SBO PRAC Flashcards
Lab manual must know - SBO oral (70 cards)
1
Q
Introduce the ureters and mention the structures it crosses to reach the bladder
A
The ureters are located between the abdominal cavity and the pelvis. They ureters exit the kidneys and travel caudad to enter the bladder. They transport urine.
Renal Pelvis
Ureters
- Passing down psoas
- Crossing genitofemoral N.
- crossing gonad vessels
- Leaving psoas at the bifurcation of common Illiac A.
- Passing over sacroiliac joint
- ***males** cross vas deferens before piercing posterolateral angle of blader
2
Q
A
3
Q
Introduce and label the male genitalia
A
The male genitalia is located in the pelvic cavity. It is composed of the prostate, penis and testes. Its main function is for male reproduction even though urine is also expelled by the male urethra.
- Anal canal
- Preprostatic urethra
- prostatic urethra
- intermediate urethra
- spongy urethra
- scrotum
- testes
- epididymides
- vas deferens
- Seminal vesicles
- ejaculatory ducts
- prostate
- bulbourethral glands
Penis
- root
- body
- glans
- corona
- crura (corpora cavernosa)
- corpus spongiosum
4
Q
What is the nerve supply to the right side of the colon
A
Sympathetic - splanchnic N.
Parasympathetic - Vagus N.
5
Q
Introduce and label this slide
A
The liver
is located in the abdominal cavity in the Left upper quadrant under the rib cage. The liver function is to filtrate blood coming from the digestive tract, detoxify chemicals, metabolize drugs, secrete bile. the liver is divided into the diaphragmatic and visceral surfaces, and its made out four lobes.
Slide - Hepatic lobule
The liver is made out of lobules which are The functional unit of the liver. The structure is hexagonal in shape made out of
- P= portal tract
- F= fibrous septum (mostly clear in pigs)
- V= terminal hepatic venule (central vein)
Lobule can also be divided into ancinus which is a functional unit. Kernel shaped with portal tracts as the centre and the V at the sides. divided into 3 zones (1 being closest to P with more O2)
Function:
- carry blood away from portal tract to vein via sinusoids
- carry bile from central area into portal via canulas
6
Q
Introduce and label this slide
A
Lymph node
Widely distributed secondary lymphoid organs, clustered along lymphatic vessels. Structure: fibrous structure divided by trabeculae and stroma of reticular connective tissue. Function House lymphocytes and macrophages, Site of immune system activation, Filtering of lymph.
Cross-section of lymph node
- C=capsule
- T=trabeculae: extension from the capsule
- SF = Secondary follicles: active with germial centre
- PF=primary follicle: inactive
- S=subscapular sinuses: afferent lymphatic vessels
- MC= medullary cords: extensions of the cortex
- MS= medullary sinuses: drain efferent lymph into blood
- M=medulla
- H=hillum
- P=paracortex: T lymphocites interact with antigens
- Cx= cortex
7
Q
label the oesophagus
A
Cervical oesophagus
Thoracic oesophagus
Abdominal oesophagus
Upper oesophageal sphincter (pharyngoesophageal sphincter)
Oesophageal constriction where the oesophagus is crossed by the arch of the aorta
Oesophageal constriction where the oesophagus is crossed by the left main bronchus
Lower oesophageal sphincter (where the oesophagus passes through the diaphragm)
8
Q
Label the IMA supply to the colon
A
- Abdominal Aorta
- IMA
- Left colic artery = Splenic flexure + descending colon
- Sigmoidal arteries = sigmoid colon
- superior rectal artery = superior aspect of rectum
9
Q
What are the relations of the bladder
A
Superior: Sigmoid colon + ilium
Inferior/posterior:
- Male: Base is separated by rectum by seminal vesicles and vas deferens
- Female: rectum is separated by vagina
Apex: separate from pubic bone by retropubic space
10
Q
Identify 4 bloood vessels related to the oesophagus
A
Inferior thyroid arteries (thyrocervical trunk)
Ventral paired branches from the thoracic aorta
Left gastric artery (celiac trunk)
Left inferior phrenic artery
11
Q
label the superior aspect of the liver
A
- Ligamentum venosum
- Coronary ligament
- bare area
- Right / left Hepatic vein
- Groove for IVC
- Triangular ligament
- Portal vein
- Proper hepatic artery
- bile duct
- gall bladder
- quadrate lobe
- Triangular ligament
12
Q
Label the Diaphragmatic surface of the liver
A
- Right lobe
- left lobe
- Falciform ligament
- Round ligament
- Triangular ligament
- Coronary ligament
- Bare area
13
Q
Label this model of the celiac trunk
A
Abdominal Aorta
-
Celiac trunk
- Left gastric Artery - lesser curvature stomach
- Splenic Artery
- Lt gastro-omental A. - greater omentum
- Short gastric Arteries - fondus + cardia stomach
- Common Hepatic Artery
- Proper Hepatic Artery
- Rt/ Lt hepatic - liver
- Right Gastric Artery - greater curvature stomach
- Gastroduodenal Artery
- Rt gastro-omental A. - greater omentum
- Supraduodenal - D1
- Anterior superior Pancreaticoduodenal
- Posterior superior pancreaticoduodenal
- Proper Hepatic Artery
14
Q
What is the nerve supply to the liver?
