Test Block 5 Samsam Review

Front 1

Paraurethral glands opens in

Back 1

external urethral orifice

Front 2

Homologous structure of Paraurethral glands of Skene?

Back 2

it is in female, males Homologous structure is Prostate.

Front 3

Bulbourethral glands Homologous structure :

Back 3

Male: Cowpers
Female: Bartholins

Front 4

Homologous structure of Inferior Vesical Artery

Back 4

It is in Males & Females Homologous structure is Vaginal Artery.

Front 5

Homologous structure of Uterine Artery

Back 5

It is in Females & Males Homologous structure is Artery of Ductus Deferens

Front 6

Homologous structure of Clitoris

Back 6

It is in Females & Male Homologous structure is Penis

Front 7

Homologous structure of Prepuce of Clitoris

Back 7

It is in Female & Males Homologous structure is Glans Penis
( Glans Penis is part that is circumcised)

Front 8

Homologous structure of Bulbs of Penis

Back 8

In Males & Females Homologous structure is Bulbs of vestibule

Front 9

Contents of Pelvis

Back 9

Urinary Bladder
Anterior Urinary Tract
Internal Male & Female Genital Organs
Distal Part of GI Tract (Rectum)
Rectovesical Pouch
Vesicouterine/Uterovesical Pouch ( Female Only)

Front 10

Superior Part of Pelvis and Anterior Wall

Back 10

False Pelvis
Anterior Wall is Muscular

Front 11

Inferior Part of Pelvis and Anterior Wall

Back 11

True Pelvis
Anterior Wall is Boney
Important for Child Bearing

Front 12

Superior Pelvic Aperture
(Pelviv Brim or Inlet)

Back 12

Heart Shaped Border between the true and false pelvis
Between promontory of sacrum and pubic tubercle

Front 13

Traverse Diameter

Back 13

13.5-14 cm

Front 14

Oblique Diameter 1

Back 14

12-12.5 cm

Front 15

Oblique Diameter 2

Back 15

11.5-12 cm

Front 16

Anatomical Conjugate

Back 16

12 cm

Front 17

True Conjugate

Back 17

11.5 cm

Front 18

Diagonal Conjugate

Back 18

13 cm

Front 19

Pelvic Outlet

Back 19

Diamond Shaped Border between tip of coccyx and Lower border of pubic symphysis

Front 20

Interspinous Diameter

Back 20

10 cm

Front 21

Median Conjugate

Back 21

11.5 cm

Front 22

Straight Conjugate

Back 22

9.5 cm

Front 23

Vaginal Delivery

Back 23

Fetus passes through pelvic inlet >lesser pelvis>cervix>vagina>pelvic outlet.

Because Pelvic outlet has a larger sagital diameter the head is able t pas through birth canal in extended position (with face down)

Front 24

Peritoneum

Back 24

Covers major part of pelvic wall and parts of urinary bladder, uterus, and rectum

Front 25

Rectovesical Pouch

Back 25

Pocket formed by peritoneum between Urinary bladder and Rectum

Front 26

Median Umbilical Fold

Back 26

-produced by peritoneum
- in midline
-remnant of embryonic allantois

Front 27

Medial Umbilical Ligaments

Back 27

-produced by peritoneum
-Obliterated umbilical arteries
-Found in body of urinary bladder extended to the umbilicus

Front 28

Lateral Umbilical Folds

Back 28

Over inferior Epigastric Vessels (from external Iliac Vessels)

Front 29

Fxn & Innervation of Ilipsoas Muscle

Back 29

-Formed by Psoas and Iliacus Muscle
-Covers Ala (wing) of ileum
-Fxn: Chief Flexor of hip & Lateral Flexor of Vertebral Column
Innervated: Lumbar Plexus (L1-L3) & Femoral Nerve

Front 30

Fxn & Innervation of Obturator Internus

Back 30

-Covers Lateral Wall of Pelvis
-Fxn: Lateral Rotation of thigh at hip joint & abductor when leg is flexed
-Innerv: Nerve to Obturator Internus ( L5-S2)

Front 31

Piriformis

Back 31

- sometimes may be partially or totally absent
-covers posterior wall of pelvis
-fxn: lateral rotation & Abduction of Thigh
-Innervation: Nerve to piriformis (S1-S2)

Front 32

Pelvic Diaphragm

Back 32

-Floor of Pelvis
-Separates Pelvis from Perineum

Front 33

Levator Ani

Back 33

-Supports all Pelvic Structures & Organs
-Resists Intra-abdominal pressure
-Innerv: S4 N., Inferior Rectal N (from Pudendal), & Coccygeal Plexus

Front 34

Muscles of Levator Ani

Back 34

Puborectalis: Helps Fecal Continence
Pubococcygeus
Ileococcygeus

Front 35

Male's Levator Ani

Back 35

Attaches to Wall of prostate (Levator prostatae)

Front 36

Female's Levator Ani

Back 36

Attaches to urethra/vagina ( pubovaginalis)

Front 37

Coccygeus M.

Back 37

-Not Part of Levator Ani
-Posterior part of pelvic floor
-Fxn: Contraction flexes coccyx
-Innervation: S4-S5

Front 38

Injuries to Pelvic Floor and Perineum

Back 38

-can be caused through childbirth
-Levator Ani Muscle most often injured
-can alter position of bladder and uterus
-urinary stress incontinence

Front 39

Urinary Bladder in Adults

Back 39

-In lesser pelvis, beneath peritoneum and behind pubic bone.

Front 40

Urinary Bladder in Newborns

Back 40

Above pubic bone

Front 41

How much urine can the Urinary Bladder hold?

Back 41

-500-700 mL
-Urgency occurs around 280-350 mL

Front 42

Detrusor Muscle

Back 42

-Internally covered by Transitional Epithelium
-Rough folds on mucosal surface that becomes smooth when filled with urine

Front 43

Internal Urethral Sphincter

Back 43

-At trigone
-formed by smooth muscle of bladder
-controlled by autonomic nervous system

Front 44

Epithelium of Urinary Bladder

Back 44

-Transitional Type of Epithelium

Front 45

Peritoneum of Urinary Bladder

Back 45

-Covers bladder to Transverse Reverse Fold where ureters open into bladder

Front 46

Paracystium

Back 46

-Loose Connective Tissue
-Contains Nerves & Vessels
-Surrounds bladder anteriorly and laterally

Front 47

What is the bladder supported by in Males?

Back 47

Medial Umbilical Ligament & Pubovesical Ligament

Front 48

What is the bladder supported in Females?

Back 48

Pubourethral Ligament

Front 49

Sympathetic Innervation of Urinary Bladder

Back 49

Inferior Hypogastric plexus (Lesser, least and lumbar splanchnic nerve)

Front 50

Sympathetic (motor and sensory)

Back 50

-> Responsible for motor (efferent) innervation of bladder and causes contraction of internal urethral sphincter and relaxation of Detrusor Muscle.
-> sensory (afferent) information from bladder.

Front 51

Parasympathetic Innervation of Urinary Bladder

Back 51

Pelvic Splanchnic Nerve (S2-S4) via Inferior Hypogastric Plexus

Front 52

Parasympathetic (motor and sensory)

Back 52

-> Motor Efferent- relaxation of internal Urethral Sphincter and Contracts Detrusor Muscle.
-> Sensory Afferent- Pain/ Stretch inform from bladder

Front 53

Referred pain of Urinary Bladder

Back 53

dermatomes of perineum / posterior upper thigh

Front 54

Blood Supply of Urinary Bladder

Back 54

Branches of Internal Iliac
-Superior Vesical Artery
-Obturator Gluteal Artery
-Inferior Gluteal Artery
-Inferior Vesical Artery (Male)
-Vaginal & Uterine Artery (Female)

Front 55

Venous Drainage of Urinary Bladder

Back 55

-Vesical Venous Plexus- Connects to vertebral Venous Plexus (in both sexes)
-also connects to prostatic venous plexus in males

Front 56

Lymphatics of Urinary Bladder

Back 56

Lymph nodes along umbilical artery

Front 57

Atonic Bladder

Back 57

-Enlarged Bladder that doesn't empty normally.
-due to denervation or obstruction
-incontinence due to overfilling

Front 58

Hypertonic Bladder

Back 58

-Excess tension in Detrusor Muscle
-Due to irritant or post-surgery

Front 59

Male Urethra

Back 59

-Muscular Tube (20 cm long)
-Starts from internal urethral orifice of urinary bladder to external urethral orifice at tip of glans penis
- has 4 parts

Front 60

Preprostatic Urethra

Back 60

-In Pelvis
-Follows internal Urethral Orifice

Front 61

Prostatic Urethra

Back 61

-In Pelvis
-Ends where Urethra is covered by external urethral sphincter
-most dilated part of urethra
-Covered by Urothelium

Front 62

Urethral Crest

Back 62

-Ridge on middle of posterior wall
(prostatic urethra)

Front 63

Seminal Colliculis

Back 63

-(prostatic urethra)
-expansion of crest

Front 64

Prostatic Sinuses

Back 64

-(prostatic urethra)
-on both sides of seminal colliculus
-openings of prostatic ductules
-secretes prostate gland

Front 65

How openings does the ejaculatory duct have?

Back 65

2 openings

Front 66

Prostatic Utricle

Back 66

-Blind opening in middle of seminal colliculus
-Remnant of Mullerian (paramesonephric) duct

Front 67

Mullerian (paramesonephric) duct

Back 67

-regresses when the male genital organs develop during early embryonic life.
-prostatic utricule is remnant of this
-female, primitive genital tissue

Front 68

Membranous Urethra

Back 68

- In perineum
-Narrowest
-Most prone to injuries/damage due to being fixed/less mobile
-Covered by pseudostratified or stratified columnar epithelium
-surrounded by the extern

Front 69

Spongy Urethra

Back 69

-In Perineum
-Covered by pseudo stratified or stratified columnar epithelium (end is covered by squamous epithelium)
-Urethral glands of Littre
-Cowper's/bulbourethral gland opens here
-

Front 70

What control is the External Urethral Sphincter Under?

Back 70

Voluntary control (pudendal)

Front 71

What control is Internal Urethral Sphincter under?

Back 71

autonomic nervous system

Front 72

Blood Supply of Urethra

Back 72

Branches of Internal Iliac:
-Inferior Vesical Artery
-Middle Rectal Artery
-Internal Pudendal Artery

Front 73

Venous Drainage of Urethra

Back 73

-Vesical Vein
-Middle RectalVein
-Pudendal vein

Front 74

Innervation of Urethra

Back 74

-Pudendal Nerve: Voluntary Control (PNS)
-Pelvic Splanchnic Nerve: Parasympathetic
-Inferior Hypogastric Plexus : Sympathetic

Front 75

Seminal Vesicles

Back 75

-5-10cm long
-Produces Alkaline Secretion
-Covered by Pseudostratified columnar epithelium
-Opens into Ductus Deferens and produces ejaculatory duct

Front 76

Seminal Fluid

Back 76

Bulk of Semen

Front 77

What do the alkaline secretions from the seminal vesicles produce?

Back 77

-fructose (energy for spermatozoa)
-Sugars
-Proteins
-prostaglandins
-etc

Front 78

Blood supply of Seminal Vesicle

Back 78

-inferior vesical
-middle rectal arteries

Front 79

Prostate

Back 79

-Largest Accessory gland in Male Reproductive system
-2/3 glandular & 1/3 fibromuscular
-covered by vascular&fibromuscular capsule (smooth m & connective tissue)
-

Front 80

How many glands does the Prostate have?

Back 80

- about 40 tubuloalveolar glands
-ends in 20-30 prostatic ducts- opens in prostatic sinus

Front 81

Zones of Tubuloalveolar Glands

Back 81

1. Transition Zone
2.Central Zone
3. Peripheral Zone

Front 82

Transition Zone

Back 82

-comprises 5% of prostatic volume
-site of 10% of prostate cancers.

