Lab test for Thorax, Abdomen, & Pelvis Flashcards

Question

true rib, false rib, floating rib

Answer 1

ribs 1-7 directly connect to the sternum, hence are true, with ribs 8-12 more indirectly or not connected or false ribs, Ribs 11-12 are floating or vertebral ribs without any cartilaginous connection to the sternum.. ribs 1-7 true, 8-10 false, 11-12 floating, angle pt of greatest curvature and hence most likely to break there, note the facets on the tubercle for articulation with the transverse process.

Answer 2

The 1st rib cannot be palpated because it lies deep to the clavicle; thus, count the ribs and intercostal spaces anteriorly by sliding the fingers laterally from the sternal angle onto the 2nd costal cartilage. Start counting with rib 2 and count the ribs and spaces by moving the fingers inferolaterally. The 1st intercostal space is inferior to the 1st rib; likewise, the other spaces lie in- ferior to the similarly numbered ribs.

Answer 3

round, tapered superior end of lung, above clavicle. projects 2 to 4 cm above the medial clavicle, and so are potentially vulnerable to be punctured in that area

Answer 4

While not for anatomy, look for an example of tertiary bronchi and the surrounding material; useful to know for extensive thoracic work, e.g., CXR, cardiothoracic surgery.

Answer 5

not occupied in quiet respiration parts, potential spaces for fluid accumulation, e.g., hemothorax.

Answer 6

where the root is attached to the lung. e entrance of pulmonary arteries and bronchi, as well as the exit of pulmonary veins

Answer 7

separates superior and middle lobe in R lung

Answer 8

so 2 on L, 3 on R.

Answer 9

surrounded by visceral pleura, a sub lung with a secondary bronchus (tertiary bronchi have bronchopulmonary segments not separated by the folds of visceral pleura). Right lung with superior, middle, inferior lobes; left lung with superior and inferior lobes. The lobes of the lungs (three in the right, two in the left) are further divided into bronchopulmonary segments as the vessels and airways continue to branch out. Branching into lobar and broncholobar segments\> pulmonary veins to left atria coming into 4 veins coming back into it.

Answer 10

fills pleural cavity. Pleura and Lungs- The cervical pleurae and apices of the lungs pass through the superior thoracic aperture into the root of the neck superior and posterior to the clavicles. The anterior borders of the lungs lie adjacent to the anterior line of reflection of the parietal pleura between the 2nd and 4th costal cartilages (Fig. SA1.4). Here, the margin of the left pleural reflection moves laterally and then inferiorly at the cardiac notch to reach the level of the 6th costal cartilage. The anterior border of the left lung is more deeply indented by its cardiac notch. On the right side, the pleural reflection continues inferiorly from the 4th to the 6th costal cartilage, paralleled closely by the anterior border of the right lung. Both pleural reflections pass laterally and reach the midclavicular line at the level of the 8th costal car- tilage, the 10th rib at the midaxillary line, and the 12th rib at the scapular line, proceeding toward the spinous process of the T12 vertebra. Thus, the parietal pleura extends approximately two ribs inferior to the lung. The oblique fissure of the lungs extends from the level of the spinous process of the T2 vertebra posteriorly to the 6th costal cartilage anteriorly, which coincides approximately with the medial border of the scapula when the upper limb is elevated above the head (causing the inferior angle to be rotated laterally). The horizontal fissure of the right lung extends from the oblique fissure along the 4th rib and costal cartilage anteriorly.

Answer 11

separates inf/sup lobes of L lung, and inf lobe of R lung from middle, superior lobes

Answer 12

adherent to thoracic wall (separable by thin layer of endothoracic fascia), diaphragm, and pericardium. lining the body wall aspect of the pleural cavity would be innervated by intercostal nerves

Answer 13

lung is surrounded by a pleural sac, pleural cavity a closed, potential space containing pleural fluid. two pleural cavities and a pericardial cavity. The parietal pleura lining the body wall aspect of the pleural cavity would be innervated by intercostal nerves, in contrast to the visceral pleura covering the lungs. This overall pattern is generated by the formation of the lungs embryologically Òbudding offÓ inferior to the pharyngeal arches into the developing cavity, if you remember the image from head and neck embryology. The pleural cavities are separated from each other via the mediastinum.

Answer 14

R is wider, more vertical than L, so aspirated material there

Answer 15

., v. 2 pulm veins each side, superior, inferior

Answer 16

those bronchi supplying bronchopulmonary segments

Answer 17

closely adherant to all of the lung, continuous with parietal pleura at root of lung

Answer 18

in interventric groove, supplying ant. septum and ant. LV wall

Answer 19

thicker valves than pulmonary valves; just superior to the valves are the origins of the coronary a. have cusps

Answer 20

apex is blunt, formed by LV, L 5 ICS, medial to L MCL [mid clavicular line]; base is posterior, mostly LA (think of the body in a supine position to help orient for that). NOTE the inferior surface of the heart is diaphragmatic. The heart developmentally rotates to the left, so note that the apex of the heart is dominated by the left ventricle and aiming anterolaterally. The apex beat is an impulse that results from the apex being forced against the anterior thoracic wall when the left ventricle contracts. The location of the apex beat (mitral area) varies in position; it may be located in the 4th or 5th intercostal spaces, 6Ð10 cm from the midline of the thorax. In contrast, the base of the heart would be posterior, and is dominated by the left atrium. The diaphragmatic surface of the heart would be dominated by the inferior aspect of the left ventricle. heart developmentally rotates to the left, so note that the apex of the heart is dominated by the left ventricle and aiming anterolaterally. In contrast, the base of the heart would be posterior, and is dominated by the left atrium.

Answer 21

R-L, brachiocephalic trunk dividing into left and right common carotid arteries, L common carotid, L subclavian a. off of the arch

Answer 22

supplying right atrium.Ê

Answer 23

where the RCA runs through, encircles superior part of heart, separates atria from ventricles

Answer 24

interatrial septum on the ventricular side of the coronary sinus orifice

Answer 25

threads from papillary mm, prevent cusp inversion in systole

Answer 26

L border of heart to poster. surface, commonly anastomosing with RCA, so LA and left surface of heart

Answer 27

main vein of heart post. part of coronary groove, other cardiac v. drain into this.

Answer 28

lymphoid organ, not from gut tube, removes abnormal RBCs, stores Fe from recycled RBCs, and initiates immune responses. Worry about rupture with L thoracoabdominal injuries, esp. if already enlarged, e.g., mononucleosis.

Answer 29

ventricular filling once the AV valves open as the pressure in the ventricles drop, with a final contraction of the atrium for the last filling. Blood goes from point of low to high pressure so in diastole as relaxing and letting ventricles fill pressure drop semilunar valves, AV valves open allowing blood to fill w/ a finally squeeze 20% of blood from atrial contraction. P wave indicates the electrical stimulation before the atrial contraction that finishes diastole.

Answer 30

remnant of the fetal foramen ovale, directionally "in line" with blood entering from IVC. Fossa ovaliis remanant of foramen ovale that allowed us to bypass blood when we were in utero. Musculature different so much of atrial wall smooth, once in ventricles of heart loglike meaty appearance with traveculae carnae squeezing more of th eblood out.Ê

Answer 31

travels with LAD, then L circumflex a. to reach coronary sinus

Answer 32

drains inf. body. Before birth, IVC valve aimed towards foramen ovale (valve on inf side, nonfunctional after birth).

Answer 33

separates ventricles

Answer 34

contains conduction system; membranous portion is where VSDs more likely to occur, superior towards aortic valve. a thin membranous component superiorly. with a thin membranous component superiorly. The ventricular walls are dominated by Òbroken upÓ trabeculae carneae.Ê

Answer 35

auricle primitive part, 4 pulmonary v. enter. Oxygenated blood through pulmonary veins will return to the heart into the left atrium. softer walled lower pressure affecting them, right ventricle thinner than left. auricles of the atria will have pectinate muscles, but much of the atrium has a smooth surface

Answer 36

LV on CXR. corresponds to a line connecting the left ends of the lines representing the superior and inferior borders.

Answer 37

between L auricle and pulm trunk to reach coronary groove. Supplies most of LV and LA and IV septum (including AV bundles). Blood supply to heart: in general, coronary arteries form an upside-down "crown" around the heart, with the coronary arteries lying in grooves or sulci. Both left and right coronary arteries arise from small openings in the aortic sinuses just above the semilunar valve cusps. anterior interventricular (left anterior descending) branch, and circumflex branch, supplying most of left ventricle. arise from small openings in the aortic sinuses just above the semilunar valve cusps.

Answer 38

off of circumflex, to follow left heart border and lateral left ventricle

Answer 39

thick-walled to generate pressures for systemic circulation. Diastole: ventricular filling once the AV valves open as the pressure in the ventricles drop, with a final contraction of the atrium for the last filling Systole: ventricular contraction, with the AV valves closing to prevent eversion of blood into the atria, and when pressure is high enough, opening of the semilunar valves, which will then shut as the pressure drops in the ventricle with relaxation. P wave indicates the electrical stimulation before the atrial contraction that finishes diastole. QRS complex: the depolarization of the ventricles before they contract, with S1 indicating that the AV valves are closing. T wave: ventricular repolarization, then the ventricle relaxes, setting up the semilunar valve closure of S2. Also note the fibrous skeleton of the heart, to help anchor the valves as well as insulate between the atria and ventricles so that electrical activity normally goes through the AV node. Electrical activity prior to mechanical activity. P wave squeeze of diastole. Ventricular depolarizzation first valves to shut and mechanical traction across heart and subsequent wave fo repolarization, T wave, as thatÕs happening relaxation of mechanical activity of ventricles dub quick sharpr sound of aortic and pulmonic valve. Fibrous ring supporting valve- electrically preferntially drive all activity through AV node so atria depolarize AV node giving time to fill and then have ventricular depolarization. Blood goes from point of low to high pressure so in diastole as relaxing and letting ventricles fill pressure drop semilunar valves, AV valves open allowing blood to fill w/ a finally squeeze 20% of blood from atrial contraction. Inceasing our pressure within ventricle into systolic chordae tendinae preventing from everting into atrium. Pressure rises until pressure overcomes those

Answer 40

remnant of ductus arteriosus in fetus. From pulm art to descending aorta. Often a site near coartaction; also a potential tethering site of aorta in trauma and subsequent rupture.

