Summary Tablesraphal significient Abdominal and Pelvic Structures

Osteology

pubis

an angulated bone that forms the anterior part of the pelvis, one of three bones that form the os coxae:
ilium, ischium, pubis; its body forms 1/5 of the acetabulum; its symphyseal surface unites with the pubis
of the opposite side to form the pubic symphysis; the superior and inferior pubic rami participate in the
formation of the obturator foramen

body_______superolateral portion of the pubis, the body of the pubis forms about 1/5 of the
acetabulum

pecten_______ridge on superior surface of the superior pubic ramus, attachment point of the pectineal
ligament; also called the pectineal line

ilium_______fan-shaped bone that forms the lateral prominence of the pelvis, one of three bones that
form the os coxae: ilium, ischium, pubis

arcuate line_______ridge running from anteroinferior to posterosuperior on the inner surface of the
ilium, inferior boundary of the iliac fossa; marks the plane of transition from abdominal cavity to pelvic
cavity (Latin, arucate = bowed)

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sacrum

a triangular bone that is the posterior skeletal element forming the pelvis it is formed by 5 fused
vertebrae; the sacrum and two os coxae bones form the pelvis (Latin, sacrum = sacred bone)

promontory________a projection of the superior part of the sacrum in an anterior direction, the body of
the fifth lumbar vertebra sits on the sacral promontory and articulates with it through a symphysis

iliopectineal line_______the union of pectineal and arcuate lines, together with the ala of the sacrum
and the sacral promontory, this line (also known as the linea terminalis) marks the pelvic brim or the
boundary between false pelvis above and true pelvis below

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Muscles

Muscle Origin Insertion Action Innervation Artery Notes Image

diaphragm_______o:xiphoid process, costal margin, fascia over the quadratus lumborum and psoas
major mm. (lateral & medial arcuate ligaments), vertebral bodies L1-L3, i:central tendon of the
diaphragm, a:pushes the abdominal viscera inferiorly, increasing the volume of the thoracic cavity
(inspiration), n:phrenic nerve (C3-C5), b:musculophrenic a., superior phrenic a., inferior phrenic a., left
crus attaches to the L1-L2 vertebral bodies, the right crus attaches to the L1-L3 vertebral bodies

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iliacus_______o:iliac fossa and iliac crest; ala of sacrum, i:lesser trochanter of the femur, a:flexes the
thigh; if the thigh is fixed it flexes the pelvis on the thigh, n:femoral nerve, b:iliolumbar a., inserts in
company with the psoas major m. via the iliopsoas tendon

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psoas major________o:bodies and transverse processes of lumbar vertebrae, i:lesser trochanter of

femur (with iliacus) via iliopsoas tendon, a:flexes the thigh; flexes & laterally bends the lumbar vertebral
column, n:branches of the ventral primary rami of spinal nerves L2-L4, b:subcostal a., lumbar aa., the
genitofemoral nerve pierces the anterior surface of the psoas major m.

psoas minor_______o:bodies of the T12 & L1 vertebrae, i:iliopubic eminence at the line of junction of
the ilium and the superior pubic ramus, a:flexes & laterally bends the lumbar vertebral column,
n:branches of the ventral primary rami of spinal nerves L1-L2, b:lumbar aa., absent in 40% of cases

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quadratus lumborum_______o:posterior part of the iliac crest and the iliolumbar ligament, i:transverse
processes of lumbar vertebrae 1-4 and the 12th rib, a:laterally bends the trunk, fixes the 12th rib,
n:subcostal nerve and ventral primary rami of spinal nerves L1-L4, b:subcostal a., lumbar aa., the lateral
arcuate ligament of the diaphragm crosses the anterior surface of the quadratus lumborum m.

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Viscera

Organ/Part of Organ Location/Description Notes

kidney

excretory organ of the urinary tract located on the posterior abdominal wall, retroperitoneal; right
kidney is lower than the left - its superior pole reaches the 12th rib; superior pole of the left kidney
reaches as high as the 11th rib; kidneys develop from the intermediate mesoderm in the embryo

calyx, minor_______portion of the urinary collecting system within the kidney that drains one renal
papilla, one renal papilla projects into the lumen of one minor calyx; several minor calyces unite to form
a major calyx (Greek, calyx = cup)

calyx, major_______portion of the urinary collecting system within the kidney that drains several minor
calyces, major calyx collects urine from several renal papillae; all major calyces unite to form the renal
pelvis (Greek, calyx = cup)

pararenal fat_______extraperitoneal fat surrounding the kidney, pararenal fat is located external to the
renal fascia

perirenal fat_______extraperitoneal fat surrounding the kidney, perirenal fat is located within the renal
fascia; it is also located within the renal sinus surrounding the calyces and blood vessels

renal columns_______columns of tissue that are histologically identical to tissue found in the renal
cortex, but which are located in the medulla between the renal pyramids, interlobar arteries pass from
the renal sinus to the renal cortex within the renal columns
renal cortex_______outer layer of kidney, renal cortex contains the majority of the glomeruli

renal fascia________a fascial pouch derived from extraperitoneal connective tissue that contains the
kidneys, the suprarenal glands, the renal vessels and perirenal fat, renal fascia of the right and left sides
is joined across the midline in close relationship to the renal aa. and vv.; renal fascia encapsulates the
inferior vena cava and aorta at the level of origin of the renal vessels; do not confuse renal fascia with
the renal capsule - the renal capsule is histologically part of the kidney and there is no fat between it and
the kidney

renal hilum_______opening on medial margin of the kidney leading into the renal sinus, the renal
vessels enter/leave the kidney at the hilum; the renal pelvis leaves the kidney at the hilum

renal medulla_______inner layer of the kidney, renal medulla contains most of the tubules of the kidney
organized as renal pyramids; renal columns consist of cortex-like tissue arranged between the pyramids
in the renal medulla

renal papilla_______tip of renal pyramid projecting into a minor calyx, several minor calyces combine to
form a major calyx; all of the major calyces in the kidney unite to form the renal pelvis (Latin, papilla = a
nipple)

renal pelvis_______large collecting duct for urine that is formed by the union of the major calyces, renal
pelvis is the dilated origin of the ureter; it is located at the renal hilum and is surrounded by the renal
sinus

renal pyramid_______cone-shaped arrangement of tubules in the renal medulla, tip of the renal
pyramid (papilla) projects into a minor calyx

renal sinus_______hollowed out area on the medial margin of the kidney, renal sinus opens at the renal
hilum; it contains the renal aa. and vv., major calyces and renal pelvis, perirenal fat