A
- Sympathetic supply T5-T9 celiac plexus
- Parasympathetic CNX
15
Q
Introduce and label the kidneys
A
The kidneys are located on the left and right upper quadrants of the abdomen towards the posterior aspect of the body, above the vertebral level L2/3. There are two bean-shaped kidneys. Their function is to Produce Urine, Erythropoietin, Renin: (blood pressure regulation), Vitamin D: converts inactive form (cholecalciferol) to an active form (calcitriol), Gluconeogenesis.
- Superior/ inferior poles
- Medial - lateral borders
- Hilum (renal vein, artery + pelvis)
- Renal Capsule
- Perinephric fat (fat glands between minor calices)
- Cortex
- Medulla
- Renal column
- Renal pyramid
- renal papillae
- Ureters
- Major Calix
- Minor Calix
16
Q
Introduce the liver
A
The liver is located in the right upper quadrant and part of the left of the body underneath the rib cage. It is separated from the thoracic cavity by the diaphragm.
The liver has two surfaces the Diaphramatic and visceral and 4 lobes, Rt, Lt, caudate, quadrate.
The liver has 500 + functions but the main ones are:
- Synthesis (plasma protein, bile, hormones, haemopoesis)
- Detoxification
- Metabolism & storage (fats, carbs, amino acids, minerals)
- Excretion of bilirubin
- Immune function
17
Q
Introduce and label the bladder
A
The bladder is located in the pelvic cavity in front of the rectum/vagina and Depending on the contents it may reach the umbilicus. The bladder is a strong hollow organ with muscular walls, which serves as a temporary reserve for urine.
- Inferior / posterior surface base
- inferior lateral surfaces X 2
- Superior surface
- apex
- Body
- Fundus
- Neck
- Uvula
- Internal urethral orifice
- External urethral orifice
- ureters orifice
- Trigone - internal base of the bladder
18
Q
Introduce and label the spleen
A
The spleen is located in the left hypochondriac region, in the posterolateral aspect of the fo the abdominal cavity, under the diaphragm and ribs 9 to 11. Its main functions are Immunity, Blood filter, Reservoir: (blood, platelets, monocytes), Recycles by-products of RBC. The spleen has a shaped like a closed fist, it has 2 surfaces, diaphragmatic (left dome) and visceral. It has 3 borders Superior, inferior, anterior.
4 impressions,
- Left kidney,
- Stomach
- splenic flexure
- pancreas.
Other
- Hilum
- Gastrosplenic lig.
- Splenorenal lig.
- splenic artery
- Splenic vein
19
Q
Label this model of IMS
A
- Inferior mesenteric artery
- Left colic artery
- Ascending colic artery - transverse colon + splenic flexure
- Descending colic artery - descending colon
- Sigmoid arteries - sigmoid colon
- Superior rectal arteries - superior rectum
- Left colic artery
20
Q
Name the relations of the spleen to the abdominal cavity
A
Anteriorly: Stomach - via gastrosplenic lig.
