Utmb Anatomy Test 2

Front 1

What is the origin of the internal thoracic arteries?

Back 1

Subclavian artery

Front 2

what 2 areas or structures does the internal thoracic artery nourish?

Back 2

intercoastal spaces anteriorly via small intercoastal branches and from the musculophrenic artery and the rectus abdominis via the superior epigastric artery

Front 3

what muscles hold the internal thoracic artery to the inside of the chest wall?

Back 3

Transverse thoracic

Front 4

what is the sensory innervation to the pleura lining the thoracic cavity (coastal part)?

Back 4

intercoastal nerves

Front 5

what is the sensory innervation to the pleura lining the mediastinum?

Back 5

phrenic nerve

Front 6

what is the sensory innervation to the pleura lining the diaphragm?

Back 6

phrenic (central part) and intercoastal nerves (peripheral)

Front 7

what is the sensory innervation to the pleura lining the costal and diaphragmatic surface of lungs?

Back 7

visceral afferents

Front 8

what is the sensory innervation to the pleura lining the oblique fissures?

Back 8

visceral afferents

Front 9

in general, by how many ribs higher does the inferior border of the lungs lie than the lowest extent of the parietal pleura?

Back 9

2

Front 10

in the mid axillary line, the mid-inspiration, the lungs cross the what rib while the lower border of the parietal pleura crosses which rib?

Back 10

8th and 10th

Front 11

to drain fluid from the pleural cavity the drain tube is commonly placed in the 8th or 9th ICS, mid-axillary line. the drain enters what recess?

Back 11

costodiaphragmatic recess

Front 12

what intercostal muscle layers does the intercostal neurovascular bundle travel between?

Back 12

the intermost intercostal and the internal intercostal muscles

Front 13

developmentally, each lung has how many broncho-pulmonary segments?

Back 13

10

Front 14

anatomically the superior lobe of the lung lies mostly ______, while the inferior lobe lies mostly ______.

Back 14

superior lies mostly anterior
inferior lies mostly posterior

Front 15

what is the lingual?

Back 15

lower projection off the left upper lobe of lung

Front 16

lingual is synonymous with what part of the right lung?

Back 16

middle lobe

Front 17

the apex of each lung lies above the _____ and what rib to extend into the root of the neck.

Back 17

clavicle and 1st rib

Front 18

what travels with the segmental bronchi through the middle of the broncho-pulmonary segment?

Back 18

segmental bronchi and artery

Front 19

what is the result of sympathetic innervation to the lung?

Back 19

vasodilation of pulmonary and bronchial vessels, decreased mucus secretion and bronchodilation.

Front 20

lymphatic drainage of the lungs is collected by what set of lymph nodes?

Back 20

pulmonary to hilar

Front 21

other than pulmonary vessels, what is the blood supply to the lungs and bronchi?

Back 21

bronchial arteries

Front 22

the lung and viscera pleura are insensitive to somatic-type stimuli, expect for _______

Back 22

stretch or distension

Front 23

which primary bronchus is more likely to receive a foreign body and why?

Back 23

right main bronchus, it is wider and straighter continuation of trachea

Front 24

what is another name for the upper lobar bronchus and why?

Back 24

epiarterial, it lies above the right pulmonary artery

Front 25

at the hilum of the lung, what pulmonary structures generally lies most anterior? posterior? superior?

Back 25

pulmonary veins
bronchus
pulmonary artery

Front 26

at what vertebral body level and sternal level does the trachea bifurcate?

Back 26

at the sternal angle, 4th thoracic vertebral body level

Front 27

what is the upward pointing projection on the inside of the trachea at its bifurcation into primary bronchi?

Back 27

carina

Front 28

what nerve runs anterior to the root of the lung?

Back 28

phrenic nerve

Front 29

what nerve runs just posterior to the root of the lung?

Back 29

vagus nerve

Front 30

what component of the ANS is found on the lateral sides of vertebral bodies in thorax?

Back 30

sympathetic chain and greater splanchnic nerve

Front 31

where is the needle placed to avoid the intercostals neurovascular bundle while removing fluid from costodiaphragmatic recess?

Back 31

through the middle of the space, using the superior border of the rib below as a guide

Front 32

in a unilateral sucking or open pneumothorax, what does the mediastinum and inflated lung do during inspiration?

Back 32

they deviate to the side opposite the opening in the thoracic wall

Front 33

in a unilateral tension pneumothorax, what does the mediastinum and inflated lung do upon expiration?

Back 33

they remained deviated to the side opposite the opening in the thoracic wall

Front 34

during inspiration describe the changes in shape and volume of the thoracic cavity.

Back 34

all volumes increase, thus pressure decrease within thoracic cavity. the ribcage elevates increasing the side to side diameter (bucket handle) and the AP diameter (pump handle), while the diaphragm contracts and drops, increasing superior-inferior diameter.

Front 35

what bony landmark divides the superior and inferior mediastina?

Back 35

sternal angle

Front 36

the thymus is found in which division of the mediastinum?

Back 36

superior and anterior

Front 37

what is the primary "artery" found in the post mediastinum?

