Friday, 18 January 2013

Renal & Reproductive Anatomy Key Words


Here's a list of Anatomy words that I've slightly organised to help revise for Anatomy spot exams. It's not a complete list and it does require prior knowledge of the structures mentioned. I used it simple to jog the memory and associate certain words with each other.

Red is used to denote the anatomy in females only, blue for males only and purple for both (when it is unclear). It's not completely colour coded because it is assumed that certain key structures (e.g. penis, clitoris, uterus, etc.) would not be confusing.

This list is intended to help revise for Renal & Reproductive Anatomy with some mention of bones and cartilage. 
Pelvis
  • pelvic inlet
    • oval , heart-shaped
    • larger, more shallow
    • subpubic angle is wider
    • acetabulum is smaller
Perineum
  • pubic symphysis
  • ischiopubic rami & ischial tuberosities
  • sacrotuberous ligament
  • coccyx

Sacrospinous and sacrotuberous ligaments form greater and lesser sciatic foramen

Anal triangle
  • ischiorectal fossa
Urogenital triangle
  • perineal membrane
  • superficial perineal pouch
    • Ischiocavernosus m.
    • Bulbospongiosus m.
    • Superficial transverse perineii m.
    • Scrotum
    • Penis (crus, body, glans)
    • corpus cavernosum (corpora cavernosa)
      • crus
    • corpus spongiosum & urethra
      • forms glans penis
      • bulbous spongiosus
    • bulb of vestibule
      • forms glans clitoris
    • greater vestibular gland
    • 2 crura --> clitoris
    • glans clitoris
  • deep perineal pouch
    • deep to perineal membrane
    • deep transverse perineii m.(pierced by urethra + vagina)
    • external sphincter of urethra
    • membranous part of urethra
    • bulbourethral gland
  • colle's fascia (membranous layer of superficial fascia of perineum)
    • attached to perineal membrane, ischiopubic rami, membranous layer of superficial fascia of AAW
    • lines labia
    • lines penis and scrotum (dartos fascia)
- perineal body (mass of fibromuscular tissue)
Perineal injury – fluid collects in superficial perineal pouch

Levator ani muscles
  • spincter vaginae
  • Puborectalis (sling)
  • sacral plexus and pudendal n.

Obturator internus
  • lateral rotation of hip, stabilizes
  • sacral plexus
Piriformis
  • lateral rotation of hip, stabilizes
  • sacral plexus

Coccygeus
  • sacral plexus

Internal Pudendal a.
  • leaves through greater sciatic foramen, enters perineum through lesser sciatic foramen
  • Penis
Prostatic venous plexus
  • penis

Lumbosacral Plexus
  • Lumbosacral trunk
    • anterior rami of L4, L5
  • Lumabr plexus
    - anterior rami of L1 – L3 and part L4
  • Sacral plexus (S2, S3, S4)
    - anterior rami of S1 – S3 and part S4
    • Sciatic n.
      • nerves leaving through greater sciatic foramen
    • obturator nerve
    • Pudendal n.
      • External urethral sphncter
      • Deep transverse perineal
      • superficial transverse perineal
      • ischiocavernosus
      • bulbospongiosus
      • skin of perineum
      • anal canal and external anal sphincter

Pelvic Splanchnic nerves


Penis
  • root (2 crua + bulb)
  • body (2 corpora cavernosa and corpus spongiosum)
  • prepuce (double layer of skin)

Clitoris
  • urethra does not pass through
  • root (2 crua)
  • body (2 corpora cavernosa), suspended from symphysis pubis
  • glans clitoris is attached to body of clitoris and bulbs of vestibule

Mons pubis
  • labia majora
    • round ligament
Labia minora
  • sebaceous glands
  • vestibule of vagina
    • urethra and vagina orifices
    • opening of greater vestibular (Bartholi's) glands
      • fluid for sexual arousal

Urethra
  • 4cm
  • attached to anterior wall of vagina
  • 20cm
    • preprostatic urethra
      • internal urethral sphincter
  • prostatic urethra
  • membranous urethra
    • external urethral sphincter
  • penile urethra
    • intrabulbar fossa (bend vulnerable)
    • bulbourethral glands open
      • fluid for sexual arousal

Uterus
  • anteverted, anteflexed
  • fundus, body, cervix
    • body flattened anteroposteriorly
    • internal and external os

Broad Ligament
  • double fold of peritoneum
  • Uterine tube
    • infundibulum, fimbriae, ampulla, isthmus, intramural part
  • Mesometrium
  • Mesovarium
  • Mesosalpinyx