Answer 41

travels with posterior interventricular a. to coronary sinus

Answer 42

AV valve on left side, the valve most commonly affected by rheumatic fever (RF). AV valves have striking w/ large leaflets parachute chords (chorae tendinae) with papillary muscles holding it into place. Three valves on right similar to three lobes of lung on left. Two on right for both heart and lung.Ê

Answer 43

crosses from IV septum to ant. papillary mm., carries some of R branch of AV bundle

Answer 44

supplies SA node in majority of people--off of RCA and its atrial branch

Answer 45

conical projections mentioned above with bases attached to wall of ventricle

Answer 46

part of serous pericardium, underneath fibrous pericardium (inelastic and protective electrically preferntially drive all activity through AV node so atria depolarize AV node giving time to fill and then have ventricular depolarization. ). The pericardiacophrenic a. (off of internal thoracic a.) and vein travel with the phrenic n.

Answer 47

anterior part with rough mm. edges, smooth part (sinus venarum) where the sinus venosus has grown in, developmentally speaking

Answer 48

potential space with some serous fluid; cardiac tamponade as a concern. Pericardial cavity- media stinum. Pleura little thin simple squamous epithelium of lungs (visceral) compared to the side of the body wall (parietal) different pleura. To innervate body wall have innercostal nerves, will be able to identify pretty tightly. If something more visceral more indirect and less innervated- throbbing hurting type pain. Superficial to deep: pericardium, the sac that covers the heart, consists of two parts: outer fibrous pericardium, inelastic and protective; inner serous parietal pericardium. pericardial space (cavity), with lubricant serous fluid (normally 15-50 mL). Heart covered with visceral (hard to tell pain), pericardial sac more parietal (phrenic nerve tell you pain coming from there) slippery layer so visceral and parietal side are not rubbing too much up against eachother. with lubricant serous fluid.

Answer 49

the largest branch of RCA, supplies both ventricles in that region

Answer 50

ant., right, left cusps.

Answer 51

R, L pulm arteries, with branches to lobar and segmental branches

Answer 52

open to post. aspect of LA (bronchial veins of lung tissue into azygos system for comparison)

Answer 53

primitive RA is the auricle. Deoxygenated blood collected here. Right ventricle thinner in contrast to left (120/80), lungs have much lower blood pressure even if same amount of blood is going through at the same time. auricles of the atria will have pectinate muscles, but much of the atrium has a smooth surface. the right atrium, note the fossa ovalis, a remnant of the foramen ovale.

Answer 54

RA, e.g., on CXR [chest x-ray). corresponds to a line drawn from the 3rd right costal cartilage to the 6th right costal cartilage; this bor- der is slightly convex to the right.

Answer 55

found in AV groove, supplies right side of heart and nodes (see separately listed branches). Overall, RCA supplies RA, RV; SA and AV nodes (in most people). runs in coronary groove between right auricle (part of atrium), with a marginal branch and posterior interventricular (descending) branch. The RCA supplies both (over half of population) the sinoatrial node (sinuatrial node, SA node) and (for most of population) the atrioventricular (AV) node. arise from small openings in the aortic sinuses just above the semilunar valve cusps.

Answer 56

tapers into conus arteriosus before pulm. Trunk, generates lower pressures than RV. The right ventricle will pump deoxygenated blood through pulmonary arteries into the pulmonary circulation around the alveolar sites of gas exchange. This is a low pressure system, with a systolic/diastolic of ~ 25/8 mm H. Right ventricle thinner in contrast to left (120/80), lungs have much lower blood pressure even if same amount of blood is going through at the same time.

Answer 57

to supply R wall.

Answer 58

lateral RA where SVC enters, near muscle ridge

Answer 59

paralleling right marginal artery and diaphragmatic RCA to drain into coronary sinus

Answer 60

superior vena cava returns blood from superior part of body forelimbs, head, neck, and most of abdominal and thoracic body wall, with contributing tributaries of azygos and brachiocephalic veins. SVC receives inputs from brachiocephalic veins and from azygos vein.

Answer 61

ventricular contraction, with the AV valves closing to prevent eversion of blood into the atria, and when pressure is high enough, opening of the semilunar valves, which will then shut as the pressure drops in the ventricle with relaxation. Inceasing our pressure within ventricle into systolic chordae tendinae preventing from everting into atrium. Pressure rises until pressure overcomes those from the semilunar valves of the pulmonary and aorta systolic pressure heading on out. QRS complex: the depolarization of the ventricles before they contract, with S1 indicating that the AV valves are closing. T wave: ventricular repolarization, then the ventricle relaxes, setting up the semilunar valve closure of S2. , T wave, as thatÕs happening relaxation of mechanical activity of ventricles dub quick sharpr sound of aortic and pulmonic valve

Answer 62

trabeculae carneae Òfleshy little timbersÓ, anchored only at ends highlights primitive spongy characteristics of myocardium squeezes more blood out of ventricles

Answer 63

AV valve of the right heart

Answer 64

part of serous pericardium, superficial to myocardium

Answer 65

posterior wall muscular, so possibility of erosion with chronic intubation.

Answer 66

drains posterior wall of thorax on right side, drains into SVC. Internal thoracic veins will drain the anterior intercostal veins, but the unpaired posterior veins of azygos vein on the right drain the posterior intercostal vein

Answer 67

(also seen as innominate artery or brachiocephalic trunk) soon divides into r. subclavian a., r. common carotid a.

Answer 68

keel-like ridge between the bronchal orifices, sensitive so cough reflex. Distortions seen in bronchoscopy imply disease process, e.g., from enlargement of tracheobronchial lymph nodes.

Answer 69

left coomon carotid a. as a direct branch off of the aortic arch, with the right coming off of the brachiocephalic a.

Answer 70

in the posterior mediastinum; we will note the posterior intercostal arteries off of it. out of the left ventricle, with the brachiocephalic trunk (artery) then dividing into the right subclavian and right common carotid arteries; left common carotid artery, and left subclavian artery

Answer 71

B. Describe the layers of the abdominal wall

Answer 72

posterior in position in thorax, part of posterior media stinum. collapsible muscular tube, conducting food from the laryngopharynx to the stomach by peristaltic contractions. In contrast to the stomach with its simple columnar epithelium associated with protective mechanisms to minimize damage, the esophagus is lined with a nonkeratinizing stratified squamous epithelium (and so is vulnerable to damage from gastric reflux). food tube, peristalsis from pharynx down to stomach collapsible muscular tube, conducting food from the laryngopharynx to the stomach by peristaltic contractions. In contrast to the stomach with its simple columnar epithelium, the esophagus is lined with a nonkeratinizing stratified squamous epithelium. Three possible stricture sites with physiologic narrowing can correspond to common sites of damage from swallowing caustic materials, placement of feeding tubes, or cancer (with gastric reflux a large risk factor for adenocarcinoma). Veins associated can have backflow from portal hypertension and create varicoses. pharyngeal junction- pharynx to esophagus, cross over by aortic arch and left bronchus, at diaphragm- kink built in at diaphragmatic hiatus to kink it off

Answer 73

major supply to lumbar spinal cord as it supplements the anterior spinal artery from a left posterior intercostal/lumbar a. (T8-L1 level), and so needs to be monitored, e.g., during thoracic surgery.

Answer 74

splanchnic n. main source of symp. nerves into abdomen. Coming from T5-9 to celiac ganglion aiming towards abdomen . Preganglionic fibers that pass via white rami comm. Greater runs medial to symp trunk to reach celiac ganglion and so supplies liver, spleen, stomach region (some visceral pain afferent fibers that pass back via rami comm to dorsal roots, so referred pain patterns accordingly). This means that the visceral pain afferents from that same epigastric region will be traveling back through them and enter the spinal cord at the T5-T9 levels. splanchnic nerves off of the chain represent preganglionic neurons extending to ganglia in front of the abdominal aorta

Answer 75

on left side, can be part of alternative venous drainage, there can be an accessory hemiazygos v. that is superior to that as well. hemiazygos (hemi-azygos) and accessory hemiazygos veins will be draining the posterior intercostal veins. On left side have hemiazygos more broken up on left side draining innercostal vein

Answer 76

seperates pleural and visceral cavities from eachother. space between lungs and pleurae, with heart, great vessels, esophagus, ANS (autonomic nervous system), thymus, etc. Anterior anterior to pericardium (post to sternum)ˆ the (large) thymus in youth. Superior thoracic inlet to sternal angle. Middle pericardium and heart, main bronchi, lung roots. Posterior posterior to pericardium, with esophagus and desc. thoracic aorta. is the mobile region medially positioned between the pulmonary cavities. Note four regions of the mediastinum: Localized media stinal structures. Superior, with the aortic arch and trachea, Anterior, with thymus and lymph nodes between sternum and heart, Middle, dominated by the heart, Posterior, with esophagus, thoracic aorta, azygos vein. Lymph nodes w/in lung- bronchiolar and trachea because we breath in crap and have immune survance need moist for gas exchange but not too much for pulmonary edema causing pumping to maintain it.

