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71 Cards in this Set

  • Front
  • Back
contents anterior mediastin
i. mammary vessels and LN, thymus (esp kids)
masses ant mediastin and general qualities
-terrible lymphoma
-thymoma-assoc w MG, goes around structures
-teratoma-most benign
-thyroid-pushes other structures
details thymoma
assoc MG, see in middle age
1/4 calcified
grows around structures
teratoma
3 layers germ cells arrested en route to gonads
see 20-40, more in women but men have more malignant
Ca 1/3-1/2, cystic
benign (most)=round smooth margins
malig=irreg, lobulated
ant mediastin lymphoma
90%HL, 50% NHL have LAN
lobulated, no calcification
MC ant mediastin mass
ant mass with calcif
MC teratoma, also thymoma
contents middle mediastin
heart, asc aorta, pulmon vessels, main stem bronchi, LN
MC middle mediastin mass
Lymphoma or sarcoid, also pericardial and bronchogenic cysts, AAA
sarcoid 2% rule
2% unilateral, pl eff, PTX
(so usu bilateral, rarely cxn of pl eff or PTX)
contents P. mediastinum
eso, nervous structures
masses P mediastinum, in what pts
neural:
(75% <4, younger more likely malignant)
-ganglioneuroma (symp)
-NF can degenerate to neurosarc
-NB (often symp chain, already met bone liver)
rupture superior wall of bladder (ie compression on full bladder)
within peritoneal cavity
rupture anterior bladder (ie fractured pelvis)
within retropubic space of Retzius (extra peritoneal)
rupture of urethra above UG diaphragm (ie fractured pelvis, catheter)
within retropubic space of Retzius (extra peritoneal)
rupture of urethra below UG
****MC
(ie straddle injury)
within superficial perineal space extending into scrotal, penile, anterior abd wall area.
what supfcl perineal space bw
colles fascia/dartos and external sperm
rupture penile urethra
between deep fascia of Buck, if the deep fascia is not torn the urine stays within the penis. if it is torn it goes into the superficial perineal space
name strap muscles and innerv
ansa cervicales
-sternohyoid
-geniohyoid
-thyrohyoid
-omohyoid
artery causes nose bleeds
sphenopalatine (branch of maxillary)
contents pelvic diaphragm
coccygeus and levator ani
composition levator ani
iliococcygeus
pubococcygeus
puborectalis
levator prostate
what sep UG and anal triangle
colles
what pts of att of UG and anal triangle
both use ITs, UG goes to PS, anal goes to coccyx
describe layers passed "median episitomy"
start at frenulum of labia minora,
skin,
vaginal wall
perineal
spfcl transv perineal
layers past in mediolateral episitomy
start at frenulum, 45 angle,
skin
vagina
bulb spong
this gives more room
female contents deep perineal
both sexes:
UG diaphragm
d trvs perineal
sphincter urethra
female:
urethra
vagina
branches i pudendal-a of clitoris
branches of pudendal n-dorsal n of clitoris
**no glands (unlike male)
male contents deep perineal
both sexes:
UG diaphragm
d trvs perineal
sphincter urethra
male:
mem urethra
branches i pudendal-a of penis
branches of pudendal n-dorsal n of penis
**bulbourethral glands
female contents spfcl perineal
1) urethra
vestibule of vagina
bulbosponf
ichocavern
spfxl trv perineal
2) branches i pudendal a incl perineal going to p labial a and dorsal a of clitoris
3) branches pudendal n
perineal-p labial n
dorsal n
4) vestibular bulb, crura of clitoris, perienal body
5) greater vestibular blands Bartholin
male contents spfcl perineal
1) penile urethra
bulbospong
ischiocavern
spfcl trv perineal
2) branches i pudendal a
perineal-p scrotal
dorsal a penis
deep a penis
3) branches pudendal n
perineal n-p scrotal n
dorsal n penis
4) bulb, crura of penis
perineal body
5) duct of bulbourethral
