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119 Cards in this Set
- Front
- Back
Median Umbilical Fold |
Covers median umbilical ligament. Urinary Bladder to the Umbilicus |
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Medial Umbilical Fold |
lateral to Median Umbilical ligament. Covers remnant of umbilical arteries |
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Lateral Umbilical Fold |
covers Inferior epigastric vessels. Deep Inguinal Canal is lateral to it |
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Iliopubic Tract |
Thickened Transversalis Fascia at inferior margin |
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Supravesical Fossae |
Between Median and Medial Umbilical Folds. ***Site of Supravesical Hernia (direct) |
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Medial Inguinal Fossae |
or Hasselbach Triangle. Between Medial and Lateral Umbilical folds. ** Site of indirect Inguinal Hernia |
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Lateral Inguinal Fossae |
Lateral to lateral Umbilical fold. Deep inguinal ring is the most common site of INDIRECT inguinal hernia. |
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Arcuate Line |
2/3 way up from the pubis to the umbilicus. Above, the muscular fascia splits anterior and posterior to the Rectus Abdominis. Below all layers go anterior |
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Inguinal Canal Borders |
Ant: Aponeurosis of External Oblique Post: Tranversalis Fascia - medially reinforced with CONJOINT LIG. Floor: Laterally = Iliopubic Tract --> Infolded Inguinal Lig. --> Lacunar Ligament (Pectineal) Roof:Tranversalis Fascia (lat) - centrally with CONJOINT LIG. and medial with Medial Crus. |
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Inguinal Lig |
ASIS to the pubic tubercle. Thickened External Oblique Aponeurosis |
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Superficial Ring |
Lower opening of the Inguinal Canal from by the medial and lateral crua (legs), intercrural fibres of the external aponeurosis |
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Lacunar Lig |
Stems distally and medially to the femoral canal...continues as the Pectineal Lig. |
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Reflected Inguinal Ligament |
After fibres of the external aponeurosis have curled under to make the inguinal ligament they will fan upwards and attach to the other external oblique aponeurosis |
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Embryology of Gonads |
Descend into lowermost, anterior part of the anterior abdominal wall by week 7. For temperature control. Ovaries to Pelvic Cavity and Testes follow Gubernaculum Testis Cord. |
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Inguinal Canal Content |
Ilioinuinal N. *only nerve not supplying testes Round Lig of Uterus Spermatic Cord : -Ductus (Vas) Deferences) and Artery -Testicular Artery -Pampiniform Plexus (venous plexus of testes) -Cremasteric Artery -Autonomic N. Fibres (sympathetic and para) Genital Br. of Genitofemoral |
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Layers of Spermatic Cord |
External Spermatic Fascia --> Cremaster M --> Cremasteric Fascia-->Internal Spermatic Fascia --> Obliterated Processus Vaginalis |
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Layers of Scrotum and Testes |
Skin > Dartos M. > Dartos Fascia > External Spermatic Fascia --> Cremaster M --> Cremasteric Fascia-->Internal Spermatic Fascia > Tunica Vaginalis |
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Thoracolumbar Fascia: Anterior |
Anterior Surface of TVP > covers ant. QL > invests the Transverse Abdominis. Attaches to Iliac Crest, 12th Rib and makes the Lateral Arcuate Lig., in Diaphragm |
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Thoracolumbar Fascia: Middle Layer |
Attaches to Tip of TVP > covers posterior of QL > invests the Internal Oblique |
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Thoracolumbar Fascia: Posterior Layer |
From tips of the SP > covers erectors > invests the Lats |
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Transversalis Fascia |
Recall (deep to the peritoneum and peritoneal fat). It will Change names as it travels backwards and covers various structures. Transversalis Fascia > Renal Fascia > Psoas Fascia > then attached to Vert. Bodies and Pelvis Brim Line. *Makes Medial Arcuate Lig. of Diaphragm |
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Psoas Major |
TVPs, lat Vert. Bodies and IVDs > Lesser Trochanter Innervation: APR L1, L2, L3 Action: Flexes Thigh, Trunk, lateral flexes vertebrae, balance |
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Psoas Minor |
Lateral T12 and L1 Vert. Bodies and IVD > Pectineal Line of Pubis and Iliopectinal Arch (helps make the Lacuna Lig.) Innervation: APR L1 Action: Flexes Vertebrae |
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Iliacus |
Sup 2/3 of Iliac fossa, ala of sacrum and ant. SI ligament > tendon of Psoas Mj to Lesser Trochanter of the Femur Innervation: Femoral N. (L2-L4) Action: With Psoas Mj. Flexes Thigh, Trunk, Stabilizes Hip, weak external rotator of hip |