Back 37

descending aorta

Front 38

the middle mediastinum is the "home" for what major structure/organ?

Back 38

heart

Front 39

what structures border the thoracic duct in the post mediastinum?

Back 39

aorta, vertebral bodies, esophagus

Front 40

what is the name for the thin membrane which lines the inside of the fibrous pericardium?

Back 40

parietal layer of serous pericardium

Front 41

what is the procedure called when pericardial sac is tapped with a needle for removal of fluid?

Back 41

pericardiocenthesis

Front 42

where on the ant chest wall is the aortic valve best heard? the mitral valve?

Back 42

2nd ICS, right of sternum
apex of heart, 5th ICS near left MCL

Front 43

where on the anterior chest wall is the apex of the heart projected?

Back 43

5th ICS near left MCL

Front 44

what valve is heard best at about its anatomic position as projected onto the anterior chest wall?

Back 44

tricuspid valve

Front 45

what is the name of the external depression on the heart which divides the atria from ventricles?

Back 45

coronary sulcus

Front 46

auricles are part of which heart chamber?

Back 46

atria

Front 47

the pulm trunk carries blood from which chamber of the heart?

Back 47

RV

Front 48

what is the name of the AV valve that sits bw the RA and RV?

Back 48

tricuspid

Front 49

the "rough" muscular part of the atria walls are termed the ________ muscles

Back 49

pectinate

Front 50

what is the function of the papillary/chordae tendenae complexes?

Back 50

prevent AV valve cusps from regurgitating into atria upon ventricular contractions

Front 51

How many pulm veins usually enter the LA?

Back 51

4

Front 52

what is the usual origin for the left subclavian artery? the right subclavian artery?

Back 52

aortic arch
brachiocephalic trunk

Front 53

the azygos vein arches over the root of the lung to enter what vessel?

Back 53

SVC

Front 54

in general the venous drainage from the heart is collected in what structure before being empited into the RA?

Back 54

coronary sinus

Front 55

in a left dominant coronary artery distribution pattern, which parts of the heart are supplied by branches of the left coronary artery?

Back 55

both interventricular sulci and the posterior surface of the LV

Front 56

the coronary arteries arise from the aortic sinuses of ______

Back 56

valsalva

Front 57

the impulse wave from the AV node is transmitted to the ventricles by what bundle?

Back 57

AV bundle of His

Front 58

which nerve supplies parasympathetic innervation to the thoracic viscera?

Back 58

CN X (vagus)

Front 59

what affect does sympathetic innervation have on the heart?

Back 59

increased heart rate and force of contracility, dilation of coronary arteries

Front 60

what affect does sympathetic innervation have on the lungs?

Back 60

bronchodilation, decreased mucus secretion, vasodilation of pulmonary vessels

Front 61

where is the cardiac skeleton located?

Back 61

at the level of coronary sulcus

Front 62

what is the cardiac skeleton made of in the human?

Back 62

semi-rigid, dense connective tissue

Front 63

name 3 functions of the cardiac skeleton

Back 63

attachment for valves, attachment of cardiac muscles and insulation of ventricles from electrical impulses

Front 64

what is the feature of the RA that represents a right to left shunt in fetal life?

Back 64

foramen ovale

Front 65

in fetal life, most of the blood from the pulmonary trunk is shunted to the aorta via the _______

Back 65

ductus arterosum

Front 66

what does the ductus arterosum become in an adult?

Back 66

ligamentum arterosum

Front 67

what chamber of the heart helps form the left heart border on PA plain film radiograph?

Back 67

mostly LV. the LA appendage also forms tiny part of it

Front 68

The absence of what feature of the cardiac silhouette indicates the presence of enlarged lymph nodes or masses in the mediastinum?

Back 68

the aorto-pulmonary window or wedge is missing with enlarged lymph nodes on the left. the right side shows widened mediastinum in the same region

Front 69

what is the superior extent of the pleural cavity?

Back 69

about 1 inch above the clavicle/1st rib

Front 70

what is then name of the peritoneal lined space bw the body wall and the diaphragm?

Back 70

costodiaphragmatic recess

Front 71

a PA chest x-ray should exhibit how many pairs of ribs?

Back 71

at least 8

Front 72

the anterior aspect of each rib is located ___________ to the posterior aspect of the rib

Back 72

below/inferior

Front 73

in a normal CXR what radiopaque structure can be seen in the substance of the lung?

Back 73

pulmonary vessels

Front 74

what forms the majority of right heart border?
left heart border?

Back 74

right: RA and SVC
left: LV and pulm trunk and aorta

Front 75

what is the aortic knob?

Back 75

arch of the aorta on left mediastinal border

Front 76

what part of the heart lies most anterior in thorax?
posterior?

Back 76

RV
LA and LV

Front 77

what structure normally makes an impression on the esophagus?

Back 77

aorta-superiorly

Front 78

on inspiration what is the position of the diaphragm?

Back 78

descends

Front 79

pneumonia of which lobe of the lung obsures the right heart border on PA view?

Back 79

right middle lobe

Front 80

how would free air in abdominal cavity show up on plain film x-ray?