Front 83

Central Zone

Back 83

-comprises about 25% of peripheral zone
-surrounds transition zone

Front 84

Peripheral Zone

Back 84

-70% of prostatic volume
-surrounds central zone
site of 80% of prostate cancers

Front 85

Prostatic Secretion

Back 85

-Thin, opaque, weakly acid secretion
-Contains:
-Protesases: Liquid ejaculation
-Citric Acid: Buffer Effect
-Spermine and Spermidine: influencer fertility of spermatozoa
-Prostaglandins: stimulates uterus

Front 86

Prostatic Glandular Tissue

Back 86

-Androgen Sensitive
-Secretes normal mucins
-Produces Pigment:lipofuscin'

Front 87

Corporara Amylacea

Back 87

-Calcified
-in lumen of glands
-may increase with age

Front 88

Cells in Prostatic Epithelium

Back 88

-Secretory
-Basal
-Neuroendocrine
-urothelium cells
-ejaculatory duct/seminal vesical cells

Front 89

Basal Cells

Back 89

(in prostatic epithelium)
-separate secretory from basal membrane
-Low cuboidal epithelium with columnar mucus-secreting cells
-Reserve cells-positive for androgen receptors

Front 90

Neuroendocrine Cells

Back 90

-Positive for chromogranin A/B, secretogranin II, peptide hormones, and PSA

Front 91

Blood Supply of Ejaculatory Ducts and Seminal Vesicles

Back 91

-Inferior Vesical
-Middle Rectal
-Internal Pudendal

Front 92

Venous Drainage of Ejaculatory Ducts and Seminal Vesicles

Back 92

-Prostatic Venous Plexus-> Internal Iliac Veins

Front 93

Innervation of of Ejaculatory Ducts and Seminal Vesicles

Back 93

Sympathetic & Parasympathetic (S2-S4)

Front 94

Epithelium of Ejaculatory Ducts and Seminal Vesicles

Back 94

Pseudostratified Columnar Epitheliem

Front 95

Digital Rectal Exam (DRE)

Back 95

-screening method for prostate cancer
-Dr. feels lower rectum for lumps

Front 96

Prostate-Specific Antigen (PSA) Test

Back 96

-screening method for prostate cancer
-Measures PSA in blood
-If it is high in PSA means infection/inflammation of prostate and BPH.

Front 97

Benign Prostatic Hyperplasia

Back 97

-noncancerous enlarged prostate
-causes urge to urinate frequently
-discovered through rectal exam

Front 98

Umbilical Artery

Back 98

(in Internal Genitalia)
-Carries deoxygenated blood from fetus to mother
-After birth becomes Medial Umbilical Ligament

Front 99

Contents of Internal Genitalia

Back 99

-Ovaries, Uterine tubes, uterus and Vagina

Front 100

Ovaries attached to _______

Back 100

-uterus via ovarian ligament
-lateral abdominal & pelvic wall by suspensory ligament of ovary

Front 101

External Genitalia

Back 101

-Mons Pubis : contains fat tissue
-Labia Major & Minor (surrounds vestibule of vagina)
-Clitoris: vestibule of the vagina & vestibular glands (located in perineum)

Front 102

Contents of Broad Ligament of Uterus

Back 102

-Uterine n./a./v. and Ovarian n./a./v.
-Parts of Ovary
-Fallopian tubes and ureter
-transverse cervical/cardinal ligament
-Fat/areolar tissue
-Gartner's duct (remnant of Wolfian duct-primary embryonic male genitals)

Front 103

How many reproductive eggs in reproductive life of Female?

Back 103

450

Front 104

Multiple names for Broad Ligament of Uterus

Back 104

-Mesometrium: On uterus
-Mesolapinx: around uterine tubes
-Mesovarium: around ovaries
-Suspensory Ligament of Ovary: covers ovarian vessels and extended to wall of pelvis.

Front 105

Vesicouterinne & Rectouterine Pouch

Back 105

forward and backward extensions of Broad Ligament

Front 106

Ovaries

Back 106

-Not covered by peritoneum (except vessels & ligaments covered by mesovarium)
-simple cuboidal epithelium

Front 107

Suspensory Ligament

Back 107

-attaches ovaries to lateral pelvic and abdominal wall
-contains ovarian a./v.

Front 108

Ovarian Ligament

Back 108

Attaches ovaries to uterus

Front 109

How does the epithelium in ovaries of older women appear?

Back 109

Simple cuboidal epithelium may appear rough/scarred in older women due to rupture of follicles after each release.

Front 110

Oogenesis

Back 110

-Production of egg (ovum)

Front 111

Period of Multiplication

Back 111

Oogonia gives rise to primary oocytes (5th fetal month)

Front 112

Meiosis

Back 112

takes places until puberty

Front 113

Period of Maturation

Back 113

-After puberty
-maturation of primary oocytes complete
-2nd maturation-formation of secondary oocytes
-Theca Interna- outer layer of oocyte that produces estrogen under influence of pituitary FSH

Front 114

Blood Supply of Ovaries

Back 114

• Ovarian a. (from ab. Aorta)

Front 115

Venous Drainage of Ovaries

Back 115

Ovarian v.
• Right—directly to IVC
• Left—left renal vein→IVC

Front 116

Ovulation

Back 116

o Occurs at about day 13/14
o Day 15 – ovum released from Grafian follicle, enter Fallopian tube

Front 117

Corpus Luteum

Back 117

•Remnant of follicle after release of ovum
•Contains Granulosa, lutein and theca lutein cells
•Produces progesterone and Estrogen when stimulated by LH from Pituitary gland
•Dominant follicle transforms back to Corpus luteum after ovulation
•Secretes large amt of progesterone during luteal phase

Front 118

Single Dominant Follicle

Back 118

produced in menstrual cycle, production of estradiol

Front 119

Estradiol and Progesterone

Back 119

prepare uterus for implantation of embryo

Front 120

Non-neoplastic ovarian cysts

Back 120

• Most common cause of ovarian enlargement

Front 121

Luteal Cysts

Back 121

• Most common cause of ovarian enlargement during Pregnancy

Front 122

Follicular Cysts

Back 122

• Unruptured follicles
• Severe abdominal pain when ruptured

Front 123

Polycystic Ovarian Syndrome (Stein-Leventhal Syndrome)

Back 123

oMost common female endocrine disorder
oHormonal disorder – Increased LH & Androgens, decreased FSH
oCan be caused by insulin sensitivity
oSymptoms:Multiple follicular cysts, obesity, no menstruation, excessive hairiness, and infertility

Front 124

Teratomas

Back 124

– Germ cell tumors of ovary

Front 125

Cystic Teratomas

Back 125

-(dermoid cysts of ovary) : contain various tissues (bone, teeth, skin, cartilage etc.)

Front 126

Uterus

Back 126

• Site where fetus implants and grows
• 7.5 cm long, 5cm wide and 2.5 cm thick
• Anchored between bladder and rectum by muscular connective tissue retinaculum in subperitoneal connective tissue.

Front 127

Cervix

Back 127

-Neck of Uterus
-has 2 parts: supravaginal & vaginal

Front 128

Vaginal Part of uterus

Back 128

• Called portio, clinically
• About 1 cm protruded into the vagina
• covered by stratified squamous non-keratinized epithelium (vaginal epithelium)

Front 129

External Os

Back 129

o Round but becomes transverse after childbirth

Front 130

Dynamic Support

Back 130

o Given by Pelvic Diaphragm and other muscular support
(Support of Uterus)

Front 131

Passive/Mechanical Support

Back 131

oNormally ante-flexed and bent forward 90 degrees (antroverted)
•This is responsible for the passive support of the uterus and prevents it from being pushed out of the genital opening

Front 132

Retroverted Uterus

Back 132

•Bent backward instead of forward/curve not strong enough
•Pain during intercourse, pain during menstruation, back aches, Spontaneous abortion, sterility

Front 133

Why is the cervix the least mobile part of the uterus?

Back 133

because it is supported by Endopelvic Fascia(Retinacula) which also contains smooth muscle

Front 134

Ligaments that support uterus

Back 134

• Transverse cervical (cardinal) lig
• Cervix→lat. Pelvic walls
• Sacrocervical (sacrouterine) lig – Posteriorly
• Pubocervical (Pubouterine) lig – Anteriorly
• Round Ligament –Fixes uterus in place
• From Ant. ascpect of lat. Angle
• Ovarian ligament from posterior aspect of the lateral angle

Front 135

Myometrium

Back 135

thick smooth muscle layer

Front 136

Endometrium Epithelium

Back 136

simple high columnar epithelium

Front 137

Vaginal Portion Epithelium

Back 137

stratified squamous non-keratinizing epithelium

Front 138

Pap Smear

Back 138

o Evaluate Cervical Pathology
o Count Cell types (PBC, SSC, ISC)
o Screens for pre malignant/malignant change in cervix

Front 139

Blood Supply of Uterus

Back 139

o Uterine A and Ovarian A
o Blood returns from uterus through Pampiniform plexus

Front 140

Innervation of Uterus

Back 140

o Sympathetic (T12, L1, L2)
o Parasympathetic (pelvic splanchnic S2-S4)

Front 141

Hysterectomy

Back 141

• Removal of uterus
• Ureters in danger when uterine a. cut

Front 142

Fallopian Tubes

Back 142

• Run from tubal angle of uterus →surface of ovary
•8-20cm long
•Intraperitoneal in the Mesosalpinx of the broad ligament
•Mobile
•4 parts: Infundibrium, Ampulla, Isthmus,& Uterine Part

Front 143

Infundibrium

Back 143

• Has Fimbria – finger like projections, Capture Egg

Front 144

Ampulla of Fallopian Tubes

Back 144

•part of tube where fertilization occurs (sperm meets egg) NOT IMPLANTATION
•has longitudinal grooves – guide ovum (cilia pass egg toward uterus)

Front 145

Uterine part

Back 145

Opens into lumen of uterus

Front 146

Mucosa of Fallopian Tube

Back 146

o Branching folds
o Simple high columnar cilated epithelium (pseudostratified) with glandular cells
o Ciliae produce current toward uterus (assists in migration and distribution of spermatozoa)

Front 147

Ovum released from _____ and reaches ______

Back 147

released from the follicle, and reaches the funnel via fimbria in 3-6 minutes

Front 148

Blood supply of Fallopian Tube

Back 148

o Ovarian a. & Uterine a

Front 149

Drainage of Fallopian Tube

Back 149

o R. Uterine →IVC
o L. Uterine → L. renal → IVC

Front 150

Innervation of Fallopian Tube

Back 150

o Sympathetic/Parasympathetic via pelvic splanchnic nerve.

Front 151

Ectopic Pregnancy

Back 151

•Implantation occurs at place other than ant./post. Walls of uterine cavity
•Fallopian tube cannot accommodate fetus past 2nd month, cause tube to rupture
•Severe ab. pain
•Surgical evacuation of fetus necessary

Front 152

Salpingitis

Back 152

•Inflammation (Pelvic Inflammatory disease, PID) and infection(gonorrhea and chlamydia) of Fallopian tubes
•Leads to loss of epithelium
•Interfere with fertilization →sterility
•Symptoms: Fever, cervical motion tenderness, lower ab. pain, new/different discharge, painful intercourse, irregular menstrual bleeding

Front 153

Histerosalpingography

Back 153

•Used to examine women having difficulty becoming pregnant
•Contrast medium injected in uterine tubes to see if they’re connected to ovaries,
•evaluate shape/structure of uterus, and any scarring in uterine/peritoneal cavities

Front 154

Vaginal Prolapse

Back 154

o Uterus drops lower when uterine support lost
o Most common after multiple pregnancies

Front 155

Cervical Incompetence

Back 155

o Internal os incompetent
o Repeated 2nd trimester miscarriages (habitual abortion)
o Causes: Infection, hypertension, Diabetes

Front 156

Surgical Treatment of Cervical Incompetence

Back 156

• Shirodkar/Mcdonald – tie cervix at 14 weeks, remove at 36 weeks
• Mcdonald’s—variation of shirodkar, suture sup. To outer surface of servix, near internal os
o For individuals with scarring

Front 157

Leiomyomas(fibroids)

Back 157

oEstrogen sensitive smooth muscle tumors of Uterus
oMost common benign tumors in females
oFrequent in women over 30, rare under 18yrs
oRegress after menopause
oMay lead to removal of uterus especially in people who have already had multiple children
oIn pregnancy, may enlarge and cause obstructive delivery

Front 158

Vagina

Back 158

•Thin walled, muscular tube (Cervix→Vestibule of vagina)
•Covered internally by Stratified nonkeratinizing squamous epithelium (Almost no glands)

Front 159

Parcolpium

Back 159

o Tissue on outside of vagina
o Connects to urinary bladder and rectum

Front 160

Portio

Back 160

•Lower part of cervix
oProtrudes into upper vagina
oForms recess called Fornix

Front 161

Ant. Fornix

Back 161

below vesicouterine pouch

Front 162

Post. Fornix

Back 162

below rectouterine(douglas) pouch

Front 163

In Vaginal examination

Back 163

oPalpate through post. Fornix:
•Rectouterine pouch, rectum and vertebrae

Front 164

Secretion of Vagina

Back 164

o Glandular secretion of cervix
o Greater/lesser vestibular (bartholin’s) glands

Front 165

Acidic Environment of Vagina

Back 165

-protects from infections/microbes
-pH 4-4.5

Front 166

Blood Supply of Vagina

Back 166

o Uterine a, Vaginal a, & Pudendal a.

