Flashcards
ANAT PREP M1
Cards in this deck (109)
- 1What are the suprarenal glands? Where are they located?They are a pair of endocrine glands situated antero-superior to each superior renal pole. They are retroperitoneal structures.
- 2Right Suprarenal Gland Site: Anterior Relations: Posterior Relations: Arterial supply: Venous drainage: Lymphatic drainage: Nerve supply:Site: The upper poles of both kidneys opposite the vertebral end of the 11th intercostal space & the 12th rib
Anterior Relations: Inferior vena cava and the liver
Posterior Relations: Diaphragm
Arterial supply: 1) superior suprarenal artery from inferior phrenic artery, 2) middle suprarenal artery from abdominal aorta directly, 3) inferior suprarenal artery from renal artery
Venous drainage: Right suprarenal vein ends in the IVC
Lymphatic drainage: Lateral aortic nodes
Nerve supply: Each Gland is Supplied by the Preganglionic Fibers from the Splanchnic Nerves, Reaching the Gland Via Coeliac & Renal Plexus. - 3Left Suprarenal Gland Site: Anterior Relations: Posterior Relations: Arterial supply: Venous drainage: Lymphatic drainage: Nerve supply:Site: The upper poles of both kidneys opposite the vertebral end of the 11th intercostal space & the 12th rib
Anterior Relations: Stomach and splenic artery and pancreas
Posterior Relations: Diaphragm
Arterial supply: 1) superior suprarenal artery from inferior phrenic artery, 2) middle suprarenal artery from abdominal aorta directly, 3) inferior suprarenal artery from renal artery
Venous drainage: Left suprarenal vein ends in the left renal vein
Lymphatic drainage: Lateral aortic nodes
Nerve supply: Each Gland is Supplied by the Preganglionic Fibers from the Splanchnic Nerves, Reaching the Gland Via Coeliac & Renal Plexus. - 4What is involved in the urinary viscera?The two kidneys, the ureters, the bladder, and the urethra.
- 5hat is the anatomical site of the kidneys?● Extending from the level of the upper border of the 12th thoracic vertebra superiorly.
● To the 3rd lumbar vertebra inferiorly. - 6Which is higher, the right or the left kidney? Why?The left kidney is higher.
The right kidney is 1⁄2 inch lower due to being crowed by the liver. - 7What is the hilum of the kidney? Where is it located? What passes through here?● Hilum - means the point of attachment of a seed to its stem/vessels.
● At the medial border, there is a fissure in the concave part of the kidney which is called the
Hilum.
● The renal vessels & ureter passes through here. - 8Describe the arrangement of structures at the hilum. Anterior: Intermediate: Posterior:Anterior: Renal Vein
Intermediate: Renal Artery
Posterior: Renal Pelvis (pelvis of the ureter) - 9Label blood vessels in the following diagram from 1-5.1. Superior Suprarenal Artery from Inferior Phrenic Artery
2. Middle Suprarenal Artery from Abdominal Aorta Directly
3. Right Renal Artery
4. Left Renal Artery
5. Abdominal Aorta - 10Left Suprarenal Gland Function:They are responsible for releasing three classes of hormones; mineralocorticoids, glucocorticoids, and androgens along with Catecholamines.
- 11Renal Medulla Function:The inner-most region of the kidney, arranged into pyramid-like structures,
that consist of the bulk of the nephron structure. - 12Renal Cortex Function:The outer region of the kidney, between the renal capsule and the renal medulla, consists of a space that contains blood vessels that connect to the nephrons.
- 13Ureter Function:Carry urine from the kidneys to the bladder.
- 14The posterior surface of the kidney has no peritoneal covering and is related directly to the following structures:1. Diaphragm
2. 12th rib on the right side and 12th & 11th ribs on the left side because the left kidney is higher than the right one.
3. Below the diaphragmatic area medially is the Psoas muscle.
4. Below the diaphragmatic area (intermediate area) is the Quadratus Lumborum muscle which is
separated from the kidney by the following structures: the Subcostal Vessels, Subcostal Nerve, Iliohypogastric Nerve & Ilioinguinal Nerve.
5. Below the diaphragmatic area (laterally) is the Transversus Abdominis muscle. - 15Anterior relations of the right kidney:Peritoneum (This is a covering of the abdominal organs. The posterior side of the peritoneum comes over and on top of the kidneys anteriorly. It then goes out to cover different organs.)