Back 80

as a radiolucent (dark) region inferior to the diaphragm

Front 81

how do you describe a PA CXR of person with severe emphysema?

Back 81

barrel shaped long and rounded, but low hemi-diaphragm domes

Front 82

fluid accumulating in the pleura space is referred to as...

Back 82

pleural effusion

Front 83

in contrast to pneumonia, how do large effusions affect the organs of the thorax?

Back 83

pneumonias occupy the lung space with little or no displacement, effusions push the lungs and mediastinum to the opposite side- space occupying

Front 84

on a pneumonthorax the visceral pleura of the partially deflated lung is seen as a thin ________

Back 84

white line

Front 85

name 4 reasons for mediastinal widening that are caused by disease states

Back 85

pulm HTN
lung cancer
aorta rupture
enlarged mediastinal lymph nodes
cardiomegaly

Front 86

cardiomegaly due to mitral valve regurgitation is due mainly to enlargment of what?

Back 86

LA

Front 87

cardiomegaly due to aortic valve regurgitation is due mainly to enlargment of what?

Back 87

LV

Front 88

what view is best on aortagram to clearly visulize the 3 chief supra-aortic branches off the aortic arch?

Back 88

lateral view

Front 89

what is the vertical midline feature on the abdominal wall that intersects the umbilicus?

Back 89

linea alba

Front 90

in the quadrant system, what is the landmark for the 2 perpendicular lines?

Back 90

umbilicus

Front 91

in the quadrant system, where is the appendix located? the liver? the stomach?

Back 91

lower right
upper right
upper left

Front 92

what is the bony component of the abdominal wall inferiorly?

Back 92

the pelvis (ilium, pubis, sacrum)

Front 93

how many lumbar vertebrae are there?

Back 93

5

Front 94

which ribs supports the posterior abdominal wall posteriorly?

Back 94

11 & 12

Front 95

what is the name of the thick fatty layer on the abdominal wall?

Back 95

Camper's fascia

Front 96

what is the clinical significance of Scarpa's fascia?

Back 96

forms the wall for a potential space bw the superficial fascia of the skin and the underlying abdominal wall

Front 97

how do the lateral abdominal muscles compare to the intercostal muscles?

Back 97

they are 3 in number, innervated mostly by thoracic nerves, helps control pressure in body cavity

Front 98

what are the collective functions of the abdominal muscles?

Back 98

protection, flex trunk, helps control intra-abdominal pressure

Front 99

what is the makeup of the anterior rectus sheath above the arcuate line?

Back 99

in general the anterior rectus sheath is composed of the aponeuroses of the external oblique and the internal oblique above the arcuate line, and all 3 aponeuroses below the arcuate line. the posterior rectus sheath above the arcuate line is composed of the aponeuroses of the transversus abdominis and the internal oblique, and below the arcuate line only transverses fascia

Front 100

how do the lateral abdominal muscles differ in innervation from the anterior abdominal muscles?

Back 100

the 3 lateral abdominal muscles are innervated by T7-L1, the rectus abdmoinis is supplied by T7-T12

Front 101

how do the nerves and vessels reach the rectus abdominis?

Back 101

they run bw the 2 inner lateral muscle layers and pierce the rectus sheath laterally

Front 102

what makes up the inguinal ligament?

Back 102

the thickened lower margin of the external oblique aponeurosis

Front 103

what forms the anterior wall of the inguinal canal?

Back 103

external oblique aponeurosis

Front 104

what runs thru the inguinal canal in the male? the female?

Back 104

spermatic cord
round ligament

Front 105

what muscle layer gives rise to the cremasteric fascia?

Back 105

internal oblique, rarely transverses abdominis too

Front 106

what is the name given to the testicular vein in the spermatic cord?

Back 106

pampiniform plexus

Front 107

what is the name of the sperm duct?

Back 107

vas deferens, or ductus deferens

Front 108

what is the name of the peritoneal sack located in the scrotum, anterior to the testes?

Back 108

tunica vaginalis

Front 109

what is the thick coat of the testes called?

Back 109

tunica albugenia

Front 110

what structure is responsible for storing sperm, once produced by the testes?

Back 110

epididymus

Front 111

in performing a vasectomy, what layers are incised to reach the vas deferens?

Back 111

skin, colles fascia, dartos muscle, external spermatic fascia, cremasteric fascia/muscle, internal spermatic fascia, extraperitoneal fat

Front 112

what is the relationship of the hernia neck of an indirect hernia to the inferior epigastric vessels?

Back 112

the neck of the indirect hernia lies lateral to the inferior epigastric vessels

Front 113

what is the most common age groups for occurrence of indirect inguinal hernias? direct inguinal hernias?

Back 113

indirect: young males: mostly newborns and toddlers <1yo

direct: middle aged to old males, with weak abdominal muscles

Front 114

what is the difference bw hematocele vs hydrocele?

Back 114

the tunica vaginalis contains blood in a hematocele, but peritoneal like fluid in a hydrocele

Front 115

on which side is a variocele most common?

Back 115

left

Front 116

a patent processes vaginalis is a ready made path for which type of inguinal hernia?

