anatomy II 2
Terms
undefined, object
copy deck
- contents anterior mediastin
- i. mammary vessels and LN, thymus (esp kids)
- masses ant mediastin and general qualities
-
-terrible lymphoma
-thymoma-assoc w MG, goes around structures
-teratoma-most benign
-thyroid-pushes other structures - details thymoma
-
assoc MG, see in middle age
1/4 calcified
grows around structures - teratoma
-
3 layers germ cells arrested en route to gonads
see 20-40, more in women but men have more malignant
Ca 1/3-1/2, cystic
benign (most)=round smooth margins
malig=irreg, lobulated - ant mediastin lymphoma
-
90%HL, 50% NHL have LAN
lobulated, no calcification
MC ant mediastin mass - ant mass with calcif
- MC teratoma, also thymoma
- contents middle mediastin
- heart, asc aorta, pulmon vessels, main stem bronchi, LN
- MC middle mediastin mass
- Lymphoma or sarcoid, also pericardial and bronchogenic cysts, AAA
- sarcoid 2% rule
-
2% unilateral, pl eff, PTX
(so usu bilateral, rarely cxn of pl eff or PTX) - contents P. mediastinum
- eso, nervous structures
- masses P mediastinum, in what pts
-
neural:
(75% <4, younger more likely malignant)
-ganglioneuroma (symp)
-NF can degenerate to neurosarc
-NB (often symp chain, already met bone liver) - rupture superior wall of bladder (ie compression on full bladder)
- within peritoneal cavity
- rupture anterior bladder (ie fractured pelvis)
- within retropubic space of Retzius (extra peritoneal)
- rupture of urethra above UG diaphragm (ie fractured pelvis, catheter)
- within retropubic space of Retzius (extra peritoneal)
-
rupture of urethra below UG
****MC
(ie straddle injury) - within superficial perineal space extending into scrotal, penile, anterior abd wall area.
- what supfcl perineal space bw
- colles fascia/dartos and external sperm
- rupture penile urethra
- between deep fascia of Buck, if the deep fascia is not torn the urine stays within the penis. if it is torn it goes into the superficial perineal space
- name strap muscles and innerv
-
ansa cervicales
-sternohyoid
-geniohyoid
-thyrohyoid
-omohyoid - artery causes nose bleeds
- sphenopalatine (branch of maxillary)
- contents pelvic diaphragm
- coccygeus and levator ani
- composition levator ani
-
iliococcygeus
pubococcygeus
puborectalis
levator prostate - what sep UG and anal triangle
- colles
- what pts of att of UG and anal triangle
- both use ITs, UG goes to PS, anal goes to coccyx
- describe layers passed "median episitomy"
-
start at frenulum of labia minora,
skin,
vaginal wall
perineal
spfcl transv perineal - layers past in mediolateral episitomy
-
start at frenulum, 45 angle,
skin
vagina
bulb spong
this gives more room - female contents deep perineal
-
both sexes:
UG diaphragm
d trvs perineal
sphincter urethra
female:
urethra
vagina
branches i pudendal-a of clitoris
branches of pudendal n-dorsal n of clitoris
**no glands (unlike male) - male contents deep perineal
-
both sexes:
UG diaphragm
d trvs perineal
sphincter urethra
male:
mem urethra
branches i pudendal-a of penis
branches of pudendal n-dorsal n of penis
**bulbourethral glands - female contents spfcl perineal
-
1) urethra
vestibule of vagina
bulbosponf
ichocavern
spfxl trv perineal
2) branches i pudendal a incl perineal going to p labial a and dorsal a of clitoris
3) branches pudendal n
perineal-p labial n
dorsal n
4) vestibular bulb, crura of clitoris, perienal body
5) greater vestibular blands Bartholin - male contents spfcl perineal
-
1) penile urethra
bulbospong
ischiocavern
spfcl trv perineal
2) branches i pudendal a
perineal-p scrotal
dorsal a penis
deep a penis
3) branches pudendal n
perineal n-p scrotal n
dorsal n penis
4) bulb, crura of penis
perineal body
5) duct of bulbourethral - cervical ca mets to which LN
- obturator (ovarian to paraortic)