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ureter

muscular tube that serves as the duct of the kidney to carry urine to the bladder, ureter is continuous
proximally with the renal pelvis; it passes over the pelvic brim medial to the testicular/ovarian vessels; it
passes obliquely through the posterior wall of the urinary bladder and drains at the posterolateral angle
of the vesical trigone (Latin, ureter/oureter = urinary canal)

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suprarenal gland

endocrine gland located superomedial to the kidney; right suprarenal gland is somewhat triangular in
shape, left suprarenal gland is semilunar in shape, suprarenal cortex manufactures corticosteroids;
suprarenal medulla manufactures epinephrine and norepinephrine; suprarenal medulla receives
preganglionic sympathetic innervation from the greater thoracic splanchnic n.; also known as: adrenal
gland

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ductus deferens________duct of the testis, ductus deferens is continuous with the tail of the epididymis;
it passes through the superficial inguinal ring, inguinal canal and deep inguinal ring to reach the
posteroinferior surface of the bladder where it joins with the duct of the seminal vesicle to form the
ejaculatory duct (Latin, ductus = to lead + deferens = to carry away)

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ampulla of the ductus deferens_______dilated part of the ductus deferens located posterior to the
bladder, ampulla of the ductus deferens joins with the duct of the seminal vesical to form the ejaculatory
duct (Latin, ampulla = a flask or the dilated part of a duct or channel; ductus = to lead + deferens = to
carry away)

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ampulla of the uterine tube________widest and longest part of the uterine tube, ampulla of the uterine
tube arches over the ovary and ends laterally in the infundibulum (Latin, ampulla = a flask or the dilated
part of a duct or channel)

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anal canal________terminal end of the digestive tract, anal canal is continuous with the rectum above
and opens at the anus below; it is regulated by external and internal anal sphincters

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anal columns_________longitudinal folds of mucosa on the inner wall of the anal canal, anal columns
are connected inferiorly by anal valves; rectal vessels lie beneath the submucosa of the anal columns

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anal valves________folds of mucosa joining adjacent anal columns at their inferior ends, anal valves can
be difficult to locate in the older individual

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bladder, urinary
hollow muscular organ posterior to the pubic symphysis and body of the pubis that acts as a reservoir for
urine, urinary bladder is held in place by the pubovesical/puboprostatic ligaments; ureters enter the
posterolateral surface of the bladder at the posterior two angles of the vesical trigone

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body of the uterus________part of the uterus from the fundus and the isthmus, the uterine cavity is thin
anteroposteriorly and wide in the transverse plane

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cervix_______narrowed inferior end of the uterus, cervix is inferior to the isthmus of the uterus and
projects into the vagina; it is surrounded by the vaginal fornices (anterior, posterior and lateral) (Latin,
cervix = neck)

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clitoris________combination of 3 erectile bodies: glans clitoris and 2 corpora cavernosa clitoris, clitoris is
covered by smooth skin

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corona of the glans________margin of the glans projecting beyond the ends of the corpora cavernosa,
overhangs the neck of the glans that separates the body from the glans of the penis

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ejaculatory duct________duct formed by the union of the duct of the seminal vesicle and the ampulla of
the ductus deferens, ejaculatory duct passes through the prostate gland to empty onto the seminal
colliculus along the urethral crest in the prostatic urethra

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epididymis_________beginning of the duct system of the testis, the head of the epididymis is located on
the superior surface of the testis and receives sperm from the efferent ductules; the body of the
epididymis lies posterolateral to the testis and is separated from the testis by the sinus of the epididymis;
the tail of the epididymis is located inferiorly and is continuous with the ductus deferens; the ductus
deferens ascends to pass through the abdominal wall via the inguinal canal (Greek, epididymis = covering
the testicle)

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external urethral meatus (orifice)_________slitlike opening of the spongy urethra near the tip of the
glans

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fimbria of the uterine tube_________N finger-like projections surrounding the opening into the uterine
tube, fimbria spread over the medial surface of the ovary; the ovarian fimbria is an extra long fimbria
that attaches to the ovary (Latin, fimbria = fringe)

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frenulum________a more posterior or deeper part of the labia minora passing posterior to the clitoris,
(Latin, frenulum = bridle, a narrow reflection of membrane from the lower surface of the glands with the
prepuce)

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fundus of the uterus_________the rounded anterosuperior part of the uterus, fundus of the uterus is
defined as that portion of the uterus located superior to an imaginary line joining the points of entry of
the uterine tubes; the uterus is normally anteverted and anteflexed, so the fundus normally points
anterosuperiorly (Latin, fundus = bottom)

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glans penis/clitoridis________expanded distal end of the corpus spongiosum which caps the ends of the
corpora cavernosa, the fossa navicularis is an expanded portion of the penile urethra that occurs in the
glans (Latin, glans = acorn)

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hymen thin,________usually incomplete septum at the inferior vaginal orifice, the hymen is the
remnant of the urogenital septum of the embryo, and the hymeneal caruncles are remnants of the
hymen (Greek, hymen = a membrane)

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infundibulum of the uterine tube_______funnel-shaped distal end of the uterine tube, fimbria are
attached to the margin of the infundibulum (Latin, infundibulum = a funnel)