Back 116

indirect

Front 117

what is the initial lymphatic drainage of the testes and why is it different from that of the scrotum?

Back 117

testies lymphatics follow testciular vessels toward the para-aortic (lumbar)

scrotal lymphatics follow external pudendal vessels toward the superficial inguinal lymph nodes.

difference due to the fact that testes develop high on the posterior abdominal wall and descend into the scrotum, unlike scrotum that develops from anterior abdominal wall. Generally, lymphatics follow the vessels that supply the organ or region

Front 118

what is the name of the peritoneum lining the GI tract organs?

Back 118

Visceral peritoneum

Front 119

how does the peritoneum compare to the pleura?

Back 119

it is the same, except for location

Front 120

name 3 functions of the mesenteries.

Back 120

support, fat storage, transmits vessels, nerves and lymphatics

Front 121

what is the name of the mesentery that drapes off the greater curvature of the stomach?

Back 121

greater omentum

Front 122

what is it referred to as the "Policeman of the abdomen"?

Back 122

it adheres to inflamed tissue and tends to separate it from the rest of the peritoneal cavity

Front 123

in what quadrant is the liver located?

Back 123

upper right

Front 124

what are the 3 parts of the small intestine?

Back 124

duodenum, jejunum, ileum

Front 125

what part of the GI tract "frames" the small intestine?

Back 125

large intestine (colon)

Front 126

in what quadrant of the abdomen would you find the appendix?

Back 126

lower right

Front 127

what is the name of the mesentery to the sigmoid colon? the small intestine?

Back 127

sigmoid mesocolon
mesentery proper

Front 128

what is the location of the spleen?

Back 128

left side, posterior to the mid axillary line, oriented along the long axis of the 10th rib

Front 129

what is the name of the colic flexure where the transverse colon turns into the descending colon?

Back 129

left colic flexure or splenic flexure

Front 130

what is the characteristic shape of the stomach?

Back 130

J shape

Front 131

what part of the stomach usually contains swallowed air?

Back 131

fundus

Front 132

what is the name of the mucosal folds in the stomach?

Back 132

rugae

Front 133

what is the name of the sphincter that lies bw the stomach and the duodenum?

Back 133

pyloric

Front 134

how is the 1st part of duodenum likes the last part of the stomach?

Back 134

it has smooth mucosa

Front 135

what empties into the 2nd part of the duodenum?

Back 135

major duodenal papillae

Front 136

what is the characteristic shape of the duodenum?

Back 136

C shape

Front 137

what lies nestled in the curve of the duodenum?

Back 137

head of pancreas

Front 138

what is the name of the mucosal folds in the small intestine?

Back 138

plicae circularae

Front 139

name 5 ways the ileum differs from the jejunum?

Back 139

ileum is smaller in size, has fewer and lower plica, is less vascular, has more encroaching mesenteric fat, has shorter vasa recti, more complicated arcades, have Peyer patches, possible Meckel's diverticulum

Front 140

what is name of the part of the large intestine that connects to the ileum and the appendix?

Back 140

cecum

Front 141

what is McBurney's Point?

Back 141

surface projection onto anterior abdominal wall of the location where the appendix originates from the cecum

Front 142

what characteristics distinguish the large intestine from the small intestine?

Back 142

the presence of tenia coli, plica semilunares, haustra, and epiploic appendages

Front 143

what arterial trunks supplies the foregut?
midgut?
hindgut?

Back 143

Celiac
SMA
IMA

Front 144

what are the 3 branches off the celiac artery?

Back 144

left gastric, splenic, common hepatic

Front 145

name the arteries that collectively supply the jejunum and ileum?

Back 145

intestinal

Front 146

what is the origin of the middle colic artery and what general region does it supply?

Back 146

SMA, transverse colon

Front 147

why are the vessels to the gut smaller than they initially appear on visual inspection?

Back 147

they are "coated" with an autonomic nerve plexus

Front 148

which unpaired artery gives rise to the left colic artery and sigmoidal arteries?

Back 148

IMA

Front 149

what is the functional significance of the marginal artery?

Back 149

provides for a continuous anastomotic supply of blood to the colon in the event that a major colic branches are compressed, temporarily or permanently

Front 150

what 3 veins converge to form the portal vein?

Back 150

Splenic and SMV, plus IMV

Front 151

where is the portal vein formed?

Back 151

behind the neck of the pancreas

Front 152

what is the function of the portal vein?

Back 152

bring nutrient rich, still moderately oxygenated blood to the liver for processing from the GI tract

Front 153

what is portal hypertension?

Back 153

restriction of blood flow thru the portal vein

Front 154

what are some symptoms of chronic portal HTN?

Back 154

splenomegaly, hemorrhoids, esophageal varices, caput medusa

Front 155

how can sx of chronic portal HTN be alleviated?

Back 155

surgically routing portal to the IVC thru fusion of these vessels or other adjacent porta/caval vessels (left renal and splenic veins)
also an interventional procedure called TIPS- trans intrahepatic portal shunt

Front 156

how many lobes does the liver have?

