UCF Dr. Dow Anatomy Exam 3 study guide
What is the clinical significance paraoesophageal hiatal hernia?
-Cardia doesn't move but part of the fundus and peritoneum passes through the esophageal hiatus. -Usually no regurgitation
What is the clinical significance of endometriosis
-Endometrial growth that occurs outside of the uterus -Very painful
Glands in the body and fundus: Chief cells function:
-Produce pepsinogen
What is the functions of the kidney?
-Production of urine by eliminating waste and harmful metabolic products -Regulate electrolyte and water equilibrium and pH in body -Filters blood in nephron -Produces ultra filtrate of blood plasma -Regulate NaCl concentration -Produce erythropoietin to encourage RBC formation for low oxygen levels
what is the mechanism of Ejaculation
-Projectile outflow of semen from external urethral orifice -sympathetic nerves lead to the closure of the internal urethral sphincter, which is proceeded by contraction of the urethral muscle accompanied by contraction of the bulbospongiosus muscle by the somatic nerve -Following ejaculation, penis becomes flaccid again and the helicine arteries contract which allow the blood to flow out
Glands in the body and fundus: Mucoid Cells Function
-Protect simple columnar epithelial cells
Locations of Medial Muscle Group:
-Rectus Abdominis -Pyramidalis
what are the contents of the Rectus Sheath-
-Rectus abdominis muscle -Inferior and Superior epigastric vessels -Intercostal nerves (5 lower -subcostal nerve
What is the mechanism of an erection
-Relaxation of helicine arteries due to stimulation of the Parasympathetic nerves -Blood rushes to fill the sinuses of the corpora cavernosa; tunica albuginea become tightened -Bulbospongiosus and ischiocavernosus muscles contract, compressing the veins in the corpora cavernosa, restricting blood flow -As a result, both corpora cavernosa and spongiosum become enlarged, rigid, and the penis erects
What are the nine regions of the abdomen
-Right Hypochondriac region -Epigastric region -Left Hypochondriac region -Right Lumbar Region -Umbilical Region -Left Lumbar Region -Right Iliac Region -Hypogastric Region -Left Iliac Region
Contents for the inguinal Canal in women:
-Round ligament of ligament of the uterus and lymphatics
What is the importance of stomach Rugae and Oblique muscle layer of the stomach?
-Rugae: allows for expansion -Oblique Muscle Layer: allows for churning
What are the unique characteristics of each layer of the adrenal Medulla
-Secretes epinephrine and norepinephrine -Regulated directly by sympathetic system (adrenalin)
Blood Supply of Esophagus:
-Upper part (cervical portion): by inferior thyroid artery -Middle part (thoracic portion): by thoracic aorta (4-5 arteries ) and from bronchial arteries -Lower part including the abdominal portion: left gastric artery (from Celiac artery) and inferior phrenic artery (from abdominal aorta)
What are the content of the spermatic cord
-Vas Defrens -Arteries (Testicular, Ductus deferens, and cremaster) -Pampiniform plexus -Autonomic nerve fibers -Genital branch of genitofemoral nerve -Lymphatics -Cremaster muscle
What is the venous Drainage of the stomach?
-Veins: All blood is drained via Portal vein directly (left and right gastric veins) or indirectly through the splenic vein (the left gastroepiploic vein and short gastric veins) -The right gastroepiploic vein goes to the superior mesenteric vein.
What is the venous drainage of the Kidney?
-Via the renal veins that drain into the IVC -Since the IVC is on the right side of the abdominal cavity, the left renal vein is longer than the right renal vein -More importantly, the left gonaldal vein drains into the left renal vein, but the right gonadal vein drains into the IVC directly
What is the development of gallstones
-formed due to an imbalance in the concentration of cholesterol and bile salts in the bile; precipitation of the salts or cholesterol leads to stone formation
What is the location of Vermiform Appendix
-from the posteromedial aspect of the cecum about 2-3 cm below the ileocecal junction
What are the parts of the nephron?