Answer 77

from C3, 4, 5, they course anterioromedially along pericardium, with motor and sensory to central diaphragm (and sensory to pericardium)--hence, referred pain patterns of say, right shoulder pain from inflamed gallbladder. The contraction of the intercostal muscles, scalenes, and other accessory muscles raises the ribs and expands the diameter of the thorax (25% of inspiratory effort compared to the diaphragm via the phrenic nerve), with normal expiration from muscular relaxation, particularly of the diaphragm (vs. abdominal muscle contraction for forced expiration). to the diaphragm makes up a neurovascular bundle with pericardiophrenic artery and vein on the lateral aspect of the pericardium. Phrenic nerve- C3,4,5, on either side of pericardium. Gotta breath to stay alive located in the diotome.

Answer 78

also known as innominate v., they are without valves, feed into SVC, from jugular, subclavian veins. R brachiocephalic receives R lymphatic duct, L brachiocephalic v. receives thoracic duct.

Answer 79

rami communicantes\* white myelinated preganglionic fibers from T1-L2. Grey (unmyelinated) postganglionic fibers into spinal nerves. "The further you get from home, the dirtier you get" as a mnemonic.

Answer 80

, left\* this hooks around ligamentum arteriosum (motor source to larynx, so hoarseness if damaged or impinged, e.g., by tumor or trauma). strikingly looping around aortic arch at ligamentum arteriosum to travel back up to larynx. right recurrent laryngeal nerve often loops around the right subclavian artery and so is typically not often affected, the left recurrent laryngeal nerve around the aortic arch can be impacted by mediastinal events, such as thoracic aneurysms.

Answer 81

from T5-T9 aiming towards the abdomen. The greater splanchnic nerve is of interest as this represents (preganglionic) sympathetic neurons traveling towards the celiac ganglia. This means that the visceral pain afferents from that same epigastric region will be traveling back through them and enter the spinal cord at the T5-T9 levels. Phrenic nerve surface of heart, vena cava, brachiocephalic trunk, superior vena cava (azygous vein (draining osterior intercostal veins along the way). Preganglionic running forward greater splanchic nerve, synpase spot for sympathetic system go down to abdominal aorta, celiac super and inferior mesenteric arteries preaortic ganglion (splanchic nerve- celiac artery 5-9 thoracic) visceral pain afferents from viscera traveling back and coming into spinal cord at those levels. T10 umbillicus not sure where it is causing reffered pain pattern.

Answer 82

left off of aortic arch, with the right off of the brachiocephalic artery. From the main supply of the upper limbs, the subclavian arteries, arise the internal thoracic arteries (internal mammary arteries) just lateral to the sternum

Answer 83

collection of neuroectodermal ganglia, paravertebral. visible on the anterolateral aspects of the vertebral bodies. Thoracolumbar outflow from T1-L2, so first leg often into a chain of ganglia into each body segment. Consisting of ascending and descending fibers. rami communicantes tying into the intercostal nerves. rami communicantes tying into the intercostal nerves. visceral afferent neurons carrying pain sensation will travel with the sympathetics.

Answer 84

thoracic duct, azygos v. on R side of it going through aortic hiatus of diaphragm as well. The aorta splits into common iliac arteries close to the level of the umbilicus on the left. The inferior vena cava is to the right. Internal illiac- deeper true pelvis. Celiac in vein form is superior and inferior mesenteric vein. Paired vessels drain into inferior vena cava can go along body wall into zygos system for alternate pathway. Note that there are paired vessels to paired organs, e.g., suprarenal and renal arteries, gonadal arteries, lumbar arteries, with corresponding veins. The azygos system can be an alternative pathway of drainage for the lumbar veins. In terms of unpaired arteries, the celiac, superior mesenteric, and inferior mesenteric arteries arise from the abdominal aorta, but the corresponding venous components are part of the hepatic portal system, as highlighted last week before the break.

Answer 85

major lymphatic drainage for the body as it originates from the cisterna chyli in the abdomen. Damage to the thoracic duct can lead to chylothorax. Right lymphatic duct draining right side of head and right arm. main lymphatic duct, medial to azygos vein starts from cisterna chyli, post.; drains into L subclavian/ L int. jugular junction. lungs aim medially into pulmonary, bronchopulmonary, tracheobronchial, bronchomediastinal nodes, and so can be of consideration for lung cancer and other lung diseases.main lymphatic vessel of the body will be medial to azygos vein.

Answer 86

T cell maturation, large in childhood, involutes, ant./sup. mediastinum

Answer 87

note how r. main stem bronchus is more in line and slightly wider than l. main stem bronchus, so more likely for aspirate to end up in right lung.

Answer 88

drainage around the bifurcation

Answer 89

Vagus nerve (CN X) is active in terms of parasympathetic innervation to the thorax and much of the abdomen. located near gut (esophagus). ÒDescendingÓ (embryologically speaking) aortic arches pull vagal fibers to gill arch mm into a loop; think of the length of a giraffeÕs l. recurrent laryngeal nerve! coming along common carotid artery.

Answer 90

inguinal ligament starts from here, TFL (tensor fasciae latae m.), rect. femoris mm. as well. anterior superior iliac spine; one end point that along with the umbilicus helps determine McBurneyÕs point connected to the pubic crestÊ

Answer 91

note inferior, medial slanting of fibers, flat layer end in aponeuroses

Answer 92

another place to pack in fat within the layers of the abdominal wall (subserous fascia is another synonym)

Answer 93

from median/transumbilical planes LUQ (stomach); RUQ (liver), LLQ (sigmoid colon); RLQ (appendix)

Answer 94

the tubercle is the most lateral point of (as landmarks for regions), 6 cm post. to ant sup iliac spine. useful to determine L4 level, e.g., for lumbar puncture

Answer 95

note superior-aiming flat slant of fibers, as they spray up from iliac crest, most inferior fibers join with trans. aponeurosis for conjoint tendon used in hernia repair.

Answer 96

abdominal musculature ends in Tendon broad aponeuroses that connect midline as the linea alba, as well as compose the rectus sheath in which the rectus abdominis muscles reside. help stomach muscle support, compress abdominal viscera, and can help flex or roatte trunk. linea alba aponeuroses fusing in midline midline incision to avoid vessels and nerves. Aponeurosis of external oblique rolled along creating inguinal canal that spermatochord travels through beginning opening at either end of inguinal canal. ON outside of inguinal canal thatÕs covered by skin w/ gap of superficial inguinal ring through oblique aponeurosis.

Answer 97

remnants of umbilical arteries that once fed into int. iliac arteries.

Answer 98

obliterated urachus (allantois) [fetal bladder component] from bladder to navel

Answer 99

MCL, SCP (subcostal plane), TTP (transtubercular iliac tubercles on iliac crest, around L5) R, L hypochondriac, epigastric// R, L lateral/lumbar region, umbilical// R, L inguinal region, pubic or hypogastric. Major contents include thoughts such as pancreas in umbilical region and spleen in L hypochondriac

Answer 100

small vessels in superficial fascia that are involved in caput medusae

Answer 101

cartilaginous joint with disc

Answer 102

terminates pubic crest, on pubic body where inguinal ligament attaches

Answer 103

rectus element of abd. wall, surrounded by aponeurosis into rectus sheath; at the arcuate line (about 1/3 inferior from umbilicus to pubis), the rectus sheath is only anterior (so that rectus abdominis m. are backed by transversalis fascia)

Answer 104

Note that a number of these abdominal wall objectives represent the layers of the abdominal wall, from superficial to deep.

Answer 105

can contain fat (see Camper's layer) and the deeper membranous layer (of Scarpa). These distinctions become more important in the lower abdominal wall and perineum because of urinary extravasation issues where urine and blood can be trapped between the membranous layer and the deep fascia over muscles. Sagging folds in the fatty layer (panniliculi) can be noticeable in very heavy individuals.

Answer 106

abdominal fascia deep to body-wall mm,relatively firm and membranous, lining the transversus abdominis m.

Answer 107

horizontal flat fibers; note internally the arcuate line marking when the rectus sheath does not have the aponeurosis of trans. abd. mm. running deep to it.

Answer 108

fibers of internal oblique m. joining with those of tranversus abdominis m. to form a structure that attaches to the pubic crest; can be used in hernia repair. a merger of internal oblique and transversus abdominis fibers, is often used as an anchor for surgical hernia repairs

Answer 109

from int. oblique fascia. Cremasteric mm (strands) in there. Cremasteric reflex from ilioinguinal n (L1) region (thigh) and motor to cremasters from genital branch of genitofemoral n. (L1-2). fibers reflexively draw the scrotum up through the motor innervation of the genitofemoral nerve (L1-L2).Ê

Answer 110

firmly attached to skin, gives "ridging" (wrinkling), in superficial fascia (membranous layer)

Answer 111

through transversalis fascia. Indirect inguinal hernia lateral to inf. epigastric and down the (majority of inguinal hernias for both genders). through transversesalis fascia can go to conjoined tendon for anchoring a repair going on.Ê

Answer 112

hard and cord-like in feel, a consideration for vasectomy, derived from mesonephric (wolffian) duct, carries sperm along from epididymis to the ejaculatory duct

Answer 113

sup/post to testis, storage there 18-24 h gives sperm mobility.sperm maturation in high convuluted tubules.Ê

Answer 114

band of soft CT to inferior end of testis, guidance if not necessarily pulling, or keeping open inguinal canal. Gubernaculum a name really for the embryonic structure.

