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171 Cards in this Set

  • Front
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4 muscles of the abdomen

EO


IO


Transversus abdominus


Rectus abdominus


*Pyramidalis

Orientation of external oblique

Obliquely downward and medially

Rectus abdominis whose lateral borders convex to form

Linea semilunaris

Abdominal muscle oriented upward and medial

Internal oblique

Conjoint tendon splits to form

Rectus sheath

Conjoint tendon formed by 2 muscles

IO


Transversus abdominis

Union of aponeurosis of external oblique and anterior layer of IO forms


*above the arcuate line

Anterior wall of the rectus sheath

Union of aponeurosis of the transversus abdominis and posterior layer of IO


*above the arcuate line

Posterior wall of the rectus sheath

What muscle contributes to the posterior layer of the rectus sheath below the arcuate line

Transversalis fascia

Muscles found in the rectus sheath

Rectus abdominis


Pyramidalis

Blood supply of the abdominal muscles

Superior epigastric


Inferior epigastric


Deep circumflex iliac


*same as venous


*drains to internal thoracic, external iliac

Boundaries of Hesselbach's triangle

Inf epigastric artery - sup/lateral


Inguinal/Poupart's ligament - inferior/lateral


Rectus abdominis - medial

Contents of inguinal canal found in both males and femalez

Ilioinguinal nerve


L1

Difference between indirect and direct inguinal hernia

Congenital


Narrow neck of hernial sac


Lateral to inferior epigastic vessels


Enters the scrotum

Hernia covered only by external spermatic fascia

Direct inguinal hernia

Cremaster muscle is derived from what layer of the abdominal wall

Interior oblique

Dartos muscle is derived from what layer of the abdominal wall

Superficial fascia

Tunia vaginalis is derived from what layer of abdominal wall

Peritoneum

Spinal nerve which supplies the cremasteric reflex

L1

Nerves that supply the sensory and motor function for the cremasteric muscle

Femoral of genitofemoral - afferent


Genital of genitofemoral - efferent

8 retroperitoneal organs

Pancreas


Ureter


Kidney


IVC


Duodenum - 2nd-4th


Ascending colon


Descending colon


Abdominal aorya

Subdivision of the peritoneal cavity that lies posterior to the stomach and lesser omentum

Omental bursa


Lesser sac

Boundaries of Formanen of Winslow


*communication between lesser and greater sac

Ant: Hepatoduodenal ligament


*portal vein + hepatic artery + bilr duct


Post: IVC


Sup: Caudate lobe


Inf: Superior duodenum

3 parts of the omentum

Gastrophrenic


Gastrosplenic


Gastrocolic

Peritoneal reflection that supports hollow viscous to body wall

Mesentery

Peritoneal reflections that connects viscera to each other

Ligaments

Rebound tenderness


Guarding


Signs of what condition ?

Inflammation of parietal peritoneum

Structures penetrated by midline paracentesis

Skin


Superficial fascia


Deep fascia


Linea alba


Transversalis fascia


Extraperitoneal fat


Parietal peritoneum

Lateral paracentesis will injure the ?

Inferior epigastric artery and above deep circumflex arteru

2 unpaired arteries of the abdominal aorta


*terminal branches

Common iliac


Median sacral

3 branches of the celiac artery

Left gastric


Splenic artery - L gastroepiploic, Short gastric


Hepatic - Right gastric, R/L hepatic, gastroduodenal (R gastroepiploic, superior pancreaticoduodenal)