-glomerulus -bowman's capsule -proximal tubule -loop of henle -distal tubule -collecting duct
what is the importance and function of Hepatocytes
-helps to detoxify drugs
What is the clinical significance of hypertrophic pyloric stenosis?
-enlargement of circular muscle cells in pyloric sphincter which causes narrowing in pyloric channel which obstructs food passage -Nonbilious vomiting and olive sized mass during palpation
What is the clinical significance of Pancreatitis?
-inflammatory disease of the pancreas, acute or chronic -Acute pancreatitis may resolve without persistent histologic changes, in contrast to the chronic pancreatitis -Biliary tract disease (gallstone in ampulla of Vater), alcohol, infections and trauma can lead to pancreatitis -Severe abdominal pain radiating to the back
What is the clinical significance of cystic fibrosis?
-inherited disease caused by mutation in the transmembrane conductance regulatory gene (CFTR), defect in Cl- channel -affecting the respiratory system, GI tract and pancreatic enzymes deficiency leading to malabsorption and steatorrhea -Mucus build-up
What are the endocrine functions of the pancreas?
-islets of Langerhans -Alpha cells: produce glucagon -Beta cells: produce Insulin -Blood glucose concentration regulators -Delta cells: produce somatostatin
Structures and Organs that belong to Hindgut:
-left 1/3 of the transverse colon -descending colon -sigmoid colon -rectum -upper part of anal canal
What is the location & importance of seminal vesicle
-lie posterior to the bladder between rectum and fundus of the bladder, and superior to the prostate -Works with prostate to produce fluid aspect of seminal plasma
Structures and Organs that belong to Midgut:
-lower half of the 2 nd part of the duodenum -jejunum -ileum -colon (cecum, ascending and the right 2/3 of the transverse colon)
unique characteristics of Direct Inguinal Hernia:
-medial to epigastric vessels - don't pass through the inguinal canal (parallels spermatic cord) - low risk of strangulation/ infarct - are almost always acquired - Middle age man (over 40 y) - smaller in size - occurs within Hesselbach's triangle
What is the diagnoses of gallstones?
-painful splinting of reparation in right upper quadrant of palpation (Murphy's sign) -5F's: female, fertile, forty/fifty, full-figured, and fair
What is the clinical significance of Cirrhosis of the liver?
-persistent inflammatory reaction and progressive destruction of the liver due to necrosis and replacement by fibrosis and compensatory hyperplasia -Causes backup of all functions of liver where necrosis takes place
What is the importance of Glisson's Triad?
-portal triad
What is the clinical significance of Lesser Sac (Omental Bursa/Omental Foramen/Epiploic Foramen)
-pouch behind stomach. Possible site for internal herniation and allows for access to cystic artery of gallbladder
What are the four parts of male urethra & their characteristics
-preprostatic: before prostate gland -prostatic: most dilated part of urethra -membranous: most vulnerable part to injuries due to being fixed and less mobile -spongy: full length of penis. Longest part
What are Internal Hemorrhoid's
-prolapses of rectal mucosa containing superior rectal veins. -They occur above the pectinate line. -Painless bleeding, autonomic nerve supply (also called Piles)
Know the overall function of the duodenum
-secrete substances to slow down peristalsis, stop HCl, produce CCK to contract gallbladder and release bile, and regulate pancreatic enzyme and juices
What is the clinical significance of the pectinate line of the anal canal?
-separates the internal and external anal canal
Enteroendocrine cell: G-Cell (Gastrin) function
-stimulate acid secretion and growth of parietal cells
What is the clinical significance of Vagotomy?
-surgical treatment of Gastric ulcer -used for treating gastric ulcers not responding to drugs - cutting vagus nerve to stimulate HCl production
What is the mechanism of Emission
-sympathetic stimulation causes the ductus deferens and seminal vesicle to deliver semen from the epididymis to the beginning of the urethra (prostatic urethra) by means of peristalsis
What is the clinical significance of Zenker's diverticulum?
-upper esophagus, dysphagia, and halitosis -Protrusion of esophagus in upper esophagus -*Complications: ulceration, bleeding, and inflammation* -Therapy: surgery
what is the clinical significance of Sliding Hiatal Hernias?