Posteriorly: Diaphragm - separate spleen from lung and left R9-11
Inferiorly: Left colic flexure -
Medially: Tail of pancreas & Left kidney - via splenorenal ligament
21
Q
Introduce Internal Oblique
Origin
Insertion
Neurove supply
Action
A
The internal oblique is the intermediate layer of the flat muscles of the anterolateral aspect of the abdomen. Fibres run Horizontally at level of ASIS, Obliquely upwardsuperior to the ASIS, Obliquely downward inferior to the ASIS. together the flat muscles compress and support the abdominal viscera.
Origin: Thoracolumbar fascia, ant 2/3 illiac crest, lat. 1/2 inguinal ligament
Insertion: Inf. borders R10-R12, linea Alba, pectineal line via conjoint tendon
Nerve supply: Thoracoabdominal N. + first lumbar N.
Action: Flexion + Rotation trunk, support abdominal viscera
22
Q
Introduce Rectus abdominis
Origin
Insertion
Nerve supply
Action
A
Rectus abdominis is the primary vertical muscle of the abdomen. It is anchored transversely to the anterior layer of the rectus sheath at the tendinous intersection. Together with the flat abdominal muscles, it compresses and supports the abdominal viscera.
Origin: Pubic symphysis and pubic crest
Insertion: Xiphoid process + costal cartilage 5-7
Nerve supply: Thoracoabdominal N.
Action: Flex the trunk and support abdominal viscera.
23
Q
Introduce and label the thyroid gland
A
The thyroid gland is located in the anterior aspect of the neck, wrapped around the trachea above ring 2/3. It has to lateral lobes and the isthmus. Its function is to regulate the metabolism and growth.
Vascular supply
- Thyroid veins (superior, middle, inferior)
- Thyroid arteries (superior, inferior)
24
Q
Name the structures around D1
A
Location
- Vertebral level L1
- Cap and mesentery
- Hepatoduodenal ligament
- Greater omentum (inferiorly)
Anteriorly
- Peritoneum
- gall bladder
- Liver
Posteriorly
- Bile duct
- gastroduodenal Artery
- Hepatic Portal Vein
- IVC
Superiorly - Neck of gall bladder
Inferiorly - Neck of pancreas
Medially - Pylorus
25
Introduce and label the gall bladder
The Gallbladder is located in the right upper quadrant in the abdominal cavity, in the gallbladder fossa of the visceral surface of the liver. It is shaped as pear shape sac. Its main function is the storage and concentration of bile.
* Fundus
* Body
* Neck
* Cystic duct
not in the picture - Cystic Artery
26
What is the histological layers of the prostate
**Tubuloalveolar glands** - produce 305-50% seminal fluid
* Prostate specific antigen (PSA)
**Supporting stroma**
* Fibrous connective tissue
* Smoth muscle fible
* Prostatic interstitial cell
27
What is the arterial supply pathway to the pancreas?
**_Head_**
celiac trunk
common hepatic
gastroduodenal
\*\*posterior superior pancreaticoduodenal
\*\*anterior superior pancreaticoduocenal
**_Body + Tail_**
celiac trunk
splenic artery
branches of splenic artery
28
Name the structures surrounding D4
Ascending part
Location
* L3 vertebral level
* Duodenojejunal flexure
Posteriorly
* Left psoas
* left margin of aorta
Medially
* Hea of pancreas
* SMA
* SMV
Superiorly - body of pancreas
Inferiorly - small intestine (jejunum)
29
Talk about the structures surrounding the pancreas
Head:
* IVC
* Right renal artery
* right left renal vein
Neck
* superior messenteric vessels
* pylorus of stomach
Body
* Aorta
* SMA
* left suprarenal gland
* left kidney and vessels
* L2
Tail
* left kidney
* hilum of spleen
* left colic flexure
* between splenorenal ligament
30
Label the SMA supply to the colon
* Abdominal Aorta
* **SMA**
1. Middle colic artery = _Transverse colon + Hepatic_ flexure
2. Right colic artery = _ascending colon_
3. Ileocolic artery
1. posterior cecal arteries = _ceacum_
2. anterior cecal arteries = _ceacum_
3. Apendicular artery = _appendix_
31
Introduce and label this slide
**Prostate**
The prostate is part of the male reproductive system. It is located in the pelvic cavity inferior to the bladder around the prostatic urethra. It is the largest accessory gland of the male reproductive system and produces seminal fluid. It is shaped like a walnut and made out of tubuloalveolar glands. Has 3 **Zones** Peripheral, transitional, centra.