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Quadratus Lumborum |
Medial 12th Rib and TVPs of Lumbar (L1-L4) > Iliolumbar Lig and internal lip of Posterior iliac crest Innervation: Anterior branches of T12-L4 nerves Action: Extends and Lat. Flex of Vertebrae, fixes 12th rib during inspiration (opposite to diaphragm pull) |
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Diaphragm |
Innervation: Phrenic Nerve (C3-C5). (Motor and Sensory) , Intercostal N.(peripheral sensation) Blood: Pericardiophrenic A. (internal Thoracic) Musculophrenic A. (anteriorly) Superior Phrenic A. Inferior Phrenic A. |
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Subcostal Nerve |
APR of T12...not in Lumbar plexus, below 12th rib... Runs like an intercostal nerve of the 12th rib. Passes through TA of the abdominal wall to run between it and IO Supplies: ant. lat ab wall and skin descends over iliac crest and hip |
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Lumbar Nerve Plexus |
Sympathetic Innervation - iliohypogastric, ilioinguinal -genitofemoral -lateral femoral cutaneous - femoral (to psoas and iliacus) - obturator (and accessory obturator) - Lumbosacral Trunk |
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Iliohypogastric N. (T12, L1) |
Pierces TA and innervates it and the IO Supplies: skin over the iliac crest and superior lateral buttocks (cluneal N do the rest), skin over inguinal lig. and pubic region |
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ilioinguinal N. (T12, L1) |
Runs parallel to the iliac crest Pierces TA at about ASIS, drops into the inguinal canal (doesn't enter via deep inguinal ring).Divides into Femoral and Scrotal/Labial divisions Supplies the lower TA and IO, ant scrotum/labia and anterior-medial thigh. |
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Genitofemoral N. (L1, L2) |
Pierces the Psoas Mj. but remains below the psoas fascia. Femoral Br. passes under the inguinal lig to supply the femoral Triangle Genital br. travels through inguinal canal to the Cremaster M and the skin of Scrotum/Labia |
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Lateral Femoral Cutaneous N (L2, L3) |
Travels inferior and lateral across the iliac crest. Passing under the Inguinal Lig. 2-3cm medial to the ASIS. Supplies the Anterior and Lateral Skin of the thigh Has Post and Ant Br. |
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Femoral N. (L2, L3, L4) |
Emerges lateral to the Psoas and travels down its lateral border. Anterior to Iliacus then passes under the inguinal ligament Supplies: Hip Flexors and knee Extensors (anterior thigh muscles) and the Skin over the Anterior and Medial thigh with anterior cutaneous branches. |
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Obturator N (L2, L3, L4) |
Emerges on the medial border of the psoas and travels under it. Drops into the lesser pelvis and travels over the pelvis brim to the Obturator Foramen where it exits through the Obturator groove into the medial thigh Supplies: Adductor muscles and the skin of the medial thigh *10% have an accessory |
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Lumbosacral Trunk (L4, L5) |
Roots unite near the pelvis brim. Lumbar Components travel inferiorly over the saral ala to meet the sacral plexus ***Why we might get Sciatica from L4/L5 disruptions. |
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Abdominal Cavity Borders |
Superior: Diaphragm, Inferior Thoracic Aper. Inferior: Superior Pelvic Aperature (Pelvic Cavity * not true border) Ant: Costal Margins, Xiphoid , Abdominal Wall, ASIS, inguinal lig., pubic tubercles, superior pubic crests and pubic symphysis Post: Post Ab. wall, lumbar vertebrae, Psoas, QL |
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Parietal Peritoneum |
Covers the walls of the Abdominal Cavity. We can have folds in the Peritoneum (median, medial and lateral umbilical). Pernitoneal Fossa can be formed between folds or organs covered. Diaphragmatic or Abdominal or Pelvic |
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Visceral Peritoneum |
Covers the organs. Only autonomic innervation |
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SupraColic Compartment |
A greater peritoneal sac containing liver, gall bladder and cystic duct, stomach, spleen 1st part of duodenum. Inferior border is the Transverse Mesocolon Mesentary |
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InfraColic Compartment |
A greater peritoneal sac containing the jejenum, ileum, caecum, appendix and the ascending and descending colon. The superior border is the Transverse Mesocolon Mesentary |
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Omental Bursa |
The lesser peritoneal sac (caused by the 90 deg. right turn made by the stomach during development). Posterior to the Stomach and Lesser Omentum and Superior to the Transverse Mescolon Mesentary. |
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Omental Foramen |
Free edge of the Lesser Omentum forms the anterior border (also called the Heptaduodenal Lig.). The Liver is above, the 1st part of duodenum is below and the IVC and right crus of diaphragm is behind. How the greater and lesser peritoneal sacs communicate |