Foregut is supplied by what artery

Celiac trunk

Collateral circulation formed by celiac artery occlusion in aortic aneurysm

Pancreaticoduodenal branches of SMA


Gastroduodenal

All veins drain to the IVC except

L suprarenal


L gonadal

4 portal-caval anastomoses

Esophageal of L gastric = esophageal of azygous


Superior rectal = middle/inferior rectal


Paraumbilical


Colic veins = retroperitoneal veins

Length of the esophagus

10inch


25cm

3 esophageal constrictions

Pharyngoesophageal 18cm/7.2cm


Thoracic 28cm/11.2


Diaphragmatic 44cm/17.2


*sites of carcinoma

Innervation of the anterior esophagus

Left vagus


*LARP

Condition caused by incompetent esophageal spinchter


Subternal burning pain

GERD

Mechanism of achalasia

Smooth muscle fails to relax


Dilated esophagus

4 types of diaphragmatic hernia

Congenital - L posterolateral part


Hiatal - esophageal hiatus


Paraesophageal


Restrosternal

Purpose of Sengstaken-Blakemore Balloon insertion

Esophageal hemorrhage from esophageal varices


Gastric balloon anchors tube against esophageal gastric

Distance between the external orifices of the nose and stomach

17.2 inch


44cm

Capacity of stomach

1.5L

Function of stomach

Food blender and reservior


Enzymatic digestion

Wide part of pylorus

Pyloric antrum

Sharp indentation which approximates the junction of the body and pyloric part of the stomach

Angular incisure/notch

Location of the cardiac orifice on the surface anatomy of the stomach

6th left costal cartilage


T10-T11

Location of the fundus of the stomach

5th left rib MCL

Location of pyloric antrum

9th CC


L1

Location of the pyloric canal

L2-L4

Blood supply of the lesser curvature of the stomach

R/L gastric arteries

Blood supply of the greater curvature of the stomach

R/L gastroepiploic arteries

Fundus of the stomach is supplied by

Short f


gastric

Sympathetic innervation of the stomach is from what segment of the spinal cord

T6-T9

MC location of gastric ulcers

Lesser curvature

MC location of gastric carcinomas

Pylorus

Length of the duodenum

10inch


25cm

4 divisions of the duodenum

Superior - 5cm, L1


Descending - 7-10cm, R sides of L1-L3


Horizontal - 6-8cm, L3


Ascending - 5cm, L2-L3

MC location of duodenal ulcers

Anterior wall of the first part of the duodenum

Hemetemesis is bleeding from where ?

Proximal to ligament of Trietz

Length of jejenum and ileum

6-7m long

Blood supply of jejenum and ileum

SMA at L1


Arterial arcade


Vasa recta

4 differences between jejenum and ileum

Greater vascularity


Less fat


Large and tall plicae circularis - Valves of Kerckring


Less Peyer's patches

MC part of SI involved in intussusception

Ileocecal

Ventral pancreatic bud forms what ?

Head


Uncinate process

Duct of Wirsung joins bile duct to form

Hepatopancreatic ampulla

Duct of Santorini drains into

Main pancrearic duct

5 ligaments of the liver

Falciform


Coronary


R/L triangular ligament


Ligamentum teres - quadrate (GB)


Ligamentum venosum - caudate (IVC)

Contents of the portal triad

Portal vein


Hepatic artery


Bile duct

Maneuver which controls hemorrhage of the liver by clamping the hepatoduodenal ligament

Pringle's maneuver

Function of the gallbladder

Receives, stores and concentrate bile by absorbing water and salt

Capacity of the bladder

30-50ml

Part of the gallbladder which gave rise to cystic duct

Neck

Infunfibulum of the GB found at the junction between neck and cystic duct

Hartmann's pouch

Components of the Triangle of Calot

Liver (sup)


Cystic duct (inf)


Common hepatic duct (medial)

Common site of impacted gallstone

Hepatopancreatic ampulla


*referred pain in the epigastric region

Stone blocking the cystic duct causes what kind of pain

Biliary colic

Thickened bands of muscles seen in the large intestine

Taenia coli

Longest part of the large intestine

Transverse colon


15 inches

Blind ended pouch situated in the R iliac fossa

Cecum


2.5

Location of McBurney's point

Location of appendix


Base situated 1/3 of the way up the line joining ASIS to the umbilicus

MC position of the appendix

Retrocecal

Injured nerve during appendectomy manifesting as weakening of the abdominal wall

Iliohypogastric

At what level does the sigmoid colon become the rectum

S3

Left sided colicky pain


Abdominal distention


Hematochezia


What condition?

