What's the superficial/innermost layer of the esophagus?
What's another term for the sphincter between the esophagus & stomach?
What attaches the small intestine to the back of the abdominal cavity?
What does acid in stomach do?
What are 4 layers of stomach, from outside to inside?
The specialized epithelial cells of the stomach are located in the __1__ gland, and secrete precursor of __2__ & _____ 3 _____
What type of pain will a patient experiencing a gastric ulcer experience? When will they likely experience the pain?
How would subjective report of pain differ between gastric ulcers & duodenal ulcers?
What does duodenum require to reduce acidity of chyme? Where does it come from?
What are some meds/dietary items that contribute to ulceration of GI system?
What potential life-threatening complication arises in children with cystic fibrosis in relation to digestion/nutrition? This is similar with pancreatic cancer.
What 2 juices help breakdown fat?
What happens to the villi as you move into the jejunum & ileum?
1. Where do gastric epithelial cells start?
2. How long do they live?
Crypt cells (at bottom of villi) secrete this hormone when fat moves into duodenum
Triggers brain to suppress appetite; causes release of bile from gallbladder
Absorbed from chyme by epithelial cells; released into interstitial fluid to freely pass into capillaries that innervate the hepatic portal venous system
In the portal system, blood goes through how many capillary beds?
Where are they located?
Since tiny lipid/protein droplets are still too big to enter the GI capillaries, what must happen?
Part of intestine housing large # of bacteria that can digest things that we can't (i.e. plant material)
Which organs or part of organs aren't located in the peritoneum, but rather in the retroperitoneal region?
What's the clinical significance of having part of the duodenum, as well as the entirety of the kidneys & spleen, in the retroperitoneal space (outside of peritoneum)?
Liver is made up of approximately 200,000 hexagonal structures (lobules). Blood enters these through a group of how many vessels? What is this group called?
What does the portal triad vasculature consist of?
What portion of the portal triad vasculature supplies nutrients from the GI tract?
What portion of the portal triad vasculature supplies nutrients & O2 to the hepatocytes?
Lipid & protein packets created by small intestine epithelial cells that absorb lipid droplets
Travel from thoracic duct through circulation, getting partially digested by muscle & adipose cells (extracting triglycerides & some cholesterol) before getting "gobbled up" by liver
If LDL's become too abundant, __1__ swallow them & become engorged (hanging around site of endothelial injury), becoming __2__ cells, which contribute substantially to CAD
What does amino acid breakdown in the liver produce, and what is it converted into?
What 2 kinds of dysfunction contribute to jaundice (hyperbilirubinemia)?
Portal HTN, part of cirrhosis, can be defined as?
What are some of the complications r/t cirrhosis?
Caused by abnormal collateral circulation as a result of portal HTN
Why are the kidneys at greater risk of damage following a strong blow to the abdomen in comparison with the other abdominal organs?
1. What makes up 50% of the nitrogenous wastes in urine?
2. What is this byproduct a result of?
-Cortex is outermost; medulla is middle portion that also contains the renal pyramids
-Renal pyramids are the triangular-shaped fibrous parts included in the medulla
-Minor calyces are small extensions from pyramids; major are the larger extensions from the minor
-Renal pelvis is the large collection from the major calyces
-Renal artery is bifurcated, smaller; renal vein is larger, singular
What are the 2 kinds of nephrons in the kidney?
What are the 3 layers associated with glomerular filtration?
How does blood, which doesn't normally go into filtrate, exit the glomerulus? Where does it go from there?
3rd leading cause of kidney failure; filtration slits of podocytes can get clogged by antigen-antibody complexes if present in high concentration; autoimmune
Glomerulonephritis is an autoimmune attack on the glomeruli. What organism/s are linked to this inflammatory immune disorder?
65% of water in filtrate gets reclaimed here; active transport occurs here; substances leave filtrate & enter interstitial fluid; everything can freely pass into peritubular capillaries
Substances are also pumped from interstitial fluid into filtrate at this location when undesirable elements fail to filter through glomerulus
Most of the filtrate's water is moved to the interstitial fluid at this point in the nephron
Much of the Na+ content in filtrate is reabsorbed into circulation at this point in the nephron
After passing this point in urine filtration, only about 10% of original Na+ content & 20% of original H2O content remain
What is an optional step in urine formation that occurs usually at the end of filtration, and is dependent upon systemic status & needs?
If, at the end of filtrate formation, either the body doesn't need any osmolarity/pH buffering, or those changes have already occurred, what happens to filtrate?
If blood osmolarity (concentration) is too high, what happens in the kidneys?
What is the pressure difference inside the glomerulus?
What are 3 mechanisms that maintain GFR rate of 110-120mL/min?
Specialized local cells inside the PCT do what when they detect either low rate of filtrate or low Na+?
When JG cells around afferent arteriole detect either low BP or low Na+ in filtrate, they release what hormone?
Released by the adrenal gland under stimulus from angiotensin II, aldosterone acts on what part of the nephron?
Causes vasoconstriction of arterioles & precapillary sphincters, raising systemic BP
When baroreceptors in the carotid sinus detect low BP, they send signals to the __1__, which directs the __2__ gland to release __3__. This acts on the DCT & collecting ducts.
Excess glucose builds in the __1__, causing excess __2__ to remain in filtrate, resulting in __3__.
How does diabetes, and subsequent hyperfiltration, caused nephron damage?
How does hyperfiltration lead to proteinuria?