Answer 115

oblique passage, 4 cm long, ant wall ext oblique aponeurosis, post wall transversalis fascia, openings are rings. In here are spermatic cord, round ligament and ilioinguinal n. exists with inner (deep inguinal ring) and outer (superficial inguinal ring) openings

Answer 116

formed by foldover of ext oblique aponeurosis muscle between the anterior superior iliac spine and the pubic tubercle

Answer 117

"gubernaculum" of ovaries, attached to labia majora walls (ligament of ovary and uterus). Women will have an inguinal canal as well, but in contrast to a spermatic cord, will have a round ligament of the uterus traveling through it

Answer 118

from labioscrotal swellings of anterior abd. wall, raphe midline. Lymphatic drainage superficial. In order to mature, mammalian sperm requires lower than normal body temperature; hence the location of the testes in the scrotum off of the anterior abdominal wall. The temperature of the scrotum may be slightly adjusted by the wrinkling affects of the smooth muscle contractions of the dartos muscle in the superficial fascia.

Answer 119

dense appearing, site of sperm production in testis

Answer 120

the spermatic cord begins at deep inguinal ring, ends at post testis, with ductus deferens, VAN, and lymphatics. Varicocoele-varicosities of sperm cord veins. External spermatic fascia from external oblique aponeurosis, cremasteric fascia from internal oblique muscle, and internal spermatic fascia from transversalis fascia

Answer 121

opening in aponeurosis of external oblique. Direct inguinal hernia protrudes abd. wall, covered by peritoneum, medial to inf. epigastric, to superficial ring. "Turn head and cough"-the finger is positioned in the superficial ring

Answer 122

artery off of L2 or so from the abd. aorta, so deep lymphatics as metastasis in testicular CA. Pampiniform (venous) plexus, if dilated, form a scrotal varicocele; will eventually coalesce into testicular v. The testicular artery, testicular vein (in the form of the pampiniform plexus), and lymphatics join with the ductus deferens just before entering the deep ring of the inguinal canal.Ê

Answer 123

should be descended into the scrotum in adults. Testis travelling through wall picking up layers creating external spermatic fascia from external oblique, cremaster fascia internal oblique, internal spermatic fascia from transversalis fascia (cuts off around hips and inguinal happens inferior). 3 spermatic fascia layer and contributed from internal oblqieu gets cremasteric area genital femoral nerve around L1-l2.

Answer 124

dense, white connective tissue capsule of testis

Answer 125

potential peritoneal space, distortable by hydrocoele

Answer 126

cecum, ascending colon cecum pouch with no mesentery at beginning of large intestine (fermentation spot in rabbits and horses for cellulose). Ascending colon up R side.

Answer 127

mucosal/submucosal folds of small intestine that do not disappear with expansion.

Answer 128

C-shaped around the pancreas. Buffers chyme, duodenal ulcers here. Flexure is the angle at which the duodenum ends, and the ligament (suspensory muscle) extends as muscle from the r. crus of diaphragm to connective tissue around the celiac a. and SMA, before reaching the junction. Functional (and embryological) landmark. duodenum is only about 25 cm long, circular folds and villi and is considered to have four parts. It is noticeable for its submucosal (Brunner) glands that along with the pancreatic buffering juice give off bicarbonite to help neutralize the acidic chyme from the stomach.

Answer 129

dilated superior portion of stomach, with the antrum closer to the pyloric sphincter. The fundus/body vs. antrum represents a physiological distinction of glands with pepsin, acid, and intrinsic production, vs. the location of most of the gastrin production. Note the different regions of the stomach, with the body and fundus with fundic glands with parietal cells (acid and intrinsic factor that assists with vitamin B12 absorption) and chief cells (pepsinogen _ pepsin), and the antrum, with an increased number of gastrin-producing G cells. G cells (gastrin) locally acting hormone enhancing formation of mucosa and enhances acid production. Difference in esophageal paritinizing esophageal epithelium and simple columnar of stomach clearly seperated. The gastroesophageal junction (Z line) is visibly distinctive.Ê

Answer 130

mucosal/submucosal folds of stomach to allow expansion

Answer 131

left/inferior convex margin of stomach

Answer 132

the teniae coli keep colon under tension, hence forming this overall pouching pattern

Answer 133

2-3 cm inferior to it, the appendix opens.

Answer 134

at the ileocecal junction, to help prevent backflow

Answer 135

distal 40% of small intestine. Peyer's patches more common here, vascular arcades more complicated. Bile acids absorbed here as part of enterohepatic circulation. with the ileum most noted for reabsorption of bile and vitamin B12. The ileum will have more lymphoid nodules (Peyer patches) as it is closer to the colon and its bacterial flora. ileum ends into the medial side of the cecum via the ileocecal junction guarded by the ileocecal valve. The cecum contains the vermiform appendix. The appendix is attached to the ileum by a small mesentery and may therefore have a highly variable position, but the appendicial base is traceable by following the teniae coli or bands of longitudinal muscle of the colon. Lymphoid surveillance of chloronic flora.

Answer 136

proximal 40% of small intestine distal to duodenum. Thicker, more vascular, redder, often empty. Caliber of lumen larger, plicae circulares palpable here. Most of absorption here. jejunum and ileum make up the remaining 6 meters of mobile small intestine (40%, 60%, respectively). Most of the digestion and absorption occurs in the jejunum. has circular folds in its mucosal surface known as circular folds (plicae circulares) that become less prominent in the ileum. Branching patterns of the superior mesenteric artery help to distinguish jejunum from ileum externally. The localized branching of SMA can mean a localized ischemia or infarct of intestine if one of those branches is obstructed, e.g., via an embolus. The jejunum and ileum (more than jejunum) make up the remaining 6 meters of mobile small intestine (40%, 60%, respectively). The jejunum has circular folds in its mucosal surface known as circular folds (plicae circulares). Note that the branching of the SMA (superior mesenteric artery) help to distinguish jejunum from ileum. This branching of SMA can mean a localized infarct of intestine if one of those branches is obstructed, e.g., via an embolus. Mesenteric ischemia abdominal pain complaints are common among older individuals. The jejunum is active with secretion and absorption, with the ileum absorbing what is left, with a distinctive focus on absorption of vitamin B12 and bile salts.

Answer 137

by inferior component of L kidney, transverse colonˆ descending colon. Superior and inferior mesenteric artery branches anastomose at this point.

Answer 138

larger lumen, slower passage, more bacteria (e.g., vitamin K production), water reuptake. large intestine (colon) is divided by the left and right colic flexures into ascending, transverse, and descending colons. The longitudinal muscle of the colonic muscularis is localized into three teniae coli that generate a pouch-like (sacculated) pattern of haustra. In contrast to the villi of the small intestine, the mucosa of the colon is notable for mucus glands to help lubricate the contents. Muscular is externa- outside of large intestines or Tania colI making patchy Hofstra. Colin mostly absorbs water, goblet cells to lube the load. The large intestine (colon) is divided by the left and right colic flexures into ascending, transverse, and descending colons, with a proximal portion of cecum with appendix, and distal sigmoid colon and rectum. The cecum is covered by peritoneum, but is otherwise not fully anchored. The appendix is very mobile, as allowed by its mesoappendix. The ileocecal valve helps to prevent backflow into the ileum, while the orifice of the appendix is small. The transverse and descending colons are anchored to the posterior abdominal wall, with the transverse colon mobile but draped with the greater omentum. The sigmoid colon has a mesentery, and so is also mobile. The haustra (sacculations) of the large intestine spring from the teniae coli, with longitudinal muscle gathered into three bands. The divisions of the colon can be followed by ileocolic, right colic, and middle colic arteries off of the superior mesenteric artery, and left colic, sigmoid, and superior rectal arteries off of inferior mesenteric artery.

Answer 139

right/superior concave margin of stomach

Answer 140

the "mesentery" between the liver and the stomach, so that the liver's mesenteric portal triad) run through this. With rotation of liver to R and stomach to L, end up with omental bursa dorsal to it.

Answer 141

8-10 cm distal to pylorus, the projecting opening into the duodenum is the papilla. The smooth muscle deep to that opening is the sphincter, and the dilated region deep to that where the bile and pancreatic ducts join is the ampulla.Ê

Answer 142

pouches of peritoneum filled with fat along the colon. Omental is L. and epiploic is Gr.

Answer 143

exit from stomach, with sphincter a palpable band of smooth m. Pyloric stenosis in male infants projectile vomiting.

Answer 144

near by the R liver lobe, ascending colonˆ transverse colon

Answer 145

fixed terminal part of intestine. Pelvic, begins at S3 level. P, peristalsis and relaxation of internal anal sphincter. S, relaxing rectal walls, contracting the involuntary sphincter.

Answer 146

at distal end of descending colon, at the level of the iliac crest

Answer 147

small intestine consists of three parts of duodenum (galbladder and pancreas dump chemicals into this portion contributing to chemical digestion), jejunum, and ileum (mostly absorption). Overall, the small intestine is the site of food digestion and absorption, with prominent histological features of villi. The duodenum has the additional histological feature of submucosal duodenal glands (Brunner glands) that secrete mucus and bicarbonate to help to neutralize the chyme. 6 meters, most of digestion and absorption here

Answer 148

most dilated/expanded portion of the alimentary canal,tract, mechanical acid bath, as it converts food into chyme with acid production from parietal cells and pepsin (protein digestionÕs) production from chief cells in the glands in the gastric mucosa. G cells that produce gastrin to stimulate the mucosa is preferentially found in the antral region of the stomach. The pyloric sphincter is a separate band of smooth muscle regulating the entrance of the chyme into the duodenum. Infantile hypertrophic pyloric stenosis can present with projectile vomiting in the newborn. prepares food for small intestine, also useful for vomiting

Answer 149

3 longitudinal bands begin at appendix (location guide for it as a result) and run in colon outer surface.