**_This is the cross-section of the prostate_**
* Sp= Fibrous septa
* Cap= capsule
* PZ= peripheral zone: the bulk of gland
* St= fibrous stroma: no glandular tissue
* U= urethra
* C= urethral crest
* ED=ejaculatory ducts
* Tz= Transitional zone: surround prostatic urethra
* Cz= Central zone: base of prostate
32
What are the gastric gland cells produced in the stomach that aid digestion?
**Mucous neck cells**
**Parietal cells**
* Secrete HCl: acidity of gastric juice
* produce intrinsic factor: absorption Vitamin B12 @ terminal ileum
**Chief cells**
* Produce pepsinogen & gastric lipase
* Low pH required for conversion of pepsinogen to pepsin
**Enteroendocrine cells**
* Secrete hormones & chemical mediators
* Gastrin (from G cells) (control secretory activity)
* Histamine (secretion),
* serotonin (contractility)
33
Introduce these slides
Stomach
The stomach is located in the abdominal cavity in the epigastric and left hypocondriac region. It sits between the oesophagus and the D1 portion of the duodenum. Its main functions are to secret acid, digest food,
Structure
* L= Longitudinal layer (muscle)
* C=circular layer (muscle)
* O= oblique layer (muscle)
* SM=sub mucosa
* MM= muscularis mucosa
* M=mucosa
* GM = Lamina propia
* SE= surface epithelium
* GP= gastric pit
* Serosa
34
What are the peritoneal relations to the Kidneys?
The kidneys are retroperitoneal
**Superiorly -** Diaphragm
**Posteriorly**
* Lower ribs
* QL
* Psoas
* costodiaphragmatic recess of pleura
* Iliohypogastric nerve
* Illiohypoinguinal nerve
**Anteriorly:**
* Rt: liver duodenum Ascending colon
* Lt: stomach, spleen, pancreas, jejunum, descending colon
35
Introduce Transverse abdominal
Origin
Insertion
Nerve supply
Action
This is the innermost layer of the anterolateral flat muscles of the abdomen. Superior Fibres run transversomedially and inferior run parallel to Int. oblique. together the flat muscles compress and support the abdominal viscera.
**Origin:** Inf. Surf. Costal Cartillage 7-12, Throacolumbar Fascia, Illiac crest, Lat. 1/3 inguinal ligament.
**Insertion:** Linea alba, aponeurosis int. oblique, pubic crest, pectineal line via conjoint tendon.
**Nerve supply:** First Lumbar N. + thoracoabdominal N.
**Action:** compresion and support abdominal viscera.
36
introduce and label the histology slide
**Pancreas**
The Pancreas is located in the abdominal cavity in the epigastric and left the hypochondriac region. It is retroperitoneal and sits posterior to the stomach in a transverse direction with the head connected to D2 and the tail resting on the spleen. It has an elongated tadpole shape and is approx 15cm long. It functions is to act as an exocrine and endocrine gland.
**_pancreatic islets_**
Endocrine cells - A cluster of hormone producing cells.
* _Alpha_ cells produce glucagon, - Increase blood sugar
* _Beta_ cells produce insulin - lower blood sugar
**Strucutre**
* I= Islets of langerhans: mde out of Ancinar cell (endocrine cell)
* Intercalated duct (middle of ancini)
* D=Interlobular duct: Recibe via septa the hormones produced.