Front 167

Episotomy

Back 167

• In childbirth, baby’s head too big to fit and not tear perineal m.
• Perineum and vaginal wall cut for delivery, then sutured after birth

Front 168

Endometrium

Back 168

Menstrual Cycle
-• Everything under control of FSH & LH hormone
o Mucosa of the uterus
o Lies directly on the muscle (myometrium)
o Simple high columnar epithelial (some ciliated) cells
o Contains uterine glands

Front 169

Basal Layer of Endometrium

Back 169

• Not shed during menstruation
• Distinguished from functional layer (superficial)
- 1mm high

Front 170

Phase of desquamation and regeneration

Back 170

o1st to 4th day
oProgesterone – decreases
oEstrogen – increases
oSuperficial portion of endometrium (functional layer) is shed
•Eventually functional layer is regenerated from the basal layer and the wound is closed

Front 171

Phase of Proliferation

Back 171

o 5th – 15th day
o Ovulation period
• Usually takes place during days 13-14
o Mainly controlled by estrogen
o Functional layer grows
o Glands get bigger
o Spiral arteries form
o Body temperature rises

Front 172

Phase of Secretion

Back 172

o 15th – 28th day
o Controlled by Progesterone
•Mucous secretion and increase in blood vessels
o At end of this phase:
• Progesterone decreases
• Arteries contract due to drying
• Ischemia follows
• Tissue damage & bleeding starts again

Front 173

Ultrasonograph

Back 173

-patient drinks a lot of water so bladder is full and a probe is inserted into vagina through cervix

Front 174

Lymphatic drainage of Upper parts of uterus & uterine tubes

Back 174

• Lat. Aortic nodes →Rt&Left Lumbar lymph trunks → Cisterna Chyli →Thoracic Duct

Front 175

Lymphatic drainage of Lower parts of uterus/cervix & upper vagina

Back 175

• Ext./Int. iliac nodes, sacral nodes → common iliac nodes → Lateral Aortic nodes → Cisterna Chyli → Thoracic Duct

Front 176

Lymphatic drainage of Ovary

Back 176

• Lymph vessels along Ovarian a. → Lateral aortic nodes → Cisterna chyli → thoracic duct

Front 177

Lymphatic drainage of Middle Vagina

Back 177

• Int. iliac nodes → Common iliac & Lat. Aortic → Rt/left lumbar lymph trunks → Cisterna chili

Front 178

Vaginismus

Back 178

o Involuntary contraction of bulbospongiosus m.
o Leads to painful intercourse

Front 179

Perineum

Back 179

• Lowest part of turnk
• Includes Penis, Scrotum and Testes in male
• Includes Vulva(ext. genitalia) and Anus

Front 180

Perineal Body

Back 180

o Fibromuscular
o In center of perineum @ arbitrary line
o Site of attachment of all Perineal Muscles

Front 181

Arbitrary Line between ischeal tuberosities

Back 181

Divides perineum into Urogenital and Anal Triangles

Front 182

Urogenital Triangle

Back 182

-Anterior
• Contains perineal m. and ext. genital organs
• Covered by perineal membrane

Front 183

Anal Triangle

Back 183

-Posterior
• Contains anus, perineal fat tissue (Fat Pad), nerves and vessels

Front 184

Fatty Sup. (outer) layer

Back 184

(Superficial Perineal Fascia)
-cont. w/ Camper’s Fascia of abdominal wall and cont. w/ post. Fat Pad of Anal Triangle

Front 185

Female Fatty Superior Outer Layer

Back 185

Builds content of Labia Majora and fat tissue of Mons Pubis, anteriorly

Front 186

Male Fatty Superior Outer Layer

Back 186

Cont. superiorly with abdominal fatty layer, becoming thinner in urogenital Triangle
o Replaced by Dartos m. in scrotum/penis

Front 187

Deep membranous Perineal Fascia of Females

Back 187

• Forms Labia Majora
• Cont. with Abdominal membranous (Scarpa’s) Fascia

Front 188

Deep membranous Perineal Fascia of Males

Back 188

• Cont. w/ Dartos fascia of scrotum/penis
• Cont. w/ Scarpas fascia anteriorly and laterally

Front 189

Deep membranous Perineal Fascia

Back 189

Does not Extend to Anal Canal

Front 190

Deep Perineal (Investing/Gallaudet’s) Fascia

Back 190

• Invests in: Sup. Transverse Perineal m., Bulbospongiosum, and Ischeocavenosus m.
• Cont w/ Deep fascia covering Ext. Ab Oblique, superiorly
• Connected to – Suspensory lig of penis/clitoris

Front 191

Perineal Membrane

Back 191

• Deeper than skin & perineal fascia
• Covers Deep Transverse Perineal m. Inferiorly
• Covers Urogenital triangle
• Does NOT extend to Anal triangle

Front 192

Perineal Pouches

Back 192

o Sup. Perineal Pouch – Between perineal fascia & Perineal membrane
o Deep Perineal Pouch—between perineal membrane and Pelvic Diaphragm

Front 193

Deep Perineal Pouch Males Vs. Females

Back 193

•Male contains: Membranous urethra, and bulbourethral glands
•Females Contains: Proximal urethra
•BOTH:Ext. Urethral Sphincter, Deep Transverse Perineal m., and Dorsal vessels of Penis/Clitoris

Front 194

Sup. Perineal Pouch Males Vs. Females

Back 194

• Males – contains: Root of Penis/associated m., Proximal part of spongy urethra, Sup. Transverse Perineal m., Pudendal N, Internal Pudendal vessels
• Females – contains: Clitoris/associated muscles, Bulb of vestibule(including bulbospongiosus m. and Bartholin glands)

Front 195

All muscles of perineum innervated by:

Back 195

Pudendal Nerve
* Pudendal nerve originates from same spinal sets as Pelvic Splanchnic Nerve not the same nerve
- Pudendal-Somatic & Pelvic Splanchnic-Autonomic

Front 196

Fxn & Innerv of External Anal Sphincter

Back 196

• Fxn: Closes anal canal, supports perineal body
• Inv: Pudendal n.

Front 197

Fxn & Innerv of Bulbospogiosus M.

Back 197

• Fxn: Support perineal body, aid in erection of Penis/Clitoris by applying pressure to blood vessels
• Inv: Pudendal n.

Front 198

Fxn & Innerv of Ischeocavernosus m.

Back 198

• Inv: Pudendal n.
• Fxn: Helps with Erection of Penis/clitoris

Front 199

Fxn & Innerv of Sup. and Deep Transverse Perineal Muscles

Back 199

• Inv: Pudendal n
• Perineal Membrane between these 2 muscles
• Fxn: Aid pelvic diaphragm in intrapelvic/intra-abdominal orgasm and support perineal body

Front 200

Fxn & Innerv of Ext. Urethral Sphincter

Back 200

• Inv: Pudendal n.
• Comprised of fibers of deep transverse perineal m.
• Surrounds urethra
• Function: Compresses Urethra(and vagina in females), Urinary continence

Front 201

Male Ext. Urethral Sphincter

Back 201

o Part continuous on ant. prostate

Front 202

Female Ext. Urethral Sphincter

Back 202

o Surrounds urethra and vagina forming Urethrovaginal Sphincter

Front 203

External Male Genital Organs

Back 203

Scrotum & Penis

Front 204

Internal Male Genital Organs

Back 204

Testes epididymis, Vas Deferens, Seminal Vesicle, Ejaculatory duct, prostate gland, bulbourethral gland

Front 205

Scrotum

Back 205

o Out pouching of skin, covers testes
o Innervation:
• Genitofemoral n.— Anterolateral
• ilioinguinal n.—Anterior
• Pudendal n.—Posterior
• Post. Femoral Cutaneous n.—Inferior

Front 206

Layers of Scrotum

Back 206

• Skin of abdominal wall
• Dartos Fascia & Dartos m.
• Ext. Spermatic Fascia
• Cremaster m. and Fascia
• Int. Spermatic Fascia
• Tunica Vaginalis

Front 207

Dartos Fascia & Dartos m.

Back 207

• Continuation of sup. Fascia in Ab. wall
• Attached to skin
• Contractions – causes scrotum to wrinkle (cold temperature, prevents heat loss)

Front 208

Ext. Spermatic Fascia

Back 208

• Continuation of Ext. Ab. Oblique

Front 209

Int. Spermatic Fascia

Back 209

• Continuation of trasversalis fascia

Front 210

Tunica Vaginalis of Scrotum

Back 210

• Continuation of peritoneum
• Remnant of embryonic Processus Vaginalis

Front 211

Lymphatic Drainage of Scrotum

Back 211

• Sup. Inguinal nodes → Deep Inguinal nodes → Ext&Common iliac nodes →Deep nodes around Aorta → Cisterna Chyli

Front 212

Swollen lymph nodes near scrotum indicate?

Back 212

infection in external genitalia, cancer or lower limb infection

Front 213

What happens if process vaginalis remains open?

Back 213

o Hydrocele – accumulation of clear fluid
o Hematocele – accumulation of blood
o Spermatocele – accumulation of sperm

Front 214

Testes(Orchis)

Back 214

o Suspended in Scrotum by Spermatic cord
•Left testis is hung more inferiorly

Front 215

Thermoregulators of testes

Back 215

• Pampiniform plexus (surrounds testes)
• Dartos fascia (wrinkles or relaxes)
• Cremaster Muscle (raises or lowers)

Front 216

Tunica Albuginea

Back 216

– tough connective tissue, tightly envelops each testis
•Sends septae into testis, dividing testicle into 200-300 lobules

Front 217

Lobules

Back 217

contain many seminiferous tubules→ lead to Rete Testis with straight endings: Tubuli recti→ interconnected, lead to efferent ductules→ reach ducts of epididymis→ merge into ductus deferens

Front 218

Spermatozoa

Back 218

produced in lumen of seminiferous tubules – transported through this pathway to Prostate & Urethra*

Front 219

Descending of Testes

Back 219

Begin to descend toward Pelvis/scrotum – 7th intrauterine week (due to high temp.)
•Descent guided by gubernaculum testis
•Usually close to or inside scrotum by 7th intrauterine month

Front 220

Tunica Vaginalis of Testes

Back 220

• Double layer membrane of peritoneum
• Passes through Inguinal canal before testes
• Layers fuse together forming Processus Vaginalis
• Covers tunica albuginea (but not completely)

Front 221

Innervation of Testes

Back 221

• Sympathetic – T7
• Parasympathetic – vagus
•Comes along the testicular a. as testicular plexus

Front 222

Blood Supply of Testes

Back 222

• Testicular/Gonadal a.

Front 223

Venous Drainage of Testes

Back 223

• Pampiform Plexus to testicular v.
• Left Testicular v. →Left renal v.
• Rt testitcular v. → IVC

Front 224

Lymphatic Drainage of Testes

Back 224

• Sup/Deep Lymph plexus→ Preaortic& Lumbar nodes → Cisternal Chyli

Front 225

What is variocele? What are consequences?