Right suprarenal gland
Second part of the duodenum
Right lobe of liver
Right colic flex. Ure
Coils of small intestine
Ascending branch of right colic artery - 16Anterior relations of the left kidney:Peritoneum
Left suprarenal gland
Stomach
Spleen, body of pancreas and splenic vessels
The left colic flexors and the beginning of the descending colon
Coils of Jejunum
Branches of the left colic vessels - 17What are the ligaments of the kidney?Lieno-renal ligament: lieno an old term for spleen, renal in reference to anything kidney related (splenorenal ligament)
Coronary ligament: ‘coronation’ as in ‘crown’ as in encircling - 18What keeps the kidney in its place? (From deep to superficial)From deep to superficial:
-A true fibrous capsule
-Perirenal fat
-Renal fascia -Pararenal fat - 19What is a floating kidney? Is this a life-threatening condition?-A condition which causes the kidney to drop downward, especially when a person stands up or goes from a lying down to upright position.
-This condition is especially dangerous because the ureters or renal blood vessels can become twisted or kinked during movement
-Presents with pain over the upper abdomen and flank, being more common on the right side
-Can cause disruption to the outflow of urine which results in distension of the kidney with urine
-Obstruction of blood supply causes kidney ischemia and pain
-Stretching of nerves around the blood vessels can also cause pain - 20What arteries supply the kidneys? At what spinal level do these arteries arise?Renal arteries from off of the abdominal aorta at the spinal level of L2
- 21Describe the venous drainage of the kidneys.-Renal veins drain directly into the inferior vena cava
-Left renal vein is longer than the right, it passes in front of the abdominal aorta just below the origin of the superior mesenteric artery
-Difference between the left and right: the left renal vein receives blood from the left suprarenal and left gonadal vein - 22Describe the lymphatic drainage of the kidneys.Two lateral aortic lymph nodes.
- 23Describe the nerve supply of the kidney.Renal plexus and least splanchnic nerves which are vasomotor function.
- 24What is Morris Rectangle?A way to mark the surface location of the kidney.
- 25Describe the basic internal gross anatomy of the kidney: Cortex Renal medulla Renal pyramids Renal pelvis- A cortex surrounds an inner medulla.
- The renal medulla is divided into renal (medullary) pyramids and renal columns made of cortical
tissue.
- The renal pyramids have their apex (renal papilla) pointed toward the center of the kidney. This is where the tubules dump into first minor calicies, which then join with others to form major calicies, and finally the renal pelvis.
- Renal pelvis = proximal, dilated portion of the ureter. - 26What is the function of the ureter? How long is it?What is the function of the ureter?
- Carry urine from kidneys to bladder
How long is it?
- 25-30cm - 27What structure does each ureter cross along its course? What special structures cross the ureters in males and in females?What structure does each ureter cross along its course?
- Bifurcation of common iliac artery
What special structures cross the ureters in males and in females?
- Males: ureter is crossed by ductus deferens
- Females: ureter is crossed by uterine artery - 28What is the importance of the oblique passage of the ureter in the bladder wall?- It prevents backflow of urine into the ureter when the bladder is distended.
- 29Where are the sites of natural constrictions of the ureter? 3 Natural sites of constriction: What is their significance?1. Pelvic-ureteric Junction (ie. kidney’s pelvis)
2. Pelvic brim where it crosses the termination of common iliac artery (in front of SI joint)
3. Wall of the urinary bladder (medial to ischial spine)
What is their significance?
- These sites are where calculi become lodged most easily. - 30Describe the blood supply of the ureters.- Renal Artery
- Gonadal Artery
- Common Iliac Artery - 31Describe the nerve supply of the ureter. Relate it to referred pain from ureteric stones.Describe the nerve supply of the ureter. Relate it to referred pain from ureteric stones.
Ureter has different sources of nerve supply:
- The renal and aortic plexuses
- The superior and inferior hypogastric plexuses
Patterns of referred pain (ie. ureteric stones):
- Pain fibers from the ureter are carried to Spinal level L1/2. A cremasteric reflex may occur by
way of referral pain to the Genitofemoral nerve (also L1/2), which supplies the cremasteric muscle. - 32What is the surface anatomy of the ureter? Where is the ureteric pain referred to?It is represented by a vertical line from a point on the transpyloric plane, 5cm from the midline to the pubic tubercle.
Pain fibers from the ureter are often carried principally to the level of the spinal nerve L2. Thus, a cremasteric reflex may occur by way of referral of pain to the genitofemoral nerve (L1, L2), which supplies the cremasteric muscle. - 33What is the difference in anatomical site of the urinary bladder in adults and children?In adults, the empty bladder lies in the lower and anterior part of the lesser (true) pelvis. The distended bladder rises upwards into the abdomen and may reach the level of umbilicus stripping off peritoneum of the anterior abdominal wall.
In children, the bladder is an abdominal organ. It gradually sinks into the pelvic cavity by the age of puberty. - 34What is the capacity of the urinary bladder?In adults, the capacity of the bladder is about 300ml and it can tolerate up to 500ml, however, more distension is painful.