Answer 150

mesentery of transverse colon, attached near inferior pancreatic border.

Answer 151

transverse is large and mobile, descending down the L side. Descending colon often site of "apple core" colon cancer lesions.

Answer 152

variable position, lymphoid organ, small lumen, so often obstructed into appendicitis

Answer 153

area of liver uncovered by peritoneum near diaphragm

Answer 154

functionally part of L lobe; located by IVC

Answer 155

fusion of cystic and hepatic ducts in edge of lesser omentum. Bile (galbladder stores and concentrated) and pancreatic secretions will enter the lumen of the duodenum via the major duodenal papilla, with control by the sphincter of Oddi (hepatopancreatic sphincter). s in the right free margin of the lesser omentum and is accompanied by portal veins and the hepatic artery as part of the portal triad. Hepatopancreatic heapua with the sphincter of addi on dudodenal papilla.

Answer 156

fusion of R, L hepatic ducts

Answer 157

peritoneal reflections around the bare area. supporting the liver off of the diaphragm represent folds of peritoneum holding it onto septum traversum.

Answer 158

drainage of gall bladder. (coming off galbladder. Cystic artery off of right hepatic artery of cystahepatic triangle or the triangle of kalo) joins the common hepatic duct to form the common bile duct.Ê

Answer 159

sickle-shaped" remnants of ventral mesentery of liver that connect towards the umbilicus

Answer 160

inf. to liver, storage for bile (contraction stimulated by CCK if fatty meal) depression at the visceral edge of the liver. With a thin muscular coat and thick mucous membrane, it concentrates and stores bile

Answer 161

from separate liver lobes

Answer 162

obliterated umbilical v in inf. margin of falciform ligament (round lig. of liver another name for lig. teres)Ñleads to ductus venosus (lig. venosum) in liver

Answer 163

remnants of ductus venosus shunting umbilical blood around liver; along side the caudate lobe.

Answer 164

function separately (own arteries, veins). (albumins- protein in blood, clotting factors, bile created), gallbladder (bile stored hear goes through sphincter of Oddi into duodenum). mong its many roles, the liver is responsible for metabolism of many substances, synthesis of a number of blood products such as albumin and clotting factors, and production of bile for fat emulsification. The liver is the largest abdominal organ, with four lobes: right, left, (Divided by falsiform ligament from ventral mesentery) caudate, and quadrate-galbladder (caudate and quadrate are functionally part of the left lobe, as defined by the left hepatic artery). The porta hepatis on the visceral side of the liver is the entranceway/exitway of common hepatic artery, portal vein, and the common bile duct. There are several Òlow pointsÓ for peritoneal accumulation, e.g., following infection, by the liver, e.g., the hepatorenal recess. Ligamenta TeriÕs (round ligament remnant from umbilical vein), ligamentum venous (curves around into inferior vena cava. Door to liver- common hepatic artery (splits into left and right), portal vein, coming out is hepatic duct feeding into cystic duct w/ gallbladder becoming bile duct sending off to duodenal lumen. Portal triad all three vessels (portal vein, hepatic artery, common bile duct) buried in edge of lesser omentum. The liver is an organ set up for filtration of blood (3/4 hepatic portal vein, with nutrient-rich blood from the intestines, and _ hepatic artery, with oxygenated blood). This blood is filtered in discontinuous capillaries called hepatic sinusoids past sheets of hepatocytes and drains into central veins, which coalesce into hepatic veins that then drain into IVC. Nutrient rich blood from portal system into very large discontuous sinusoid gauntlet between sheets of hepatocytes draining central vein, hepatic vein, and inferior vena cava. Canaliculi- draining bile through filtering nutrient rich blood detoxing, synthesizing albumin (oncotic pressure), coagulation factors. Bile is generated constantly by the liver cells, and is drained by canaliculi between them to bile ducts and then to the gall bladder for concentration, before continuing out the biliary tree.

Answer 165

the opening that is posterior to the portal vein, hepatic artery, and bile duct; possible trapping spot for small intestine loop

Answer 166

space behind stomach partially created by lesser omentum (and splenic ligaments), so a concern if a posterior perforation of stomach

Answer 167

deep transverse fissure inferiorly that contains portal vein, hepatic artery, bile duct. "Crossbar of H", with L side for ligamenta venosa and teres, and R side for gall bladder, IVC fossa.

Answer 168

functionally part of L lobe; by gall bladder

Answer 169

venous supply of digestion products from intestine, created by junction of splenic and superior mesenteric veins. Valveless, so when backed up, clinically relevant anastomoses, e.g., hemorrhoids, varices, occur.

Answer 170

supplies stomach, duodenum, and other regional viscera. 3 branches of common hepatic a., left gastric a., splenic a. Note that celiac artery has three main branches of common hepatic artery (liver, gastroduodenal artery), left gastric artery (less curvature of stomach left and right gastroomental), and splenic artery (Squiggly coiled adhering to surface of pancreas)

Answer 171

from celiac trunk, drains into hepatic sinusoids, along with portal vein blood

Answer 172

artery stems from bifurcation of abdominal aorta; veins contribute to IVC

Answer 173

supply to gall bladder, may be variable in its origin (important for cholecystectomy!)

Answer 174

as part of azygos v., involved in varices, along with l. gastric v. of portal system.

Answer 175

off of common hepatic a., supplies stomach, pancreas, first part of duodenum

Answer 176

off of celiac trunk, arterial supply to liver tissue

Answer 177

several veins draining into IVC, representing coalesced central veins from liver lobules. In parallel with the celiac, superior mesenteric, and inferior mesenteric arteries, blood from the intestines drains to the liver by the hepatic portal system, with major vein contributions of inferior mesenteric vein draining into splenic vein, with splenic vein and superior mesenteric vein forming the hepatic portal vein. Liver gets blood from intestines. If liver trouble filtering can have some portal items that pop up. Paired organs goes into inferior vena cava draining into heart.

Answer 178

these have implications in colon surgery, hence the encouraged effort to highlight them separately; branches of SMA that supply appendix and cecum, ascending colon, and transverse colon, respectively.

Answer 179

enters rectus sheath inferiorly from external iliac at arcuate line, hernia landmark. bleeding from epigastric vessels that is trapped in rectus sheath may present as tender hematoma.Ê

Answer 180

supplies from L colic flexure to rectum

Answer 181

typically drains into splenic v. supplies from approximately the large colonic flexure to the rectum.

Answer 182

drainage of lower part of body except for portal system

Answer 183

aims towards stomach lesser curvature (left portion). L. gastric a. off of celiac trunk; l. gastric v. can anastomose with esophageal v. and generate esophageal varices in portal hypertension.

Answer 184

right off of gastroduodenal a., left off of splenic a.; they supply the greater curvature of the stomach and the greater omentum.

Answer 185

from common hepatic art. Right hepatic a. supplies right lobe and the left hepatic a. supplies left, caudate, and (most of) quadrate lobes.

Answer 186

l. colic a. as portion of inf. mesenteric that supplies descending colon vs. the sigmoid arteries that upply the sigmoid colon (4 branches), where the IMA continues inferiorly as the superior rectal arter.

Answer 187

off of hepatic art., supplies right portion of stomach's lesser curvature

Answer 188

short, at right angles off of abdominal aorta and inferior vena cava, respectively.

Answer 189

note difference of veins, with R vein into IVC, L vein into L renal vein, whereas the arteries are relatively unpaired coming off of the abdominal aorta.

Answer 190

"Mr. Squiggly," supplies the dorsal mesogastrium organ of the spleen; off of celiac a.

Answer 191

inferior to splenic arteryÑfollow it to portal vein

Answer 192

continuation of internal mammary (thoracic) a. for rectus sheath and its overlying skin anastomose w/ counterparts

Answer 193

blood supply of primary intestinal loop, covers from (partway through) duodenum to L colic flexure. Covers vast majority of small instesine, and proximal half of large intestine over left renal vein supplying everythin after duodenum, ileum, jejunem, ascending and descending colon, transverse colon it goes out then coils back in.Ê

Answer 194

largest portal v. tributary, follows the artery but drains into hepatic portal v.

Answer 195

autonomic ganglia associated with the major abdominal arteries, with their autonomic coverage reflecting gut embryology, e.g., celiac ganglion covers T5-9 to stomach and liver. These ganglia should be whitish and firm near where their respective arteries originate.

Answer 196

(lumbrosacral plexus, L2-4) exits under inguinal ligament, major supply to anterior thigh mm. Large n. between psoas major and iliacus mm.

Answer 197

from L1/L2, on anterior surface of psoas major. Cremaster muscle innervation.

Answer 198

the superior portion of L1 (vs. ilioinguinal n.), innervates hypogastric region and internal oblique and transversus abdominis (transverse abdominal) mm. Cutaneous branch (on R) innervates McBurneyÕs point of appendicitis fame. which will cross the abdominal wall at about the level of the McBurney point (the RLQ location where the appendix attaches to the cecum)

Answer 199

collateral branch of L1 ventral ramus, sensory to scrotum, labia majora. Note it "swooping from high" from the quadratus lumborum m. to its course in the inguinal canal. travel through the inguinal canal (but not starting at the deep inguinal ring).