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interureteric ridge_________mucosal fold on the inner posterior wall of the bladder connecting the
paired ureteric orifices, interureteric ridge is the superior boundary of the vesical trigone

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isthmus of the uterine tube,_________constricted part of the uterine tube that is adjacent to the uterus,
isthmus of the uterine tube is the narrowest part
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isthmus of the uterus_________constricted part of the uterus between the body and the cervix, isthmus
of the uterus is about 1 cm in length and its cavity enters into the internal cervical os

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labia majora________fat-filled elevations of hair-covered skin lying on either side of the vestibule of the
vagina, labia majora are joined across the midline by the anterior and posterior labial commissures; they
blend into each other anteriorly to form the mons pubis (Latin, labia = lips)

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labia minora______paired folds of hairless skin located medial to the labia majora and extending
posteroinferiorly from the clitoris, the anterior end of each labium minus divides: the anterior division of
each labium forms the prepuce of the clitoris and the posterior division of each labium forms the
frenulum of the clitoris (Latin, labia = lips)

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ligamentum teres uteri________also known as: round ligament of the uterus (Latin, teres = round)

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mons pubis_______rounded, fatty prominence anterior to the pubic symphysis, (Latin, mons =
mountain)

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ovarian ligament______a band of connective tissue that connects the ovary to the lateral surface of the
uterus, a remnant of the gubernaculum; it is continuous with the round ligament of the uterus at the
lateral surface of the uterus; ovarian ligament lies within the mesovarium; also known as: proper ovarian
ligament

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ovary

female gonad that lies in the ovarian fossa within the true pelvis in contact with the fimbria of the
uterine tube, ovary is both an endocrine and an exocrine gland; it is held in place by the ovarian
ligament, mesovarium, and suspensory ligament of the ovary

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pectinate line______an irregular line joining the undersides of the anal valves, pectinate line is where
the mucosal lining of the digestive tract becomes continuous with the skin of the anal aperture

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posterior fornix of the vagina________space within the vaginal canal posterior to the cervix, an incision
made superiorly through posterior fornix will enter the rectouterine pouch of the peritoneal cavity
(Latin, fornix = arch or vault)

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prepuce________fold of smooth skin extending over the glans penis/clitoris, the anterior divisions of the
labia minora combine to form the prepuce of the clitoris (Latin, praeputium = foreskin)

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prostate

exocrine gland located inferior to the urinary bladder and superior to the urogenital diaphragm, multiple
small ducts drain into the prostatic urethra as it passes through the prostate; subject to benign and
malignant enlargement, which may compromise micturition due to projection of the uvula into the
bladder (Greek, prostate = one stand before, this gland stands before the bladder)

prostatic utricle________a small blind diverticulum in the posterior wall of the prostatic urethra on the
summit of the seminal colliculus, prostatic utricle is a remnant of the fused lower ends of the
paramesonephric ducts - the fused paramesonephric ducts form the uterine canal in the female (Latin,
utriculus = little leather bag)

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rectum

distal end of the colon, rectum begins at about the S3 vertebral level; it is continuous distally with the
anal canal

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round ligament of the uterus__________a connective tissue band that attaches to the inner aspect of
the labium majus and the uterus, round ligament of the uterus traverses the superficial inguinal ring,
inguinal canal and deep inguinal ring to reach the lateral surface of the uterus below the uterine tube; it
is a remnant of the gubernaculum; it is continuous with the ovarian ligament; it holds the fundus of the
uterus forward; also known as: ligamentum teres uteri

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scrotal raphe_______the midline, bilateral embryonic formation of the scrotum, (Greek, raphe = a seam
or suture)

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scrotum

sac of hair-covered skin containing the testis in the scrotum the fatty and membranous layers of the
superficial fascia (as seen in the lower abdominal wall) are fused to form the tunica dartos scroti

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seminal colliculus__________elevation on the posterior wall of the prostatic urethra, the seminal
colliculus is a mound in the posterior wall of the prostatic urethra; on its summit is found the opening of
the prostatic utricle (Latin, colliculus = mound)

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seminal vesicle________blind sac located on the posterior surface of the bladder lateral to the ampulla
of the ductus deferens, seminal vesicle produces seminal fluid; its duct joins with the ampulla of the
ductus deferens to form the ejaculatory duct

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seminiferous tubules________convoluted tubules of the testis in which sperm are produced, drain via
efferent ductules into the head of the epididymis

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spermatic cord________bundle of vessels, nerves and lymphatics ensheathed in tissue layers derived
from the abdominal wall; it begins at the deep inguinal ring, passes through the inguinal canal and the
superficial ring to reach the testis in the scrotum, spermatic cord comprises the: ductus deferens,
testicular a., pampiniform plexus, deferential a. & v. and genital br. of the genitofemoral n.; coverings of
the cord are the: internal spermatic fascia (from the transversalis fascia), cremasteric muscle and fascia
(from the internal abdominal oblique), external spermatic fascia (from the external abdominal oblique
aponeurosis)

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suspensory ligament of the ovary_________peritoneal fold overlying the ovarian vessels as they cross
the pelvic brim to reach the ovary, continuous with the broad ligament at the ovary

testis

an endocrine and exocrine gland contained within the scrotum, testis is the male gonad; its exocrine
product is sperm which drain to the head of the epididymis via efferent ductules; its endocrine product is
testosterone; the testis migrates into the scrotum shortly before birth; it is tethered to the scrotum
inferiorly by the scrotal ligament (a remnant of the gubernaculum)

tunica albuginea, testis_______outer white fibrous covering of the testis, tunica albuginea is a dense
connective tissue capsule that is covered on its external surface by the visceral layer of the tunica
vaginalis testis (Latin, tunica albuginea = white membrane, covering)

