SUGER Anatomy Flashcards
(161 cards)
1
Q
What are the functions of the kidneys?
A
They act to filter and excrete waste products from the blood. They are also responsible for H2O and electrolyte balance.
2
Q
What is found at the renal hilum?
A
Renal arteries and veins, ureter, nerves and lymphatics.
3
Q
Which kidney is often positioned lower in the abdomen and why?
A
The right kidney, this is due to the presence of the liver.
4
Q
What are the renal arteries a branch of?
A
The abdominal aorta just below the SMA.
5
Q
Which renal artery is longer?
A
The right renal artery, this is due to the position of the aorta being slightly to the left.
6
Q
Which artery crosses the IVC posteriorly?
A
The right renal artery.
7
Q
Where do the renal veins drain?
A
Into the IVC.
8
Q
What are the 3 main layers of an adrenal gland?
A
- Perinephric Fat
- A cortex.
- A medulla at the centre.
9
Q
Adrenal glands: What cells are contained within the medulla and what do they secrete?
A
Chromaffin cells - they secrete catecholamines e.g. adrenaline. This is a ‘fight or flight’ response.
10
Q
What are the 3 arteries that supply the adrenal glands?
A
- Superior adrenal artery.
- Middle adrenal artery.
- Inferior adrenal artery.
11
Q
What is the superior adrenal artery a branch of?
A
The inferior phrenic artery.
12
Q
What is the middle adrenal artery a branch of?
A
The abdominal aorta.
13
Q
What is the inferior adrenal artery a branch of?
A
The renal arteries.
14
Q
What does the right adrenal vein drain into?
A
The IVC.
15
Q
What does the left adrenal vein drain into?
A
The left renal vein (and then into the IVC).
16
Q
What muscle lies below to psoas major?
A
Quadratus lumborum.
17
Q
What is the origin of quadratus lumborum?
A
Iliac crest and the iliolumbar ligament.
18
Q
What is the action of psoas major?
A
Flexion of the hip.
19
Q
What is the innervation of psoas major?
A
L1-3 nerves.
20
Q
What nerves lies on the anterior surface of psoas major?
A
The genitofemoral nerve.
21
Q
Where does the femoral branch of the genitofemoral nerve go?
A
It passes under the inguinal ligament and supplies sensory innervation to the inner thigh.
22
Q
Where does the genital branch of the genitofemoral nerve go?
A
It passes through the deep inguinal ring to enter the inguinal canal. It supplies the cremaster muscle.
23
Q
What vein does the right gonadal vein drain into?
A
The IVC.
24
Q
What vein does the left gonadal vein drain into?
A
The left renal vein (and then the IVC).
25
What is the innervation of iliacus muscle?
Femoral nerve (L2-4).
26
What nerve lies in the groove between the iliacus and psoas major?
The femoral nerve.
27
What nerve emerges from psoas major medially?
Obturator nerve.
28
What does the femoral nerve give motor innervation to?
The anterior thigh muscles that flex the hip and extend the knee.
29
What is the action of iliacus?
Flexion of the hip.
30
What does the femoral nerve give sensory innervation to?
Cutaneous branches pass to the antero-medial thigh. The terminal branch, saphenous nerve, supplies the medial side of the leg and foot.
31
What does the obtruator nerve give motor innervation to?
The medial thigh muscles inolved in adduction.
32
What does the obtruator nerve give sensory innervation to?
The skin of the medial thigh.
33
What are the walls of ureters composed of and why?
Smooth muscle walls. When the muscle contracts it produces peristaltic waves that propels the urine into the bladder.
34
What is the name of the point at which the renal pelvis narrows?
The ureteropelvic junction.
35
What is the significance of the ureters piercing the bladder obliquely?
It creates a physiological valve that acts to prevent the back flow of urine.
36
Do the ureters cross the ovarian arteries and the ductus deferens anteriorly or posteriorly?
Posteriorly. (Water (ureters) under the bridge (artery)).
37
What is the function of the bladder?
Collection, temporary storage and expulsion of urine.
38
Give 3 ways in which the bladder is specialised for storage.