Back 225

o Incompetency of Pampiform Plexus, Enlarged veins in Scrotum
o Leads to Pain and infertility

Front 226

Functions of Testes

Back 226

•Produce Spermatozoa
•Secrete mail androgens i.e. testosterone via Leydig(interstitial) cells
•Sertoli cells – envelop spermatogonia, support them to maturation
•Secrete Inhibin – regulate sperm and testosterone production

Front 227

Sertoli cells

Back 227

envelop spermatogonia, support them to maturation

Front 228

Spermatogenesis

Back 228

• Formation of male gametes
• 3 phases : Spermatocytogenesis , Meiosis, Spermatogenisis

Front 229

Spermatocytogenesis

Back 229

oPhase 1
oAt puberty
oPrimordial germ cells differentiate into Type-A spermatogonia
oUndergo mitosis (provides continuous supply of stem cells for entire reproductive life)

Front 230

Meiosis

Back 230

-phase 2
-Some type-A differentiate into type-B spermatogonia
-DNA replication – form primary spermatocytes→meiosis I to form 2 secondary spermatocytes→meiosis II form 4 spermatids

Front 231

Spermatogenisis

Back 231

-Phase 3
-Spermatids – morph into formation of Spermatozoa

Front 232

Total time for sperm formation

Back 232

64 Days

Front 233

Hypothalamic Control

Back 233

• Arcuate nuclei of hypothalamus – secrete GnRH
• Ant. Pituitary – secretes FSH & LH

Front 234

Sertoli Cells

Back 234

Negative feedback of FSH secretion

Front 235

LH

Back 235

acts on leydig hormones to promote testosterone synthesis

Front 236

Testosterone

Back 236

Inhibits secretion of LH by inhibiting release of GnRH

Front 237

Inhibin

Back 237

inhibits secretion of FSH

Front 238

Epididymis

Back 238

•Lies on Post. Surface of testis
•Covered by Tunica Vaginalis (exept at Post. Border)
•Head, body & tail
•Site of Maturation, motility and Storage of Sperm
• Spermatozoa(non-motile) mature to sperm(motile) here
oDone by growing flagella
•Stereociliated pseudostratified columnar epithelium

Front 239

Where and how does Spermatozoa mature to sperm?

Back 239

in Epididymis by growing flagella

Front 240

Duct of Epididymis

Back 240

• Formed by convoluted tubules in head that become smaller toward tail
• Drains to Vas Deferens

Front 241

Sperm

Back 241

limited mobility for 18-24 hours, due to effects of secretion

Front 242

how much sperm is produced in young males a day?

Back 242

120,000,000 sperm produced per day

Front 243

Blood Supply of Epididymis

Back 243

Inferior Vesicle Artery

Front 244

Venous Drainage of Epididymis

Back 244

Inferior Vesicle Vein

Front 245

Vas Deferens

Back 245

•Infraperitoneal
•Strong muscle – Contraction suction & pressure, play role in quick passage of spermatozoa
•Sperm released here upon sexual stimulation
•Sterociliated pseudostratified columnar epithelium

Front 246

3 layers of Vas Deferens

Back 246

• Inner longitudinal
• Middle circular
• Outer longitudinal

Front 247

Vasectomy

Back 247

tying off Vas Deferens

Front 248

Blood Supply and Venous Drainage of Vas Deferens

Back 248

B.S: Inferior Vesical Artery
Venous Drainage:Inferior Vesicle Vein

Front 249

Corpora Cavernosa

Back 249

•Erectile tissues
•Enclosed by tunica albuginea
• Covered by deep & superficial fasciae of penis

Front 250

corpus spongiosum

Back 250

• Covered by deep & superficial fasciae of penis

Front 251

Penile Raphe

Back 251

• Ridge of skin on ventral(urethral) surface
• Continuous w/ scrotal & perineal Raphe
• Extends to anus

Front 252

Prepuce (foreskin)

Back 252

•Circumcision occurs here
•Prolongation of skin and fasciae, as double layer over Glans Penis
•Frenulum of Prepuce
•Elastic band of tissue
•Inf. aspect of glans penis, near urethral orifice
•Opens at tip of Glans

Front 253

Erection

Back 253

•Parasympathetic (pelvic splanchnic) through Prostatic Plexus
•When stimulated helicine arteries relax & blood fills sinuses of corpora cavernosa ->Tunica Albuginea tightens->Bulbospongiosus & Ischoeocavernosus m. contract & compresses veins in corpora cavernosa. Outflow of blood restricted->Corpora Cavernosa&Spongiosum become enlaged/rigid & Penis becomes Erect

Front 254

What happens after ejaculation?

Back 254

helcine arteries contract & blood leaves

Front 255

Emission

Back 255

• Sympathetic (L1 – L2)
• Ductus deferens & seminal vesicle deliver semen to prostatic urethra through Peristalsis

Front 256

Peristalsis

Back 256

Ductus deferens & seminal vesicle deliver semen to prostatic urethra

Front 257

Ejaculation

Back 257

• Parasympathetic (S2-S4)– Contraction of urethral m.
• Somatic(pudendal)—contraction of bulbospongiosus m.
• Sympathetic n. – Closure of Int. Urethral Sphincter

Front 258

Phimosis

Back 258

-foreskin cannot be withdrawn
-circumcision required

Front 259

Paraphimosis

Back 259

-circumcision required
-Foreskin cannot be drawn over glans penis

Front 260

Hypospadias

Back 260

o Ext. Urethral Orifice not where it’s supposed to be.
o Inferior to normal location
o Congenital Malformation

Front 261

Female External Genitalia

Back 261

•AKA (Vulva)
o Made of Labia Majora, Labia Minora, Clitoris and Vestibule of Vagina

Front 262

Mons Pubis

Back 262

Above vulva
•Covered by hair, skin and fat tissue
•Skin features Sebaceous glands, Sweat Glands and Scent Glands

Front 263

Labia Majora

Back 263

•2 folds of hair covered skin, and underlying fat tissue
•Skin Features Sebaceous glands, Sweat Glands and Scent Glands

Front 264

Triangular Pubic hair

Back 264

• Formed by hair of Mons Pubis and Labia Majora

Front 265

Frenulum

Back 265

Band of skin that connects the 2 Labia Minora, Posteriorly

Front 266

Labia Minora

Back 266

• 2 folds of hairless skin,
• Medial to Labia Majora on each side, surrounding vestibule of Vagina

Front 267

Prepuce of clitoris and Frenulum of Clitoris

Back 267

Connects 2 labia minora, anteriorly

Front 268

Clitoris

Back 268

•Originates as 2 limbs – Crura of Clitoris
•Each crus of clitoris, covered by 1 Ischeocavernosus m.
•Erectile organ – contains corpora cavernosa
•Only fxn is sexual arousal
•Enlarges upon tactile stimulation

Front 269

Body of Clitoris

Back 269

• Formed by Crura uniting, beneath Pubic Symphysis
• Turns Backward, Ends in glans clitoris

Front 270

Vestibule of Vagina

Back 270

•Space between labia minora
•Contains openings of Urethra, Vagina, and Greater/Lesser Vestibular glands
•Ducts of Paraurethral glands
•on each side of Ext. Urethral Orifice
•Vaginal Orifice

Front 271

Hymen

Back 271

-Covers Vestibule of Vagina
-(Thin fold of Mucus Membrane) in females who have never had sex

Front 272

Hymenal Caruncles

Back 272

Few remnants of hymen that may be visible after sex

Front 273

o Bulbs of Vestibule (Corpora Cavernosa of Vestible)

Back 273

• Consist of venous plexus
• Covered by bulbosponginosus

Front 274

Lymphatic Drainage of Lower part of Vagina

Back 274

•Sup. Inguinal Nodes → Deep Inguinal Nodes→ Ext./Common Iliac nodes →Lat. Aortic nodes →Lumbar nodes →Cisterna Chyli → Thoracic duct

Front 275

Clitoris/Labia Majora

Back 275

•Deep & common iliac nodes→ Lat. Aortic nodes→Cisterna Chyli → Thoracic duct

Front 276

Vulva/Perineal Skin

Back 276

•Sup/deep inguinal nodes→Ext./Common iliac nodes→Lat. Aortic nodes→Cisterna Chyli→Thoracic Duct

Front 277

Chapter 9

Back 277

Oral and Nasal Cavities

Front 278

Oral Cavity

Back 278

•Proximal/Beginning digestive tract
•Consists of 2 parts: Vestibule of mouth & Oral Cavity Proper

Front 279

Vestibule of Mouth

Back 279

• Between lips/cheeks and gum/teeth
• Parotid(stensin’s duct) – opens here, near 2nd molar tooth

Front 280

Oral Cavity Proper

Back 280

Behind Teeth

Front 281

Structures found in Oral Cavity

Back 281

o Gums, Teeth, Openings to Salivary Glands, Tongue
o Palatine tonsils(in tonsilar fossa),
o Uvula,
o Oropharyngeal isthmus(in back of oral cavity, leads to oropharynx downward, and nasopharynx upward)

Front 282

Obicularis Oris M.

Back 282

o Surrounds opening of mouth,
•covered by Epithelium of skin on outside
•Oral Mucosal Epithelium on inner surface of lips
•Blood vessels beneath this give lips reddish color
o Innervated by Facial nerve

Front 283

What makes up the floor of the mouth?

Back 283

Mylohyoid & Geniohyoid m.

Front 284

What makes up lateral wall of mouth?

Back 284

Buccinator Muscle

Front 285

Hard Palate

Back 285

o Ant. 3/5 of roof of mouth
o Maxillary and palatine bones
o Separates nasal cavity from oral cavity

Front 286

Soft Palate

Back 286

o Muscles, glands, lymphoid tissue, aponeurosis
o Oral Side: Stratified squamous epithelium
o Nasopharyngeal side: Pseudostratified ciliated columnar epithelium
o Uvula descends from Post. Side

Front 287

Epithelium Oral Side of Soft Palate

Back 287

Stratified squamous epithelium

Front 288

Epithelium Nasopharyngeal side of Soft Palate

Back 288

Pseudostratified ciliated columnar epithelium

Front 289

All Muscles of Palate Innervated by :

Back 289

->Pharyngeal Plexus(CN IX and X)
•CN IX – normally sensory innervation to Oral & Laryngeal Areas
•CN X – usually Motor
•EXCEPTION: Tensor Veli Palatine:Innervated by CN V

Front 290

Sensory Innervation of Palate

Back 290

•Maxillary N (CNV/2) through Pterygopalatine branch:
oGreater palatine n.
oLesser palatine n.
oNasopalatine n.

Front 291

Mucous membrane, glands and other palate structures innervation:

Back 291

•Parasympathetic Fibers (from sup. salivatory nucleus) with sympathetic fibers

Front 292

Fxn & Innervation of Palatoglossus M.

Back 292

Innervation :Pharyngeal Plexus(CN IX and X)
Fxn: Elevates Tongue

Front 293

Fxn & Innervation of Palatopharyngeus

Back 293

Innervation :Pharyngeal Plexus(CN IX and X)
Fxn: Elevates Pharynx

Front 294

Fxn & Innervation of Uvulae Muscle

Back 294

Innervation :Pharyngeal Plexus(CN IX and X)
Fxn: Elevates Uvula

Front 295

Fxn & Innervation of Tensor Veli Palatini

Back 295

•Elevates velum of the palate to horizontal plane during swallowing, tenses soft palate, opens Eustachian tube
•INNERVATED BY CN V

Front 296

Fxn & Innervation of Levator Veli Palatini

Back 296

Innervation :Pharyngeal Plexus(CN IX and X)
Fxn: Elevates soft palate

Front 297

Congenital Malformation of Palate(Cleft Palate)

Back 297

oLat. Palatine processes, Nasal Septum and/or Med palatine processes fail to fuse
oMany causes: i.e. increased steroid use during fetal development
o Can be Posterior or Anterior
•Posterior more common

Front 298

Cleft Lip

Back 298

oFailure of maxillary and Medial Nasal processes to fuse
oCausing persistent lateral groove ← Can Be unilateral or Bilateral
oUnilateral cleft lip – Most common congenital malformation of head

Front 299

Salivary Glands

Back 299

•Exocrine glands – Produce Saliva
•Consists of Parotid, Submandibular and Sublingual glands

Front 300

Parotid Gland

Back 300

Superior
oSerous type secretory glands
oSuperficial and deep parts
oSaliva goes through Parotid(Stensen’s) Duct

Front 301

Innervation of Parotid Gland

Back 301

•Parasympathetic
•Secretomotor
•Originate from CN IX
• Sympathetic
•Vasomotor
•Originate – upper thoracic segments.