- what limits birth canal in vagina area
- ischial spines, sacrospinous lig
- ant fornix, describe location
- ant to cervix, just next to vesicouterine puch, can palpate bladder thru here
- describe location p fornix
- next to rectouterine pouch of Douglas, can palpate rectum, S1 sacral promontory, coccyx
- blood supply internal female genitalae
-
uterine a (via trvs cervical lig)
ovarian a (broad lig)
a clitoris (dorsal and deep) - pudendal innerv female
-
pudendal S2-5 out grtr sciatic, in lessr sciatic, thru Alcock's canal
perineal n
p labial n
i rectal
d clitoris - innerv female besides pudendal
-
ilioinguinal-a labial
genitofemoral
perineal branch of p femoral cutaneous - what goes thru grtr sciatic foramen
-
s gluteal van
i gluteal van
i pudendal va
pudendal n
sciatic n
piriformis - pelvic inlet measurement
-
best is diag conjugate which is sacral promontory to infr PS (measured on exam)
(the other is called true conjugate) - borders of pelvic outlet
-
coccyx
IT
infr pubic ramus
PS - two pelvic outslet mesaurements
-
trvs (bw IT)
interspinous, if <9.5 cm problem - pudendal n block key landmark
- find the ischial spine
- elements broad lig
-
mesovarium, mesoalp, mesomet
round lig uterus
suspensory of ovary
trvs cervical w uterine van
remnant meso (paraoph, epooph, Gartner duct)
ureter
fallopian tubes - support uterus
-
pelvic diaphragm
UG diaph
bladder
round lig
broad lig
uterosacral
pubocervical - hold uterus in anteverted position
- uterosacral lig
- parts uterus
-
fundus
cornu-entry uterine
body w isthmus (c sxn spot)
cervix - position uterus
-
antiflexed (angle bw cervix and body uterus)
ante verted (angle bw cervix, vagina) - ext os is what shape if had kid
- transverse
- location bartholins
- around urethra
- paraurethral glands of Skene
- around urethra
- blood supply male
-
testicular a
a ductus deferens (i iliac)
cremasteric (i epigastric)
ext pudendal (femoral a)
drains by pampiniform plexus to test v - LN for male
-
scrotum-spfcl inguinal
testes-deep lumbar (renal hilus) - prostate blood supply
-
i vesical (i iliav) to prostatic venous plexus then
1) i iliac-IVC
2) vertebral, cranial dural sinuses
note for mets! - penis blood supply
-
deep a penis (erection) to dorsal a (i pudendal) then
1) deep dorsal v to prostatic venous plexus
2)spfcl dorsal v-ext pudendal to grtr saph to femoral v to IVC - rupture antr bladder
- goes into RPS
- rupture urethra above UG
- goes into RPS
- tear urethra below UG
- spfcl perineal (scrotum, penis, ant abd)
- tear penile urethra
- beneath bucks-penis only
- layers cut thru in vasectomy
-
colles-dartos
ext sperm
cremasteric
int sperm
NOT tunica vaginalis - key components seminal vesicle
- fructose, choline
- contents prostatic fluid
-
citric a
acid P (dx ca)
PG
fibrinogen
PSA (dx ca)-serine protease liquefies sxns - path of sperm
-
testes: seminfer, strt tubules, rete testes, efferent ductules
epidid
vas deferens/ductus deferens
sperm cord thru deep inguinal ring
ampulla seminal vesicle joins making ejac duct
prostatic urethra
prostate - tunica vaginales
- everywhere but not P testes
- urethra in male is in
- corpus spongiosum
- spongiosum come from (male)
- bulb, ends in glans
- what covers crus and bulb
- ichsiocavernosus and bulbospong respectively
- crura leads to
- corpus cavernosum
- describe contents penile shaft
-
1 corpus spongiosum w urethra, 2 corpus cavernosum with tunica albuginea around each
deep a. is within corpus cavernosum
dorsal a, n,
spfcl and deep dorsal veins - describe clitoris
-
no corpus spongiosum
body of clitoris formed by 2 corpus cavernosum which are cont w crura, glans formed by fusion of vestibular bulbs - bulb of vestib covered by
- bulbospongiosum
- fourchette covers
- perineal
- vestibule
- area w/in labia minora