Back 156

2-4: right and left (caudate and quadrate part of right anatomic, but part of left functional lobe)

Front 157

what separates the liver into anatomic lobes?

Back 157

falciform ligament and left sagittal fissure

Front 158

what lies in the right hepatic fossa?

Back 158

Gallbladder and IVC

Front 159

what is the round ligament of the liver?

Back 159

the remnant of the umbilical vein

Front 160

what is the porta hepatis?

Back 160

hilum of liver (transverse hepatic fissure)- contains components of hepatic artery, hepatic ducts and portal vein

Front 161

what are the 2 sources of blood to the liver?

Back 161

portal vein (70%) and hepatic artery (30%)

Front 162

what separates the liver into functional lobes?

Back 162

physically- the middle hepatic vein
by definition- right and left branching of the hepatic arteries, portal veins, and hepatic ducts

Front 163

what is the function of the gallbladder?

Back 163

stores, concentrates and releases bile

Front 164

what is the name of the duct that transmits bile to and from the gallbladder?

Back 164

cystic duct

Front 165

what is the special connective tissue formation in the duct that prevents over distension and collapse of the duct to the gallbladder?

Back 165

spiral valve (of Heister)

Front 166

what is the route of bile once produced until it reaches the duodenum?

Back 166

liver, hepatic ducts, common hepatic duct, cystic duct, gallbladder, cystic duct, common bile duct, ampula of Vater, major duodenal papillae, duodenum

Front 167

what is the function of the pancreas?

Back 167

endocrine- sugar metabolism: glucagon and insulin
exocrine- digestion: bicarb, lipases, amylases, proteases

Front 168

where is the head of the pancreas located? the tail?

Back 168

nestled in the C shaped crook of the duodenum
at the hilum of the spleen

Front 169

what is the relationship of the main pancreatic duct and common bile duct?

Back 169

they empty into a common site- ampula of Vater

Front 170

where is the spleen located?

Back 170

posterior to the mid-axillary line, left side, along the 10th rib

Front 171

why is it commonly injured in MVAs?

Back 171

it is on a pedicle made from the greater omentum and is relatively mobile. it therefore can become a projectile within the peritoneal cavity during a severe MVA and crashes against the inside of the rib cage. It is often bruised or lacerated

Front 172

what other organ is also at risk in MVA that injures the spleen?

Back 172

tail of pancreas as well as the splenic vessels

Front 173

what does the muscular component of the diaphragm attach to "centrally"?

Back 173

central tendon of the diaphragm

Front 174

what passes thru the diaphragm at the level of 10th thoracic vertebral body? what other structure accompanies it?

Back 174

esophagus
vagus nerve

Front 175

why are they accessory/aberrant arteries common?

Back 175

during its ascent out of the pelvis, the kidneys lose and re-establish their arterial supply and thus may have multiple branches rather than just one renal artery to each kidney

Front 176

what is the effect on diaphragm function if the right phrenic nerve is damaged?

Back 176

right hemidiaphragm is paralyzed- expansion of lung on affected side more difficult

Front 177

what are the 2 muscles in the posterior abdomen that forms the chief flexor of the thigh?

Back 177

iliacus and psoas

Front 178

where do the kidneys originate during development?

Back 178

in the pelvis

Front 179

what is the order of structures at the hilum of the kidney?

Back 179

vein, artery, ureter/renal pelvis

Front 180

what are the major structures in the kidney medulla?

Back 180

renal pyramids

Front 181

into what structure does renal papillae empty urine?

Back 181

minor calyx

Front 182

what is the name of the fatty "encasement" that surrounds the kidney?

Back 182

perirenal fat

Front 183

how can accessory/aberrant renal arteries lead to hydronephrosis?

Back 183

accessory arteries to the inferior pole of the kidney can compress the ureter, thus restricting urine flow and eventually dilation of the collecting system within the kidney with backed up urine

Front 184

what are end arteries and give 4 examples.

Back 184

arteries that do not anastomose with other arteries
ex. vasa recti, segmental renal arteries, segmental hepatic arteries, segmental pulmonary arteries, appendicular artery (named vas recti)

Front 185

what is the shape of the left suprarenal gland?

Back 185

crescent

Front 186

where is the hilum of the suprarenal gland?

Back 186

where the suprarenal vein exits the gland

Front 187

name 4 different paired arteries off the abdominal aorta from superior to inferior

Back 187

inferior phrenic, renal, testicular/ovarian, lumbar, common iliac

Front 188

at what lumbar vertebral level does the aorta bifurcate?

Back 188

L4

Front 189

into what venous structure does most of the veins of the retroperitoneum drain on the right vs the left side?

Back 189

right- IVC
left- left renal vein

Front 190

what does the left renal vein pass over to reach the IVC? what does it pass under?

Back 190

aorta
SMA

Front 191

what nerves of the lumbar plexus are involved in cremaster reflex?

Back 191

the cremaster reflex tests the integrity of L1-L2 spinal cord level. By stroking the skin over the femoral triangle, the cremaster muscle reflexly contracts, raising the testicle. the nerve involved is mostly genitofemoral nerve, but some sensory from ilioinguinal nerve

Front 192

what are the 2 lumbar plexus nerves that innervate the thigh?