-when cardia and even part of the fundus slide up through the esophageal hiatus. -Regurgitation and heart burn
what is the importance & function of Ito Cells
-fat storage cells
What are the functions of the Liver?
-Bile production -Involved in carbohydrate and protein metabolism -Vitamin and protein production -Detoxification of drugs
what is the blood Supply of the Stomach:
(Celiac trunk branches) -Left gastric artery -Common hepatic artery → right gastric artery -Common hepatic artery → gastroduodenal artery → right gastroepiploic artery -Splenic artery → short gastric arteries and left gastroepiploic artery
What is the clinical significance of Hydrocele of the Cord:
(Testis connected to the spermatic cord, descends from the abdominal cavity to the scrotum via the inguinal canal during the intrauterine life • Preceding descension, part of the processus vaginalis (the peritoneum) travels through the canal to "line" the developing scrotum) -process vaginalis fails to close after testis have descended; fluid forms around the spermatic cord
What is the clinical significance of Cryptorchidism:
(Testis connected to the spermatic cord, descends from the abdominal cavity to the scrotum via the inguinal canal during the intrauterine life • Preceding descension, part of the processus vaginalis (the peritoneum) travels through the canal to "line" the developing scrotum) -when the testis fails to descend
What is the treatment of Appendicitis
*removal of appendix -Appendectomy
Unique characteristics of Indirect Inguinal Hernia:
- lateral to epigastric vessels - passes through the inguinal canal (inside spermatic cord) - high risk of strangulation/ infarct - congenital and acquired - in younger people - bigger in size
what is the Clinical significance of Hemigastrectomy?
-Billroth I and II, vagotomy and pylorectomy/antrectomy -Removal of stomach to control gastric secretion
What is the innervation of the digestive tract: Submucosal plexus of meissner
-Branches of vagus nerve
What is the function of Jejunum and the ileum?
-Absorption of the digested food
what is the Clinical Significance of Barrett's Esophagus?
-Acid reflux from one epithelium to the other
What are the exocrine functions of the pancreas
-Acinar cells -Secretion -CCK -Bile secretion from gallbladder -Pancreatic secretion contains lipase to break down fat, amylase to break down carbohydrates, and inactive proteases (chymotrypsinogen, trypsinogen, etc.) to break down proteins -Enzymes are activated in the small intestine by Enterokinase
What is the importance of Juxtaglomerular?
-Afferent portion of glomerular arteriole -Special cells that sense stretch
Innervation of Lateral Muscle Group:
-All innervated by 6 lower intercostal nerves and L1
Innervation of Medial Muscle Groups:
-All innervated by 6 lower intercostal nerves and L1
how are hemigastrectomy, vagotomy and Gastric Ulcers related?
-All surgical Treatments of Gastric Ulcers
What is the clinical significance of Meckel's Diverticulum?
-An ileal outpocketing typically located with in 50-75 cm (40 cm in newborn) of the ileocecal valve -Pouch of mucosa that doesn't belong -May mimic pain of appendicitis -About half of them cause ulceration, inflammation, and GI bleeding because of the presence of ectopic acid-secreting gastric epithelium; pancreatic tissue may also be present there *Rule of Two's: occurs in about 2% of children, 2 feet from the ileocecal valve, contain 2 types of ectopic mucosa (gastric and pancreatic), usually occurs at 2 years of age*
What is the blood supply and drainage of small intestines?
-Arteries: branches of the superior mesenteric artery -Veins: Superior mesenteric vein into the portal vein and to the liver
What us the location & importance of vas deferens
-Ascends in the spermatic cord -allows passage of sperm from testes/epididymis to urogenital track
What is the clinical significance of peritoneal spaces and compartments
-Because of the arrangement of the peritoneum, fluid in the abdominal cavity tends to collect and become localized in certain regions or compartments -Post-operatively significant
What is the histology of Esophagus (The four layers)
-Mucosa -Submucosa -Tunica muscularis -Adventitia
What is the treatment of gallstones?