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urachus_________joins the apex of the fetal bladder to the umbilicus, after birth, the urachus becomes a
remnant called the median umbilical ligament (Greek, urachus/ourachos = the urinary canal of a fetus)

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ureteric orifices________openings of the ureters in the bladder wall

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urethra

duct that drains the urinary bladder, urethra has three parts in the male: prostatic, membranous &
penile/spongy; female urethra is much shorter than the male urethra, consisting of the membranous
part only

urethra, membranous_______part of the urethra that passes through the urogenital diaphragm
(sphincter urethrae muscle and perineal membrane), female: membranous urethra connects the urinary
bladder to the external urethral orifice at the vestibule of the vagina; male: membranous urethra
connects the prostatic urethra with the spongy/penile urethra

urethra, penile________part of the urethra contained within the bulb and the corpus spongiosum of the
penis, longest part of male urethra; penile urethra has a dilation in the region of the glans called the
navicular fossa; also known as: spongy urethra

urethra, prostatic_______part of the male urethra passing through the prostate gland, prostatic urethra
begins at the internal urethral orifice at the anteroinferior angle of the vesical trigone; posterior wall of
the urethra has an elevated ridge called the urethral crest with a prominence called the seminal
colliculus (veru montanum); seminal colliculus has a blind diverticulum called the prostatic utricle with
orifices of ejaculatory ducts located below it

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ureter

muscular tube that serves as the duct of the kidney to carry urine to the bladder, ureter is continuous
proximally with the renal pelvis; it passes over the pelvic brim medial to the testicular/ovarian vessels; it
passes obliquely through the posterior wall of the urinary bladder and drains at the posterolateral angle
of the vesical trigone

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uterine tube
the duct of the ovary; it extends from the ovary to the uterus, uterine tube has four named parts:
infundibulum is the funnel shaped opening - fimbria encircle this opening; ampulla is a dilated region
that connects the infundibulum with the isthmus; isthmus is the constricted part nearest the uterus;
intramural part is within the uterine wall

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uterus

hollow muscular organ within which the fertilized ovum develops; normally lies anteverted
posterosuperior to the bladder, uterus is anteflexed (curved anteroinferiorly) at the uterine isthmus; the
fundus is the part superior to the entrance of the uterine tubes and it normally lies anterosuperiorly; the
body meets the cervix at a constricted area called the isthmus; the cervix projects into the vagina

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uvula of the bladder________elevation of the inner bladder wall posterosuperior to the internal urethral
orifice , uvula is caused by the middle lobe of the prostate gland; if the prostate becomes enlarged
(either benign hypertrophy or malignancy) the uvula can constrict the internal urethral orifice and cause
difficulty in voiding the bladder; only found in males

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vagina

part of the female genital canal located between the vestibule and the cervix, vaginal fornices surround
the cervix; the word "vagina" is derived from the Latin word for ,D:

vesical trigone________smooth triangular region located on the inner surface of the posterior wall of
the urinary bladder, vesical trigone is bounded by the openings of the ureters (2) superolaterally, the
interureteric ridge between the openings of the ureters and the internal urethral orifice inferiorly (Greek,
trigone = triangle)
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vestibule of the vagina________region inferior to the hymen/hymeneal caruncles and between the labia
minora, vestibule of the vagina contains the external urethral orifice, the opening of the vagina and the
openings of the greater vestibular glands

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vulva_______serves as sensory and erectile tissue for sexual intercourse and arousal, directs the flow of
urine, prevents entry of foreign material into the urogenital tract, clinically called the pudendum

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Peritoneal Specializations and Associated Structures

broad ligament _________peritoneal fold extending from the pelvic walls to the uterus and uterine
tubes, broad ligament has three named parts: mesovarium, mesosalpinx, mesometrium

mesometrium________part of the broad ligament below the junction of the mesosalpinx and the
mesovarium, mesometrium attaches the body of the uterus to the pelvic wall

mesosalpinx________part of broad ligament that supports the uterine tube, mesosalpinx extends
inferiorly to meet the root of the mesovarium; it attaches the uterine tube to the mesometrium (Greek,
salpinx= trumpet, so-named for its resemblance to a trumpet)

mesovarium_________part of broad ligament that forms a shelf-like fold supporting the ovary,
mesovarium is located perpendicular to the plane of the mesosalpinx and mesometrium; it attaches the
ovary to the mesometrium and mesosalpinx (Latin, ovarium = ovary)

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rectouterine fold_______a peritoneal fold extending across the floor of the pelvic cavity from the sacrum
(beside the rectum) to the uterus, rectouterine fold contains the rectouterine ligament which is a
condensation of endopelvic fascia that is important for support of the uterus

rectouterine ligament_________a condensation of extraperitoneal connective tissue & smooth muscle

(rectouterine muscle) connecting the isthmus of the uterus to the sacrum, rectouterine ligament is
important for support of the uterus

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tunica vaginalis testis________a peritoneal sac located anterolateral to the testis, tunica vaginalis testis
has two layers: visceral and parietal; the visceral layer lies on the anterolateral surface of the testis and
epididymis; the parietal layer lines the inner surface of the scrotal sac; (Latin,vaginalis is derived from the
word sheath, tunica = a coat)

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Arteries

aorta, abdominal________o:the continuation of the descending thoracic aorta, b: inferior phrenic aa.
(2), celiac trunk, middle suprarenal aa. (2), lumbar aa. (4 pairs), superior mesenteric a., renal aa. (2),
testicular/ovarian aa. (2), inferior mesenteric a., median sacral a., common iliac aa. (2), s:abdominal wall;
gastrointestinal tract; body below the level of the respiratory diaphragm, abdominal aorta passes
posterior to the diaphragm (aortic hiatus) at the level of the T12 vertebral body

celiac trunk_______o:abdominal aorta at level of T12-L1 intervertebral disc, b:left gastric, splenic,
common hepatic, s:stomach, lower esophagus, liver, upper duodenum, pancreas, spleen, (Greek, celiac =
belly; the celiac artery supplies the principal organs of the belly)
common iliac_______o:abdominal aorta, b:external iliac a., internal iliac a., s:pelvis, lower limb,
abdominal aorta bifurcates at the level of the L4 vertebral body to form the right and left common iliac
aa.; the common iliac artery bifurcates anterior to the sacroiliac articulation into its terminal brs.
(external iliac a. and internal iliac a.)