Sigmoid volvulus

Differences between upper and lower anal canal

With anal columns


Columnar epithelium - stratified squamous


Sensitive to stretch - pain/temp/touch


Superior rectal A/V - inferior


Inferior mesenteric LN

Internal vs external hemorrhoids

Painless vs painful


Covered by mucosa vs skin


Internal rectal venous plexus

Remant of the proximal portion of the yolk stalk


Arises from the antimesenteric border of ileum

Meckel's diverticulum


Rule of 2

Defects in the migration and differentiation of neural crest cell results in what GI condition?

Achalasia

Innervation/blood supply summary

Muscle of the loin

Psoas major

Insertion of psoas and iliacus

Lesser trochanter of femur

3 coverings of the kidney

Perirenal fat


Gerota's


Pararenal fat

Anastatomosis done in renal transplantation

Renal artery to internal iliac artery


Renal vein to external iliac vein

Match layer of adrenal gland layer and hormone

Glomerulosa - aldosterone


Fasciculata - cortisol


Reticularis - androgens

Adrenal cortex derived from ?


Medulla derived from ?

Mesoderm


Neural crest

Adrenal medulla secretes what hormone ?

Catecholamine


Epi/NE

All veins drain into the IVC except

L gonadal


L adrenal

Excessive androgen production


Causes masculinization in females

CAH

Lining of ureter

Transitional epithelium

Ureter in males ?


Ureter in females ?

Vas deferens


Beneath broad ligament crossed by uterine artery

3 pelvic sites at risk for surgery

Ureter lies medial to ovarian vessel


Inferior to uterine vessels


Lateral to cervix

Renal colic is referred pain over which dermatomes

T11-L2

Base of the male UB separated from rectum by the

Denonvillier's fascia

Maximum capacity of the UB

500ml

Neck of the bladder held in position by

Puboprostatic and pubovesical ligament

Nerves responsible for bladder emptying

Pelvic splanchnic


S2, S3, S4

Primitive organ which contributes to the genital system

Mesonephros

Metanephros becomes the

Permanent kidneys

Ureter


Renal pelvis and calices


Collecing duct


Derived from?

Ureteric bud

Metanephric tubule gives rise to

Renal corpuscle


PCT


Loop of Henle


DCT

Fate of the urogenital sinus


Vesicle ?


Pelvic ?


Phallic ?

Urinary bladder


Urethra, prostatic and membranous parts, lower part of the vagina


Genital tubercle, external genitalia

Borders of the pelvic inlet

Ant - symphysis pubis


Lat - iliopectineal line


Post - sacral promontory

Borders of pelvic outlet

Ant - pubic arch


Lat - ischial tuberosities


Post - tip of coccyx

Different between female and male pelvis

Less curved


Wider sciatic notch


Everted ischial tuberosity


Oval shape

From sacral promontory to the superior margin of the pubic symphysis


What conjugate?

True conjugate

From sacral promontory to the inferior margin of pubic symphysis


What conjugate?