Answer 200

from L2/L3 (also known as lateral cutaneous n. of thigh). Deep to inguinal ligament near ASIS. Meralgia paresthetica or burning sensation on lateral femoral region if there is impingement of this nerve.

Answer 201

(lumbrosacral plexus, L2-4), leaves through obturator foramen, adductor muscles of thigh; find at medial border of psoas major m.

Answer 202

branches of renal pelvis; you may note the difference between minor calyces that drain the renal papillae and major calyces they coalesce into.

Answer 203

aponeurosis of diaphragm

Answer 204

a "double fold" of mesentery hanging down from stomach, secondary fusion with transverse colon (for support) laden with fat. Prevents adhesions between visceral/parietal peritoneum. With mobility, can "wall off" infections. Drape over inflamed organs to minimize adhesions to body wall.Ê

Answer 205

iliacus from iliac crest to blend in with psoas major; femoral n; major hip flexor

Answer 206

runs through length of pancreas, for exocrine function. Duodenal- retroperitoneal swops around head of pancreas. Just before it enters the duodenum, the common bile duct is joined by the duct of the main pancreatic duct, creating a hepatopancreatic ampulla (of Vater). Release of bile and pancreatic secretions through the major duodenal papilla into the lumen of the duodenum is controlled by the papillary sphincter (of Oddi) that opens at meal time. Depending on where gallstones lodge, cholecystitis, jaundice, or even pancreatitis can occur.

Answer 207

retroperitoneal up close to abdominal wall, head surrounded by duodenum, and with pancreatic cancer in the head, the risk of common bile duct or ampulla of Vater obstruction and hence, jaundice. (Blood sugar and glucagon, pancreatic duct meeting up w/ common bile duct at egress of major duodenal papilla creating buffering juices). pancreas has both endocrine functions. Its endocrine function is best known as controlling blood glucose levels with insulin and glucagon. Its exocrine function is focused on a variety of pancreatic enzymes to enhance digestion of proteins (proteases), carbohydrates (amylases), and lipids (lipases), where the emulsification with bile has helped to make that easier. The pancreas has with exocrine and endocrine functions. The exocrine functions of buffering juices and digestive enzymes stem from the ducts and acini, respectively, while the islets of Langerhans are noted for endocrine production of insulin and glucagon (and somatostatin). Panceatic enzimes proenzyme nonactive form acitve in duodenum for safety feature.

Answer 208

lots of packing for the kidney, in addition to pararenal retroperitoneal fat.

Answer 209

lined by peritoneum vs. deep to peritoneum (and deep to the body wall muscles), respectively. Later in development, there is fusion of much of the dorsal mesentery of the abdominal gut to the parietal peritoneum of the dorsal wall, so that many structures originally in the peritoneal cavity, e.g., pancreas, duodenum, ascending and descending colon, are considered retroperitoneal. Other organs such as the kidneys develop deep to the peritoneal cavity and so are retroperitoneal in that manner.

Answer 210

remember, both visceral and parietal. Expanses of peritoneum and how some things become retroperitoneal (kidneys developed from posteriorly-placed mesoderm, the pancreas, duodenum, ascending and descending colons by fusion of dorsal mesentery to dorsal parietal peritoneum).

Answer 211

psoas major m. and psoas minor m. O T12-L5, I lesser trochanter, N L1, L2 rami, O flexes thigh at hip joint. Psoas abscess from vertebral lesion (e.g., TB) draining into psoas sheath. About half of individuals will have a psoas minor strap-like muscle superficial to psoas major and iliacus combine to form major hip flexor iliopsoas major hip flexor.Ê

Answer 212

affect on vertebral column, extend, laterally flex (still a hypaxial muscle, innervated by ventral rami of T12-L4 as it reaches from last rib and lumbar vertebrae to iliac crest). Assists erector spinal in extending and lateral flexing lumbar spine around 12th rib.

Answer 213

(L. ÒlegÓ) arise from lumbar vertebrae, blend in with anterior longitudinal ligament along the vertebral bodies. Right crus \> left. The ligament of Trietz that suspends the duodenum originates from the right crus. lateral attached to inferior ischia rami. with the penile crura alongside extending as corpora cavernosa that are more dorsal to the ventral corpus spongiosum.Ê

Answer 214

note the amount of protection surrounding them. (protected by layers of pararenal and perirenal fat) and pancreas. The kidneys are primarily retroperitoneal from developing in the intermediate mesoderm and the pancreas is secondarily retroperitoneal after developing off of the foregut. Ascending and descending colon against back wall but kidneys and adrenals develop back behind peritoneum always retroperitoneal can spill a round big abdominal pelvic cavity. contain an outer cortex and an inner medulla, with microscopic nephrons as the functional units. Drainage into calyces, pelvis, and ureter may be affected by renal calculi (kidney stones). The bladder will be more formally addressed in the pelvic lectures. Posterior abdominal contents- hepatic portal into inferior vena cava. Celiac ganglion from splenic nerve. are bean-shaped organs buried in fat in the upper abdominal cavity and behind the peritoneum (note the level of containment compared to the spleen). Kidneys contain an outer cortex and an inner medulla, with microscopic nephrons as the functional units, with their loops of Henle and collecting ducts in the medulla, and glomerular capsules, proximal convoluted tubules, and distal convoluted tubules in the cortex (wait until the physiology sequence for further details). Kidneys below peritoneal area form the beginning. Loop of henle in medulalry or parametal part into minor and major calyxes into renal pelvis. Transitional epithelium doesnÕt leak non leaking exercise. Renal calculi- sticking points out of ureter from pelvis into ureter, illiacs and psoas major transition to bladder coming underneath bladder pinches off ureters to prevent backflow.

Answer 215

renal cortex outer functional layer of kidney Bowman's capsule, convoluted tubules (renal columns are extensions of cortex between medullary pyramids, consisting mostly of interlobar arteries)

Answer 216

e.g., pelvis draining into ureter

Answer 217

8-18, represent loops of Henle, vasa recta, and collecting ducts

Answer 218

apex of each renal pyramid, opens into a (minor) calyx

Answer 219

enlargement leading to ureters

Answer 220

lymphoid organ, not from gut tube, removes abnormal RBCs, stores Fe from recycled RBCs, and initiates immune responses. Worry about rupture with L thoracoabdominal injuries, esp. if already enlarged, e.g., mononucleosis.

Answer 221

note the different vessels entering here

Answer 222

think of the spleen growing in the dorsal "mesogastrium" and splitting it, hence forming a dorsal portion of splenorenal ligament, and a ventral portion of gastrosplenic lig.

Answer 223

cortical hormones (aldosterone, cortisol), medullary hormones of epinephrine and norepinephrine. contain an outer cortex producing mineralcorticoids (aldosterone) and glucocorticoids (cortisol) in a relatively zonal pattern, and an inner medulla (derived from neural crest cells) that is developmentally associated with the sympathetic nervous system, producing epinephrine and norepinephrine. (suprarenal) glands contain an outer cortex producing mineralcorticoids (aldosterone control salt and water) and glucocorticoids (cortisol) in a relatively zonal pattern, and an inner medulla (derived from neural crest cells) that is developmentally associated with the sympathetic nervous system, producing epinephrine and norepinephrine. Aldosterone made in medulla from neural crest cells sympathetic nerual crest cells

Answer 224

muscular ducts; renal colic from kidney stones. have walls of smooth muscle and are lined with transitional epithelium. As with the esophagus, there are three areas of relative constriction for the ureters: Ureteropelvic junction, Crossing external iliac artery and vein to enter the pelvic brim, Entrance into the bladder

Answer 225

Muscles of the posterior abdominal wall include:psoas major and iliacus that combine to form the major hip flexor iliopsoas 10& of population have psoas minor, quadratus lumborum that assists erector spinae in extension of the lumbar spine, and with ipsilateral contraction, with lateral flexion, diaphragm, The lumbar plexus of nerves is visible with its relationship to those muscles: From superior to inferior: Iliohypogastric nerve (L1) to the McBurney point level around illac level in the front, Ilioinguinal nerve (L1) into the inguinal canal and external genitalia such as the scrotum or labia majora, Lateral femoral cutaneous nerve (lateral cutaneous nerve of thigh): lateral thigh; if impinged as it crosses the iliac crest, it can create a lateral thigh burning pain of meralgia paresthetica, Genitofemoral nerve to either the cremaster muscles in the spermatic cord or to the inner thigh, Femoral nerve to quadriceps sensory to inner thigh, Obturator nerve to thigh adductor

Answer 226

our of each, for sacral nerves, for their ventral and dorsal rami, respectively.

Answer 227

that meet at acetabulum, os coxa) made of ilium, ischium, and pubis

Answer 228

tail remnant, usually 4 rudimentary vertebrae; coccydynia or pain in coccygeal region from falling

Answer 229

part of abdominal cavity, between ilia

Answer 230

defined as superior to the the ischial spine and defined by the sacrospinous ligament. Items to the lower extremity leave pelvis through here. main way that vessels and arteries leave/enter the pelvis

Answer 231

separates greater from lesser sciatic notch, project towards the fetal passageway. Strong hip bone connections to the sacrum at the sacroiliac joint allow for a stable pelvis.Ê

Answer 232

weight-bearing when sitting. Ischial features of the ischial tuberosity, upon which one sits, and ischial spine

Answer 233

pelvic cavity, integral part of birth canal

Answer 234

defined by ischial spine, the lesser sciatic notches and both the sacrospinous and sacrotuberous ligaments. Items to the perineum leave pelvis through here. pathway to external genitalia and superficial perineal structures.Ê

Answer 235

covered by obturator fascia, obturator nerve enters thigh via it. Obterator foramen covered up by a membrane with an opening for obturator nerve artery and vein for lower extremity.Ê

Answer 236

overall formed by pubic crestÑiliopectinal (iliac arcuate) lines laterallyÑsacral promontory. Arcuate line along ilium, pectineal line along pubis.