-Cholecystectomy: removal of the gallbladder due to severe biliary colic, cystic duct obstruction or cholecystitis -Medication
What is the clinical significance of Hirschsprung's disease?
-Deficiency of nerve cells in submucosal plexus' -Congenital mega colon -No mucus secretions and no movement (peristalsis) -Rectum is constricted and causes colon to become enlarged -Associated with down syndrome and Chagas disease. 90% restricted to the rectum. -Diagnosis is by rectal biopsy. Prolapse of the rectum: may occur through anus
What is the blood supply of kidney?
-Direct branches of the abdominal aorta -Renal arteries also give the inferior suprarenal arteries
What is the difference between direct and indirect inguinal hernia
-Direct is smaller than Indirect -Direct is medial and Indirect is Lateral -Direct does not pass through the canal and Indirect passes through canal -Direct is low risk and Indirect is high risk
Which organs are categorized as Retroperitoneal?
-Duodenum in small intestine -Pancreas -Kidney -Suprarenal glands -Colon (Ascending and Descending) -Rectum (upper 2/3) -IVC -Uterine cervix
What is the clinical significance of Gastric Ulcers?
-Erosion of stomach lining due to defective mucosal barrier -More common in lesser curvature of stomach -Treatment: Vagotomy (when drugs don't work)
Structures and Organs that belong to Foregut
-Esophagus -stomach -2nd part of the duodenum -liver -biliary system -gall bladder -pancreas
Which type of epithelium lines the gastrointestinal tract from the mouth to the external anal canal?
-Esophogus: Stratified non-keratinized squamous epithelium -Stomach through lower anal canal: Simple columnar epithelium -External anal canal: Stratified non-keratinized squamous epithelium
Locations of Lateral muscle Group:
-External abdominal Oblique -Internal Abdominal Oblique -Transverse Abdominis
The origin of the Inguinal Ligament:
-External abdominal oblique muscle (it's rolled up)
What is the Sliding hiatal hernia treatment?
-Fundoplication or radio-frequency treatment
What is the paraoesophageal hiatal hernia: Treatment
-Fundoplication or radio-frequency treatment
What enteroendocrine cell is found within the gastric pits in the pyloric antrum?
-G- Cells
Gastric Pits vs. Gastric Glands
-Gastric pits: no presence of chemical digestive cells. Lead into glands -Gastric glands: presence of chemical digestive cells
What is the clinical significance of esophageal varices?
-Gastric veins drain into the portal vein; therefore, this is a link between portal and the systemic circulation (Porto-Caval anastomosis). In liver cirrhosis patients it happens often
Unique characteristics of paraoesophageal hiatal hernia:
-Herniated portion of stomach is superior of diaphragm on one side of esophagus
Unique characteristics of a Sliding Hiatal Hernias
-Herniated portion of stomach superior to diaphragm on left and right side of esophagus
What is the importance and function of Disse's space
-Houses Ito cells
What is the renin-angiotensin-aldosterone system?
-If Granular cells detect a decrease in blood pressure they secrete a hormone called Renin -Renin is released into the blood were it converts angiotensinogen (build in the liver) into to angiotensin I -As the blood passes through the lungs, Angiotensin I makes contact with an enzyme released by lung epithelium called Angiotensin Converting Enzyme (ACE) -ACE converts angiotensin I into angiotensin II -Angiotensin II has multiple targets, including the adrenal gland. Adrenal derived aldosterone causes an increase in blood volume, resulting in an increase in blood pressure.
What is the blood supply and venous drainage of the colon
-Ileocolic artery, cecal artery, appendicular, right colic, and middle colic arteries -Superior and inferior mesenteric artery -Superior and inferior mesenteric vein
Which muscles form the wall of the pelvis?
-Iliacus, psoas major -Obturator internus -Piriformis, pubococcygeous, iliococcygeous, and puborectalis, coccygeous -Urogenital diaphragm
What are the nerves of the Lumbar Plexus
-Iliohypogastric n -Ilioinguinal n -Genitofemoral n. -Lateral Femoral cutaneous n. -Obturator n. -Femoral n. -Short, direct muscular branches
What are the functions of the Spleen?