* F= Mucosa Fold
* AC= Adiposite (white holes) - atrophy of cells (more in old people)
* S= Septa between lobules
**Horomones**
37
Label the diagram of the male urethra
* Preprostatic urethra (Urethral internal orifice)
* Prostatic urethra (in protate)
* Intermediate urethra (membranus part
* Bulbourethral glands
* spongy urethra (penile)
* Urethral external orificie
38
Identify the structures between the adrenal glands Rt to left
IVC
Rt crus of the diaphragm
Celiac ganglion and trunk
SMA
Lt crus of the diaphragm
39
Introduce External Oblique
Origin
Insertion
Nerve supply
Action
External Oblique is the outermost muscle of the flat muscles found at the anterolateral aspect of the abdomen. Fibres run inferomedially. together the flat muscles compress and support the abdominal viscera.
## Footnote
**Origin:** Ext. Surfaces R5 -R12
**Insertion:** Linea Alba, Pubic tubercle, Ant 1/2 iliac crest
**Action**: Flexion, rotation of trunk + compression abdominal VIscera
**Nerve supply:** Thoracoabdominal N. (ventral rami inf 6 Tx N.) + Subcostal N.
40
Label the stomach
Cardia
Fundus
Body
Pyloric region (antrum, canal, sphincter)
Greater curvature of the stomach
Lesser curvature of the stomach
Angular notch
Cardiac notch
41
What is the Arterial supply to the male genitalia
* **Prostate:** prostatic areteries - from illiac artery
* **Testes**:
* Scrotal arteries - ext. / int. pudendal
* Testes: testicular arteries - abdominal aorta
* **Penis:** Internal pudendal artery - ant. int. illiac artery
42
Introduce this histology slide
Gallbladder
The Gallbladder is located in the right upper quadrant in the abdominal cavity, in the gallbladder fossa of the visceral surface of the liver. It is shaped as pear shape sac. Its main function is the storage and concentration of bile.
**_Slide corresponds to a cross-section of the gallbladder divided in 3 sections_**
**Mucosa: (inner layer)**
* •Simple columnar epithelium that possesses microvilli (absorption)
* •When empty the mucosa is thrown into honeycomb-like folds
**Muscularis****: (middle layer)**
* •Contains smooth m., collagen & elastin
* •Contracts in response to cholecystokinin & vagal stimulation
**Adventitia/Serosa:**
* _Adventitia_: Surface-attached to the **liver**
* _Serosa:_ **Peritoneal** surface
43
What is the arterial supply pathway to the adrenal glands and the main veins
**Arteries**
Abdominal aorta
* Inferior phrenic Artety
* _Superior adrenal artery_
* _Middle adrenal artery_
* Renal Arteries
* _Inferior Suprarenal artery_
**Veins**
Rt adrenal vein
Lt adrenal vein
44
Introduce and label this slide
Thyroid
the thyroid is located on the anterior aspect of the neck wrapped around the trachea superior to rings 2/3. It is made composed of two lobes and the thymus. Its function is to produce and secrete hormones.
**Thyroid gland**
_Spherical Follicles_
Each follicle is surrounded by a ring of _follicular cells_
_Follicular cells_ secrete _Thyroglobulin_ precursor for thyroid hormones found in a gel made of _Colloid_
_Parafollicular cells_ found in the gaps between follicles secrete **calcitonin** that affects storage of calcium
**Thyroid hormones**
* all hormones contain iodine
* Thyroxine
* Thyotironnine
45
What is the arterial supply pathway to the liver
Celiac trunk
Common hepatic
Proper Hepatic Artery
Left hepatic A.
Right Hepatic A.
46
Introduce and label this model
The Kidney
The kidneys are located in the posterior aspect of the abdominal cavity between the vertebral levels of L2/3 and T11/12. There are two bean-shaped kidneys in the body whose main function is to filtrate blood and produce urine.
Model of the inside of a Kidney, showing the nephron and glomerulus.
47
Label the diagram of the rectum
* Rectum
* Anorectal flexure
* Anal canal
* Anus
Not in diagram
* Rectosigmoid junction
48
Introduce the adrenal glands and mention the peritoneal relationships
They are located in the abdominal cavity and sit above the superior pole of the kidneys. the Rt adrenal is triangular in shape while the lt is semilunar. Function: produce corticosteroids (glucocorticoids, mineralocorticoids, adenoids) and ephinephrin
* Rt Adrenal:
* ANteriolateraly Rt crus of the diaphragm
* Anteromedially overlapped IVC
* Anteriolateraly overlaped by liver
* Lt Adrenal:
* Contact spleen stomach and pancreas
49
Introduce and label this slide
Bladder
The bladder is located in the pelvic cavity, anterior to the rectum/ vagina. It is a muscular sac tetrahedral in shape that acts as temporary storage of urine.