Ovary
  • ovarian fossa
  • obturator nerve (laterally related)
    • disease of ovary referred to medial aspect of thigh
  • ligament of ovary
    • round ligament (to labium majora)
  • ovarian artery (from Aorta)
    • in suspensory ligament of ovary
    • venous drainage , ovarian veins (to left renal v. and IVC)
  • uterine artery (crossed by ureter)
      • branch of internal iliac a.
      - anastomosis of ovarian & uterine arteries in broad ligament
  • danger of severe haemorrhage in ectopic pregnancy
  • uterine veins -> internal iliac vein
  • vaginal artery and vein (internal iliac vessels)

Vaginal fornices

Mammary gland
  • nipple, areola
  • ligaments of Cooper
  • axillary LN, Parasternal LN, Abdominal LN.
  • Lactiferous ducts

Recto-uterine pouch (Pouch of Douglas)
Uterovesical pouch

Prostate
Seminal vesicles
Ductus deferens
  • ampulla
Testicular arteries and veins

Scrotum, testis, spermatic cord
  • Dartos muscle
    • ANS
  • Spermatic cord
    • Internal spermatic fascia (from transversalis fascia)
    • Cremaster muscle and fascia (from internal oblique muscle)
      • genital branch of genitofemoral n.
    • External spermatic fascia (from external oblique aponeurosis)
  • Pampiniform plexus of veins
    • varicocele (usually left side)
  • Tunica vaginalis
  • Epididymis
  • Testis
    • tunica vaginalis
    • tunica albuginea (outer layer)
    • mediastinum
  • Lympathics of scrotum: superficial inguinal LN

Epididymis
  • head, body, tail

Ductus Deferens
  • ampulla
  • joins seminal vesicle to form ejaculatory duct

Prostate
  • puboprostatic ligaments
  • inferior vesical artery (from internal iliac a.)
  • prostatic venous plexus (to internal iliac veins and internal vertebral venous plexus)

Boundaries in Inguinal canal
  • external oblique aponeurosis
  • Trnsversalis fascia, conjoint tendon
  • arching fibres of internal oblique and transversus abdominis
  • lacunar ligament

Kidneys
  • retroperitoneal
  • T12 – L3
  • Suprarenal gland
  • related to psoas major and quadratus lumborum
  • capsule, perirenal fascia, renal fascia
  • hilum
  • sinus
    • perinephric fat
  • outer cortex
  • inner medulla
    • pyramids and cloumns
      • apex of pyramid = renal papilla
        • minor calyx
          • major calyx
            • renal pelvis
              • urter

Renal arteries and veins
  • L2
  • right renal a. posterior to IVC
  • veins lie anterior to arteries
  • Lateral aortic LN

Ureter
  • descends on psoas major, behind peritoneum
  • on tips of transverse processes of lumbar vertebrae
  • cross the bifurcation of common iliac vessels
  • crossed by ductus deferens/ uterine artery
  • pass obliquely to base of bladder
    • 3 constriction sites:
      • junction of renal pelvis with ureter
      • bifurcation of common iliac vessels at pelvic brim
      • wall of urinary bladder
  • blood supply from branches of renal arteries, common iliac and internal iliac arteries.
  • Lateral aortic LN and Iliac LN

Bladder
  • apex, base, superior surface, inferolateral surfaces
  • mucosa of base is smooth
    • trigone
    • in contact with seminal vesicles and ductus deferens
    • in contact with vagina and cervix
  • wall of bladder
    • detrusor muscle (smooth)
      • internal urethral sphicter
  • blood supply from superior and inferior vesicular arteries (branches of internal iliac a.)
  • vesical venous plexus (joins prostatic venous plexus -> internal iliac v.)
  • Iliac LN
  • inferior hypogastric n. plexus

Vertebral column
  • 33 vertebrae
  • 7 cervical
    • short body, short bifid spinous process
    • triangular vertebral foramen
    • C7 has a long spinous process
    • C1 = atlas
      • no body
      • ant. Arch, post. Arch
    • C2 = axis
      • dens/ odontoid process
        • aplical ligament
        • alar ligament
    • atlanto-occipital joint (synovial) - yes
    • atlanto-axial joint (synovial) – no
  • 12 thoracic
    • triangular vertebral body
    • ribs 1 – 10
      • 2 synovial joints
        • head articulates with vertebra of same number and the one superior
        • tubercle articulates with transverse process of vertebra of same number
  • 5 lumbar
  • 5 sacral
  • 4/5 coccygeal