1. Rugae give the bladder a great capacity to expand.
2. Detrusor muscle relaxes in storage, increasing bladder volume.
3. Urethral sphincters contract.
39
Which urethral sphincter is composed of skeletal muscle?
The external urethral sphincter.
40
Which urethral sphincter is under voluntary control?
The external urethral sphincter.
41
Which urethral sphincter is composed of smooth muscle?
The internal urethral sphincter.
42
Which urethral sphincter is under autonomic control?
The internal urethral sphincter.
43
What is the specialised smooth muscle of the bladder wall called?
The detrusor muscle.
44
What is the blood supply to the bladder?
The internal iliac arteries.
45
What nerve provides sympathetic innervation to the bladder?
| What does this allow?
The hypogastric nerve (T12-L2).
| Causes relaxion of the Detrusor muscle, promoting urine retention
46
What is the affect of sympathetic innervation on the bladder?
Relaxation of the detrusor muscle and constriction of the internal urethral sphincters - this promotes urine retention.
47
What is the affect of parasympathetic innervation on the bladder?
Contraction of the detrusor muscle and relaxation of the internal urethral sphincters - this promotes micturition.
48
What is the role of the sensory nerves in the bladder wall?
They signal the need to urinate to the brain when the bladder becomes full.
49
Name 3 locations where the ureter narrows and renal stones may be present.
1. Ureteropelvic junction.
2. As the ureter passes the pelvic brim.
3. Where the ureters enter the bladder.
50
What two lumbar plexus nerves have the same nerve roots?
Femoral and Obtruator - L2,3,4.
51
What 3 bones make up the hip bone?
1. Ilium.
2. Pubis.
3. Ischium.
52
What is the socket called formed from the fusion of the ilium, pubis and ischium?
The acetabulum.
53
What bone articulates with the acetabulum?
The head of the femur.
54
Name 2 important ligaments that attach from the sacrum to the ischium.
1. sacrospinous ligament.
| 2. sacrotuberous ligament.
55
Where does the sacrospinous ligament run between?
The sacrum to the ischial spine.
56
What are the 3 main differences between male and female pelvis
1. The female has a larger angled sub-pubic arch.
2. The pelvic outlet is rounder in females.
3. In a female, the sciatic foramen are more at the back
57
What do the left gonadal veins (ovarian and testicular) drain into?
The left renal vein, then into the IVC
58
What forms the floor of the inguinal canal?
The inguinal ligament.
59
What does the inguinal canal transmit in males?
The spermatic cord
60
What does the inguinal canal transmit in females?
1. Round ligament of the uterus
2. Ilioinguinal nerve
3. Genital branch of the genitofemoral nerve.
61
What are the nerve roots for the ilio-inguinal nerve?
L1.
62
What does the ilio-inguinal nerve give sensory innervation to
- Skin on the upper middle thigh.
- In males it supplies the skin over the penis and scrotum.
- In females it supplies the skin over the mons pubis and labium majora.
63
How do the testes move from the posterior abdominal wall to the scrotum?
The paired gubernacula aid in the descent of the testes. The testes are guided through the inguinal canal and then into the scrotum
64
Define hernia.
Protusion of an organ through the wall or cavity that normally contains it.
65
Where does the inferior epigastric artery lie?
Immediately medial to the deep inguinal ring.
66
What are the 3 layers of tissue surrounding the spermatic cord?
1. External spermatic fasica.
2. Cremaster muscle and fascia.
3. Internal spermatic fascia.
67
What layer of the abdominal wall is the external spermatic fascia derived?
Derived from the aponeurosis of external oblique.
68
What layer of the abdominal wall is the internal spermatic fascia derived?
Transversalis fascia.
69
What layer of the abdominal wall is the cremaster muscle and fascia derived?
Internal oblique.
70
What is the function of the cremaster muscle?
To raise and lower the testes in order to regulate scrotal temperature for optimum spermatogenesis.
71
What is the vas deferens?
The duct that transports sperm from the epididymis to the ejaculatory ducts.
72
What 3 arteries are contained within the spermatic cord?
1. Testicular artery
2. Cremasteric artery
3. Artery to the vas deferens
73
What 3 veins are contained within the spermatic cord?