In some instances where there is stroke or nerve damage, where the body can longer detect how much fluid is in the bladder, it can get a bit higher. Or when a patient is incapable of holding their bladder and loses elasticity and stretches too far, it can get up to 800ml - 1L. - 35Describe the shape of the urinary bladder.The empty bladder when hardened in situ has the shape of a 3-sided pyramid having an apex, a base (fundas), 3 surfaces (superior, right and left inero-lateral) and a neck which is directed inferiorly.
- 36Describe the structures related to the following parts of the bladder. Apex of the bladder: Base (Fundus) of the bladder:Apex of the bladder:
- Directed anteriorly lying behind the upper border of symphysis pubis
- Continuous with the median umbilical ligament
Base (fundus) of the bladder:
- Directed posteriorly, could be regarded as a posterior surface for the bladder. Its postero-superior angles receive the ureters
- In males: its upper part is covered by peritoneum of the recto-vesical pouch
- The base is related to the rectum but is separated from it by the seminal vesicles and vas
deferens, and the peritoneal pouch.
- In females: it is related to the anterior wall of the vagina. - 37Describe the structures related to the following parts of the bladder. Superior surface: Inferolateral surface:Superior surface
- It is covered by peritoneum
- In males: it is related to the sigmoid colon and loops of ileum
- In females: it is related to anterior surface of the uterus with loops of ileum in the utero-vesical pouch
Inferolateral surfaces:
- These surfaces are devoid of peritoneal covering
- The right and left inferolateral surfaces meet at the anterior border and are related to retropubic pad of fat which separates them from the body of the pubis, obturator internus and levator ani on each side.
- The anterior border is separated from the symphysis pubis by the retropubic pad - 38Describe the structures related to the following parts of the bladder. Neck of the bladder:Neck of the bladder:
- It is the angle on which it rests inferiorly and is the most fixed part of the bladder. It lies about 3cm behind the lower part of the symphysis pubis. It is continuous with the origin of the urethra at the point where the two inferolateral surfaces & base intersect
- In the male: the neck rests on the base of the prostate gland - 39Describe the ligaments of the bladder: Pubovesical vs Pubo-prostatic: Median umbilical ligament (remnant of urachus): Medial pubo-vesical ligament (in females): Medial pubo-prostatic ligament (in males):Pubovesical vs Pubo-prostatic
- Women do not have a prostate gland therefore they have only pubovesical ligament
- Men have prostate therefore have puboprostatic ligament
Median umbilical ligament (remnant of urachus): extends from the apex of the bladder to the umbilicus
-The neck is the most inferior part of the bladder and also the most “fixed” part
-It is anchored into position by a pair of tough fibromuscular bands, which connect the neck and pelvic part of the urethra to the postero-inferior aspect of each pubic bone.
Medial pubo-vesical ligament (in females): it extends from the back of the body of the pubis to the neck of the bladder
Medial pubo-prostatic ligament (in males): it extends from the back of the body of the pubis to the sheath of the prostate and neck of the bladder. - 40Describe the Trigone of the bladder and its boundaries. How is it different from the rest of the bladder?Definition: it is a triangular area of the bladder mucosa
Boundaries: it is bounded by the two ureteric orifices (form one of the upper angles of the trigone) and the internal urethral orifice
Special property: it is more sensitive and vascular than the rest of the bladder - 41Where is the internal urethral orifice? What is its role?- Located near the base of the bladder and adjacent to the urethra, the internal sphincter muscle is a continuation of the detrusor muscle
- This is under involuntary control
It is the primary muscle that can restrict the flow of urine - 42What is the external urethral sphincter? Is it under voluntary or involuntary control?Located around the back, base of the bladder, and is made up of skeletal muscle It is under voluntary control of the somatic nervous system
- 43What is the arterial blood supply of the bladder in males and females?Males: Superior and inferior vesical arteries (originating roughly from the internal iliac artery)
Females: superior vesical and vaginal arteries.
Additional arteries: obturator, inferior gluteal and middle rectal. (small supply, simply passing through the region) - 44Describe the venous drainage of the bladder.Venous drainage to the vesical venous plexus, which is continuous with the prostatic plexus in males and in females is continuous with the vaginal plexus, then finally drains into the internal iliac veins.
- 45Describe the lymphatic drainage of the bladder.Mainly the external iliac lymph nodes. A few vessels end in the internal iliac, obturator and common iliac lymph nodes.
- 46Describe the nerve supply of the bladder.Sympathetics and parasympathetics from the vesical plexus. Parasympathetics from S2-4 nerves. Sympathetics from T11-L2. External urethral sphincter has somatic innervation through the pudendal nerve (S2-4).