-Immune organ -Removes old RBC's from circulation -Iron storage (gives brown color) -Blood storage in dog
What is the location of Ito Cells
-In disse's space
Venous Drainage of Esophagus:
-Inferior thyroid vein, azygos, hemiazaygos, and gastric veins
What is the origin of the Cremaster Muscle:
-Internal abdominal oblique
What is the location of the Rectus Sheath
-Lies on the outer portion of the Rectus abdominis
What is the location & importance of the epididymis
-Lies on the posterior surface of the testis -Quality control and package warehouse for sperm
What is the clinical significance of Achalasia?
-Loss of nerve of a part of esophagus. Doesn't allow for peristalsis in area. Can cause food to back-up traveling through esophagus
What is the Clinical Significance of appendicitis
-May be occluded by a fecalith or inflammation and edema of the lymphatic tissue leading to acute (acute abdomen) and chronic appendicitis *- Pain is preumbilical at T10 dermatome (sympathetic) *- Appendectomy using the McBurney's point between umbilicus and right anterior superior Iliac spine (junction between right 1/3 and mid 1/3). *- The Iliohypogastric nerve should be saved, if not, muscle weakness and direct Inguinal hernia may result
What is the clinical significance of Leiomyomas
-Most common uterine tumors -Estrogen sensitive smooth muscle tumors that, during pregnancy, may enlarge and cause obstructive delivery
What three types of cells would be found in the gastric glands in the body and Fundus of the stomach?
-Mucoid -Parietal -Chief
What are the aspects of the menstrual cycle
-Mucosa of the uterus (endometrium) lies directly on the muscle (myometrium) - Simple columnar epithelial (some ciliated) cells, and contain uterine glands -A basal layer (1mm thick), which is not shd during menstruation, can be distinguished from a functional layer (stratum compactum and stratum spongiosom, up to 8mm) - ~28 day cycle, with day one the first day of menses - Made up of a follicular/proliferative phase and luteal/secretory phase -*Desquamation and Regeneration*: - 1 st to 4th day, disappearance of progesterone and increase in estrogens - The superficial portion of endometrium is shed; eventually the epithelium and connective tissue of the functional layer regenerate from the basal layer -* Follicular/ Proliferative Phase*: - Menses (5 days) + Proliferative phase (9 days) -After menses, there is a gradual increase in GnRH release and subsequent gonadotropins -Estradiol concentration increases with follicular development -Proliferation refers to the increase in thickness of the endometrium immediately following menses -*Luteal/Secretory Phase*: -Ovulation occurs at the end of the follicular phase, between day 11-14 - Secretory phase (14 days) - Progesterone and estradiol increase dramatically; both secreted from the CL (species specific) -Endometrium reaches maximal thickness, providing the optimal environment for an embryo -If no established pregnancy, then the luteal phase ends with menses
Clinical Significance of Cremasteric Reflex:
-Palpate upper thigh to bring testes closer to which to help with determination of nerve damage or testicular torsion diagnosis
Secondary condition caused by gallstones?
-Pancreatitis as a build-up of enzymatic breakdown in pancreas due to blockage of gallstone
What is the innervation of Hindgut
-Parasympatheic: Pelvic Splanchnic nerves (S2,S3,S4) -Sympathetic: T5-L2 spinal segments
What is the innervation of Foregut:
-Parasympatheic: Vagus nerve (CN X) -Sympathetic: T5-L2 spinal segments
What is the innervation of Midgut:
-Parasympatheic: Vagus nerve (CN X) -Sympathetic: T5-L2 spinal segments
What is the innervation of the stomach?
-Parasympathetic: Vagus -Sympathetic: Splanchnic nerve (S2-S4)
Innervation of small intestine
-Parasympathetic: Vagus nerve -Sympathetic: T5-L2 spinal segment
What is the innervation of the rectum and anus
-Parasympathetic: pelvic splanchnic nerve (S2-S4) -Sympathetic: from lumbar part of the trunk through the superior hypogastric plexus.
what are Male pelvis characteristics vs a womans?