Back 192

femoral and obturator

Front 193

what nerve gives parasympathetic innervation to most of the GI tract?

Back 193

vagus

Front 194

what is the result of parasympathetic innervation to the gut?

Back 194

increased peristalsis, increased secretion of digestive juices, sphincter control

Front 195

what are visceral afferents and what is the characterisitc of the pain associated with them compared to somatic afferents?

Back 195

sensory nerves of the GI tract. visceral afferents that carry pain perception are thru stretch receptors. it is perceived as dull, achy, poorly localized pains over general areas either referred to the midline or over the affected solid organs

Front 196

in the gut, what does increased sympathetic tone result in the GI tract?

Back 196

vasoconstriction of the vessels of the gut

Front 197

in the abdominal cavity, the GI tract drains into which set of lymph nodes?

Back 197

preaortic or intestinal nodes

Front 198

the retroperitoneum and LE drains into which set of lymph nodes?

Back 198

para-aortic or lumbar nodes

Front 199

in general, they lymphatic drainage of the abdomen and its contents follows the path of what other system?

Back 199

blood vessels

Front 200

into which lymph nodes does the testes/ovaries drain?

Back 200

para-aortic/lumbar nodes

Front 201

into which lymph nodes does the scrotum initially drain into?

Back 201

superficial inguinal nodes

Front 202

what is the key characteristic of the lumen of the esophagus following barium swallow?

Back 202

monotonously smooth

Front 203

when the patient is lying on their back, what part of stomach is most posterior and thus fills with barium after partial barium swallow?

Back 203

fundus

Front 204

what internal structures are obvious on partial emptying of stomach?

Back 204

rugae

Front 205

what characteristic shape does the first part of duodenum exhibit on barium filling?

Back 205

arrow head or x-mas tree

Front 206

where is the anatomical location of the duodeno-jejunal junction?

Back 206

posterior to the stomach

Front 207

what is the characteristic appearance of the lumen of the jejunum on barium swallow study?

Back 207

feathery

Front 208

the ileum is mostly located in the lower abdomen and loops fall into what?

Back 208

the pelvic cavity

Front 209

on barium enema of the large intestine what are the bulges/segments of the gut called?

Back 209

haustra

Front 210

bc of motility of the sigmoid colon, it is often ______ on itself and rectum on barium study

Back 210

superimposed

Front 211

to study the lining of the large intestine, a small amount of barium is used to coast the gut lining when placed under what?

Back 211

pressurized gas

Front 212

the normal liver appears as a ________ mass in the URQ on CT

Back 212

homogeneous

Front 213

the pancrease appears as a lightly ________ elongated tissue that stretches across the left posterior and middle abdominal wall on CT

Back 213

lobulated

Front 214

what is considered the radiologist's friend bc it provides a dark outline to most soft tissue organs on CT?

Back 214

fat

Front 215

what can be seen on the posterior abdominal cavity wall on the LUQ on CT?

Back 215

the spleen

Front 216

the kidneys lie in the post abdominal region in a ___________ position, surrounded by radiolucent ______________ on CT

Back 216

retroperitoneal
perirenal fat

Front 217

on excretory or retrograde cystogram, the contents of the bile duct and pancreatic duct can be seen emptying into the what?

Back 217

duodenum

Front 218

on US gallstones appear as _______ objects surrounded by _________ bile

Back 218

white (hyperchoic)
dark (anechoic)

Front 219

on SMA arteriorgram, the intestinal branches are mostly found ______ of the midline

Back 219

left

Front 220

what is the demarcation bw the false and true pelvis?

Back 220

the pelvic brim, following along the superior margin of the pubic symphysis of the pubis arcuate line of the ilium, ala of the sacrum and sacral promontory

Front 221

what are the 3 bones that make up the hip bone?

Back 221

ilium, ischium, pubis

Front 222

what is the structure where the 2 hip bones unite anteriorly?

Back 222

pubic symphysis

Front 223

what part of the sacrum unites with the hip bones posteriorly?

Back 223

the ala of the sacrum articulate with the ilium and are held in place by strong sacroiliac ligaments. there is actually a joint which is reasonably nonmotile, the sacroiliac joint

Front 224

what ligaments and bony prominences are involved in the formation of the greater and lesser sciatic foramina?

Back 224

the sacrotuberous and sacrospinous ligaments that connect the ishial tuberosity and ischial spine to the sacrum. the space bw the sacrotuberous and sacropspinous ligaments is the lesser sciatic foramen

Front 225

in the anatomical position what 2 bony features of the pelvis lie on the same vertical plane?

Back 225

the anterior part of the pubic symphysis and the ASIS

Front 226

Who has the widest subpubic angle?

Back 226

females

Front 227

who has the smallest pelvic inlet and outlet?

Back 227

males

Front 228

who has shallowest true pelvis?

Back 228

females

Front 229

What is the pouch of Douglas and what is its clinical significance?