inferior phrenic________o:abdominal aorta, b:superior suprarenal aa., s:diaphragm, suprarenal gland,

inferior phrenic a. is the first abdominal branch of the aorta; it may arise from the celiac trunk (Latin,
phrenic = diaphragm)

lumbar_______o:abdominal aorta, b:anterior br., posterior br., spinal br., s:psoas major m., psoas minor
m., quadratus lumborum m., spinal cord and vertebral column, deep back muscles, the 4 lumbar arteries
on each side arise from the posterior surface of the aorta at the level of vertebrae L1-L4; they course
posterior to the psoas major m.

mesenteric, inferior______o:abdominal aorta at the level of the L3 vertebral body, b:left colic a., sigmoid
aa.(2-3), superior rectal a., s:splenic flexure, descending colon, sigmoid colon, superior part of rectum
branches of the inferior mesenteric a, anastomose in the marginal artery (Greek, mesos = middle
+ enteron = intestine)

mesenteric, superior_______o:abdominal aorta at the level of the lower 1/3 of the L1 vertebral body,
b:inferior pancreaticoduodenal a., middle colic a., jejunal a., ileal a., right colic a., ileocolic a., s:inferior
part of the head of the pancreas, distal duodenum, jejunum, ileum, cecum, appendix, ascending colon,
transverse colon, superior mesenteric a. supplies the midgut derivatives; brs. of the superior mesenteric
a. participate in formation of the marginal artery (Greek, mesos = middle + enteron = intestine)

testicular artery_______o:aorta, s:testis and epididymis

uterine_______o:internal iliac a., anterior division, b:tubal br., vaginal br., s:uterus, uterine tube, uterine
a. anastomoses with the ovarian a. and the vaginal a.; it passes superior to the ureter in the pelvis;
remember the saying "water under the bridge"

median sacral_______o:abdominal aorta, b:5th lumbar aa., s:sacrum, median sacral a. appears to be the
continuation of the abdominal aorta in the median plane, although it is much smaller in size

renal_______o:abdominal aorta at the level of the upper border of the L2 vertebra, b:inferior suprarenal
a., apical segmental a., anterior br: superior anterior segmental a., middle anterior segmental a., inferior
segmental a.; posterior br.: posterior segmental a., s:kidney, upper ureter, suprarenal gland, the right
renal a. is longer than the left renal artery; the right renal artery passes posterior to the inferior vena
cava

suprarenal, inferior______o:renal a., b:numerous unnamed branches, s:inferior aspect of the suprarenal
gland, inferior suprarenal a. may anastomose with the superior suprarenal a.
suprarenal, middle______o:abdominal aorta, b:numerous unnamed branches, s:medial side of the
suprarenal gland, middle suprarenal a. anastomoses with the superior suprarenal a. and the inferior
suprarenal a.

suprarenal, superior_______o:inferior phrenic a., b:multiple small aa., s:superior aspect of the
suprarenal gland, superior suprarenal aa. are numerous small vessels that enter the suprarenal gland
independently

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Veins

Vein Tributaries Drains Into Regions Drained Notes

renal, left_______t:left ovarian/testicular v., left suprarenal v., sometime the left inferior phrenic v.,
d:inferior vena cava, rd:left ovary/testis; left ureter; left kidney; left suprarenal gland; left part of the
respiratory diaphragm, left renal v. crosses the abdominal aorta under the origin of the superior
mesenteric a., creating a site of potential compression of the left renal vein

renal, right_______t:multiple tributaries exit the kidney, d:inferior vena cava, rd:right kidney ,right renal
v. is shorter than the left renal v.

suprarenal v._____t:no named tributaries, d:left: left renal v.; right: inferior vena cava, rd:suprarenal
gland, left suprarenal v. is usually joined by the left inferior phrenic v.

vena cava, inferior_______t:formed by the union of the paired common iliac vv; tributaries: lumbar vv. 1-
4, right ovarian/testicular v., renal vv., right suprarenal v., right inferior phrenic v., hepatic vv., d:right
atrium, rd:all of the body below the level of the respiratory diaphragm, the inferior vena cava is longer
than the abdominal aorta

D:
Nerves

Nerve Source Branches Motor SensoryNotes

aorticorenal ganglion_______o:preganglionic sympathetic via the lesser thoracic splanchnic n., b:brs. to
the renal plexus, m:vascular smooth muscle of the brs. of the renal aa., s:pain from the kidney,
suprarenal gland, upper ureter, a sympathetic ganglion; located above or near the origin of the renal a.
from the abdominal aorta (Greek, ganglion = a knot or swelling)

celiac ganglion_______o:preganglionic sympathetic axons arrive via the greater thoracic splanchnic n.,
b:postganglionic sympathetic axons distribute via the celiac plexus along brs. of the celiac trunk,
m:vascular smooth muscle of the brs. of the celiac trunk, s:pain from the stomach, liver & biliary system,
spleen, upper half of the duodenum & pancreas, a sympathetic ganglion; usually 2 celiac ganglia are
located on the abdominal aorta at the origin of the celiac trunk; brs. of the vagal trunks pass through the
celiac ganglion without synapsing (Greek, celiac = belly + ganglion = a knot or swelling)

collateral ganglia______o:splanchnic nn. (thoracic, lumbar), b:plexuses to abdominal & pelvic ,