1. Testicular vein.
2. Cremasteric vein.
3. Vein to the vas deferens
74
What 3 nerves are contained within the spermatic cord?
1. Ilio-inguinal nerve.
2. Genitofemoral nerve.
3. Sympathetic plexus.
75
What are '4 others' contained within the spermatic cord?
1. Vas deferens.
2. Lymphatics.
3. Tunica vaginalis. (was known as the process vaginalis in the foetus, adheres to the surface of the testis and reflects onto the internal aspect of the scrotum
4. Venous Plexus
76
What are the 3 erectile tissues contianed within the root of the penis?
1. 2x Crura (form corpus cavernosum in body).
| 2. 1x Bulb (forms corpus spongiosum in body).
77
What is the glans of the penis?
The most distal part of the penis formed by the expansion of the corpus spongiosum. It contains the urethral orifice.
78
Is ejaculation caused by parasympathetic or sympathetic innervation?
Sympathetic.
79
Which nerves provide sensory innervation to the scrotal skin?
- Ilio-inguinal.
- Genital branch of genitofemoral.
- Branches from the perineal nerve.
80
Give 3 functions of the pelvis.
1. Transfers weight.
2. Provides attachment for muscles and ligaments.
3. Contains and protects pelvic viscera.
81
Give 3 functions of the pelvic floor muscles.
1. They support abdomino-pelvic viscera.
2. They resist increases in intra pelvic pressures.
3. They maintain urinary and faecal continence.
82
What are the 2 main muscles of the pelvic floor?
1. Levator ani muscles.
| 2. Coccygeus muscle.
83
What is the innervation to the levator ani muscles?
Branches of the pudendal nerve, S2, 3, 4 roots.
84
What is the function of levator ani?
Maintains faecal continence, during defecation this muscle relaxes.
85
What is the perineum?
An anaotmical space located below the pelvic diaphragm; it is diamond shaped and contains urinary, GI and reproductive viscera.
86
What divides the perineum into anterior and posterior triangles?
An imaginary line drawn between the ischial tuberosities.
87
What are the 3 sub-divisions of the uterus?
1. Fundus.
2. Body.
3. Cervix.
88
What is a fornix?
the pocket of the Vagina that extends up, surrounding the Cervix. There is an anterior and posterior part.
89
What are the 2 orifices of the cervix?
1. The internal orifice - communicates with the uterus.
| 2. The external orifice - communicates with the vagina.
90
How does the uterus lie with respect to the bladder?
Posterior-superior.
91
What are the three tissue layers that make up the uterus?
1. Peritoneum.
2. Myometrium: smooth muscle layer.
3. Endometrium: inner mucous membrane lining.
92
What are the two divisions of the endometrium?
1. Stratum basalis.
| 2. Stratum functionalis.
93
Which layer of the endometrium is shred in menstruation?
The stratum functionalis.
94
What is the round ligament and what is its function?
A remnant of the gubernaculum.
| Its function is to maintain the anteverted position of the uterus.
95
What is the uterine artery a branch of?
The internal iliac artery
| They travel in the cardinal ligament
96
What is the function of the uterine tubes?
They assist in the transport and transfer of ovum from the ovary to the uterus.
97
Give 2 ways in which the uterine tube is adapted for the transport of ovum to the uterus.
1. Ciliated columnar epithelium wafts the ovum to the uterus.
2. Contraction of the smooth muscle layer.
98
Where in the uterine tube does fertilisation normally occur?
In the ampulla, this is the widest part of the tube and is lateral to the isthmus.
99
What is the final part of the uterine tube?
The fimbriae, finger-like projections coming off the infundibulum.
100
What is the function of the fimbriae?
To capture the ovum.
101
What is the blood supply to the uterine tubes?
The ovarian and uterine arteries.
102
What is the ovarian artery a branch of?
The abdominal aorta.
103
What are the female gonads?
The ovaries.
104
Give 2 functions of the ovaries.
1. To produce oocytes.
| 2. To produce oestrogen and progesterone
105
What is the epithelium surface of the ovary?
Simple cuboidal epithelium.
106
What does the ovarian ligament connect?
The ovary to the uterus
107
What does the left ovarian vein drain into?