Back 229

The rectouterine space or peritoneal space between the uterus and anterior rectum. Clinically it is an important area adjacent to the posterior fornix of the vagina. The thin vaginal wall is all that separates the peritoneal cavity from the outer environment. It can easily be punctured thus transmitting infection to the peritoneal cavity.

Front 230

What is the sacral plexus?

Back 230

The sacral plexus is composed of ventral primary rami of segments S1 to S5 and the lumbosacral trunk from L4-5. These nerves combine to form the major nerves that leave the pelvis to supply the lower limb.

Front 231

What are the major nerves derived from the sacral plexus?

Back 231

Sciatic, superior and inferior gluteal, pudendal, posterior femoral cutaneous, and pelvic splanchnics.

Front 232

What are the two sources for sympathetic nerves in the pelvis?

Back 232

Sacral sympathetic trunk (or chain) and the hypogastric plexus.

Front 233

What is the origin of the parasympathetic innervation to the pelvic viscera?

Back 233

Pelvis splanchnics from S2-S4.

Front 234

What are the chief arteries off the internal iliac artery?

Back 234

Superior and inferior gluteal arteries, umbilical supplying superior vesicular branches, obturator, middle rectals, internal pudendals, uterine and vaginal branches

Front 235

What arteries in the pelvis are unique to females?

Back 235

Uterine and vaginal branches off the internal iliac, and ovarian from the lumbar aorta.

Front 236

What is the origin for the common variation of the obturator artery?

Back 236

It may arise off the inferior epigastric branch from the external iliac and pass over the pelvic brim to the obturator canal (20% occurrence).

Front 237

On a rectal exam, what can be palpated anteriorly in the female?

Back 237

cervix of uterus

Front 238

What is the muscular sheet found at the pelvic outlet? What are its components?

Back 238

Pelvic diaphragm
levator ani and coccygeus muscles.

Front 239

What is the name of the medial part of the levator ani that keeps the “kink” in the anus?

Back 239

Puborectal sling.

Front 240

What is the path for the ureters? Where are the three constrictions or narrowed areas in the ureters?

Back 240

They pass down the posterior abdominal wall, over the pelvic brim, along the posterior wall of the pelvis and then anterior to the enter posterior wall of the bladder.
Three constrictions are 1) at the renal pelvis, 2) where they cross the external iliac artery and pass over the pelvic brim, and 3) as they pass through the bladder wall. These areas are where large calculi, ‘kidney stones’, often are stopped and then cause increased pain. Small stones may pass with little or no pain.

Front 241

As the ureters approach the uterus, what structure crosses immediately over them?

Back 241

Uterine artery

Front 242

What is the smooth area in the bladder where the ureters pierce the bladder wall?

Back 242

Trigone, outlined by the inlets of the ureters and inferiorly by the outlet of the bladder

Front 243

What is the name of the smooth muscle found in the urinary bladder wall?

Back 243

Detrusor muscle

Front 244

What is the ring of smooth muscle called at the neck of the urinary bladder?

Back 244

Internal sphincter

Front 245

What is its innervation of the internal sphincter?

Back 245

It is closed tonically by the sympathetics and stimulated to open by the parasympathetics (by inhibition of sympathetics).

Front 246

On rectal exam what can be palpated anteriorly in the male.

Back 246

Prostate and seminal vesicles

Front 247

Where is the membranous urethra located in both sexes?

Back 247

Within the urogenital diaphragm

Front 248

What is the pathway for sperm after passing through the superficial inguinal ring?

Back 248

In the vas deferens the sperm pass through the inguinal canal, then through the deep inguinal ring, over the pelvic brim, along the lateral aspect of the bladder, join the duct of the seminal vesicle to form the ejaculatory duct, passes through the prostate gland, and enter the prostatic urethra on the posterior aspect along the colliculus seminalis

Front 249

Into what do the ejaculatory ducts empty?

Back 249

Prostatic urethra, along the side of the colliculus seminalis

Front 250

What nerve group functions during ejaculation?

Back 250

Parasympathetics, cause contraction of urethral muscles. Sympathetics, cause movement of sperm down the vas and secretion of glands (emission)

Front 251

How does the prostate empty into the urethra compared to the ejaculatory ducts?

Back 251

Numerous small ducts open into the prostatic urethra

Front 252

What is the name for the longest part of the urethra in males?

Back 252

Spongy urethra (since it enclosed by the corpus spongiosum

Front 253

The female urethra opens into what space?

Back 253

vestibule

Front 254

What arteries supply the rectum?

Back 254

Superior rectal from inferior mesenteric, middle rectal form internal iliac, and inferior rectal from internal pudendal artery

Front 255

What are the boundaries of the perineum?

Back 255

It is a diamond formed by the pubic symphysis, pubic rami, ishial rami, ishial tubosities, sacrotuberous ligaments, and coccyx

Front 256

What are its two subdivisions, and in general what is found in each?

Back 256

Anal triangle; anal canal, external anal sphincter, and ishiorectal fossa. Urogenital triangle; UG diaphragm, scrotum/labia, penis/clitoris, vestibule

Front 257

What are the boundaries of the ischiorectal fossae? With what is it normally filled?

Back 257

Perineal body anteriorly, laterally obturator internus muscle, levator ani. They are filled with fat.