m:smooth muscle in blood vessels supplying the abdominopelvic viscera, s:pain from the
abdominopelvic viscera, sympathetic ganglia; also known as: preaortic ganglia which include: celiac,
aorticorenal, superior & inferior mesenteric; brs. of the vagal trunks pass through but do not synapse in
collateral ganglia

ganglia, myenteric______o:preganglionic parasympathetic via anterior and posterior vagal trunks (gut
proximal to the left colic flexure) and pelvic splanchnic nn. (gut distal to the left colic flexure),
b:postganglionic parasympathetic via many short fibers, m:smooth muscle of the gut wall, s:none,
minute ganglia located within the myenteric plexus; parasympathetic terminal ganglia

ganglia, preaortic______o:splanchnic nn., b:plexuses to abdominal and pelvic viscera, m:vascular smooth
muscle of vessels that supply abdominopelvic viscera, s:pain from abdominopelvic viscera, also known
as: collateral ganglia which include the celiac ganglion, aorticorenal ganglion, superior mesenteric
ganglion and inferior mesenteric ganglion; preganglionic parasympathetic axons of vagal trunk origin
pass through the preaortic ganglia but do not synapse there
ganglia, submucosal of the gut______o:preganglionic parasympathetic arrive via branches of the
anterior and posterior vagal trunks (gut proximal to the left colic flexure) and pelvic splanchnic nn. (gut
distal to the left colic flexure), b:postganglionic parasympathetic via many short fibers, m:secretomotor
to glands in the mucosa of the gut, s:none, terminal parasympathetic ganglia; parasympathetic terminal
ganglia; also known as: Meissner's plexus

ganglia, sympathetic chain______o:preganglionic sympathetic fibers arrive via white rami

communicantes of ventral primary rami of spinal nerves T1-L2, b:postganglionic sympathetic fibers
depart via gray rami communicantes to all spinal nn.; internal & external carotid nn.; cervical cardiac brs.;
thoracic direct visceral brs.; greater, lesser & least thoracic splanchnic nn.; lumbar splanchnic nn.; sacral
splanchnic nn., m:dilator pupillae, vascular smooth muscle, arrector pili muscles, sweat glands,
suprarenal medulla, heart, lungs and gut, s:pain from viscera, located lateral to the vertebral bodies in
the neck, thorax & abdominopelvic cavity; the ganglia plus their interconnecting fibers are also known as
the sympathetic trunk; preganglionic cell bodies are located in the intermediolateral gray matter of
spinal cord levels T1-L2

ganglion, inferior mesenteric_______o:preganglionic sympathetic axons from the intermesenteric plexus

and the 2nd lumbar splanchnic n., b:contributes to the inferior mesenteric plexus; contributes to the
superior hypogastric plexus, m:vascular smooth muscle of brs. of the inferior mesenteric a., s:pain from
descending colon and sigmoid colon; pain from upper , a sympathetic ganglion; located on the
abdominal aorta at the origin of the inferior mesenteric a.; may be a series of small, indistinguishable
ganglia rather than a single large one

ganglion, superior mesenteric_______o:preganglionic sympathetic axons from the celiac plexus,

b:contributes to the superior mesenteric and intermesenteric plexuses, m:vascular smooth muscle of
brs. of the superior mesenteric a., s:pain from the lower half of the pancreas and duodenum, jejunum,
ileum, cecum, appendix, ascending colon and transverse colon, a sympathetic ganglion; located on the
abdominal aorta at the origin of the superior mesenteric a.

greater thoracic splanchnic n._______o:neurons in the intermediolateral cell column of spinal cord levels
T5-T9; the greater thoracic splanchnic nerve appears to arise by multiple contributions from the
sympathetic trunk, b:no named branches, m:celiac ganglion; preganglionic fibers supply the adrenal
medulla which releases epinephrine and norepinephrine into the blood, s:pain from the abdominal
viscera, greater thoracic splanchnic n. passes through the crus of the respiratory diaphragm;
postganglionic processes from the celiac ganglion spread down the aorta and distribute with its
branches; they innervate the smooth muscle of these vessels and vascular smooth muscle in the organs
supplied (Greek, splanchna = viscera)

hypogastric n._______o:superior hypogastric plexus, b:inferior hypogastric plexus, m:supplies vascular

smooth muscle of the pelvic viscera, s:pain from the pelvic viscera, paired; hypogastric n. lies inferior to
the common iliac vessels; it contains postganglionic sympathetic axons

hypogastric plexus, inferior________o:hypogastric nn. and sacral splanchnic nn. (postganglionic

sympathetic axons); pelvic splanchnic nn. (preganglionic parasympathetic axons from the ventral primary
rami of spinal nerves S2-S4), b:contributes branches to: uterine/vaginal plexus, vesical plexus, prostatic
plexus, m:sympathetic: supplies vascular smooth muscle of vessels supplying the pelvic viscera;
parasympathetic: supplies smooth muscle of the pelvic viscera, s:pain from the pelvic viscera; general
visceral afferent from the pelvic viscera, inferior hypogastric plexus lies between the pelvic viscera and
the pelvic wall (Latin, plexus = a braid)

hypogastric plexus, superior_______o:intermesenteric plexus and lumbar splanchnic nn. (postganglionic

sympathetic axons), b:hypogastric nn. (right and left), m:vascular smooth muscle of the pelvic viscera
(sympathetic), s:pain from the pelvic viscera; general visceral afferent from the pelvic viscera, superior
hypogastric plexus is the continuation of the intermesenteric plexus; it crosses the pelvic brim (Latin,
plexus = a braid)

intermesenteric plexus_____o:lumbar splanchnic nn. 1 and 2, b:renal, testicular (or ovarian) and ureteric
brs., m:sympathetic: smooth muscle of vessels supplying the gut distal to the left colic flexure, s:pain
from the descending colon, sigmoid colon and rectum, intermesenteric plexus is continuous with the
superior mesenteric plexus; it continues inferiorly as the inferior mesenteric plexus and superior
hypogastric plexus; intermesenteric plexus does not carry vagal parasympathetic fibers; located anterior
to the abdominal aorta between the superior and inferior mesenteric aa. (Latin, plexus = a braid)