-Pelvic Inlet (brim) >Narrow >Basically heart-shaped -Pelvic outlet >Narrower >ischial tuberosities longer, sharper >point medially -less movable coccyx
What are the characteristics of the female pelvis to the male pelvis
-Pelvic inlet (brim) >wider >oval from side to side -Pelvic outlet >Wider >ischial tuberosities shorter, farther apart >everted -more movable coccyx
The importance of Greater Omentum:
-Prevents the visceral peritoneum to adhere to the parietal peritoneum -Has considerable mobility and moves by peristaltic movements of the viscera -Contains fat and lymphocytes and other immune cells to protect against infection or inflammatory conditions in the abdominal cavity -Abdominal policeman -Moves towards the inflamed or infected area (e.g: the Appendicitis) -Protects abdominal organs against injury and acts as an insulator against loss of body heat
Glands in the body and fundus: parietal HCI cells
-Produce HCI and intrinsic factor for B-12 absorption in the ileum
Contents of the Inguinal Canal in men:
-Spermatic cord
Which organs are categorized as intraperitoneal?
-Stomach -Jejumum and ileum in the Small intestine -Spleen -Liver -Gallbladder -Cecum with vermiform appendix -Colon (Transverse and sigmoid colon)
What is the importance of rectus sheath
-Structural integrity of rectus abdomens muscle
What is the clinical significance of Portocaval anastomosis?
-Superficial veins that drain into portal vein -Blood backup into rectum with engorgement of vessels around rectum
what is the venous drainage of the rectus and anus
-Superior: Inferior mesenteric vein -> Portal vein -Middle: Internal iliac vein -Inferior: Internal iliac vein
what is the blood supply of the rectus and anus
-Superior: inferior mesenteric artery -Middle: Internal iliac arteries -Inferior: Internal pudendal artery
What are the functions of the nephron?
-The nephron is the functional unit of the kidney; 1.5 million nephron per kidney -Blood enters the nephron through an arterial network (the glomerulus) where it is filtered -While the ultra filtrate passes through various parts of the nephron, various substances like glucose, Na+ and water are reabsorbed to reduce the volume from 150 liter per day to 1.5 liter of urine
What are the unique characteristics of each layer of the adrenal cortex
-Zona Glomerulosa: produce aldosterone. Regulates electrolyte and fluid homeostasis -Zona Fasciculata: Produce cortisol and androgens to regulate carbs, lipid, and protein metabolism (glucocorticoids) -Zona Retculata: Produce small amount of sex hormones and supplement gonadal sex hormones
what is the function of Vermiform Appendix?
-accumulations of lymphatics in the mucosa and the submucosa -large amount of beneficial bacteria to help clean out colon
What are external Hemorrhoid's?
-are thromboses (blood clots) in the veins of the external rectal plexus (inferior rectal veins) and are covered by the skin. -They occur below the pectinate line -painful. -Somatic innervation, (inferior rectal branch of the pudendal nerve)
What is the location of Glisson's Triad
-at each corner of hexagon in liver
What is the location & importance of Prostate
-behind the pubic symphysis -Works with seminal vesicle to produce fluid aspect of seminal plasma
What if the location of Disse's space
-between sinusoids and surface of liver
What is the location of the Inguinal Canal
-bottom of external oblique muscle
What is the function of Glisson's Triad?
-branch of portal vein, proper hepatic artery, and common bile duct
What is the innervation of the Digestive tract: Myenteric plexus of Auerbach?
-branches of vagus nerve
What is the innervation of the Cremaster Muscle:
-by the genital branch of the Genitofemoral nerve
What is the location of Hepatocytes
-cells in each hexagon of liver
Name and characteristics of four parts of duodenum
1. Superior: connected to pyloric orifice. Site of ulcer 2. Descending: Have papilla's for secretion of bile and other enzymes 3. Horizontal: Anterior to IVC and abdominal aorta 4. Ascending: Travels across midline to duodenojejunal flexure
Blood supply of Foregut
Celiac Trunk
Blood supply of Hindgut:
Inferior Mesenteric Artery
Blood supply of midgut:
Superior Mesenteric artery