- 47How long is the male urethra?18-20 cm in length
- 48Male urethra: Preprostatic part Length and site: Special feature and importance: Lymphatic drainage:Length and site: 1-1.5 cm
The portion before the prostate directly below the bladder
Special feature and importance: Surrounded by smooth muscle bundles which also surround the bladder neck and form the internal urethral sphincter, contraction of which prevents the retrograde flow of semen into the bladder during ejaculation
Lymphatic drainage: Drains lymphatically along with the urinary bladder:
External iliac lymph nodes. A few vessels end in the internal iliac, obturator and common iliac lymph nodes - 49Male urethra: Prostatic part Length and site: Special feature and importance: Lymphatic drainage:Length and site: 3-4 cm
The portion within the prostate.
Special feature and importance: The 2 ejaculatory ducts open into it. It is inside the prostate, turns from a urinary function into sexual function as well.
Lymphatic drainage: Lymphatic drainage goes to the internal iliac lymph nodes - 50Male urethra: Membranous part Length and site: Special feature and importance: Lymphatic drainage:Length and site: 2cm
The portion that passes through the pelvic diaphragm and external urethral sphincter
Special feature and importance: During its course within the deep perineal pouch it is surrounded by the external urethral sphincter (skeletal muscle) and a pair of bulbourethral glands.
Lymphatic drainage: Lymphatic drainage goes to internal iliac lymph nodes - 51Male urethra: Spongy part Length and site: Special feature and importance: Lymphatic drainage:Length and site: 15cm
Longest portion in the penis itself.
Special feature and importance: The bulbourethral glands open into it
Lymphatic drainage: Lymphatics mainly go to deep inguinal lymph nodes - 52Regarding the Female urethra, complete the following: ● It is about _cm long and _ mm in diameter. ● It begins at the _________ and runs anteroinferiorly behind the _____. ● It traverses the _______ and _______ to end at the __________ anterior to the opening of the vagina. ● Its lymphatic drainage goes to the _________ lymph nodes.● It is about 4 cm long and 6 mm in diameter.
● It begins at the internal urethral orifice (bladder neck) and runs anteroinferiorly behind the
symphysis pubis.
● It traverses the deep perineal pouch and perineal membrane to end at the external urethral orifice
anterior to the opening of the vagina.
● Its lymphatic drainage goes to the internal iliac lymph nodes. - 53Why are females more susceptible to urinary infection than males?Females are more susceptible to urinary infection than males because the female urethra is short, straight, and very near to the anus.
- 54What are the components of the reproductive system in men?abdomen, pelvis, and perineum (2 testis, 2 epididymis, 2 ductus deferens, 2 ejaculatory ducts, urethra and penis and accessory glands; prostate, pair of seminal vesicles and pair of bulbourethral glands)
- 55What are the male External genital Organs?They are present in the perineum (outside the pelvic cavity). Includes the layers of the scrotum, coverings and contents of the spermatic cord, structure, blood supply, and lymphatic drainage of the testis and the epididymis.
- 56What are the internal genital organs?Ductus (vas) deferens, seminal vesicles, ejaculatory duct and prostate
- 57The scrotum is a cutaneous fibro-muscular sac which contains _______, ______, ______________. It is divided into two compartments by an incomplete median partition called the ___________ (includes all layers of the scrotal wall EXCEPT the skin).The scrotum is a cutaneous fibro-muscular sac which contains the testes, epididymis, and lower parts of the spermatic cord. It is divided into two compartments by an incomplete median partition called the scrotal septum (includes all layers of the scrotal wall EXCEPT the skin).
- 58What are the layers of the wall of the scrotum from superficial to deep?Skin, superficial fascia (Dartos muscle, Colles fascia), external spermatic fascia, cremaster muscle and fascia, internal spermatic fascia, and loose alveolar tissue.
- 59Describe the innervation of Dartos muscle and its function.Contraction of this muscle wrinkles the skin and therefore decreases heat loss. Functions to regulate the temperature of the testes and of sperm. The muscle is supplied by sympathetic fibers of the genital branch of the genitofemoral nerve.
- 60Describe the nerve supply of the scrotum.Anterior 1⁄3 is supplied by the ilioinguinal nerve and the genital branch of the genitofemoral nerve. Posterior 2⁄3 is supplied by S3 via sacral nerves (branches from the pudendal nerve and perineal branches from the posterior cutaneous nerve of the thigh).
- 61Describe the blood supply of the scrotum. Arterial Supply: Venous Drainage:Arterial Supply: superficial and deep external pudendal branches of the femoral artery, cremasteric branch of the inferior epigastric artery and sacral branches of the internal pudendal artery
Venous Drainage: follows the external pudendal arteries to the great saphenous vein (anterior scrotum) and follows the internal pudendal arteries to become tributaries of the internal iliac vein (posterior scrotum) - 62Describe the lymphatic drainage of the scrotum.Lymph vessels pass along the external pudendal blood vessels to end in superficial inguinal lymph nodes.