Diagnonal conjugate

Distance between ischial tuberosities

Transverse diameter

Distance between ischial spines

Interspinous diameter


<9.5cm

Common contents of the pelvic cavity in males and females

Urinary bladder


Ureter


Sigmoid colon


Rectum

Contents of the lesser sciatic foramen

Pudendal nerve


Nerve to obturator internus


Internal pudendal vessel


Tendon of obturator internus

3 muscles which compose the levator ani

Iliococcygeus


Pubococcygeus


Puborectalis

Action of the levator ani

Muscular support


Increases intraabdominal pressure for defecation, vomiting


Supports the head of the baby during expulsion

3 conditions due to pelvic diaphragm weaknrss

Uterine prolapse


Cystocoele


Rectocoele

2 triangles of the perineum

Urogenital


Anal

Components of the perineal body

Bulbospongiosus


EAS


Ischiocavernous

2 perineal fascia

Superficial - Colle's


Deep - Perineal membrane

Common structures in male and female superficial perineal space

Bulbospongiosus


Ischiocavernosus


Perineal body


Perineal branch of pudendal nerve

Benefit of mediolateral episiotomy

Less risk in incising the fibers of the EAS

Posterior branches of the internal iliac artery

Iliolumbar


Lateral sacral


Superior gluteal

Vertebral roots of pudendal nerve

S2


S3


S4

Anatomic landmark for doing pudendal block anesthesia

Ischial spine

Motor function of the pudendal nerve

Voluntary fecal and urinary incontinence


Maintain erection


Expulsion of urine from penile urethra

Indifferent stage lasts until what week

7th week of development

Gonadal sex is determined by

TDF on Y chromosome


SRY gene

At 8th week what cell secretes androgenix hormones which induces masculine differentiation

Leydig/Interstitial cells

What cells secrete MIH to inhibit development of paramesonephric duct

Sertoli cells

2 androgenic hormones

Testosterone


Androstenodione

Derivatives of the mesonephric duct

Epididymis


Vas deferens


Ejaculatory duct

Derivatives of the paramesonephric duct

Uterine tubes


Uterus


Vagina

All primary oocytes are formed by ?

5th month


*arrested at various stages of oogenesis

Primary oocytes are arrested in what stage ?

Prophase of Meiosis I

After puberty primary oocyte develops into ?


*during menstruation

Secondary oocyte


1st polar body

What changes does the secondary oocyte undergo ?

Metaphase of Meiosis II


*develops at fertilization

At what stage of development does implantation happen

Blastocyst

What reaction triggered by sperm penetrating zona pellucida

Acrosome reaction


Acrosin

Steps of fertilization and initiation of cleavage

Blastula with blastomeres


Combine to form morula by undergoing compaction

Timeline of ovulation to implantation

Fertilization 12-24hrs


2 cell stage 30 hrs


Morula 3 days


Blastocyst 5 days


Implantation 7 days

Preferred site of implantation of the embryo

Posterior superior wall of the uterus


Functional layer of the endometrium during the secretory phase

Function of the epididymis

Storage and maturation of sperm cell

Capacity of the gallbladder

30-50ml

MC location of cryptorchid testis

Inguinal canal

Descent of the testis occurs when

26-28 wks: descended retroperitoneally to the deep inguinal rings due to enlargement of the fetal pelvis

Length of the vas deferens

18in, 45cm

Vas deferens combine with seminal vesicle to form

Ejaculatory duct

Source of alkaline phosphatase in the semen

Seminal vesicle

Prostate lobe palpable by DRE

Posterior


Lateral *largest

Calcified secretions from the glandular area surrounding the prostatic urethra

Corpora amylacea

Largest accessory gland of the body

Prostate


*walnut shaped

BPH commonly occurs in the

Periurethral zone

Prostate adenocarcinomas typically present in the

Peripheral


Posterior

Histology of female genital organ

Simple cuboidal

Inner cortex of the ovaries contain the

Ovarian follicles

Length of the fallopian tube

4in


10cm

Widest part of the fallopian tube

Ampulla


*isthmus

Measurement of uterus

3inch long


2inch wide


1inch thick

Normal postion of the uterus

Anteversion (along the long axis of the vagina)


Anteflexed (body of the uterus on the cervix)

Lymph drainage of the vagina

Upper 3rd - int/ext iliac


Middle 3rd - internal iliac


Lower 3rd -superficial

Labioscrotal swellings to develop to form what in male and female ?

Scrotum


Labia majora (labial commisures)

Homologue of urogenital folds

Penis, spongy urethra


Labia minora, frenulim