Front 302

Structures embedded in Parotid gland

Back 302

• Facial N. (CNVII)

Front 303

Submandibular gland

Back 303

•In submandibular triangle
•Secretion reaches Oral Cavity under tongue via Submandibular(Wharton’s) Duct
•Smaller than parotid
•Serous and mucus type glands

Front 304

Sublingual Gland

Back 304

•Smaller than parotid
•Serous and mucus type glands
•Smallest in region
•Beneath mucus membrane of floor of mouth, over mylohyoid m.
•Secretion reaches Oral Cavity via Bartholin’s Duct—empties into submandibular duct

Front 305

Innervation of submandibular &subligual

Back 305

•Parasympathetic(Preganglionic Fibers)
•Secretomotor
•Originating from Sup. Salivatory Nucleus (from CN VII)
•Sympathetic(Postganglionic Fibers)
•Vasomotor
•Origin – Upper thoracic segs.

Front 306

Saliva Functions

Back 306

• Lubrication of digested food by mucus
• Protection of mouth/esophagus by dilution and buffering of ingested foods
• Initial Starch digestion, by Alpha-amylase
• Initial Triglyceride digestion by lingual lipase

Front 307

How much salivary secretion is produced everyday ?

Back 307

1 liter a day

Front 308

Salivary Gland Stones (sialothiasis)

Back 308

• Most common disease of Salivary gland
• Submandibular gland, most succeptible

Front 309

•Sialodenectomy

Back 309

o Removal of gland
o Necessary when Sialodenectomy becomes Chronic

Front 310

Mumps

Back 310

•Inflammation of parotid gland
•If severe, can lead to Bell’s plasy
oDue to CN VII compression
•Also cause infertility

Front 311

Tongue

Back 311

•From 2nd-3rd branchial arch
•Muscular organ, aids in:
oIngestion, swallowing, chewing, sucking and speech
•Carries special Sense organs for Taste, Touch, Pressure and other gen. senses
•Body has Oral and Pharyngeal portions

Front 312

Regions of Tongue

Back 312

oDorsum
oInf. Surface
oRoot
oTip

Front 313

Terminal Sulcus

Back 313

-Inverted ‘V’ Shape groove
-Marks boundary between body and root.

Front 314

Foramen Cecum

Back 314

-Blind hole
-Site where thyroid gland moves from oral cavity to neck in embryonic development
-**Malformation**
•Lingual thyroid may be present here, and produce thyroid hormones

Front 315

Dorsum of Tongue

Back 315

-Mucosa covered by papillae(increase area for taste receptors)
-Mucous Membrane contains taste buds – sensory organ of Taste

Front 316

Fungiform Papilla

Back 316

• Dorsum, and appendix
• Appear reddish
• Have taste buds but no gustatory gland

Front 317

Folliate Papillae

Back 317

Sides of tongue

Front 318

Firiform Papillae

Back 318

• Dorsum
• Sensitive to touch
• Smallest papillae

Front 319

Vallate Papillae

Back 319

•8-10 - total
•Largest
•Epithelium – contains most of the taste buds
•Serous glands – opens into trench that surrounds papilla
•Serous secretion released to wash away flavors of papilla

Front 320

Mucous membrane of inferior surface of tongue

Back 320

•Cont. w/ other parts of oral cavity
•Forms frenulum in center
•Contains lingual veins
•Used to bypass 1st pass effect, for faster drug administration
•Contains Caruncula lingualis
•Opening for submandibular ducts

Front 321

Taste Zones

Back 321

o Sweet – at tip of tongue
o Salty/Sour – on Sides of tongue
o Bitter – Toward root of tongue

Front 322

ALL MUSCLES OF TONGUE INNERVATED BY ______ EXCEPT FOR_________

Back 322

HYPOGLOSSAL N. (CN XII) ,
EXCEPT FOR: PALATOGLOSSEUS M.(INNV BY PHARYNGEAL PLEXUS)

Front 323

Syloglossus

Back 323

•Elevation/retraction of tongue
•Innervated by hypoglossal Nerve

Front 324

Hypoglossus

Back 324

•Innervated by hypoglossal Nerve
•Depression of tongue

Front 325

Genioglossus

Back 325

•Innervated by hypoglossal Nerve
•Depression of tongue

Front 326

Palatoglossus

Back 326

•Innervated by pharyngeal plexus
•Elevates post. Tongue
•Closes oropharyngeal isthmus
•Aids initiation of swallowing

Front 327

Sup/inf Longitudinal m.

Back 327

•Innervated by hypoglossal Nerve
•Curling tip of tongue up/down
•Shortening tongue

Front 328

Transverse m.

Back 328

•Innervated by hypoglossal Nerve
•Controls elongation/narrowing of tongue

Front 329

Vertical m.

Back 329

•Innervated by hypoglossal Nerve
•Widens/flattens tongue

Front 330

Sensory feeling of Lingual n (from CN V/3)

Back 330

• Carries general senses, i.e. pain, touch, and temp
• from ant 2/3 of tongue

Front 331

Sensory feeling of Glossopharyngeal n. (CN IX)

Back 331

• Carries general senses from post 1/3, innervates post 1/3

Front 332

Sensory feeling of Int. Laryngeal branch of Vagus n. (CN X)

Back 332

• Carries general sense info from very back of tongue
• Innervates very back of tongue

Front 333

Sensory feeling of Chorda Tympani of Facial N (CN VII)

Back 333

• Carries special senses(taste) from Ant. 2/3 through Lingual N.

Front 334

ALL TASTE FIBERS TERMINATE IN _____

Back 334

NUCLEUS SOLITARIUS

Front 335

Hypoglossal N. (CN XII)

Back 335

•Primary motor nerve to m. of tongue

Front 336

What does Paralysis of the Hypoglossal n. lead to?

Back 336

deviation of tongue toward affected side, due to pressure from intact side

Front 337

Major blood supply of Tongue

Back 337

Lingual A. (from ext. carotid a)

Front 338

Minor Blood Supply of Tongue

Back 338

Inf. Alveolar A, Facial A, and Ascending Pharyngeal a.

Front 339

Venous Drainage of Tongue

Back 339

Lingual V. → Jugular V.

Front 340

Macroglossia

Back 340

-Enlargement of Tongue:
-Often seen in hypothyroidism, amyloidosis, and cretinism (congenital hypothyroidism)

Front 341

Enamel

Back 341

Covers Tooth

Front 342

Cement

Back 342

covers root

Front 343

Pulp Cavity

Back 343

from root apex, perforated by root canal

Front 344

Dentin

Back 344

Can be penetrated easily if covering hard structures are damaged in dental caries

Front 345

Gum(Gingiva)

Back 345

-Soft mucosa-covered, fibrous tissue
-Lines alveolar cavities of jaws, and seals teeth in their location
-Periodontal Tissue – Lies around root of tooth

Front 346

Innervation of Teeth

Back 346

-Upper Row – Branches of Maxillary n. (sup. alveolar n.)
-Lower Row – Mandibular n. (inf. alveolar n.)

Front 347

Blood Supply & Venous Drainage of Teeth

Back 347

-Superior & Inferior alveolar vessels (from maxillary A.)

Front 348

Blood Supply of Oral Cavity

Back 348

•Mostly from branches of Ext. Carotid A.
-Inc. Lingual, Maxillary and Facial a.
•Blood collected by Lingual, Maxillary and Facial veins

Front 349

Tetracycline

Back 349

•Antibiotic for bacterial infections inc. pneumonia
•When given to a CHILD may lead to:
-Yellow teeth
-Enamel Hypoplasia
-Reduces growth of Long bones

Front 350

Congenital Syphilis (Treponema Pallidum)

Back 350

•Results in deformed (hutchinson’s) teeth showing indentation on borders
• May be accompanied by:
-Mental Retardation
-Hydrocephalus
-Deafness
-Blindness

Front 351

Measles (rubeola)

Back 351

•Extremely contagious
•7-14 day incubation period
•Begins with: Fever, cough, pink-eye, & excessive mucus production
•Followed by: Koplik’s Spots(red with white center) in mouth and spots on trunk within 2-3 days
•Complications:Middle ear infection (otitis media) & Pneumonia

Front 352

Herpes Simplex 1

Back 352

•Lesions around Lips and in Mouth
•Virus dormant in Sensory Ganglia, reactivated by stress
sunlight,& menstruation

Front 353

Aphthous Ulcers(canker sores)

Back 353

• Localized ulcerations in mought
• Painful greyish lesions on red base
• Often stress induced

Front 354

Peutz-Jeghers Syndrome

Back 354

•Autosomal dominant disease
•Symptoms
-Polyps of GI Tract
-Melanocytic pigmentation of lips and oral mucosa

Front 355

Addison’s Disease

Back 355

•Adrenal cortical Insufficiency
•Involves excess ACTH
•Symptoms: Abdominal Pain/weakness

Front 356

Heavy metal poisoning

Back 356

• Lead line in gingiva
• Silver Poisoning (greyish discoloration)

Front 357

Scurvy

Back 357

•Condition caused by deficiency of Ascorbic Acid (vitamin c)
•Leads to bleeding of gums
•Early symptoms:
-Discomfort & Excessive tiredness
•After 1-3 months
o Shortness of breath and bone pain

Front 358

Pharynx

Back 358

•Muscular tube: covered by mucous membrane internally; & Adventitia, externally
•Both digestive and respiratory tracts
•Connects to Facial skull, merging into esophagus at Cricoid Cartilage (C6)

Front 359

Pharyngobasilar Fascia

Back 359

-Wall of pharynx
-Not muscular but a tough fibrous membrane

Front 360

Mucus membrane sensory innervation:

Back 360

-CN IX of Pharyngeal Plexus

Front 361

Stylopharyngeus m.

Back 361

• Innervation: Motor branch of CN IX
• Fxn: Elevates and Widens Pharynx

Front 362

Muscles of Pharynx Innervated by ______

Back 362

Pharyngeal Plexus (CN X) ;except for Stylopharyngeus m.

Front 363

Nasopharynx

Back 363

•Choanae (post. Nasal aperature) down to C2 vertebral body
•Pharyngeal Opening of Eustachian(Pharyngotympanic) tube
-Cartilaginous
•Torus Tubarius (tubal tonsil)
•Salpingopalatine fold
-Bears salpingopalatine m.
•Pharyngeal (adenoid) tonsil

Front 364

Oropharynx

Back 364

• Soft palate down to level of hyoid bone
• Palatopharyngeal fold-Bears Palatopharyngeous m.

Front 365

Hypopharynx (laryngeopharynx)

Back 365

•Upper boundry of epiglottis to Cricoid cartilage (C6)
•Piriform Recess
-Groove in membrane
-Directs food away from airway and into esophagus

Front 366

Innervation of Pharynx

Back 366

-Sensory: of mucus membrane: Pharyngeal Plexus (CN IX)
-Motor: Vagus N. (CN X)

Front 367

Blood Supply of Pharynx

Back 367

-Branches of Ext. Cricoid A.
• Including: ascending Pharyngeal, facial and Maxillary arteries
• Corresponding veins drain to Internal Jugular vein

Front 368

Waldeyers Ring of Lymphoid Tissue

Back 368

- Ring formed by Pharyngeal (adenhoid), Tubal, Palatine, and Lingual tonsils that protects respiratory & digestive tracts from foreign organisms

Front 369

External Nose

Back 369

• Bone and Hyaline Cartilage
• Root – articulates with frontal bone

Front 370

Bones in External Nose

Back 370

-Nasal & Frontal processes of Maxilla

Front 371

Cartilages in External Nose

Back 371

-Lat. Nasal cartilage, greater and lesser alar cartilages on each side and Septal nasal cartilage

Front 372

Nasal Septum

Back 372

-Divides Nasal Cavity into two parts
-Ant. cartilaginous part joins bony part of septum
-Formed by: Perpendicular Plate of Ethmoid, sphenoidal crest and vomer
-Covered by:Mucous membrane(integral in nerve/blood supply)

Front 373

Nostrils (nares)

Back 373

-opening to nasal cavity

Front 374

Floor of Nasal Cavity

Back 374

Maxilla and palatine bone

Front 375

Root of Nasal Cavity

Back 375

-Nasal bone, Frontal bone, Cribiform plate of ethmoid bone, and body of sphenoid bone

Front 376

Nasal Meatus

Back 376

• Lie between conchae
• Site where paranasal and other sinuses release their discharge

Front 377

Superior Nasal Meatus

Back 377

- Where post. Ethmoidal cells open

Front 378

Middle Nasal Meatus

Back 378

-Ethmoidal Bulla seen here
•Where middle ethmoidal air cells open
-Semilunar hiatus
•Openings for ant. ethmoidal air cells and maxillary sinus found

Front 379

Inferior Nasal Meatus

Back 379

Contains opening of nasolacrimal duct.