Answer 237

bounded by sacrum (+ coccyx), ischial spines, and pubic symphysis.

Answer 238

inferior to symp. pubis, wider in females than in males

Answer 239

sacral hiatus leads into this, the end of the vertebral canal. Site for caudal anesthesia, with extradural spread of anesthesia.

Answer 240

encroaches upon pelvic inlet, created by anterior projection of S1 body

Answer 241

strong synovial joints held into place by sacroiliac ligaments; the site of ankylosing spondylitis, their involvement is seen in ankylosing spondylitis

Answer 242

runs from sacrum (and coccyx) to ischial spine

Answer 243

runs from sacrum to ischial tuberosity

Answer 244

fused vertebrae S1-S5, 4 pairs of foramina for sacral nerves; ala as the large triangular part that articulates with ilium. PSIS is a nearby landmark, as a dimple at the S2 vertebral level. posterior superior iliac spine; S2 vertebral level, as a landmark for the sacroiliac ligaments. sacrum is prevented from tilting by attached ligaments, e.g., the sacroiliac ligaments, the sacrospinous ligaments (to the ischial spine), and the sacrotuberous ligaments (to the ischial tuberosity) off to abdomen and lower limb. These last two ligaments convert the greater and lesser sciatic notches into greater and lesser sciatic foramina dividing by the pubic spine

Answer 245

with a thick fibrocartilage disc

Answer 246

surround the bulb of the penis (beginning of corpus spongiosum in between the crura). Erectile tissue covered up by bands of striated skeletal muscle to enhance contraction of tissue. Bulbospongiousus or ischial cavernosa of cruaura or legs of dorsal rami consistent along way. midline fused in males connected to inferior surface of perineal membrane

Answer 247

in deep perineal space, these form a lubricating secretion into the membranous urethra. bulbourethral gland (coming out first lubricating, prostate (prostate specific antigen to stop it from coagulating proteolitcally breaking it up allowing it to swim

Answer 248

paired erectile tissues.

Answer 249

the midline, unpaired body that has the spongy urethra running through it (although not on list, there are clitoral homologues). Male external genitlia spongious coming off of bulb of penis other erectile tissue or corpus cavernosum surrounded by overall rapping of deep fascia get erection. In males, the urethra is surrounded by the corpus spongiosum, or tubular prolongation of the bulb of the penis. Distally, the corpus spongiosum expands into the glans penis (head)

Answer 250

the dorsal artery of the penis supplies the glans penis, while the deep arteries of penis (off of internal pudendal artery) suppliy the corpora cavernosa. The deep dorsal vein drains the glans penis and corpora cavernosa, and is deep to the dorsal artery within the within the deep fascia of the penis. S impulses constrict arterial supply to erectile tissue, hence keeps it limp, but P impulses cause the trabecular walls to relax and allow more arterial blood flow to create erection. S discharges allow ejaculation, and this predominance of S after orgasm leads to back to flaccidity.

Answer 251

rom tail of epididymis to seminal vesicle; lies external but adherent to parietal peritoneum; carry sperm. The ampulla of ductus deferens. Sperm stored here prior to ejaculation.

Answer 252

leading from these to run through prostate to reach urethra. common ejaculatory duct traverses the prostate and opens into the urethra

Answer 253

meatus/opening of penis

Answer 254

head of penis and foreskin, respectively

Answer 255

surround the crura of the penis (beginnings of the corpora cavernosa); help to maintain erection hypaxial muscle

Answer 256

that part of the urethra that goes across the urogential diaphragm and therefore surrounded by the sphincter urethrae; hence, in the deep perineal space

Answer 257

the part of the urethra going through the penis

Answer 258

largest accessory gland of male reproduction, BPH and prostate CA; watery, acid phosphatase secretions (and PSA). Superior to urogenital diaphragm. The utricle is the male "homologue" of the vagina, found in the prostatic urethra flanked by the openings of the ejaculatory ducts. prostate, particularly the posterior lobe (often involved in prostate cancer), is palpable in rectal examination. The median lobe is more involved with benign prostatic hyperplasia (BPH). prostate is inferior to the bladder, surrounding the first 3 cm of the urethra, but superior to the Òurogenital diaphragmÓ structures. Vasculature on either side of prostate and nerves meaning prostate surgery has risk of neurovascular bundle comprimising erection.

Answer 259

that part that goes through the prostate, widest and most dilatable spot of the urethra

Answer 260

a peritoneal-lined pouch between anterior rectum and posterior bladder. Males will have a rectovesical pouch lined by peritoneum between bladder and rectum

Answer 261

next to ampullae on posterior bladder, create most of secretions, with sucrose. Accessory internal glands: seminal vesicles (sugar fluid to energize sperm). An outgrowth of the ductus (vas) deferens, the seminal vesicle (seminal gland), is on the backside of the bladder

Answer 262

draping of peritoneum over uterus and fallopian tubes; mesosalpinx that part of the broad ligament between the ligament of the ovary (gubernaculum remnant), ovary, and fallopian tube, with the mesovarium a fold of peritoneum that connects ovary to broad ligament

Answer 263

note that it's divided by the vaginal orifice in women hypaxial muscle overlying bulb. Erectile tissue covered up by bands of striated skeletal muscle to enhance contraction of tissue. Bulbospongiousus or ischial cavernosa of cruaura or legs of dorsal rami consistent along way.Ê

Answer 264

separated from the clitoris and spaced apart by the vagina.Ê

Answer 265

endocervix, as part of swab for Pap smears, in addition to ectoocervical samples.

Answer 266

protrudes into vaginal canal. Opening may appear lacerated after childbirth.

Answer 267

homologous to penis, with erectile tissue (no urethra running through it, so no corpus spongiosum). P, clitoral erection and increased vaginal secretion. S, orgasm. Prepuce and glands of clitoris midline fusion in male erectile tissue and genital tissue.Ê

Answer 268

mucosal lining of uterus in uterine cavity

Answer 269

vaginal recess around cervix

Answer 270

open on either side of vagina, lubricating, often infected; below bulb of vestibule; in superficial perineal space

Answer 271

this and bulbospongiosus are harder to find in women than in men, but are in homologous locations

Answer 272

homologous to male scrotum, filled with subcutaneous fat

Answer 273

hairless skin folds in between the labia majora. while the labia minora meet over the clitoris to form a prepuce, homologous to the male prepuce (foreskin).Ê

Answer 274

fatty pad anterior to symphysis pubis, covered with pubic hairs

Answer 275

thick smooth muscle wall of uterus; fibroids as leiomyomas.

Answer 276

gubernaculum remnant, does "berm shot" off of uterus, continues as round ligament of uterus (heading off to inguinal canal, right?)

Answer 277

female gonad, lateral and posterior to uterus

Answer 278

located at center of perineum, where a number of muscles and CT (connective tissue) converge. External anal sphincter, urogenital diaphragm, some of levator ani's preanal thickening, etc. Particularly important in women as a site of perineal support. Other fascia and anchorings tie into where these meet each other, thus forming the perineal body (central tendon of the perineum), a major support point.Ê

Answer 279

(of Douglas), lined by peritoneum between uterus and rectum, reachable by culdoscopy through fornix. Females with their uterus will have both vesicouterine and rectouterine pouches. The ÒdeepÓ inferior portion of the pelvic peritoneal cavity, the rectouterine pouch (of Douglas) can be accessed via the posterior fornix of the vagina with culdocentesis. Two pouches between internal pelvic organs, rectouterine pouch could palpate through posterior fornix of the vagina. Perineal membrane and deep perineal muscle with voluntary sphincter of urethra living in that

Answer 280

the female adult version of the fetal gubernaculum that ends in the labia majora

Answer 281

connects ovary to lateral wall, contains ovarian vessels and nerves

Answer 282

anterior to vaginal orifice

Answer 283

isthmus as the narrow component, ampulla as the lateral swollen component where fertilization typically occurs, infundibulum is the funnel-shaped distal end of the fallopian tubes, while the finger -like fimbriae help to "sweep" the egg up during ovulation

Answer 284

runs towards, but superior to, the ureter as the artery from the interal iliac artery to the uterus. The artery then runs along side of uterine body and supplies superior vagina as well. Note the close relationship of the ureter and the uterine artery and veins: Òwater under the bridge.Ó This is of concern during hysterectomy with the need to transect and tie off the vasculature without clamping and tying off the ureter.

Answer 285

(uterosacral lig.) condensation of pelvic (extraperitoneal) fascia containing smooth mm.; from sides of cervix to middle of sacrum, deep to peritoneum and superior to levator ani

Answer 286

uterus body, fundus, cavity body palpable on bimanual exam, fundus the rounded part of the uterine body above where the uterine tubes enter, cavity as space inside body of uterus. Anterior tilt or aniflexed position of uterus coming off is round ligament of uterus and posterior positioning of fallopina tubes and ovaries. Developmentally, the paramesonephric (MŸllerian) ducts fuse midline to form the uterus. The uterus has a fundus, a body, and a cervix. As an ovum matures, it ruptures through the surface of the ovary during ovulation to end up in the trumpet-shaped mouth of the uterine (fallopian) tube. The fimbriae help to attract ova. Myometrium thick, endometrium shed during menstrual. Cadaver has fibroid.cervix has external part and then before entering uterine cavity. Paramesonephric ducts ducts fusing deep to peritoneal cavity and product of uterus rises up and covered by broad ligament, trying to find ureter on either side of cervix comparing w/ uterine artery and vein,.