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Diaphragmatic Peritoneum |
Refers to the Shoulder, clavicle |
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Abdominal Peritoneum |
Innervated by Intercostal and Subcostal N, Ilioinguinal and iliohypogastric N Causes sharp localized pain. |
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Pelvic Peritoneum |
Innervated by the obturator nerve Refers to the low back and inner thigh |
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Intraperitoneal Organs |
Completely covered with visceral peritoneum. Esophagus, Stomach, 1st part of duodenum, liver, spleen, jejunum, ileum, caecum, transverse colon, sigmoid colon |
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Retroperitoneal Organs |
Between the posterior abdominal wall and the parietal peritoneum which covers there anterior surface. Kidneys, ascending and descending colon, duodenum parts 2-4, ab. aorta, IVC |
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Subperitoneal Organs |
Between the inferior pelvic wall and covered superiorly with parietal peritoneum |
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Omentum |
Double layer that extends away from the stomach and first part of duodenum |
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Greater Omentum |
From Greater curvature of the stomach to the Omental Tenia of the anterior transverse colon |
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Lesser Omentum |
connects the lesser curvature of the stomach to the the liver (inferior) |
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Mesentery |
double layer of peritoneum as a result of the invagination of a developing organ that contains a NeuroVascular bundle. Connects set organ to the posterior abdominal or pelvic wall |
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Transverse Mesocolon Mesentery |
Attaches the Transverse Colon (from posterior Tenia Mesocolica) to the posterior abdominal wall just inferior to the pancreas |
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Mesentery Proper |
Attaches the jejunum and the ileum and their loops to the posterior wall. Along with their vessels ( the superior mesenteric artery) |
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Mesosigma Mesentery |
Holds the sigmoid colon to the right iliac fossa (posterior pelvic wall) with its vessels branching from the inferior mesenteric artery |
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Peritoneal Ligament |
Double layer of peritoneum that connects one organ with another or the abdominal wall. Often lacks a neuromuscular bundle |
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Falciform Ligament |
Reflected diaphragmatic peritoneum that has been used to form visceral peritoneum of the liver. Keeps liver attached to diaphragm |
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Hepatoduodenal Ligament |
Thickened edge of Lesser Omentum attaching the Liver to the Duodenum. Contains portal Triad (portal vein, hepatic artery, and bile duct) |
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Gastrosplenic Ligament |
Reflection of Stomach's visceral peritoneum onto the hilum of the spleen |
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Gastrocolic Ligament |
Fixed part of the superior Greater Omentum that results in the attachment of the greater Curvature of the Stomach to the Transverse Colon |
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Splenorenal Ligament |
Reflection of parietal peritoneum onto the hilum of the spleen. |
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Ligaments of the Liver |
Falciform, R/L Coronary and R/L Triangular (all anchor to diaphragm) Round Ligament. Between Coronary Ligaments is the Bare area of the liver. |
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Suprahepatic Recesses |
Or Infradiaphragmatic. Space between the top of the liver and the diaphragm. Air from stomach or intestines can accumulate here (gastric perforations) |
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Falciform Ligament |
Divides the liver into the right and left lobes |
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Hilum of the Liver |
Contains the portal triad: Hepatic Artery, Portal Vein, Hepatic Duct |
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Hepatic Artery |
Delivers oxygenated blood to the liver |
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Portal Vein |
Brings newly absorbed nutrients from the GI tract to the liver |
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Hepatic Duct |
Eliminates secretory product - BILE from the liver to the gall bladder |
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Diaphragmatic Surface of the Liver |
Superior/Posterior/Lateral -Contains the Falciform Lig., right and left lobes, the rib impressions (laterally) and the bare area (posteriorly). |
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Visceral Surface of the Liver |
Inferior Surface - Contains 4 Lobes: Left, Right, Caudate (posteriorly) and Quadrate (anteriorly)
