Flashcards in Lecture 10 RH Deck (36):
What is the clinical implications of the testicular lymph drainage?
lymph drains into intrabdominal nodes this means tumor metastasis can be to the abdomen via these nodes.
How do the testes maintain their desired temperature in cold weather?
testes retract in cold weather due to the effect of the premasteric muscle fibers (its fucking CREmasteric YOU DIMWIT)
What are the layers of the spermatic cord?
spermatic cord contains:
internal spermatic fascia (from fascia transversalis)
Premasteric fascia (from the arching fibers of TA and IO.
External spermatic fascia (from the External Oblique muscles)
Where are premasteric muscle fibers derived from?
Only the arching fibers (FIBRES FFS) of internal oblique.
What surrounds the vessels and ducts of the testes within the spermatic cord?
Spermatic cord is surrounded by internal fascia layer, premasteric muscle layer, and external premasteric muscle layer.
What is an abdominal hernia?
Abdominal hernia is a protrusion of abdominal contents through the wall of the abdominal wall. The typical cause of this is an increase in intrabdominal pressure.
What is an inguinal hernia?
2 types; direct and indirect.
Indirect hernia protrudes through the inguinal canal. This is often due to a congenital abnormality.
Direct hernia is a protrusion into the inguinal canal through an area of weakness in its posterior wall. (wall bulges forwards through the walls of the inguinal canal)
What is the congenital abnormality that causes indirect inguinal hernias to develop?
A hole formed by the descent of the testes through the parietal peritoneum (known as the processus vaginalis) normally closes up and the pouch is fused.
Sometimes the pouch doesn't obliterate this causes the hernia to develop.
What is the common area of weakness of the abdominal wall which typically protrudes into the inguinal canal in the form of a direct inguinal hernia?
typically the medial part of the wall. (known as the inguinal hesselbach triangle)
What muscles constitute the posterior abdominal wall?
Psoas Major overlyed (overlaid you pillock) by psoas minor (2/3rds of cases).
What sheaths the posterior abdominal wall and what is its significance?
The thoracolumbar fascia which also gives rise to the anterior abdominal wall muscles.
Where does psoas major originate from? Where does it pass through and where does it insert?
overlies lumbar transverse processes.
1 continuous origin from lumbar vertebral bodies from lower T12 - upper L5 and to the disks.
It inserts into the lesser trochanter of the femur after passing through the inguinal ligament.
Where are the origin and insertion of psoas minor?
T12 - L1 origin.
Tendon blends with fascia overlying psoas major.
Where is the quadratus lumborum located and what does it attach to?
between the bottom of the 12th rib and the posterior half of the iliac crest and attaches to each transverse process that it passes through.
Where does iliacus originate?
Deep aspect of the ilium has a smooth surface called the iliac fossa. This is the origin of iliacus. Fibers form a conjoint tendon with psoas major and this muscle passes under the inguinal ligament.
What structure covers psoas and iliacus?
Psoas and iliacus have their own fascial envelope and this is known as the psoas fascia and the iliacus fascia.
How are the muscles of the posterior abdominal wall arranged relative to the lumbar spinal cord?
Lumbar vertebral column punctures into the abdominal cavity from behind and so psoas lies edge to edge with the lumbar transverse process.
What is the structure of the thoracolumbar fascia?
thoracolumbar fascia contains 3 layers:
Posterior layer connects to tip of spinal process
Middle layer from the tip of the transverse process
Anterior layer from the front of the transverse process and all 3 layers fues at the line of the 12th rib. This gives rise to all 3 anterior oblique muscles.
What is different about external oblique muscle compared to the others?
Exterior oblique muscle has a free posterior border and it doesn't connect at the same point as the other 2 oblique muscles.
What is the fascia that encloses erector spinae?
Erector spinae is contained within posterior layer of the thoracolumbar fascia
What fascia contains quadratus lumborum?
Quadratus lumborum is contained within anterior layer of the thoracolumbar fascia.
What is significant about psoas major in relation to the nerve innervation of the lower limb?
Ventral rami sink directly into psoas and forms the lumbar plexus within psoas.
How do nerves from psoas get to the groin?
Nerves to the groin slip out of psoas and run between the internal oblique and transverse abdominus muscles.
Describe the arrangement of an intraperitoneal structure.
When parietal peritoneum projects into the abdominal cavity it forms an intraperitoneal structure surrounded by visceral peritoneum and connected to the posterior abdominal wall via a mesentery.
What is the arrangement of the retroperitoneal viscera?
Some viscera are retroperitoneal and are attached to posterior abdominal wall and covered anteriorly by the parietal peritoneum.
Where are the kidneys located?
kidneys sit back in the paravertebral gutters (anterior to quadratus lumborum)
At T12 - L3 level.
Right kidney is a little lower than the left one due to the position of the liver.
How does the diaphragm influence the kidneys?
kidneys move up and down with respiration due to diaphragm movement.
What are the dimensions of the kidneys?
10 cm long 5cm wide 2.5cm thick
What structures sit right on top of the kidneys?
Adrenal glands they are asymetrical (SPELT ÀSYMMETRICAL YOU RAT):
Right one has a party hat shape
Left one has a crescent shape.
What are the characteristics of solid viscera or glands?
Made up of secretory cells. Arranged either as cortex -> medulla, or as lobes/lobules.
Additional cover over and above the capsule (usually a serous membrane)
Borders and surfaces are typically determined by adjacent structures.
Always has a hilum/slit where nerves, blood vessels, and duct enter and exit.
What are the contents of the kidney?
Kidney contains lots of perirenal fat under capsure and this is followed by renal fascia.
What is the arrangement of cells within the kidney?
Kidney contains an outer cortex with palar tissue and it leads to inner medulla with discontinuous pyramidal shapes of darker coloured cells known as medullary pyramids.
How are the structures of the renal hilum arranged?
hilum faces anteromedially. Vessels communicate with aorta and IVC which are anteromedially oriented.
From posteriorly to anteriorly:
Renal pelvis (leads to ureter)
Nerves and lymphatics are randomly arranged.
What is the arrangement of the hilar structures of the kidney?
Hilar structures are embedded in fat in a space of the kidney known as the renal sinus.
What is the path of the renal artery prior to reaching the hilum?
Renal arteries are arranged horizontally.
The IVC is arranged to the right (like the right atrium)
Right renal artery is located deep to the IVC betwen it and the lumbar vertebral column.