cervical ca mets to which LN
obturator (ovarian to paraortic)
what limits birth canal in vagina area
ischial spines, sacrospinous lig
ant fornix, describe location
ant to cervix, just next to vesicouterine puch, can palpate bladder thru here
describe location p fornix
next to rectouterine pouch of Douglas, can palpate rectum, S1 sacral promontory, coccyx
blood supply internal female genitalae
uterine a (via trvs cervical lig)
ovarian a (broad lig)
a clitoris (dorsal and deep)
pudendal innerv female
pudendal S2-5 out grtr sciatic, in lessr sciatic, thru Alcock's canal
perineal n
p labial n
i rectal
d clitoris
innerv female besides pudendal
ilioinguinal-a labial
genitofemoral
perineal branch of p femoral cutaneous
what goes thru grtr sciatic foramen
s gluteal van
i gluteal van
i pudendal va
pudendal n
sciatic n
piriformis
pelvic inlet measurement
best is diag conjugate which is sacral promontory to infr PS (measured on exam)
(the other is called true conjugate)
borders of pelvic outlet
coccyx
IT
infr pubic ramus
PS
two pelvic outslet mesaurements
trvs (bw IT)
interspinous, if <9.5 cm problem
pudendal n block key landmark
find the ischial spine
elements broad lig
mesovarium, mesoalp, mesomet
round lig uterus
suspensory of ovary
trvs cervical w uterine van
remnant meso (paraoph, epooph, Gartner duct)
ureter
fallopian tubes
support uterus
pelvic diaphragm
UG diaph
bladder
round lig
broad lig
uterosacral
pubocervical
hold uterus in anteverted position
uterosacral lig
parts uterus
fundus
cornu-entry uterine
body w isthmus (c sxn spot)
cervix
position uterus
antiflexed (angle bw cervix and body uterus)
ante verted (angle bw cervix, vagina)
ext os is what shape if had kid
transverse
location bartholins
around urethra
paraurethral glands of Skene
around urethra
blood supply male
testicular a
a ductus deferens (i iliac)
cremasteric (i epigastric)
ext pudendal (femoral a)
drains by pampiniform plexus to test v
LN for male
scrotum-spfcl inguinal
testes-deep lumbar (renal hilus)
prostate blood supply
i vesical (i iliav) to prostatic venous plexus then
1) i iliac-IVC
2) vertebral, cranial dural sinuses
note for mets!
penis blood supply
deep a penis (erection) to dorsal a (i pudendal) then
1) deep dorsal v to prostatic venous plexus
2)spfcl dorsal v-ext pudendal to grtr saph to femoral v to IVC
rupture antr bladder
goes into RPS
rupture urethra above UG
goes into RPS
tear urethra below UG
spfcl perineal (scrotum, penis, ant abd)
tear penile urethra
beneath bucks-penis only
layers cut thru in vasectomy
colles-dartos
ext sperm
cremasteric
int sperm
NOT tunica vaginalis
key components seminal vesicle
fructose, choline
contents prostatic fluid
citric a
acid P (dx ca)
PG
fibrinogen
PSA (dx ca)-serine protease liquefies sxns
path of sperm
testes: seminfer, strt tubules, rete testes, efferent ductules
epidid
vas deferens/ductus deferens
sperm cord thru deep inguinal ring
ampulla seminal vesicle joins making ejac duct
prostatic urethra
prostate
tunica vaginales
everywhere but not P testes
urethra in male is in
corpus spongiosum
spongiosum come from (male)
bulb, ends in glans
what covers crus and bulb
ichsiocavernosus and bulbospong respectively
crura leads to
corpus cavernosum
describe contents penile shaft
1 corpus spongiosum w urethra, 2 corpus cavernosum with tunica albuginea around each
deep a. is within corpus cavernosum
dorsal a, n,
spfcl and deep dorsal veins
describe clitoris
no corpus spongiosum
body of clitoris formed by 2 corpus cavernosum which are cont w crura, glans formed by fusion of vestibular bulbs
bulb of vestib covered by
bulbospongiosum
fourchette covers
perineal
vestibule
area w/in labia minora