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