral region except top of uterus
- subperitoneal region! = S2-4
113
what is a spinal block? at what sensory region gets numb?
injection at space b/w L3-4
- numbs everything below waist
- intraperiotneal region! = L1-2