**_Section of the wall of the bladder_**
MUCOSA: Bladder is lined with transitional epithelium that is thrown into numerous folds (rugae) in the relaxed state
MUSCULARIS: The smooth muscle of the bladder is referred to as detrusor muscle (L. ‘to thrust’)
* Longitudinal mm. inner
* Circular mm. middle
* Longitudinal mm. outer
ADVENTITIA: fat
50
Name the structures that surround D3
Horizontal part
location vertebral level L3
Anteriorly
* SMA SMV
* small intestine
Posteriorly
* Right psoas major
* IVC
* Aorta
* Right ureter
Superiorly - Head of the pancreas
Inferiorly - small intestine (illiac portion)
51
Introduce and label the large bowel
The large bowel is located on the abdominal cavity and attached to the greater omentum. It is divided into 6 parts as it progresses around the abdomen. its structure is mainly thick sacs named haustra held together in a muscle (teniae coli). The function of the large bowel as a whole is digestion, propulsion, absorption and defecation.
* Ceacum
* ileocecal junction
* veriform appendix
* mesoappendix
* Ascending colon
* transverse colon
* descending colon
* SIgmoid colon
* hepatic flexure
* splenic flexure
* Rectum
* Anal canal
52
Label this model of SMA
* Superior mesenteric artery
* Middle colic artery - Hepatic Flexure colon
* Superior Colic artery - ascending Colon
* Ileocolic artery
* Anterior/ Posterior cecal - ceacum
* Appendicular - appendix
53
What is the nerve supply to the male genitalia
* **Prostate:**
* Sympathetic: T12-L2 via the inferior hypogastric plexus
* Parasympathetic: •pelvic splanchnic nerves (S2-4)
* Visceral afferent fibres
* **Testes:**
* Sympathetic: T10 - 11
* Parasympathetic CNX
* Visceral afferent fibres
* **Penis:**
* Autonomic
* Sympathetic: Hypogastric and pelvis plexus (T12-L2)
* Parasympathetic: Hypogastric and pelvis plexus (S2-S2)
* Visceral afferent fibres
* Somatic
* Pudendal N. (S2-4)
* Dorsal N. (S2-4)
* Ilioinguinal (L1)
54
Introduce and label the pancreas
The Pancreas is located in the abdominal cavity in the epigastric and left the hypochondriac region. It is retroperitoneal and sits posterior to the stomach in a transverse direction with the head connected to D2 and the tail resting on the spleen. It has an elongated tadpole shape and is approx 15cm long. It functions as an exocrine and endocrine gland.
* Head
* neck
* body
* tail
* uncinate process
* pancreatic duct
* accessory pancreatic duct
55
Introduce & Label the Small Intestine
Location: The small intestine is located in the abdominal cavity. It starts at the stomach and finishes at the caecum of the large intestine in the illioceacal valve.
Function: End absortion of mnutrients and minerals from food.
Structure:
* Duodenum X 4
* Jejunum - Left
* Ileum - right
* Celiac trunk
* SMA
56
What is the nerve supply to the left side of the colon
Sympathetic via
inferior mesenteric plexus + inferior hypogastric plexus
* Splanchnic N
* Lumbar splanchnic
* Pelvic Splanchnic
57
Label the Visceral surface of the liver
* Caudate lobe
* Quadrate lobe
* left lobe
* Right lobe
* left hepatic artery
* right hepatic artery
* Portal vein
* Proper hepatic artery
* Bile duct
* Coronary ligaments
* IVC
* Round ligament
* gall bladder
\*\*Not in Diagram\*\*
* Lesser omentum
* Hepatoduodenal ligament
* Hepatogastric ligament
58
Introduce and label this slide
Kidney
The kidneys are located on the R/LUQ of the abdominal cavity at the level of T12 - L2/3 vertebrae. There are two bean-shaped kidneys. Function: Produce urine, Erythropoietin, Renin, Vitamin D, Gluconeogenesis.