least thoracic splanchnic n._______o:neurons in the intermediolateral cell column of spinal cord level
T12, b:no named branches, m:renal plexus, s:pain from the kidney and suprarenal gland, least thoracic
splanchnic n.pass through the crus of the diaphragm; it synapses in minute ganglia located in the renal
plexus (Greek, splanchna = viscera)

lesser thoracic splanchnic n._______o:neurons in the intermediolateral cell column of spinal cord levels
T10-T11; the lesser thoracic splanchnic nerve appears to arise by multiple contributions from the
sympathetic trunk, b:no named branches, m:aorticorenal ganglion;, s:pain from the kidney and
suprarenal gland, lesser thoracic splanchnic n. passes through the crus of the respiratory diaphragm;
postganglionic processes from the ganglion supply vascular smooth muscle of branches of the renal a.
and suprarenal aa.; kidney and suprarenal gland (Greek, splanchna = viscera)

lumbar splanchnic nn.________o:lumbar sympathetic ganglia L1-L4, b:no named branches m:smooth
muscle of vessels that supply the abdominal and pelvic viscera , s:pain from abdominal and pelvic
viscera, sympathetic nerves; there are four of these on each side; lumbar splanchnic nn. contribute to
preaortic abdominal plexuses (celiac, superior mesenteric, intermesenteric, superior hypogastric) (Greek,
splanchna = viscera)

mesenteric plexus, inferior_______o:intermesenteric plexus, b:multiple unnamed nn. course along the
branches of the inferior mesenteric a., m:sympathetic: smooth muscle of the vessels supplying the
descending colon, sigmoid colon and rectum, s:pain from the descending colon, sigmoid colon and
rectum, inferior mesenteric plexus contains no vagal parasympathetic fibers; pelvic splanchnic n. axons
join the most distal nn. of the plexus near gut wall (Greek, mes = in the middle of + enteron = intestine;
Latin, plexus = a braid)
mesenteric plexus, superior_______o:celiac plexus, superior mesenteric ganglion, b:multiple unnamed
nn. course along the branches of the superior mesenteric a., m:sympathetic: smooth muscle of vessels
supplying the lower pancreas, lower duodenum, jejunum, ileum, cecum, ascending colon and most of
the transverse colon; parasympathetic (vagus): smooth muscle in the gut wall of same distribution area,
s:pain & GVA of the parts of the gut named at left, superior mesenteric plexus contains a mixture of
vagal (preganglionic parasympathetic) axons and postganglionic sympathetic axons (Greek, mes = in the
middle of + enteron = intestine; Latin, plexus = a braid)

pelvic splanchnic n._______o:ventral primary rami of spinal nerves S2-S4 (cell bodies are located in the
lateral horn gray of the sacral spinal cord), b:unnamed branches contribute to the pelvic plexus (inferior
hypogastric) plexus, m:smooth muscle and glands of the gut distal to the left colic flexure; smooth
muscle and glands of all pelvic viscera, s:none, parasympathetic nerves; these contain preganglionic
parasympathetic axons (Greek, splanchna = viscera)

vagus n._______o:medulla: dorsal motor nucleus (GVE preganglionic parasympathetic); inferior ganglion
(GVA); nucleus ambiguus (SVE); superior ganglion (GSA); inferior ganglion(SVA), b:auricular br.,
pharyngeal br., superior laryngeal, superior and inferior cervical cardiac brs., recurrent laryngeal n.,
thoracic cardiac brs., brs. to the pulmonary plexus, brs. to the esophageal plexus, anterior and posterior
vagal trunks, m:SVE: intrinsic muscles of the larynx, pharynx (except stylopharyngeus), and palate
(except tensor veli palatini); GVE: smooth muscle of the respiratory tree & gut (proximal to the left colic
flexure), heart; secretomotor: mucous glands of the larynx, respiratory tree, pharynx and gut;
secretomotor to digestive glands, s:GSA: skin of the external auditory meatus; GVA: viscera of head,
neck, thorax & abdomen proximal to the left colic flexure; SVA: taste from the epiglottis, also known as:
CN X, 10th cranial nerve; the vagus n. passes through the jugular foramen to exit the posterior cranial
fossa; (Latin, vagus = wanderer due to its wide distribution to the body cavities)

esophageal plexus_______o:right and left vagus (X) nn.; thoracic visceral brs. of the sympathetic trunk,
b:anterior and posterior vagal trunks, m:preganglionic parasympathetic axons from the vagus n.supply
smooth muscle and glands of the thoracic esophagus and abdominal gut and its derivatives proximal to
the left colic flexure; postganglionic sympathetic axons from the thoracic visceral brs. supply vascular
smooth muscle in the esophageal vessels, s:vagus: GVA from the esophagus and abdominal gut proximal
to the left colic flexure; thoracic visceral brs.carry pain from the esophagus, during development of the
gut, the stomach and esophagus rotate 90° to the right with the result that the left and right vagus
nerves mix in the esophageal plexus and emerge as anterior and posterior vagal trunks (Latin, plexus = a
braid)

phrenic n._____o:ventral primary rami of spinal nerves C3-C5 (cervical plexus), b:no named branches,
mskeletal muscle of the respiratory diaphragm, s:diaphragmatic pleura; some fibers contributed to the
pericardium and to the adjacent mediastinal and costal pleurae, phrenic n. crosses the anterior surface
of the anterior scalene m. (Greek, phrenic = diaphragm)

femoral n.______o:lumbar plexus (ventral primary rami of spinal nerves L2-L4), b:anterior femoral
cutaneous brs., m:nn. to: sartorius m., rectus femoris m., vastus lateralis m., vastus intermedius m.,
vastus medialis m., pectineus m. sartorius, rectus femoris, vastus lateralis, vastus intermedius,
vastus medialis, pectineus, s:skin of anterior thigh, passes under inguinal ligament lateral to femoral a.