Front 380

Paranasal Sinuses

Back 380

• Air filled spaces inside bones of Nasal Cavity
•Function:
- Humidify & warm air for normal respiratory functions
- Add resonance to sounds
- Makes head lighter
•Covered by Mucous Membrane, a pseudostraified cilated epithelium
- Consists of Motile cells and glands
- Rich in blood Supply
- Also covers Nasal Conchae/meati

Front 381

Frontal Sinus

Back 381

- Drains to middle nasal meatus via frotonasal duct
- 3 sets of ethmoidal Air cells –
•in Ethmoidal labyrinth between orbit & nasal cavities
•1 – Post. Cells →drain to sup. meatus
•2 – Ant. Cells → Middle meatus
•3 – Middle cells → On/above ethmoid bulla in middle meatus

Front 382

3 sets of ethmoidal Air Cells & Drainage

Back 382

• in Ethmoidal labyrinth between orbit & nasal cavities
• 1 – Post. Cells →drain to sup. meatus
• 2 – Ant. Cells → Middle meatus
• 3 – Middle cells → On/above ethmoid bulla in middle meatus

Front 383

Maxillary Sinus

Back 383

- Largest sinus
- Lies in maxilla
- Drains to Semilunar hiatus of middle meatus

Front 384

Mucus Membrane of Upper Nasal Cavity

Back 384

- Inc. Roof, Sup. concha and upper Nasal Septum
- Covered by thick epithelium bearing olfactory sensory and supporting cells
- Olfactory Serous glands – Beneath Epithelium

Front 385

Lower Nasal cavity and Sinuses

Back 385

- Covered by Respiratory epithelium
•Characterized by pseudostraified columnar cilated epithelium w/ mucus producing goblet cells

Front 386

Innervation of Nose

Back 386

•Motor – Facial N. (CN VII)
•Sensory – Branches of CN V/1 (ophthalmic) and CN V/2 (maxillary)
-Tip of nose – CN V/1

Front 387

Blood Supply to Nose

Back 387

• Branches of Ophthalamic, Maxillary and Facial Arteries
• Collected by corresponding Veins

Front 388

'
Nasal Septum Deviation

Back 388

• May partly block nasal passages
• May lead to atrophic rhinitis
-Inflammation of the nose

Front 389

Sinusitis

Back 389

• Acute/chronic inflammation of mucosa of nasal and paranasal sinuses

Front 390

Rhinitis

Back 390

(hay fever) – a runny nose and stuffiness
- Usually by common cold
- Inflammation of Nasal Mucous Membrane

Front 391

Rhinorrhea

Back 391

• Persistent watery mucus discharge from nose
- Inflammation of Nasal Mucous Membrane

Front 392

Nasal Polyp

Back 392

- Inflammation of Nasal Mucous Membrane
• Pinkish gray color follicle thickening of mucosa
• Due to Edema

Front 393

Swelling of jugulodigastric node

Back 393

-behind tongue
-sometimes first sign of carcinoma of this region

Front 394

Chapter 11

Back 394

Sense Organs

Front 395

Orbital Septum

Back 395

- Separates sup. structures from content of orbital cavity

Front 396

Orbital Region of eye

Back 396

-Corresponds to approx. area covered by Obicularis Oculi M. (OOM)

Front 397

What can infections of superior structures of face cause?

Back 397

-may get to cranial venous sinuses
-may cause abscess formation in area

Front 398

Facial V. Anastomoses with _____

Back 398

Opthalmic veins
-> takes blood to cavernous sinus

Front 399

Functional Anastomoses of arteries in orbital Cavity?

Back 399

between Facial A and arteries from Ophthalmic A

Front 400

Palpebral part of Obbicularis Oculi m. Innerv, &Fxn.

Back 400

-Beneath Skin
-Innervated by Facial Nerve (CN VII)
-Fxn: Helps in closing eye

Front 401

Tarsal Plates

Back 401

• Beneath OOM
• Contain sebaceous tarsal glands that open into edge of eyelid
• Sup. and Inf. Tarsal Plates
• Made of dense collegen tissues
• Merge on both sides of eye to form medial and lateral Palpebral ligs.

Front 402

Levator Palpebrae superioris Fxn & Inner

Back 402

• Skeletal muscle
• Function – helps elevate lid
• Innervation – CN III

Front 403

Sup. Tarsal Muscle Fxn & Inner

Back 403

• Smooth Muscle
• Function – Helps elevate upper lid
• Innervation – Sympathetic N.

Front 404

Lacrimal Gland

Back 404

- Produces tears, collected in medial side of ear
- Tears → Puncta Lacrimalia (openings on inner side of lids) and enter Lacrimal Canal
- Then enter Lacrimal Sac
- Move to Nasolacrimal duct
- And finally to Inf. Nasal Meatus

Front 405

Innervation of Lacrimal Gland

Back 405

- Parasympathetic from Lacrimal and Sup. Salivatory Nuclei
- CN VII (nervous intermedius)

Front 406

Bones of Orbit

Back 406

-Superior Orbital Fissure
-Optic Canal

Front 407

Superior Orbital Fissure

Back 407

-Transmits CN III, CN IV, CN V/1 and CN VI, and Ophthalamic V.

Front 408

Optic Canal

Back 408

- Transmits Optic N, accompanied by Ophthalamic A.

Front 409

Intraocular Muscles

Back 409

• Ciliary M. around Lens
• Sphincter Pupillae
• Dilator Pupillae m. in iris

Front 410

Levator Palpebrae Superioris

Back 410

innervated by CN III

Front 411

Fxn and Innerv. Sup. Rectus

Back 411

- innervated by CN III
-Fxn – lifts eye and slightly turns it medially in adduction

Front 412

Fxn and Innerv. Inf. Rectus

Back 412

- innervated by CN III
-Fxn – Depresses eye, has slight adduction and lat. Rotation

Front 413

Fxn and Innerv. Medial Rectus

Back 413

- innervated by CN III
-Fxn – Turns eye medially in adduction

Front 414

Fxn and Innerv. Lateral Rectus

Back 414

-Fxn. Turns eye laterally in abduction
-Inv—CN VI

Front 415

Fxn and Innerv. Superior Oblique

Back 415

-Can abduct depress and internally rotate eye(intorsion)
-Innervation—CN IV
- Rotates upper half of eyeball toward nose

Front 416

Fxn and Innerv.

Back 416

- Inf. Oblique
-rotates upper half of eye toward temporal side
-Causes extorsion, elevation and abduction
- innervated by CN III

Front 417

Trochlear N(CN IV) injury

Back 417

• leads to double vision when patient looking straight forward

Front 418

What passes through Cavernous Sinus?

Back 418

CN III, IV, part of V, and VI and Int. Carotid A.

Front 419

Thrombosis(blood clot) of Cavernous Sinus or aneurysm(widening) of artery may cause?

Back 419

compress CN III, IV, part of V, and VI and Int. Carotid A. causing Ophthalmoplegia
-Paralysis/weakness of 1 or more muscles that control eye movement

Front 420

Ciliary Ganglion

Back 420

-Site of synapse of Parasympathetic, preganglionic fibers
• (originating form Edinger-Westphal nucleus)

Front 421

Outer layer of eye

Back 421

-called corneoscleral tunic
-denses & taut connective tissue capsule,Collagen fibers
Contains:
-5/6th Sclera; 1/6 Cornea
-Cnal of schlemm

Front 422

Cornea

Back 422

(anterior)
- Transparaent and avascular
- Nutrition from Aqueous Humor of Ant. Chamber
- Innervated by Ophthalamic N. (CN V/1)

Front 423

Canal of Schlemm

Back 423

- Junction of sclera and cornea
- Scleral venous sinus
- Site of venous draining in eye

Front 424

Middle Layer of eye

Back 424

- Vascular
- 3 parts: Choroid, Ciliary Body, & Iris

Front 425

Choroid

Back 425

• Contains blood vessels
• FIRMLY attached to Retina
• Lies LOOSE in Sclerea

Front 426

Ciliary Body

Back 426

• Connects choroids to circumference of Iris
• Ciliary Process
- Folds on inner surface
- Produce Aqueous Humor
- Hold lens with suspensory ligs.
• Ciliary m.
- Relaxes suspensory ligs (zonular fibers)
- Leading to thickness of lens in accommodation process(changing focus far to near)

Front 427

Iris

Back 427

• Highly pigmented
• Determines eye color
• 2 muscles:
•Dilator Pupillae
- Dilates pupil
- Inv—Sympathetic Nerves (t1-t2)
•Sphincter(Constricter)Pupillae
- Consrticts Pupil
- Mediated by: Parasymp. Fibers from Edinger-Westphal nucleus (CNIII)

Front 428

Dilator Pupillae Fxn & Innerv.

Back 428

- Dilates pupil
- Inv—Sympathetic Nerves (t1-t2)

Front 429

Sphincter(Constricter)Pupillae

Back 429

- Consrticts Pupil
- Mediated by: Parasymp. Fibers from Edinger-Westphal nucleus (CNIII)

Front 430

Internal Layer (Retina)

Back 430

• Pars Optica – visual Posterior part
• Pars Caeca – Nonvisual Anterior Part
• Ora Serrata -Junction between potica and Caeca
• Optic Portion
- Photoreceptors (cones and rods), sensitive to light, and activated to send visual info through Optic N.
• 2 Primary Layers-Outer pigment layer&Inner Neural Layer

Front 431

Optic disk

Back 431

- Site where Optic N. exits
- “Blind Spot” lacks photo receptors

Front 432

Macula Lutea

Back 432

- Lat. To optic disk
- Has Central Fovea-Highest visual acuity because it has the most cones

Front 433

Layers of Retina nerve Cells

Back 433

- 1—Ganglion Cells
- 2--- Inner nuclear layer
- 3—Outer Nuclear Layer
- Pigment epithelium

Front 434

Inner nuclear layer

Back 434

• Bipolar Cells
• Horizontal cells
• Amacrine Cells

Front 435

Outer Nuclear Layer

Back 435

• Cell bodies of photo receptors, rods and cones

Front 436

Pigment epithelium

Back 436

• Deepest layer, absorbs light, preventing it from backscattering

Front 437

Chambers of eye

Back 437

- Ant. Chamber and Post. Chamber – Contain aqueous humor
-Internal (vitreous) Chamber-Contains vitreous body (Jelly-like, watery substance)
-Lens-Transparent Structure; Water and a crystalline protein structure

Front 438

Cataract

Back 438

-Deposition of aggregated proteins in eye
-Leads to cloudy lens, light scattering and obstruction of vision

Front 439

Lens system

Back 439

Anterior image projecting apparatus
• Acts like camera :
- Diaphragm – Iris
- Lens
- Light Sensitive Film – Retina

Front 440

Optic Pathway

Back 440

•Visual info received by Retina
•Carried by Optic N to Optic Chiasma
•Optic Tract transmits infor to Lat. Geniculate body of Thalymus
•Via aptic radiations, transmitted to Area 17 of Visual Cortex(occipital lobe)

Front 441

Temporal half of Retina

Back 441

– sends visual info to same side of brain

Front 442

Nasal half of Retina

Back 442

Sends visual info to OPPOSITE side of brain

Front 443

Blood Supply of Eye

Back 443

Central A of Retina and Ciliary A’s

Front 444

Blood Drainage of Eye

Back 444

Sup/inf ophthalmic veins—into cavernous sinus—then to cranial venous sinuses (and partially through Facial V)

Front 445

Direct and Consensual Light Reflex

Back 445

• Constriction of isilateral and contralateral pupil when light shone into ONE eye
• Info from one eye activates Bilateral Edinger-Westphal Nuclei(parasympathetic) in the brainstem
• Consensual Light Reflex-due to bilateral activation, pupil on other side also constricts
• These reflexes may be lost in head trauma
• Pupilary dilation caused by CN III palsy- May be due to tumors, aneurysms or other causes

Front 446

Accommodation

Back 446

-Occurs when looking from far to near distance
-3 things occur
1. Medial Rotation of eyes
2. Constriction of Pupil
3. Contraction of ciliary m. – Leading to thickening of lens

Front 447

Glaucoma

Back 447

• Neurodegenerative disease
• Triggers induce variety of secondary events-Ultimately leads to apoptic Retinal Ganglion Cell death
• Resulting in Blindness
• Main risk factor-Heightened pressure of eye
• Primary determinant- Aqueous Humor Outflow Resistance

Front 448

Papilledema

Back 448

• Optic disk bulges out
• Due to increased intracranial pressure

Front 449

Auricle

Back 449

Elastic Cartilage Tissue
- Distant antatomical Parts
• Helix, Antihelix, Scapha, Concha, Tragus, Antitragus, Triangular fossa and Lobule

Front 450

Ext. Auditory Meatus

Back 450

- 1st 1/3 – cartilage; Internal 2/3 – Bony
- Lined by skin(epidermis)
- Contain:
• Hair
• Ceruminous Glands-Modified Sweat Glands
- Terminates at Tympanic Membrane

Front 451

Infections and lesions of Ear Canal can cause :

Back 451

-nausea and vomiting (since CN X, innv. GI tract)

Front 452

What can canal manipulation cause?