Vertebra
  • body, foramen
  • arch
    • ant. Pedicle, post. Laminae
  • transverse processes
  • spinous process
  • superior and inferior articular processes
    • at junction of pedicles with laminae
  • intervertebral foramen

Curvatures:
  • Kyphosis - hunchback
  • Lordosis – lumbar
  • Scoliosis – s-shaped

Intervertebral discs
  • secondry cartilaginous joint
  • annulus fibrosis
  • nucleus pulposus
    • gelatinous tissue
  • no disc between atlas and axis

Ligaments:
  • Short
    • interspinous ligaments
    • intertransverse ligament
    • ligamenta flava
  • Long
    • Anterior longitudinal ligament
    • Posterior longitudinal ligament
    • Supraspinous ligament

Muscles of Back:
  • Splenius capitis and cervicis
  • erector spinae
  • transversospinales
  • interspinales and intertransversarii

--Histology--
Cartilage:
Proteoglycans
Hyaline cartilage
  • purple/pink with bubbles
  • chondrocytes found within lacunae (identifying feature)
Fibrocartilage
  • hyaline + think dense collagen fibres
  • row ofchondrocytes in lacunae
  • row of dense collagen (wavy)
Elastic cartilage
  • black elastic fibres (identifying feature)
  • collagen stained red
Chondrocytes
- in lacunae (white bubbles)
Chondroblasts
Perichondrium
  • hyaline cartilage at joint surfaces has no perichondrium for replacement

Bone:
Osteoblasts
  • tappered cells / cuboidal
  • make osteoid
Osteocytes
  • tappered
  • smaller than osteoblasts
  • separated, and in white bubbles
Osteoclasts
  • multinucleated phagocytic cells
  • located in Howship's lacunae
Woven bone
  • random
Lamellar bone
  • parallel

Compact bone
  • Haversian system/ osteon
    • Haversian canal + Lamellae
  • Volkmann's canals
  • Lacunae
    • cavity containing osteocyte
  • Canaliculi
  • Interstitial lamellae

Trabecular bone
  • trabeculae
  • many adipocytes

Epiphysial growth plate
  • many layers

Kidney
Fibrous capsule
cortex
medulla
papilla
ureter
hilium
nephron:
renal corpuscle
  • glomerulus
    • mesangium
    • podocytes
  • Bowman's capsule
renal tubule
  • Proximal convoluted tubule
    • simple cuboidal epithelium
    • microvilli
  • Loop of Henle
    • thin segment (thin wall)
    • thick segement (thick wall)
  • Distal convoluted tubule
    • simple cuboidal epithelium
    • larger lumen than PCT
    • microvilli
Juxtaglomerular apparatus
  • macula densa
  • juxtaglomerular cells
  • extraglomerular mesangial cells
  • located at top of glomerulus
Collecting tubules
  • tall simple columnar cells

Ureters
  • mucosa
  • lamina propria
  • longitudinal smooth muscle
  • circular smooth muscle
  • Adventitia

Transitional epithelium
  • stratified
  • umbrella cells
  • in ureters, bladder, superior urethra

Bladder
  • transitional epithelial mucosa
  • detrusor muscle
    • inner longitudinal
    • outer circular
    • outermost longitudinal
  • adventitia

Testis
  • tunica vaginalis
  • tunica albuginea
  • septa
  • seminiferous tubules
    • epithelium
      • spermatogenic cells
        • spermatogonia (round cell)
      • sertoli cells (oval shaped)
    • myofibroblasts
  • Interstitial cells (Leydig cells)
  • rete testis
  • efferent ductules
  • ductus deferens

Epididymis
  • pseudostratified columnar epithelium
  • microvilli – stereocilia

Ductus deferens
  • pseudostratified columnar epithelium
  • small lumen

Prostate gland
  • branched tubulo-acinar glands

Ovary
  • stroma
  • germinal epithelium
  • cortex
    • follicle
    • corpus luteum
  • tunica albuginea
  • medulla

Uterine tubes
  • folded mucosa
  • ciliated epithelium
  • longitudinal and circular smooth muscle
  • serosa
  • peg cells

Endometrium
  • stratum basalis
  • stratum spongiosum
  • stratum compactum

Cervix
  • endocervical canal (single layer of tall columnar mucus-secreting cells)
  • ectocervix (thick stratified squamous)
  • juntion at external os

Vagina
  •  stratified squamous epithelium