The left renal vein.
108
Give 3 functions of the vagina.
1. It receives the penis in sexual intercourse.
2. It expands providing a delivery channel in childbirth.
3. It serves as a canal for menstrual fluid to leave the body.
109
What 2 things comprise the vaginal mucosa?
1. Stratified squamous epithelium.
| 2. Elastic lamina propria.
110
What is the blood supply to the vagina?
Uterine and vaginal arteries (branches of the internal iliac artery).
111
Give 3 functions of the vulva.
1. Sensory tissue in sexual intercourse.
2. Assist in micturition.
3. Defend the internal female reproductive tract from infection
112
What is the mons pubis?
A mass of fatty tissue lying over the pubis symphysis.
113
What are the labia majora?
Hair bearing external folds that fuse posteriorly and extend anteriorly to the mons pubis.
114
What are the labia minora?
Hairless folds that lie within the labia majora. They fuse anteriorly to form the prepuce (hood) of the clitoris.
115
What is the vestibule?
the area enclosed by the labia minora. It contains the openings of the vagina (external vaginal orifice, vaginal introitus) and urethra.
116
Where are the great vestibular glands located and what is their function?
Glands located either side of the vaginal orifice, they secrete mucous during sexual arousal.
117
What is the clitoris derived from embryologically?
The genital tubercle.
118
What is the main blood supply to the vulva?
Pudendal arteries.
119
What 2 structures combine to form the ejaculatory ducts?
The vas deferens and the seminal vesicle.
120
List in sequence the tubular structures along with spermatozoa pass to the exterior?
Testes -> epididymis -> vas deferens (goes through inguinal canal and along the lateral pelvic wall to the posterior bladder) -> seminal vesicle -> ejaculatory duct -> prostate gland -> prostatic urethra -> membranous urethra -> penile urethra.
121
What is the function of the prostate glands?
They secrete proteolytic enzymes which break down clotting factors in the ejaculate and so allowing the semen to remain fluid.
122
What does the prostate lie inferior to?
The neck of the bladder.
123
Name 2 vessels that pierce the prostate.
The urethra and the ejaculatory ducts
124
How long is the male urethra?
15-20cm.
125
How long is the female urethra?
4cm.
126
Give some signs and symptoms of an enlarged prostate gland.
An enlarged prostate would press on the bladder and so cause an increase in urinary frequency, urinary urgency, dribbling, and difficulty initiating micturition.
127
What muscle is the medial arcuate ligament related to?
Psoas major.
128
What muscle is the lateral arcuate ligament related to?
Quadratus lumborum.
129
What hormones are produced in the cortex of the Adrenal glands?
The cortex produces steroid hormones including cortisol,
| aldosterone and testosterone.
130
What is the below the Other - Sacrotuberal ligament or sacraspinal ligament?
Sacrotuberal is below the sacrospina ligament The sacrotuberal ligament is also bigger
131
Sacral Plexus: What does the Pudendal nerve supply? where does it arise from?
It innervates muscles in
the perineum and the skin of the external genitalia.
Also pelvic floor muscles. Arises from S2-S4
132
What is pudendal artery a branch of?
Internal iliac artery.
| The internal pudenal artery supplies the perineum
133
What is a direct inguinal hernia?
intra-abdominal contents are forced directly through the
posterior wall of the inguinal canal (i.e. the relatively weak transversalis fascia) and
subsequently through the superficial ring. The herniated abdominal contents do not pass
through the deep inguinal ring in direct inguinal hernias
134
What is an indirect inguinal hernia?
where intra-abdominal contents are forced through the deep
| inguinal ring and into the canal itself
135
What are the 3 muscles of the levator ani?
Puborectalis
Pubococcygeus
illiococcygeus
(the names of them point to where they are)!
They all attach to the Perineal body
136
What does the ischiocavernousus cover?
The Corpora cavernosa
137
What does the bulbospongiosus cover?
The corpus spongiosum
138
What can the diamond shape of the perineum be split int-?
Anal triangle (posteriorly) - contains the opening of the anus and the external anal
sphincter.