Back 452

-may provoke gag reflex or possible cardiac arrest

Front 453

Innervation of External Ear

Back 453

• Auriculotemporal N (from CN V)
• Auricular Branch of CN X

Front 454

Innervation of Superior Muscles around Auricle

Back 454

CNVII

Front 455

Blood Supply of External Ear

Back 455

• Ant. Post. And Deep Auricular Arteries (from Ext. Carotid)

Front 456

Tympanic Membrane

Back 456

-In tympanic groove
-Separates Ext. Auditory meatus from Middle Ear Cavity
- Parts:
• Pars Tensa
• Pars facciida-Impression due to insertion of lat. Process of Malleus
• Umbo(center)

Front 457

Epithelium of Tympanic Membrane

Back 457

• Outside – thin layer of skin
- Stratified nonkeratinizing epithelium
• Inside
- Simple Squamous epithelium
• Middle
- Connective tissue, nerves and vessels

Front 458

Otoscope (auriscope)

Back 458

• Light source shining into hollow speculum
• Clinical examination of meatus
• Cone of reflected light seen on Eardrum
• Apex of cone at Umbo
• Light expands up and down
• Shape and location of cone may change depending on state of disease in ear

Front 459

2 openings – leading to Internal Ear

Back 459

- Oval Window
• To vestibule(middle part of bony labyrinth)
• Covered by stapes
- Round Window

Front 460

Auditory (Eustachian) Tube

Back 460

- Connects nasopharynx to mid. Ear cavity

Front 461

3 ossicles of Tympanic Cavity

Back 461

• Malleus, Incus and Stapes
• Transmit sound from Tympanic membrane, across middle ear and into Internal Ear

Front 462

Fxn & Innerv of Tensor Tympani m

Back 462

• Fxn: tenses tympanic membrane
• Innv. – CN V/3

Front 463

Fxn & Innerv of Stapedius M

Back 463

• Dampens stapes, drawing back footplate from oval window, reducing sound transmission
• Innv – CN VII

Front 464

Otosclerosis

Back 464

-Calcification and hardening of Annular Ligament
-Common cause of adult deafness

Front 465

Otitis Media

Back 465

-Ear infection causing inflammation of middle ear
-Causes pain

Front 466

Myringotomy

Back 466

- Incision to Ear drum
- Relieves pressure from middle ear

Front 467

Hyperacusis

Back 467

- Acute sensitivity to light

Front 468

Membranous Labyrinth

Back 468

- Filled with Endolymph(rich in K+)
- surrounded by Bony Labyrinth
• Contains Perilymph(Rich in Na+)-Clear, aqueous Fluid

Front 469

Vestibule

Back 469

– middle part of labyrinth
- Connects to: Saccule, utricle, Cochlea, 3 semi-circular ducts

Front 470

Vestibular system

Back 470

- Sense organ for equilibrium
- Sacule, Utricle and 3 semicircular ducts

Front 471

Sacule & Utricle

Back 471

• Membranous
• Carry Macula Sacculi and Macula Utriculi-Sensory receptors, responsible for detection of linear acceleration & Pull of Gravity

Front 472

Hair Cells in Sensory Receptors

Back 472

-With Sereociliae and Kinocilium
-Covered by Otothilic Membrane- a Gelatinous tissue that contains otoliths and Calcium Carbonate (CaCO3) crystals
•Movement of sterocilia toward kinocillia, activates hair cell- Stimulus through peripheral axons of bipolar cell
• Central axons form vestibular N.
• Takes info to vestibular nuclei of brainstem

Front 473

Semicircular Ducts

Back 473

• Has Ampulla-Dilated part at base
•Contains sensory receptors on ridge called Cristae Ampularis
-Responsible for detecting Angular Acceleration
-Hair cells covered by Cupula(gelatinous mass)

Front 474

Cochlea

Back 474

• Contains :Scala Vestibule, Scala tympani and Cochlear duct
• Cochlear duct flanked by vestibule and tympani

Front 475

Cupula

Back 475

• Apex
• Contains only scala vestibbuli and cochlear duct
• Scala tympani extends to round window(closed by secondary tympanic membrane)

Front 476

Cochlear Duct

Back 476

• Triangular Canal
• Stria Vascularis (forms lat wall)-Produces endolymph content of duct

Front 477

Spiral Organ or Corti

Back 477

• Single row – inner hair cells
• 3 rows – outer hair cells-w/ sterocilia
• Both cells supported by Dieter’s (phalangeal) cells
• Displacement of hair cells against tectorial membrane-Produces neuronal impulse
• Impulse received by peripheral axons, conveyed through their central Axons
• Forming Cochlear N

Front 478

Vestibulocochlear N (CN VII)

Back 478

- Cochlear N + Vestibular N
- Exits inner ear via Int. Auditory Meatus toward brain stem

Front 479

Mechanism of Hearing

Back 479

• Soundwaves cause osscilations
• Osscialtions transmitted via ear drum, to inner ear
• through oval window to perilymph(in bony labyrinth)
• Produces fluid movement in Endolymph
• Leading to oscilations of basilar membrane
• Moves Hair cells against tectorial membrain
• Stimulates Nerve Terminals of Spriral Ganglon
• Cochlear N joins Vestibular N
• Takes hearing info to Brainstem, thalamus and Brain (sup. temporal gyrus)

Front 480

What happens to sound waves at higher frequencies?

Back 480

They remain in basal convolutions

Front 481

What happens to sound waves at middle frequencies?

Back 481

They reach middle of cochlea

Front 482

What happens to sound waves at lower frequencies?

Back 482

They reach uppermost convolutions

Front 483

Taste

Back 483

- Mediated by Gustatory Receptor cells in Taste buds
- Chemicals dissolved in saliva, stimulate GRCs
- Leads to exocytosis of neurotransmitter molecules from vesicles
- N. Impulses in Peripheral axons of Sensory neurons, that synapse with GRCs
- ALL TASTE INFORMATION ,TAKEN BY CNVII, CN IX, AND CNX to nucleus of tractus olitaries in brainstem
• Then to thalamus
- Then to Primary Gustatory Area (43) in parietal lob

Front 484

ALL TASTE INFORMATION ,TAKEN BY _____

Back 484

CNVII, CN IX, AND CNX to nucleus of tractus olitaries in brainstem

Front 485

Chapter 10

Back 485

Nervous System

Front 486

Central Nervous System components

Back 486

Brain, brain stem and spinal cord which are suspended in CSF found in the subarachnoid space

Front 487

Peripheral Nervous System components

Back 487

•Spinal Nerves, Cranial nerves and peripheral ganglia
•Dermatomes

Front 488

3 overlapping functions in Nervous System

Back 488

1. Receives Sensory input (afferent) from outside and inside the body
a. Afferent signals carried by nerve fibers of PNS to the CNS
2. Processes and interprets Sensory input
a. Making Decisions/Integration
3. Dictates a response by activating effector organs
a. Response – Motor Output: Causing muscle to contract or a gland to function
-Motor (efferent) signals are carried away from the CNS

Front 489

Arachnoid granulations

Back 489

protrusions of the arachnoid matter into the sagittal sinus

Front 490

Cells of Nervous system

Back 490

– Neurons and Neuroglia (Glial Cells)
Both densely packed in Nervous tissue

Front 491

Neurons

Back 491

• Anatomical unit of Nervous system
• Basic structural units of the nervous system
• Neuron processes(called neurites) – Axons and dendrites
• Able to be excited, transmit electrical impulses, and can travel across membrane and contact another cell, synapse, and communicate with other cells
• Conduct Electrical impulses along plasma membrane

Front 492

Spinal cord segment made of

Back 492

- Motor neuron
- Sensory neuron
- Interneuron

Front 493

Fetal Neurons

Back 493

- lose ability to divide through Mitosis
- can live and function for a long time but have a high metabolic rate and need a large amount of glucose and oxygen

Front 494

Cell Body of Neuron

Back 494

- Contains normal organelles, rER of neuron(Nissl bodies), neurofibrils and lipofuscin granules

Front 495

Axon(nerve fibers)

Back 495

- Endoneurium – surrounds axon
- Transmits neuronal impulses AWAY from neuron
- Ends at axon terminal -bouton
- 1 in every neuron
- no protein synthesis
- Size of Axon and Myelin Sheath – important for conduction velocity and Nerve Impulses

Front 496

Dendrites

Back 496

-short & increase receptive area of the neuron
-transmit impulses toward the neuron & lack Nissl bodies

Front 497

Myelinated axons

Back 497

• Myelin: 80% lipids, 20% proteins
• Myelin sheath insulates axons, preventing flow of ions to and from surroundings
• Speeds up nerve impulse

Front 498

Node of Ranvier

Back 498

– where myelin is missing
• Axon exposed and flow of ions possible

Front 499

What happens when axons are exposed?