Front 258

What is the UG diaphragm and how does it differ from the pelvic diaphragm

Back 258

It stretches between the inferior pubic rami. It lies superficial to the pelvic diaphragm and contains the external sphincter of the urethra.

Front 259

What pierces the UG diaphragm in the female? The male?

Back 259

Female – urethra and vagina
Male - urethra

Front 260

What is found in the deep perineal space?

Back 260

The urogenital diaphragm

Front 261

What is the superficial perineal space? And what is found there?

Back 261

It is the area superficial to the UG diaphragm. It contains the structures associated with the penis and scrotum, or structures of the vestibule, clitoris, and labia, plus all the associated nerves and vessels.

Front 262

What is the difference between the external and internal urethral sphincter?

Back 262

The external sphincter is under voluntary control while the internal sphincter is controlled by autonomic nerves.

Front 263

What is the chief nerve supply to the perineum?

Back 263

Pudendal nerve and its branches.

Front 264

What is the origin of the inferior rectal nerves & vessels?

Back 264

Pudendal nerve and internal pudendal artery and veins.

Front 265

What are the names of the nerves and arteries on the dorsum of the body of the penis? What is the function of the nerves found here?

Back 265

Deep dorsal vein, dorsal arteries, and dorsal nerves
Sensory to the surface

Front 266

The crura and bulb of the penis make up what basic part of the penis?

Back 266

Root of the penis

Front 267

What is the muscle layer that lies over the bulb of the penis? What is its function?

Back 267

Bulbospongiosus, compresses the bulb and assists erection

Front 268

How does the path of the urethra differ between the sexes?

Back 268

The male urethra consists of prostatic and spongy components that are not found in the female. The membranous component is common in both.

Front 269

The bulb of the penis is continuous with what structure in the shaft of the penis?

Back 269

Corpora spongiosum

Front 270

What is the mechanism of erection?

Back 270

Upon stimulation the smooth muscle in the trabeculae and arteries of the corpora relax because of parasympathetic stimulation (via pelvic splanchnics). The arteries straighten and enlarge allowing increased blood flow into the cavernous spaces. The bulbospongiosus and ishiocavernosus muscles compress the venous drainage at the periphery of the corpora and impede outflow of blood. As a result the corpora become enlarged and rigid and erection occurs.

Front 271

How do the drainage patterns for the superficial veins of the perineum differ from that of the deep dorsal vein?

Back 271

The perineum is drained via the internal pudendal veins back toward the lesser sciatic foramen while the deep dorsal vein drains through a defect in the UG diaphragm directly into a plexus of veins surrounding the prostate gland

Front 272

What is the name of the end of the uterine tube that drapes over the ovary?

Back 272

Fimbrae, which sweep over the surface of the ovary and pick up ovulated oocytes

Front 273

What is the origin of the ovarian arteries?

Back 273

They pass into the pelvis over the pelvic brim. They originate as paired arteries off the aorta

Front 274

What is the peritoneal sheet that attaches the uterus to the lateral pelvic wall?

Back 274

Broad ligament of the uterus

Front 275

What is the ligamentous structure within broad ligament that contains the ovarian vessels?

Back 275

Suspensory ligament of the ovary

Front 276

What ligament supports the cervix/uterus within the broad ligament?

Back 276

Transverse cervical or ‘cardinal’ ligament

Front 277

What is the usual orientation of the uterus in relationship to the bladder?

Back 277

Anteflexed anteriorly over the bladder

Front 278

At what uterine anatomic landmark does the uterine artery approach the uterus

Back 278

It approaches at the uterine cervix from both sides and then its branches go superiorly and inferiorly to supply the uterus

Front 279

What are the vaginal spaces around the end of the cervix?

Back 279

Anterior, lateral, and posterior fornices (fornix is singular).

Front 280

The crura of the clitoris make up what structure in the body?

Back 280

Corpora cavernosa

Front 281

What is the skeletal muscle that lays over the crura of the clitoris? What is its function?

Back 281

Ishiocavernosus muscle. Its function is to help maintain erection in the clitoris.

Front 282

What is the nerve supply to the female perineum?

Back 282

Perineal branches of the pudendal nerve

Front 283

What is the surgical procedure called that prevents the UG diaphragm from ripping during childbirth?

Back 283

Episiotomy
It is done to enlarge the vaginal orifice and prevent a jagged tear in the perineum. This heals more quickly and can prevent damage to important structures such as the perineal body that have consequences later in life in support of pelvic viscera

Front 284

In the pudendal nerve block, what bony feature does the clinician use as a guide to anesthetize the pudendal nerve?

Back 284

ischial spine

Front 285

To where do the lymphatics for the cervix drain?

Back 285

They pass along the uterine vessels to the internal iliac nodes and then superior along the aorta

Front 286

To where do the lymphatics for the scrotum/labia drain initially?

Back 286

They drain to the superficial inguinal nodes

Front 287

To where do the lymphatics of the ovary/testes drain?

Back 287

The lymphatics follow the ovarian and testicular blood vessels and ascend to the lumbar lymph nodes