• Urogenital triangle (anteriorly) - this area is a bit more complicated, and has several
layers
139
What are the layers of the urogenital triangle?
```
Skin
Perineal fascia
Superficial perineal pouch
Perineal Membrane
Deep perineal pouch
```
140
Urogenital triangle layers: What does the Superficial perineal pouch contain?
the erectile tissues of the penis or
clitoris and also 3 muscles: ischiocavernosus, bulbospongiousus and the
superficial transverse perineal muscles
141
Found Inbetween the perineal pouches, what does the Perineal Membrane consist of?
A strong fibrous membrane that provides support for the attachment of
ischiocavernosus and bulbospongiosus.
• It has specific holes in it for the urethra and vagina
142
Urogenital triangle layers: What does the Deep perineal pouch contain
lt's a space between the perineal membrane and the pelvic floor
muscles.
• Contains parts of the vagina, urethra and the external urethral sphincter
143
What travels through the Greater sciatic foramen?
Note that the greater sciatic foramen is divided into 2 parts by the piriformis muscle.
Superior and inferior gluteal arteries and veins
Superior and inferior gluteal nerves
The pudendal nerve, leaving the pelvis
144
What travels through the Lesser sciatic foramen?
The internal pudendal artery and veini
The obturator internus tendon
The pudendal nerve, re-entering the pelvis
145
What passes under the Inguinal ligament to leave the pelvis?
The Femoral nerve -
The external iliac becomes the femoral artery when it crosses under the inguinal ligament and enters the femoral triangle
146
What does the pectinate line divide?
Splits the upper and lower anal canal
It marks where endoderm and the hindgut transition to ectoderm
147
What is the blood supply to the superior part of the anal canal?
(above the pectinate line)
m inferior mesenteric artery, via the superior rectal
| arteries. The venous drainage is via the portal venous system towards the liver.
148
What is the epithelium that lines the superior anal canal?
Same as the internal mucosa, Simple Columnar
149
What is the nerve supply to the superior anal canal?
Inferior hypogastric plexus, which receives input from the sympathetic trunk, and parasympathetic fibres from the pelvic splanchnic nerves
150
What is the blood supply to the inferior part of the anal canal? (below the pectinate line)
middle and inferior rectal arteries
which originate from the internal iliac arteries
Venous drainage goes straight to the IVC, not the Liver
151
What is the epithelium that lines the inferior anal canal?
the histology is more like the epithelium of skin, i.e. stratified squamous
152
What is the nerve supply to the inferior anal canal?
The nerve supply
to this part of the anal canal and external (voluntary) anal sphincter is via the pudendal
nerve
153
How does the cervix commincate with
a) the Uterine cavity
b) the vagina
a) the Internal Os
| b) the external Os
154
Where are spermatozoa produced?
```
seminiferous tubules (lined with Sertoli Cells)
This and Interstitial tissue (with leydig tissue cells make up the individual lobules in the testes
```
155
Where does developign sperm from the seminiferous tubules collect?
the rete testes
| Afferent ducts then take the sperm to the Epididymis for storage and maturation
156
What covers the testes inside the scrotum? what is its purpose
tunica vaginalis, a closed sac of parietal peritoneal origin that contains a small amount of viscous fluid.
It works much like the peritoneal sac, lubricating the surfaces of the testes and allowing for friction-free movement.
157
What is the testicular parenchyma that enclose the testis what does it do?
tunica albuginea, a fibrous capsule that encloses the testes. It penetrates into the parenchyma of each testicle with diaphragms, dividing it into lobules.
158
What does the illiohypgastric nerve supply?
Internal oblique, and transvers abdominis
| Also sensory to skin over the pubic region
159
What nerve innervates the skin over the medial thigh?
The obturator nerve
160
Lateral Cutaneous Nerve of the Thigh;
| What does it innervate? What are its roots?
L2, L3
| Innervates the anterior and lateral thigh down to the level of the knee.
161
What does the Pudendal nerve supply?
Somatic comntrol over the bladder and bowels
- external urethral sphincter
- External Anal sphincter
- The levator ani
- Skeletal muscles in the perineum
- Sensory function to the penis and the clitoris
S2, S3, S4 keeps poo off the floor