Back 499

•Inability of ions to flow → AP jumps from one node to another via Saltatory conduction →Depolarization faster

Front 500

Unmyelinated Axons

Back 500

• AP continuous along axon, depolarizing entire axon → slower depolarization

Front 501

Classification of Nerve Fibers(axons)

Back 501

-A’ fibers , B' fibers, & C' Fibers

Front 502

A’ fibers

Back 502

• ‘A’ fibers
• Myelinated
• Subclassified to:
- Alpha – Fastest conduction velocity of ‘A’ fibers
- Beta
- Gamma
- Delta – Slowest conduction velocity of ‘A’ fibers

Front 503

‘B’ fibers

Back 503

• Myelinated

Front 504

‘C’ fibers

Back 504

• Unmyelinated, thin and slowest conduction velocity

Front 505

Initial segment

Back 505

• Most excitable site in neuron
• Controls AP and cell firing
• Nerve Impulse
-generated here and conducted along axon
-Releases neurotransmitters at axon terminals
-Neurotransmitters – excite or inhibit neurons

Front 506

Nerve Impulse

Back 506

• Occurs in Initial Segment
• Generated here and conducted along axon
• Releases neurotransmitters at axon terminals
• Neurotransmitters – excite or inhibit neurons

Front 507

Bouton

Back 507

• Axon terminal (where axon ends)
• Contains cytoskeleton (actin microfilaments, neurofilaments and microtubules)

Front 508

Axonal transport

Back 508

• via cytoskeleton – important for intracellular transport of vesicles or organelles

Front 509

Classification of Neurons

Back 509

- Based on number/branching of neuritis(axons and dendrites) & size.
->Unipolar, Bipolar, Multipolar or Golgi Type 1 & Golgi Type 2

Front 510

Unipolar Neurons

Back 510

• Single neurite branching from cell that divides shortly into peripheral and central axon
• Found in Dorsal root and sensory ganglia

Front 511

Bipolar Neurons

Back 511

• Single neurite branching from one pole of cell
• Found in Retina and Olfactory & Auditory systems

Front 512

Multipolar Neurons

Back 512

• Several dendrites and one axon
• Found in ventral horn of spinal cord and Brain

Front 513

Golgi Type 1 Neurons

Back 513

Single, long axon

Front 514

Golgi Type 2 Neurons

Back 514

Short axon, and short dendrites

Front 515

Action Potential

Back 515

• Short lasting excitation of cell
• membrane potential rises rapidly then falls-resting membrane potential is -80mV; due to the concentration in ions in neuron

Front 516

Charge outside of neuron

Back 516

Positive

Front 517

Charge Inside of Neuron

Back 517

Negative

Front 518

Na+/K+ pump

Back 518

maintains membrane polarity (Na→OUT & K→IN, against concentration gradient)

Front 519

Depolarization

Back 519

• Stimulus applied to axon→nerve impulse or action potential →increased permeability to Na+→opening Na+ channels→Increased Na+ into cell→Inside becomes positive, outside—negative.
-Leads to Depolarization of membrane

Front 520

Repolarization

Back 520

• When membrane opens K+ channels, open more after Na+ channels closed, thereby repolarizing itself

Front 521

Absolute refractory period

Back 521

- Beginning of repolarization
- Na+ channels closed, no AP can be produced
- Can’t send signal

Front 522

Relative refractory period

Back 522

- Only strong stimulus can produce AP and send signal

Front 523

Synapse

Back 523

- neurons come in close contact with each other, forming conducting pathways (connection between neurons)
- Site at which neurons communicate
- Signals pass across synapse in one direction

Front 524

Presynaptic neuron

Back 524

-conducts signal toward synapse

Front 525

Postsynaptic neuron

Back 525

– transmits electrical activity away from a synapse

Front 526

Excitatory

Back 526

– depolarize postsynaptic membrane

Front 527

Inhibitory

Back 527

-hyperpolarizing, reduce ability of postsynaptic neuron to generate AP

Front 528

Chemical Synapse

Back 528

• Unidirectional
• Neurotransmitters released from presynaptic neuron which conduct impulses toward synapse
• More common

Front 529

Electrical Synapse

Back 529

• No Neurotransmitters
• In form of gap junctions(tunnels) formed by connexons
• Connexons allow rapid ion flow between cells
• Ions – what’s sending the signal

Front 530

Neuroglia(Glial cells)

Back 530

• Nonexcitable
• Support neurons & cover nonsynaptic regions

Front 531

CNS Neuroglia

Back 531

- 4 types
• Astrocytes
• Ogliodendrocytes
• Microglial cells
• Ependymal cells

Front 532

Astrocytes

Back 532

• Most common glial cell
• Small cell body, numerous branching processes
• Supportive framework for neurons
- Supply glucose to neurons
- Take up/release ions to control environment around neurons
• In embryonic development they serve as scaffolding for the migration of immature neurons
- Cover the synaptic contacts between neurons
- Absorb excess neurotransmitters or electrolytes from extracellular fluid
• Processes form perivascular feet over vessels of brain capillaries
• Helps in formation of blood brain barrier

Front 533

Glial Scar (Glyosis)

Back 533

Tough tissue formed by astrocytes when neurons die so the regenerative cells cannot penetrate the tissue

Front 534

Blood brain barrier

Back 534

Phenomenon found in brain that protects impermeable (blood cells) because brain doesn’t have lymphatic system

Front 535

2 Types of Astrocytes

Back 535

-Fibrous
• Long processes & many filaments
• Mainly in white matter
-Protoplasmic
• Shorter processes & fewer filaments
• Mainly in grey matter

Front 536

Ogliodendrocytes

Back 536

• Small cell body, no filaments in cytoplasm
• Form Myelin sheath around axons in CNS

Front 537

Microglial cells

Back 537

• Smallest & Least common
• Phagocytic activity and immune defense

Front 538

Ependymal cells

Back 538

• Line central cavities of brain and spinal cord
• Contain cilia and microvilli

Front 539

PNS Neuroglia

Back 539

2 types
• Schwann cells
• Satellite cells

Front 540

Schwann cells

Back 540

• Form myelin around axons in PNS(surround axons)
• Help regenerating axons regrow and find destination
• Enable nerve to grow back

Front 541

Satellite cells

Back 541

• Surround neuron cell bodies in sensory ganglia

Front 542

Peripheral Nerve Fibers consist of :

Back 542

-Nerve Fascicles (groups of axons bound into bundles that are covered by connective tissue membranes)

Front 543

Fascicles covered by

Back 543

-connective tissue membranes: Epineurium, Perineurium & Endoneurium.

Front 544

Epineurium

Back 544

• Tough, Fibrous
• Surrounds entire nerve

Front 545

Perineurium

Back 545

• Surrounds nerve fascicle

Front 546

Endoneurium

Back 546

• Thin
• Surrounds axon

Front 547

Afferents

Back 547

- Peripheral(autonomic) nerve fibers
- Carry sensory signal toward CNS

Front 548

Efferents

Back 548

- Motor nerve fibers
- Carry info away from CNS
- Innervate muscles and glands

Front 549

Somatic Motor

Back 549

• Motor Innervation of All skeletal muscles, except Pharyngeal Arch m.

Front 550

Visceral Motor

Back 550

• Motor Innervation of Smooth muscle, cardiac muscle and glands
• Equivalent to autonomic nervous system (ANS)

Front 551

Branchial Motor

Back 551

• Structures developed within branchial arches of head and neck during development including Cranial Nerves
• Motor Innervation of pharyngeal arch muscles

Front 552

Somatic Sensory

Back 552

• Touch, pain, pressure, vibration, temperature
• Procioception in Skin, body wall and limbs
• Special: Hearing, equilibrium, vision & smell

Front 553

Visceral Sensory

Back 553

• Stretch, pain, temperature, chemical changes, nausea and hunger
• Special : Taste

Front 554

Types of Motor Nerves that Innervate Muscles

Back 554

• Large Alpha – innv. Extrafusal muscles
• Small Gamma – Intrafusal muscles
• C fibers
- Postganglionic autonomic efferents that supply Smooth m. in wall of blood vessels, visceral organ & glands.
- Thin nonmyelinated

Front 555

Motor End Plate

Back 555

-Neural Element, Muscular element & synaptic Cleft.

Front 556

Neural Element

Back 556

Myelinated axon loses its myelin

Front 557

Muscular element

Back 557

Naked axon in groove of sarcolemma

Front 558

Synaptic Cleft

Back 558

space between axon and sarcolemma

Front 559

Sensory Nerves

Back 559

- Distributed in epithelium and connective tissue (including bones, joints, muscles and visceral organs)
- Receive info from Receptors (sensory nerve endings)

Front 560

Mechanoreceptors

Back 560

-respond to mechanical stimulus

Front 561

Free Nerve endings (A-delta and C fibers)

Back 561

- Convey primarily pain
- Also touch, pressure and temp.

Front 562

Hair follicle receptors

Back 562

- Mechanoreptors for touch
-Bending of the hair

Front 563

Meissner’s corpuscles

Back 563

-modified, flattened Schwann cells
-Mechanoreptors that are found in Touch in palm, sole of foot, nipple and ext. genitalia

Front 564

Pacinian corpuscles

Back 564

-onion like
-Mechanoreptors that Detect vibrations in:Dermis, ext. genitalia, ligs., joint capsules etc.

Front 565

Ruffini’s corpuscles

Back 565

- Mechanoreptors that Stretch in dermis of hairy skin

Front 566

Thermoreceptors

Back 566

sense temp. change

Front 567

Pain/nociceptors

Back 567

sense pain

Front 568

Chemoreceptors

Back 568

-sense chemical changes by:
• taste/smell or oxygen and CO2 in blood
• Carotid Body (Innerv. by CN IX, X, and sympathetic n.)

Front 569

Baroreceptors

Back 569

-in big vessels that are stimulated with BP high
• Forms nerve to carotid sinus (Hering’s nerve) from CN X

Front 570

Electromagnetic receptors

Back 570

Photoreceptors that detect light

Front 571

Muscle Receptors

Back 571

• Neuromuscular spindles
• Neurotendinous spindles (Golgi tendon organ)

Front 572

Neurotendinous spindles (Golgi tendon organ)

Back 572

– in tendon
-Sense tension to prevent tearing/avulsion of tendon

Front 573

Neuromuscular spindles

Back 573

-encapsulated structures in skeletal m. that provide sensory info to the CNS for muscle activity control
- consist of 2 types of sensory innervation : annulospiral & flower spray

Front 574

Stretch Reflex

Back 574

- Elongation of intrafusal m. fibers stimulates afferent endings → sensory info to spinal cord → activate gamma motor neurons
- Gamma efferent fibers contract intrafusal m. fibers →reflex contraction of extrafusal m. fibers

Front 575

Normal Reflex

Back 575

Both intrafusal and extrafusal m. contract simultaneously

Front 576

Reflex Arc

Back 576

- Determines structural plan of nerves
- Somatic or visceral
- Working chain of coordinating neurons
- Responds to efferent impulses
- Contracting or secreting

Front 577

5 Components of Reflex Arc

Back 577

1. Receptor – where stimulus acts
2. Sensory nerve – transmits afferent impulses to CNS
3. Integration center(interneuron)—consists of one or more synapses in CNS
4. Motor neuron – conducts efferent impulses from integration center to effector
5. Effector organ – i.e. muscle or gland

Front 578

2 Types of Reflex Arc

Back 578

• Monosynaptic
• Polysynaptic

Front 579

Polysynaptic

Back 579

– More common
•Usually one interneuron between sensory/motor neurons
•Withdrawal reflexes (hot stove, touch something sharp)

Front 580

Monosynaptic

Back 580

-simplest
• Response of one synapse in spinal cord
• Patellar knee jerk
• Fastest of all reflexes

Front 581

Autonomic Nervous System

Back 581

• Sympathetic/Parasympathetic systems that Innerv. Visceral organs, blood vessels and glands
• Carry sensory innervation from organs/structures to CNS
• Regulate blood activity with endocrine system
• Autonomic and Efferent n.
• Postganglionic fibers – short. Inv: organs

Front 582

Sympathetic System

Back 582

- Prepares body for emergency (fear/exercise)
- “fight or flight”

Front 583

Parasympathetic

Back 583

- Energy conservation, activated when relaxed(sleep)

Front 584

Referred Pain

Back 584

- Pain of several visceral organs→ dermatome→sends sensory info typically to same level of spinal cord where organ receives its autonomic innv.

Front 585

Charcot Marie Tooth-X (CMT1-X)

Back 585

- Mutation in Cx-32:
• Cx-32 found in several tissues such as liver, brain and peripheral nerves
- Symptoms:
• Peripheral N. demyelination
• Axonal degeneration because of an autoimmune attack
• Preaxonal collars

Front 586

What happens if posterior part of parietal love is damaged?

Back 586

If eyes are closed when they touch a key they will not be able to tell what it is. Especially if right part is damaged.

Front 587

If cerebellum is damaged:

Back 587

person will fall on same side as injury, if you ask a person to take a cup of coffee the person will shake and spill coffee ->essential tremor _> uncontrollable shaking

Front 588

Motor aphasia

Back 588

-damage to a region in motor association cortex in left frontal love
-difficulty remembering words & losing the ability to speak, read, or write.

Front 589

Angular gyrus of parietal lobe

Back 589

-involved in sensory, speech and comprehension of language.

Front 590

Hypothalamus

Back 590

-main command center of brain: sympathetic, parasympathetic: eating, drinking, not eating, not drinking, contraction of uterus.
-Controls all endocrine activity of body, hormone secretion.

Front 591

Ophthalmoplegia

Back 591

• CN 3,4,5,6-> pass through cavernous sinus. Infection here may compress nerves and may cause ophthalmoplegia-> person cannot move the eye.

Front 592

Deploplegia

Back 592

Double Vision