**_Cross section of a kidney_**
* C= Cortex
* M= medulla
* P=papillae
* Cp = Capsule
* U= ureter
* H= Hilum
_**\*\*Mention Nephrons\*\***_
59
Label and identify the following structures of the female reproductive system
The female reproductive system is located in the pelvic cavity. The main regions are the Uterus, Ovaries, vagina, and external genitalia. The main function is a reproduction.
**External Genitalia**
* Anal & urogenital triangles
* Mons Pubis
* Labia Majora
* Labia minora
* clitoris
* vagina
* vestibule of vagina
* vaginal orifice
* Vaginal Arteries
**Uterus**
* Fundus
* Body
* Isthmus
* cervix
* Internal Os
* External Os
* Uterine Arteries
**Ovaries**
* Ovarian Vessels
* Ligament of the ovary
* Suspensory ligament of the ovary
**Urinary bladder**
* Ureters
* Vesicouterine pouch
* rectouterine pouch
60
Name the structures around D2
**Descending part**
**Location**
* Vertebral levels L2-L3
* superior duodenal flexure
* inferior duodenla flexure
Anteriorly
* Transverse colon
* Transverse mesocolon
* Small Intestine
Posteriorly
* Hilum of Right kidney
* Renal Vessels
* Ureter
* Psoas major
Superiorly - D1
Inferiorly - D3
Medially
* Head of pancreas
* Pancreatic duct
* Bile duct
* Hepatopancreatic ampulla
* hepatopancreatic sphincter
* Major/ minor duodenal papilla
61
Introduce a nephron and their process
The functional unit of the kidneys. Located on the cortex. made out of Renal corpuscle, renal tubule, collecting duct. Function: Blood filtration and urine formation.
* **Glomerulus** form filtrate
* **Proximal convoluted tubule:** Process filtrate and reabsorb H2O, K+, Ca2+ Urea, Na+ glucose, AAs, secrete drugs
* **Loop of Henle:** reabsorption water
* **Distal convoluted tubule:** Secrete ADL + Ka+ and reabsorve ADH + water + ALD + Na+
* **Collecting duct:** Receive filtrate from the nephron and pass it to the minor calyces via papilla.
62
Introduce and label this slide
Ovaries
## Footnote
The ovaries are located in the pelvic cavity oblique to the ASIS. They Lie in a shallow fossa, in the angle between the internal and external iliac vessels on the obturator nerve. There are two almond-shaped glands. Their function is the production of female gametes and synthesis of female hormones.
F= folicule: contain female gametes in various stages of development
L= broad ligament
H= helicine artery
M= medulla
CL= corpora lutea: post ovulatory follicles
Germinal epithileum: peritoneum (cover ovary)
**•Cortex**: (tunica albuginea): houses the forming gametes
**•Medulla**: contains the large vessels and nerves
63
Introduce and Label this histology slide
**Esophagus**
the Esophagus is located in the thoracic cavity mostly on the posterior mediastinum region, between the laryngopharynx and the stomach. It sits posterior to the trachea. Its function is to allow passage of food from the mouth to the stomach
**Cross-section of the esophagus**
_Mucosa_
* •Stratified squamous epithelium
* •Gastroesophageal junction: simple columnar ep.
_Submucosa_
* •Mucous-secreting glands
_Muscularis_
* •Sup. 1/3: skeletal mm
* •Mid. 1/3: mixture of skeletal & smooth mm
* •Inf. 1/3: smooth mm
_Outer layer_
* •Cervical & thoracic part: adventitia
* •Abdominal part: serosa
**labels**
* LM=Longitudinal muscule
* CM= circular muscule
* Ly= lymphoid
* G=submucosa gland
* SM= submucosa
* MM= muscularis mucosa
* E= epithilium
* L= lumen
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introduce and label this slide
Appendix
Located in the right lower quadrant of the abdominal cavity. It is an Intestinal outpouch attached to the posterior aspect of the caecum in the large bowel. Function: **Immunity**: produces and stores lymphocytes, **Reservoir** for beneficial gut bacteria Helps to r**ecolonise** the gut when needed
**_Cross-section of the appendix_**
* S=serosa layer:
* M= mesoappendix: suspensory mesentery continues from outer serosa layer
* F= follicles: simple epithileum
* Mucosa
* Submucosa
* Muscularis Externa
* Lymphoid tissue
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introduce and label this slide
Adrenal gland
The adrenal glands are located in the abdominal cavity and sit on the superior poles of the kidney. The adrenal glands are divided into two main regions, the cortex and the medulla. Their function is to produce hormones.