- 63The testis is a primary sex organ of the male. Describe its site and structure.Site: Suspended in the scrotum by the spermatic cord. Left hangs lower than the right.
Structure: Smooth ellipsoid mass, slightly flattened from side to side. Each testis is surrounded by 2 tunics: tunica vaginalis which is derived from the peritoneum and the tunica albuginea which is the fibrous capsule of the testis. Septa divides the testes into 250-300 lobules, each containing 1-4 seminiferous tubules. - 64What are the parts of the epididymis?The epididymis is formed of a head, body, and a tail (distal end). Its head joins the efferent ductules and caps the superior aspect of the testis.
- 65What are the functions of the epididymis?Non-motile sperm enter, pass through its tubes and become motile. Upon ejaculation the epididymis contracts, expelling sperm into the ductus deferens.
- 66What is the arterial supply of the testis and epididymis?1. Testicular artery (from the AA)
2. Deferential artery (from the Inf Vesical)
3. Cremasteric artery (from the Inf epigastric)
4. Posterior scrotal artery (from the Int pud)
5. Anterior scrotal artery (from the deep external pudendal) - 67Discuss the venous and lymphatic drainage of the testis and epididymis.Deep and superficial venous networks of testis, epididymis, and ductus deferens (vas). Testicular vein which ends in the Inferior Vena Cava.
Lymph drainage ends in pre-aortic and lateral aortic nodes. - 68What are the sympathetic nerve fibers that innervate the testis and epididymisThe testis and epididymis are supplied by sympathetic fibers accompanying the testicular artery (these fibers are connected with the 10th thoracic segment of the spinal cord).
- 69Discuss Thermoregulation of the testis and its significance. What factors aid in heat loss?The process of spermatogenesis needs a temperature of 2-3 degrees Celsius below the body temperature. This occurs via factors that aid in heat loss:
1) Very vascular scrotal skin which is rich in sweat glands
2) Absence of subcutaneous fat from scrotal wall
3) Relaxation of dartos muscle in hot weather leads to smooth and elongated scrotal skin
with increasing its surface area.
*The pampiniform plexus is also said to be able to pass off excess heat to the arterial system when needed. - 70What are the contents of The Spermatic cord? 2 structures: 5 vessels: 2 nervous structures:2 structures: the vas + the vestige of processus vaginlis (peritoneal remnant)
5 vessels: testicular artery, artery of vas, cremasteric artery, pampiniform plexus of veins and lymph vessels
2 nervous structures: testicular plexus of sympathetic fibers + genital branch of genitofemoral nerve - 71What are the Coverings of the spermatic cord from inside outwards?1) Internal spermatic fascia derived from the fascia transversalis
2) Cremaster muscle and fascia derived from internal
abdominal oblique
3) External spermatic fascia derived from aponeurosis of
the external abdominal oblique (margins of the superficial inguinal ring) - 72Ductus (vas) deferens begins as the continuation of the tail of the _____. Runs through the ____ canal into the pelvic cavity. Its terminal part is dilated to form the ___ of the vas, which narrows again to join the duct of the ____ to form the ejaculatory duct. Propels sperm from the ____ to the ____.Ductus (vas) deferens begins as the continuation of the tail of the epididymis. Runs through the inguinal canal into the pelvic cavity. Its terminal part is dilated to form the ampulla of the vas, which narrows again to join the duct of the seminal vesicle to form the ejaculatory duct. Propels sperm from the epididymis to the urethra.
- 73What is the neurovascular supply of the vas deferens? Arterial supply: Venous drainage: Nerves:Arterial supply: The Branch from the inferior vesical (or superior vesicle) artery Venous drainage: The vesical venous plexus
Lymphatic drainage: Lymphatics of the vas drain to the External Iliac lymph nodes Nerves: are derived from the Hypogastric plexus - 74What forms the ejaculatory duct?The duct of the seminal vesicle joins The ductus deferens to form the ejaculatory duct.
- 75What is the NAVL of the seminal vesicles?Arterial supply of the seminal vesicles: Inferior vesical and middle rectal arteries Venous drainage of the seminal vesicles: Vesicle venous plexus
Lymphatic drainage of the seminal vesicles: Internal and External Iliac nodes
Nerve supply of the seminal vesicles: Mainly sympathetic from the Hypogastric plexus - 76What is the function of the seminal vesicles?The function of the seminal vesicles is that they are responsible for secreting 60% of the volume of semen.