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Right Lobe of the Liver |
to the right of the Groove for the Gall Bladder (ant) and the IVC (post). Has Impressions from the right Kidney (renal), the Colon, and the duodenum. |
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Left Lobe of the Liver |
Left of the the Ligament Teres (or the Round Ligament) *remnant of the Umbilicus and the Ligament Venousum. Has Esophageal and Gastric impressions |
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Caudate Lobe of Liver |
Posterior Between the IVC and the and the Ligament Venosum |
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Quadrate Lobe of the Liver |
Anterior to the hilum of the liver between the gall bladder and the round ligament *remember that the round ligament also has peritoneum within it. |
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Venous Drainage of the Liver |
3 Hepatic Veins - Right, Middle and Left that all come from within the liver to open into the IVC |
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Common Hepatic Duct |
the union of the Right and Left Hepatic Ducts - Secrete Bile from the Liver |
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Cystic Duct |
Option 1 for the passage of Bile from the Liver. Transports bile to be stored in the Gallbladder. Is continuous with the Neck of the Gallbladder |
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Common Bile Duct |
Option 2 for passage of Bile from the Liver. Can receive Bile from either the Liver via the Common Hepatic Duct or From the Gallbladder via the Cystic Duct. Path - Behind Duodenum part 1> through head of Pancreas > Hepatopancreatic Ampulla which is the opening (enlargement) into the small intestine. There is a Sphincter at the opening called Oddi's sphincter. |
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Gall Bladder |
Stores bile. Has a fundus, body and neck. |
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Anatomical Structures of the Stomach |
External lesser curvature, greater curvature, cardia (with cardia sphincter, cardiac notch, fundus, body , pylorus (antrum =wider, canal = narrows) with pyloric sphincter. Internal Rugae = thick mucosa with longitudinal folds |
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Abdominal Esophagus |
1 inch in length enters the cardia of the sphincter |
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Cardia Sphincter |
Functional Sphincter that has a ring of smooth muscle |
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Plyoric Sphincter |
Anatomical Sphincter that is structurally formed to act as a sphincter... its doesn't squeeze (no muscle contraction) |
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Arteries of the Lesser Curvature of the Stomach |
Left and Right Gastric Arteries |
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Arteries of the Greater Curvature of the Stomach |
Right and Left Gastro-Omental Arteries |
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Pelvic Cavity Borders |
Superior = abdominal cavity Anterior = pubic bones and pubic symphysis Posterior = sacrum and coccyx Inferior = pelvic diaphragm ( levator ani |
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Pelvic Intra-peritoneal Organs |
Superior 1/3 of Rectum, Uterus, Uterine Tubes and Ovaries(not covered by peritoneum) |
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Pelvic Retroperitoneal Organs |
middle 1/3 of the rectum, upper part of the pelvic ureter (lumbar part) |
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Pelvic Subperitoneal Organs |
Lower pelvic ureter, urinary bladder, prostate, pelvic part of Vas deferens, seminal vesicles, pelvic part of vagina |
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Peritoneal Pouches of the Pelvis |
Recto-vesical (males only), Recto Uterine (female), Vesico-uterine (female) |
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Broad Ligament of the Uterus |
Double layer of peritoneum that results from the invagination of the Uterine Tubes entering the the uterus... |
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Round Ligament of the Uterus |
Anterior to the broad ligament. Attaches uterus to the lateral pelvic walls |
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Rectum |
Recto-sigmoid junction is at the level of S2-3. Formed from the continuation of the Tenia Coli of the Sigmoid Colon Ampulla Rectalis and the Anal Canal |
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Rectal Shape |
S shape...with 3 lateral flexures 1) superior convex to the right because of superior internal, transverse rectal fold on the left 2) intermediate convex to the left because of the intermediate internal, transverse rectal fold on the right 3) Inferior ...same as the superior but due to inferior transverse fold |
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Puborectalis |
Subcomponent of the Levator ani (inferior diaphragm of the pelvis) Separate the Ampulla and the Canal. Pulling it forward (attached on the superior pubic rami next to the symphysis) |
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Blood Supply of the Rectum |