**Cross section of adrenal gland**
_Cortex - corticosteroid hormones_
* **_Zona glomerulosa:_** _mineralocorticoids_ (balance water and minerals
* - **Aldosterone** - acts on nephron for reabsortion)
* **_Zona Fasciculata:_** g**_lucocorticoids_** (promote glucogenesis, produce glucose from fat and proteins
* - **Cortisol** - enhance SNS for BP, regulated immune response).
* **_Zona reticularis:_** _Androgens_ production
* Sex cells (estrogen, testosterone)
_Medulla_
Produce chromaffin cells - produce **_catecholamin_**e **adrenalin** 80% and **noradrenaline20%** - increase the activity of Sympathetic NS
* Increase HR & cardiac contractility
* increase Peripheral vessel constriction, increase BP
* increase bloodglucose, BMR
66
Label and introduce the boundaries of the female perineum
The perineum is a diamond shaped region on the inferior aspect of the pelvis, bound by the pubic symphysis coccyx and ischial tuberosities. Its made out of urogenital and anal triangles, Its made out of 5 layers starting with the skin up to the pelvic diaphragm. Together they form the pelvic floor.
**Anteriorly:**
* Pubic symphysis
* Mons Pubis
**Anterolaterally**
* Inferior pubic Rami
* ischial Rami
**Laterally**
* Ischial Tuberosity
* Medial aspect of Thighs
**Posterolaterally**
* Sacrotuberous ligaments
**Posteriorly**
* Sacrum
* Coccyx
* gluteal folds
* inguinal cleft
67
What are the structures of the Porta Hepatis
Portal fissure or transverse fissure on visceral surface of liver that gives passageway for
* Portal vein
* Hepatic artery
* hepatic n plexus
* hepatic ducts
* Lymph vessels
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Introduce and label this slide
**Testes**
The tests are part of the male reproductive system. They are suspended in the scrotum on the posteroinferior to the penis in the lower abdominal wall. They are the male ovoids and site for spermatogenesis.
**_Cross- section of testes_**
E= epididimis
RT= rete testes: tubes on posterior testes - drain to epidydimis
S= septum: separates **seminiferus tubules** - site of spermatogenesis
TA= tunica albuginea: fibrous capsule of testes
**Seminiferus tubules - Spermatogenesis**
* Spermatogenic cells: Sperm (sexualy mature sperm)
* sustentacular cells: suport spermatogenic cells and nourish sperm
* interstitial endocrine cells: produce testosterone
* Myoid cells: squeze sperms out of seminiferus tubes
69
introduce and label this slide
The large bowel is located in the abdominal cavity. It is made from pouches called haustra and a muscle name tinae coli. The functions of the large bowel are digestion propulsion absorption and defecation.
The slide is a cross-section of the wall of the large bowel.
From the outer layer in
* Muscular layer
* LM= longitudinal muscle
* CM= circular muscle
* Submucosa
* mucosa
* simple columnar epithelium
* Deep mucosa
* crypts (contain goblet cells)
70
Label and introduce this slide
Spleen
The spleen is located in the LUQ between R9-11. Function: Blood filtration, Immunity, Reservoir, recycle. Structure: Diaphragmatic and visceral surface + 3 borders + 4 impresions. **Friable texture**
**_Portion of spleen_**
* WP= White pulp: site of immune functions, Mostly lymphocytes suspended on reticular fibres
* RP= Red pulp: where senescent RBC and bloodborne pathogens are destroyed
* C= capsule
* T= trabeculae