Answer 287

muscular sheath, copulatory organ

Answer 288

opening to vagina

Answer 289

lined by peritoneum between bladder and uterus

Answer 290

vestibule as space between labia minora, containing vagina, urethra, and greater vestibular (Bartholin's) glands, vulva as general term (along with pudendum) of female external genitalia)

Answer 291

4 cm long, from puborectalis sling on inferiorly

Answer 292

posterior triangle of perineum

Answer 293

the bend in the rectum that is maintained by the puborectal sling of levator ani.

Answer 294

the other muscle of pelvic diaphragm, posterior (in dogs, the m. responsible for "tail between the legs")

Answer 295

a. as major bifurcation of abdominal aorta; union of L & R vein forms the IVC [inferior vena cava]

Answer 296

voluntary sphincter, blends with puborectalis part of levator ani; innervated by pudendal n. and S4. Anococcygeal lig. Is the anterior joining raphe (joining suture) of levator ani. The perineal membrane and associated muscles do not extend beyond the ischial tuberosities, leaving a free edge that is tied to the anus behind by hypaxial muscle fibers that form the external anal sphincter.Ê

Answer 297

origin of femoral artery, extension of femoral vein, respectively, with inferior border at inguinal ligament

Answer 298

large heavy m. over ischial tuberosity, powerful extensor (more detail with lower extremity)

Answer 299

a. supplies most of blood to pelvic viscera and gluteal region, while vein is the main drainage of pelvis

Answer 300

on either side of anal canal, expansion space for feces (can get ischioanal abcesses in there). ischioanal fosa fat filled between obturator internus and levator ani with pudendal nerve roots.Ê

Answer 301

the main muscle of the pelvic diaphragm, funnel-shaped; puborectalis part forms a sling around rectum that relaxes during defecation; off of obturator internus fascia; innervated by pudendal n., additional S3, S4 innnervation. muscle consists of two U-shaped slings that loop around the gut and attach at either end to the pelvis and obturator fascia. It is innervated by branches off of pudendal nerve and ventral rami of S3-S4. An important part of the levator ani loops around behind the anus to form a puborectal sling. The kink (perineal flexure) it creates separates the rectum from the anus (with a short anal canal), and acts as a supplementary voluntary sphincter, in addition to the external anal sphincter. Obturator facia covering internus w/ levator ani coming off that. Branches off of ppudendal nerve and associated vessels pudendal and internal pudendal arrery and ein w/ superior rectal muscles involved. Fat-filled ischioanal fossa to access anal sphincter. levator ani in effect forms a cone, and between it and the bony pelvis is stuffed with fat in the ischiorectal (ischioanal) fossa, through which nerves and vessels of the perineum travel (and which can be the site of painful anal fissures

Answer 302

variable origin; supplies and drains medial thigh muscle region, respectively.

Answer 303

covers much of the internal wall of the true pelvis, leaves via lesser sciatic foramen to reach greater trochanter (so a lateral rotator). Fascia on top of obturator internus big swoop holding up stuff to keep everything in.Ê

Answer 304

anal columns are folds of mucuous membranes. Anal valves connect them distally. The level of anal valves is the pectinate line, above which internal hemorrhoids (which typically don't hurt), and below which, external hemorrhoids, which are painful. . In contrast, the auricles of the atria will have pectinate muscles, but much of the atrium has a smooth surface. In the right atrium, note the fossa ovalis, a remnant of the foramen ovale. Anal columns and the associated pectinate line indicate the difference between painless internal hemorrhoids and painful external hemorrhoids, as this region of the anal canal represents the merger point between ectodermal and endodermal structures. Anal columns going on developmentally ectoderm and endoderm. Nerves coming off pudendal nerve with sharpe locatlized pain from body wall superiorectal vasculature tying in with autonomic nerve sand visceral nerve fibers causing internal hemmorhoid.

Answer 305

a fibrous membrane that separates the superficial and deep perineal spaces. The perineal membrane and associated muscles do not extend beyond the ischial tuberosities, leaving a free edge that is tied to the anus behind by hypaxial muscle fibers that form the external anal sphincter. Other fascia and anchorings tie into where these meet each other, thus forming the perineal body (central tendon of the perineum), a major support point.

Answer 306

that part of the trunk inferior to the pelvic diaphragm, with a diamond shape created by pubic symphysis, ischial tuberosities, and coccyx. the diamond-shaped region below (inferior to) the pelvic diaphragm, between the ischia, and containing the external genitalia and hypaxial muscles that anchor and move them (and the anus). It is often considered as an anterior urogenital triangle (region) and a posterior anal triangle (region) divided by a line between the ischial tuberosities. The anterior gap in levator ani needs to be "guarded" so that pelvic viscera do not fall through it. inferior rectal vessels and nerve listed here are off of the internal pudendal vessels and pudendal nerve, which are the main supplies to the perineum (between pubis, coccyx, ischial tuberosities, inferior to levator ani).

Answer 307

landmark for greater sciatic foramen; sciatic nerve protrudes inferiorly; a lateral hip rotator

Answer 308

Pudendal nerve (ventral rami of S2-4) supplies most of innervation to perineum. internal iliac artery and vein are the major vessels to the pelvic region, e.g., the internal pudendal artery to the perineal region. External pudendal artery and vein come off of external illiac spraying multiple vessels going on giving good sense why pelvic fracture can be so hemoorhaged because of proximity of small close vessels that are easily hidden by pelvic fascia.

Answer 309

from S1-S4 ventral rami, main nerves from it are sciatic and pudendal nerves, Pelvic innervation all boils down to S2,3,4 keeping things off flor. Nerves into levator ani, pudendal nerve innervating in region, autonomic nerves supplying bladder and erectile tissue ultimately with erection engorging erectile tissue more parasympathetic coming into play. Prostate between bladder and erectile tissue and manipulation ofprostate hits the wiring causing problem. Sciatic nerve coming off of lower lumbar and upper sacral nerve roots. Pelvic activiites parasympathetic activites- defecation, urination, erection. Sympathetic- tight sphincters after excitement of ejacultation inability to refill vascular cylindrers. The ventral rami of L4-S4 form the sacral plexus. Most of this sacral plexus forms the sciatic nerve (L4-S3) to the lower extremity via the greater sciatic foramen and the pudendal nerve (S2-4) to the perineum. In addition, there are hypogastric plexuses (superior and inferior) for autonomic nerves. S2,3,4 are the spinal cord levels of interest for the pelvis and perineum. Sympathetic nerves will travel through the lumbar splanchnic nerves to the hypogastric plexus, while parasympathetic nerves will travel through pelvic splanchnic nerves to their target organs. Autonomic fibers run along lateral to the prostatic capsule, and so are at risk with extensive surgery, where damage could lead to impotence.

Answer 310

with the voluntary external urinary sphincter muscle (contrasting with the involuntary internal urethral sphincter m.), in the deep perineal space.

Answer 311

this distinction made because of the phenomenon of urinary extravasation (e.g, secondary to straddle injury).

Answer 312

the space between the inferior fascia of the urogenital diaphragm (perineal membrane) and the membranous layer of subcutaneous tissue (superficial fascia) of the perineum (called Colles' fascia here; remember that discussion with the abdominal wall with Scarpa's fascia?). Dramatic urinary extravasation can occur here. Superficial perineal spac end pouch erectile tissue as deep to perineal membrane have deep perineal space with things like urethral sphincter. deep to the perineal membrane would include a compressor urethrae and a sphincter urovaginalis along with the sphincter urethrae. erectile organs and associated musculature of the external genitalia.

Answer 313

The deep perineal pouch is more consistent with the Òurogenital diaphragmÓ and the external urethral sphincter (and associated urethral and vaginal muscles) that lie deep to the perineal membrane. A complex of hypaxial muscle (including the sphincter urethrae) and fascia (particularly the perineal membrane) forms the contents of the deep perineal space (the urogenital diaphragm is an older term, but still used in several contexts). The perineal membrane helps to separate deep perineal space from the superficial perineal space.

Answer 314

along the edge of the perineal membrane, helping to stabilize the perineal body. (originates from ischium, pudendal nerve innervation).

Answer 315

triangle on post. wall of bladder formed by uretal and urethral orifices

Answer 316

anterior to internal iliac arteries. In women, crosses underneath uterine artery, Òwater under the bridgeÓ (important for hysterectomy-don't tie off the s!). Urerter coming in low near urethral opening filling upward extending over pubic symphysis.Ê

Answer 317

shorter in women than men,so higher UTI rate than in males. The shorter urethra of women puts them at higher risk for urinary tract infections (UTIs). Disruption of support in area around entrance of urethra and fascia of bladdeer cause incontenance.Ê

Answer 318

lined with transitional epithelium. Detrusor m. is the smooth muscle of the bladder wall. suprapubic location of a full, distended bladder. Deep perineal space and membrane for external urethral sphincter. Bladder bordered b prostate inferior to it but superior to deep perineal muscle and membrane. P empties, but S constricts outlets

Answer 319

anterior triangle of perineum, anal triangle dominated by levator ani have deep perineal membrane and anal muscles controlling front. Urogenital veruss anal triangle have x marks spot of perineal body visualized of arched keystone helping hold structures together along the way.Ê

Lab test for Thorax, Abdomen, & Pelvis Flashcards

(344 cards)