Urination requires cooperation between what 2 systems?
What are the 4 layers of the pelvis, starting w/innermost first?
What's the orientation of the pelvis, which is sometimes contrary to popular belief?
Since the pelvis is tipped forwards in orientation, what 2 landmarks are located on the same vertical plane?
What components of the pelvis really help with stability, allowing the transfer of weight of the upper body to the limbs?
Besides connecting pelvic bones together, what else do the ligaments & muscles of the pelvis do?
How does the pudendal nerve travel through the pelvis, and where does it go to innervate?
1. All pelvic muscles discussed in lecture are innervated by what type of nerves?
2. Where do the nerves come from?
The sacral plexus, which innervates the pelvis, also innervates what?
The gap that is anterior to the anorectal junction; urethra & vagina pass thru
What functions does the pelvic diaphragm serve?
This refers to the peritoneum's contour, draping like a sheet over furniture (organs); the pelvic peritoneal lining is continuous with the peritoneum
1. What does the peritoneal reflections form?
2. Where in women & how many?
3. Where in men & how many?
Why was the vesico-uterine pouch particularly important for surgery pre-laparoscopy?
Diamond-shaped region enclosed by the boundaries of the pelvic outlet & below pelvic diaphragm
1. The perineum is divided into how many triangles?
2. What are their names?
Are the urogenital & anal triangles in one plane or a different plane?
Key structure in the urogenital triangle; supports structures that compose external genitalia
The superficial pouch of the urogenital triangle of the perineal membrane contains what?
The deep pouch of the urogenital triangle of the perineal membrane contains what?
What is a key difference between the urogenital & anal triangles of the perineal membrane?
The erectile tissues (clitoris, glans penis) & bartholin's glands (women) are contained in what area?
Central tendon of the perineum; "center of things" at junction of UG & anal triangles (perineum)
Anchoring point for levator ani/perineal muscles (i.e. sphincters for urethra/vagina/anus), so very important for maintaining tone & integrity for pelvic organs
1. Is the anal triangle open or closed?
2. Is it covered by membrane?
This part of the anal triangle (perineal membrane) is a site of infection & may result in abscesses & these may rupture
In the event of a urethral rupture, will urine collect inside the anal triangle or upper leg?
What part of the pelvis permits a 10-15% diameter increase (transverse) during labor?
1. Major nerve of the perineum?
3. What opening does it exit pelvis?
4. What opening does it enter pelvis?
Only blocks sensation of perineum; less common with widespread use of epidural
Why is incontinence a common risk associated with childbirth?
The 3 hip bones meet up to form the socket for the femur head. What's the socket's name?
What differentiates the false (greater) pelvis from the true (lesser) pelvis?
Describe the depth & diameter of the pelvis for a male in comparison with a female
Describe the thickness & weight of pelvic bone for a male in comparison with a female
The sacrospinous & sacrotuberous ligaments turn the greater & lesser sciatic notches into foramen. Which is the larger & more superficial of the 2?
With the exception of the perineum & inferior part of vagina, which are innervated by the pudendal nerve of the sacral plexus, the reproductive organs are innervated by what type of nerves?
Are the ovaries covered by peritoneum?
1. Why can infections spread fairly easily between uterus, vagina, and ABD organs?
2. What are some examples?
What's the problem with ectopic pregnancies?
Explain 3 different times the uterine muscle length changes, and give those general lengths (i.e. short, medium, long)
What are the 2 axes for describing uterine position?
Uterus can grow __1__ times its weight & increase its muscle fiber length by __2__ times; postpartum weight loss of 50% by __3__ weeks
What helps suppress estrogen secretion & stimulate oxytocin to contract myometrium postpartum?
Cervical dysplasia isn't cancer, but it's a risk factor for developing it. What's a common cause of cervical dysplasia?
What aids in reducing the risk of pathogenic growth in the vagina?
How does ejaculation cause release of sperm?
What does the spermatic cord descend thru, and what is contained within it?
What is the anatomical equivalent of the labia majora in males? What's the major difference?
What are the 3 mechanisms for regulating the 35 degree temperature of the testes?
In the fascia of the skin; contracts & wrinkles skin to hold testes closer to the body & reduce heat loss
Covering of the spermatic cord; contracts to draw testis closer to body (warmth) or relaxes when it gets too warm
Extensive web of testicular veins leaving testis that wrap around incoming testicular artery in spermatic cord; act as countercurrent heat exchanger; as testicular artery bring blood that's warmer than venous blood, that heat transfers to testicular veins
Medial part of inguinal canal through weakness in wall; includes peritoneal sac with intestine or fat; 1/3 of hernias
Which type of hernia is often acquired, and what population is it more common in?
Where do the ductus (vas) deferens start, and where do they travel from there (until the end)?
For someone who's had a vasectomy, what fluid comprises the ejaculate?
Produces alkaline fluid w/fructose as an energy source for sperm; 70% of ejaculate volume
Know the following locations on the picture on reverse side (listed in order of flow):
-Ampulla of ductus deferens
What's important in relation to the drainage of the prostate for disease determination?
Where does prostatic cancer metastasize to?
Arteries responsible for either leaking to cause erection of penis or not leaking & communicating directly w/draining veins when penis is flaccid
What's the risk of untreated STD's in women? Men?
Trace route of sperm from testes to exiting urethra via glans penis
What must happen to a sperm in order for it to fertilize an egg?