Superior Rectal ( from inferior mesenteric) - Ampulla Middle Rectal ( ant. branch of the internal iliac) - Ampulla Inferior Rectal (br. of the internal pudendal that branches from the internal iliac) |
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Above Pectineal Line |
arteries - inferior mesenteric veins - drains to portal vein lymph - internal iliac lymph nodes nerves - Visceral (sym, para) to the inferior mesenteric ganglion |
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Below the Pectineal Line |
arteries - internal iliac (middle directly and inferior indirectly) veins - to the IVC lymph - to the superficial inguinal lymph nodes nerves - somatic (motor and sensory) pudendal nerve |
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Suppositories |
Drugs delivered through the anus will reach the rectal ampulla and be absorbed through the portal vein into the liver (metabolism) |
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Pelvic Ureter |
Retroperitoneal -passes into the pelvis anterior to the bifurcation of the common iliac artery - passes obliquely, inferior, medially through the wall of the bladder - is first covered by a bridge (either uterine artery in females of the Vas Deferens in Males) |
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Bladder |
Distensible musculo-membranous organ Reservoir for urine Mucosa with many folds except in the Vesicular Trigone |
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Empty vs Full Bladder |
Empty - in lesser pelvis, posterior to the pelvic bones Full - can reach up to the UMBILICUS and creates a supravesiclar recess between bladder and the ant. abdominal wall |
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Vesicle Trigone |
Smooth mucosa at the base of the badder (over the prostate) Posterior tips of triangle border by the Uretic Orifices Anterior tip is internal Urethra Orifice |
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Interuretic Fold |
Between left and right uretic orifices. Can become overgrown with enlarged prostate, resulting in a secondary cavity that holds urine in...preventing the complete draining of the bladder |
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Bladder Apex |
anteriorly, attached to the umbilicus by median umbilical ligament |
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Body of Bladder |
superiorly covered with peritoneum Held by the obterator internus, levator ani tendinous arch and levator ani |
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Base of the Bladder |
receives the ureters at the postero-lateral angles |
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Neck of the Bladder |
Lies on the prostate, fundus and the inferior lateral portions meet |
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Male Urethra |
20 cm Pelvic Part - Intramural (INTERNAL URETHRA SPHINCTER) and Prostatic Membranous part - EXTERNAL SPHINCTER Spongy Urethra or Perineal |
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Female Urethra |
4 cm Pelvic Part - INTERNAL URETHRA SPHINCTER Perineal Part - EXTERNAL SPHINCTER |
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Pudendal Nerve |
S2, 3, 4- keeps the pee off the floor (same with poop)...Innervation of the urethra and bladder Onuf's nucleus is the origin, will have trouble if artery of Adamkiewicz is malfunctioning |
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Prostatic Urethra |
Urethral crest > Seminal Colliculus (with prostatic Utricle (male vag) and the openings of the ejaculatory ducts Prostatic Sinuses- on either side of urethra with prostatic ducts (contribute to seminal fluid) |
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Scrotal Ductus Deferens |
starts at the testes |
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Inguinal Ductus Deferens |
travels in the inguinal canal, superior to the deep inguinal canal |
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Abdomino -Pelvic Ductus Deferens |
Enters at the deep inguinal canal > lateral to the inferior epigastric > over the external iliac vessels> pelvic brim> descends on the lateral wall of the pelvis (medial to ureter, umbilical artery, obturator vessels) posterior to the bladder |
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Seminal Glands |
Lateral to the Ductus ampulla. They join posterior to the prostate and enter urethra through the ejaculatory ducts. |
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Prostate |
Walnut sized Anterior- puboprostatic lig. and pubic symphysis Posterior - Ampulla of Rectum Inferior Lateral - Levator Ani Superior - neck of bladder inferior - EXTERNAL URETHRAL SPHINCTER |
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Lobes of the prostate |
Anterior - ant. to urethra Right and Left - on either side of the urethra Middle - Subdivisions of R/L that lie posterior to the Urethra and above ejaculatory ducts |
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Zones of the Prostate |
Peripheral - outside, 70% cancer Central - (middle lobe) - resistant to cancer Transitional - around urethra - Benign Prostic Hyperplasia Periurethral - right around urethra -similar to transitional. |