- 77Describe the ejaculatory ducts. Formed by: Begins at:Each is formed by union of the vas deferens and the duct of the seminal vesicle
It begins at prostate and passes downward and opens into the urethra. - 78Prostate: Complete the following: Description: Location: Pierced by: Upper anterior relation: Posterior relation: Inferolateral relation:● It is a firm fibromuscular glandular organ which surrounds the beginning of the urethra.
● It lies below the neck of the bladder behind the lower border of the symphysis pubis and
pubic arch and anterior to rectal ampulla.
● It is pierced by the urethra nearer to its anterior border.
● Its upper anterior part is connected to the pubic bones by the puboprostatic ligaments.
● Posteriorly, it is related to the rectum & separated from it by rectovesical fascia. It is pierced by 2
ejaculatory ducts near its upper border.
● Inferolateral surface (right an d left) are related to the anterior parts of the levator ani (levator
prostate) - 79Describe the NAVL supplying the prostate.Arteries: Internal pudendal, inferior vesical and middle rectal arteries.
Veins: They form a plexus around the prostatic sides and base. The plexus is continuous superiorly with the vesical venous plexus. The plexus receives anteriorly the deep dorsal vein of the penis and is drained posteriorly to the internal iliac veins.
Lymphatic drainage: Mainly to the internal iliac and sacral lymph nodes. Nerves: The prostatic nerve plexus derived from inferior hypogastric plexus - 80What is the main function of the prostate?The main function is to neutralize the acidity of the vagina.
- 81What are the ligaments of the penis? (The Fundiform ligament encircles the penis and attaches superiorly to linea alba.
The Suspensory ligament of the penis lies deep to fundiform ligament. It arises from the front of the symphysis pubis and fuses with the deep fascia of the penis. - 82Describe the NAVL supply of the penis?Arteries of the penis: Dorsal arteries of the penis
Veins of the penis: Superficial dorsal vein of the penis to external superficial pudendal veins. Deep dorsal vein of the penis drain to the prostatic venous plexus
Lymphatics drainage of the penis: Skin is drained to the superficial inguinal nodes. The glans penis lymphatics pass to deep inguinal and external iliac nodes.
Dorsal nerves of the penis are: Terminal branches of the pudendal nerve that run along the lateral side of the dorsal arteries of the penis.
Remember: Pudendal nerve is from the sacral plexus S2-4 - 83What is the female primary sex organ? Describe its anatomical position. What are they bounded by anteriorly and posteriorly?The ovaries: The ovaries are the primary female sex organ.
The ovaries are bounded by:
● Anteriorly: the obliterated umbilical artery
● Posteriorly: the ureter and internal iliac artery
It lies below and behind the lateral part of the uterine tube (= fallopian tube) and is attached to the upper (posterior) layer of the broad ligament by the mesovarium. - 84Describe the suspensory ligament of the ovary and its significance.Suspensory ligament of the ovary: The part of the broad ligament that extends from the tubal end of the ovary and the fimbriated end of the tube to the side wall of the pelvis. Through it pass the ovarian blood vessels, lymphatics and nerves
- 85Describe the NAVL of the ovaries/Arterial blood supply: The ovarian artery (=gonadal artery is the general term) from the
abdominal aorta. The ovarian artery passes through the suspensory ligament of the ovary, then through the mesovarium to enter hilum of ovary. As well as the uterine artery through its ovarian branch which anastomoses with branches of the ovarian artery.
Venous drainage: Veins emerge from the hilum of the ovary to form a pampiniform plexus of veins which unite to give ovarian vein. The right ovarian vein ends in the I.V.C. and the left ovarian vein terminates in the left renal vein.
Lymphatic drainage: Lateral and pre-aortic lymph nodes. Nerve supply: T10-L2 sympathetic, S2-4 parasympathetic - 86Complete the following regarding the Uterine (Fallopian) tupes. (Y3U1b 31:34) Definition: Position: Length: Two ends of the tube: ● Lateral (peritoneal) end opens: ● Medial (uterine) end opens:Complete the following regarding the Uterine (Fallopian) tupes.
Definition: A pair of ducts transmitting the ovum (= egg) from the ovary to the uterus.
Position: It lies in the medial 4⁄5 of the anterior free border of the broad ligament. Length: about 10 cm long.
Two ends of the tube:
● Lateral (peritoneal) end opens into the peritoneal cavity by piercing the upper layer of the broad ligament (this is why there can be transmission of cells. Can be problematic because there is an opening into the abdominal layer).
● Medial (uterine) end opens into the superior angle of the uterine cavity. - 87What is the part of the tube related to the ovary? What is an ovarian fimbria?● The infundibulum is the funnel-shaped lateral part of the tube that opens into the peritoneum
close to the ovary.
● Its margin presents 20-30 irregularly finger-like processes called fimbria.
● A large and deeply grooved fimbria is attached to the tubal end of the ovary called ovarian
fimbria. - 88What is the part of the tube where fertilization takes place?Ampulla: The longest and widest part of the tube, where fertilization takes place. It is thin-walled and tortuous. It arches over the tubal end of the ovary.
- 89Describe the blood supply of the tube.Vascular: Medial 2⁄3 by uterine blood vessels & lateral 1⁄3 by ovarian blood vessels
- 90Describe the nerve supply and lymphatic drainage of the tube.● Nerve: Medial 2⁄3 by uterine nerve plexus & lateral 1⁄3 by ovarian nerve plexus
● Lymphatic: Most tubal lymphatics ascend with those of the fundus of uterus and ovary to lateral
aortic and pre-aortic lymph nodes. Lymphatics from isthmus and utero-tubal junction accompany the round ligament of the uterus to the superficial inguinal lymph nodes.
9. Describe lymphatic drainage of the tube
● Most of tubal lymphatics ascend with those of the fundus of uterus and ovary to lateral aortic and pre-aortic lymph nodes. Lymphatics from isthmus and utero-tubal junction accompany the round ligament of the uterus to the superficial inguinal lymph nodes. - 91The uterus is a hollow thick – walled, pear shaped, muscular organ which the fetus develops. Site: Shape: Dimensions:Site: a non-gravid (not pregnant) uterus usually lies in the lesser pelvis between the urinary bladder anteriorly and rectum posteriorly
Shape: pear in shape with its apex directed inferiorly and its base directed superiorly Dimensions: 3 inches long, 2 inches wide and one inch thick - 92What is angle of anteversion?● The longitudinal axis of the uterus forms a right angle (90 degrees) with the axis of the vagina. This angle is called angle of anteversion. At the level of internal os, the body is slightly bend forwards on the cervix forming the angle of anteflexion
- 93List the structures related to each of the following parts of the body of uterus Fundus Anterior surface The lateral bordersFundus: Related to coils of ileum and sigmoid colon
Anterior Surface: Related to urinary bladder with the uterovesical pouch in between
The Lateral Borders: At their upper ends, the uterine tubes enter the uterus. At that level the round ligament of the uterus and the ligament of the ovary are attached anteroinferior and posteroinferiorly, respectively. The uterine tubes and the two ligaments are running in the broad ligament which extends from the lateral uterine border to the lateral pelvic wall - 94Describe the NAVL supply of the uterus.Arterial supply : Uterine artery from the internal iliac artery
Venous drainage: Uterine venous plexuses extends along the side of the uterus. The plexuses drain into the uterine, vaginal and ovarian veins.
Lymphatic drainage:
from inferior to superior —> Cervix drains to external iliac, internal iliac, and sacral lymph nodes
Body to external iliac lymph nodes
Uterotubal junction to lymphatics which pass along the round ligament of the uterus to the superficial inguinal lymph nodes
Fundus to the para-aortic lymph nodes
Nerve supply: Uterovaginal autonomic plexus from the inferior hypogastric plexus - 95List the ligaments and their attachments to the uterus.● Transverse – Aka Ligamentum Transversalis Colli or Cardinal Ligament.
○ Blends with upper fascia of pelvic diaphragm
● Anterior (pubo-cervical-vesical ligament
○ Attaches to bladder then to pubis
● Posterior (aka Utero-sacral) ligaments
○ Attach to rectum then sacrum
● 2 lateral broad ligaments attach to the mesentery.
○ Extend up into fallopian tubes
● Round ligaments are extensions of the broad ligament
○ Attach to pubic symphysis (mons pubis) - 96Describe the origin, extension, and functions following ligaments of the uterus: Transverse cervical (Machenrodt’s = lateral cervical = Cardinal) ligaments: Uterosacral ligaments Pubocervical (pubo-visico-cerivcal) ligaments● Transverse cervical (Machenrodt’s = lateral cervical = Cardinal) ligametns:
○ Origin: fan-shaped fibromuscular condensations of extraperitoneal cellular connective tissue
○ Extensions: extend from either side of the cervix and upper vagina to the lateral pelvic wall
○ Functions: Are the main ligaments that support the uterus
○ Uterine artery runs medially on its surface
● Uterosacral ligaments
Origin: Fibromuscular condensations of endopelvic fascia
Extensions: Extend from posterolateral aspect of the cervix across the side of the recturm to the middle of sacrum.
Functions: Pull the cervix backwards against the forward pull of the round ligament of the uterus, which keeps the uterus in the AVF (anteverted anteflexed) position
● Pubocervical (pubo-visico-cerivcal) ligaments
○ Origin: Condensations in the extraperitoneal cellular connective tissue of pelvic fascia
○ Extension: Extend from the cervix across the urinary bladder to the pubis - 97Describe the Round Ligament of the uterus.Fibromuscular bands attach to the anterior surface of the uterus below and in front of the uterotubal junctions. Pass anteriorly to mons pubis in front of the pubic symphysis
- 98What is the name of the lower 1/3rd of the uterus?● The cervix is the lower 1/3rd of the uterus
- 99What is the vagina?The Vagina is a fibromuscular tube that extends from the vestibule (cleft between the two labia minora) to the uterus. It lies between urethra and bladder anteriorly, and anal canal posteriorly.
- 100How is the Vagina a pelvic and perineal organ?Its upper part lies above the pelvic floor, while its lower part traverses the deep perineal pouch and opens into the vestibule in the superficial perineal pouch
- 101Describe the NAVL supply of the vagina.Arterial supply: Vaginal branches of uterine artery, branches of vaginal artery, middle rectal and internal pudendal arteries.
Venous drainage: Vaginal venous plexus which drains into vaginal veins which drains into internal iliac veins.
Lymphatic drainage: Below the hymen (lower part) into the superficial inguinal lymph nodes. Above the hymen into internal and external iliac lymph nodes.
Nerve supply: The lower inch of the vagina is pain sensitive and supplied by the pudendal nerve through the inferior rectal and posterior labial nerves. The upper part of the vagina is pain insensitive and supplied by the autonomic nerves derived from the uterovaginal plexus from the inferior hypogastric plexus. - 102Describe the following folds (ligaments). A) Anterior ligament (ureterovisceral fold) B) Posterior ligament (rectovaginal fold) C) Broad ligamentsa) Anterior ligament (ureterovisceral fold): a fold of peritoneum that extends from the anterior surface of the uterus at the junction of body and cervix to the upper surface of the urinary bladder.
b) Posterior ligament (rectovaginal fold): a peritoneal fold that extends from the front of therectum to the posterior vaginal fornix and superior to the uterus.
c) Broad ligaments: Two peritoneal folds that extend from the side of the uterus to the lateral pelvic wall. The uterus together with the 2 broad ligaments form a transverse septum which divides the pelvic cavity into two compartments; anterior compartment contains the urinary bladder and posterior compartment contains the rectum, pelvic colon, and coils of ileum. - 103What is the pelvic diaphragm? What is its significance to the female genitalia?The pelvic diaphragm consists of the levator ani and coccygeus muscles, together with their covering fascia. Often referred to as the “pelvic floor”. The pelvic diaphragm divides the pelvic cavity into the pelvic cavity proper above and the perineum below. The levator ani, which have been described as a dilator as well as a sphincter, probably serve for the fixation and prevention of prolapse of the pelvic viscera passing through the levator hiatus.
- 104What are the visceral structures that pass between the right and left levatores ani?The pelvic diaphragm has a hiatus for the passage of urethra, vaginal and anal canal.
- 105What are the boundaries of the perineumAnteriorly: Pubic arch and inferior pubic ligament Posteriorly: Tip of coccyx
Laterally: Ischial tuberosities
Antero-lateral: Pubic and ischial rami Postero-lateral: Sacrotuberous ligaments - 106What are the two divisions of the perineum? Describe them.i) Posteriorly: the anal triangle which contains the anal canal in the median plane and ischialrectal fossae, one on each side.
ii) Anteriorly: the urogenital triangle which contains urethra & external genital organs. - 107What are the superficial and deep structures contained in the urogenital triangle?a) Superficial structures: External genital organs
b) Deep structures: Erectile tissue (root of penis or bulbs of the vestibule and crura of clitoris), muscles, glands, some vessels and nerves which are enclosed within spaces (pouches) lined by fascial layers. - 108What stabilizes the uterus in its place?The cervical ligaments (pubocervical ligament, transverse cervical or cardinal ligament. And uterosacral ligament) together with the perineal membrane, the levator ani muscles, and the perineal body, are thought to stabilize the uterus in the pelvic cavity. The most important of these ligaments are the transverse cervical or cardinal ligaments.
- 109What is the effect of pregnancy on female body’s alignment?During pregnancy, several things occur that work against maintaining correct alignment. For one, the weight of the baby causes your lower back to sway as her center of gravity moves forward. The abdominal muscles become stretched as the baby grows. These muscles are less able to contract and keep her lower back in proper alignment. Hormone levels increase during pregnancy and cause joints and ligaments to loosen. To counteract the increased low the back will curve, the pregnant lady should straighten her upper back so that her ear, shoulder, and hip are aligned, tuck her pelvis under using the pelvic tilt and contract her abdominal muscles and buttocks to act as a natural “corset” for her lower back.
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- Year 3 Year 3 (Anatomy) Flashcards on ANAT PREP M1, created by Aquilina Laidlaw-allan on 06/09/2023.
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- Aquilina Laidlaw-allan
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