femoral cutaneous, lateral_______o:lumbar plexus (ventral primary rami of spinal nerves L2-L3),
b:anterior & posterior brs., m:sympathetic motor innervation to skin, s:skin of the lateral thigh,
cutaneous nn. carry postganglionic sympathetic axons to skin (Latin, cutis = skin)

genitofemoral n.________o:lumbar plexus (ventral primary rami of spinal nerves L1-L2), b:genital br.,
femoral br., m:cremaster m., s:skin of the anterior scrotum/labia majora & upper medial thigh,
genitofemoral n. lies on the anterior surface of the psoas major in the abdomen; the genital br. passes
through the deep inguinal ring and inguinal canal; brushing the thigh elicits an elevation of the testis via
the cremasteric reflex

gray ramus communicans________o:cell bodies located in the sympathetic chain ganglia, b:none,
m:carries postganglionic sympathetic axons to the spinal nerve; spinal nerve will carry those axons
peripherally to the skin, blood vessels, etc., s:none, gray rami communicantes connect the sympathetic
chain to spinal nerves at all vertebral levels (Latin, ramus = a branch)

iliohypogastric n._______o:lumbar plexus (ventral primary ramus of spinal nerve L1), b:lateral and
anterior cutaneous brs., m:muscles of the lower abdominal wall, s:skin of the lower abdominal wall,
upper hip and upper thigh, iliohypogastric n. receives a contribution from T12 in approximately 50% of
cases

ilioinguinal n._______o:lumbar plexus (ventral primary ramus of spinal nerve L1), b:anterior cutaneous
br. (also known as: anterior labial/scrotal n.), m:muscles of the lower abdominal wall, s:skin of the lower
abdominal wall and anterior scrotum/labium majus, ilioinguinal n. courses through the inguinal canal
and superficial inguinal ring

lumbar n.________o:ventral primary rami of spinal nerves L1-L5, b:contributes to the formation of the
lumbar and sacral plexuses, m:numerous: see lumbar and sacral plexuses, s:numerous: see lumbar and
sacral plexuses, lumbar nn. enter into the formation of the lumbar and sacral plexuses and do not give
branches directly to muscles or skin

lumbar plexus_______o:ventral primary rami of spinal nerves L1-L4, b:branches of the lumbar plexus:
iliohypogastric n., ilioinguinal n., genitofemoral n., lateral femoral cutaneous n., femoral n., obturator n.,
lumbosacral trunk (considered to be part of sacral plexus), brs. to the psoas major and minor mm.,
branches to the quadratus lumborum m., m:muscles of the lower abdominal wall; cremaster m., psoas
major and minor mm., quadratus lumborum m., iliacus m.; muscles of the anterior and medial thigh and
hip, s:skin of the lower abdominal wall, skin of the anterior scrotum/labium majus, skin of the anterior
and medial thigh and lateral hip, lumbar plexus is noted for its variable branching pattern of nerves that
supply the abdominal wall (Latin, plexus = to braid, a network of nerves, blood vessels, or lymphatic
vessels)
lumbosacral trunk_______o:part of the ventral primary ramus of L4 united with the ventral primary
ramus of L5, b:no named branches; it contributes to the formation of the sacral plexus, m:muscles of the
hip and posterior thigh, s:see sacral plexus, the lumbosacral trunk is not considered to be part of the
lumbar plexus (Latin, plexus = a braid, a network of nerves, blood vessels, or lymphatic vessels)

obturator n._______o:lumbar plexus (ventral primary rami of spinal nerves L2-L4), b:anterior and
posterior brs., m:muscles of the medial thigh: adductor longus m., adductor brevis m. and adductor
magnus m., gracilis m., obturator externus m., s:skin of the lower medial thigh, obturator n. passes
through the obturator canal (Latin, obturare = close, obscure)

subcostal n._______o:ventral primary ramus of T12, b:lateral cutaneous br., anterior cutaneous br.,
m:muscles of the abdominal wall, s:skin of the anterolateral abdominal wall, the subcostal n. is
equivalent to a posterior intercostal n. found at higher thoracic levels (Latin, costa = rib)

white ramus communicans_______o:cell bodies located in the lateral horn gray matter of spinal cord
levels T1-L2;, b:none, m:axons contained within white rami communicantes will synapse on
postganglionic cell bodies that will ultimately innervate the skin, viscera, glands, blood vessels, etc.,
s:pain from viscera is carried back to the spinal cord through the white ramus communicans, white rami
communicantes connect the sympathetic chain to spinal nerves at vertebral levels T1-L2; carries
preganglionic sympathetic axons (Latin, ramus = a branch)

D:
Lymphatics

Structure Location Afferents from Efferents to Regions drainedNotes

cisterna chyli_______between the abdominal aorta and the inferior vena cava anterior to the body of
the L1 or L2 vertebra, a:right and & left lumbar trunks; possibly the intestinal trunk, e:thoracic duct, rd:all
of the body below the respiratory diaphragm; all of the abdominal and pelvic viscera, cisterna chyli is an
enlargement of the lower end of the thoracic duct; it occurs in about 25% of individuals

common iliac nodes_______along the common iliac vessels; over the sacral promontory, a:external iliac
nodes, internal iliac nodes, e:lumbar (lateral aortic),chain of nodes, rd:lower limb; pelvic organs,
perineum, lower part of the anterior abdominal wall common iliac nodes are approximately 6 in
number

external iliac nodes_______along the external iliac vessels, a:superficial inguinal nodes; deep inguinal
nodes; inferior epigastric nodes, e:common iliac nodes, rd:lower limb; external genitalia; lower part of
the anterior abdominal wall, external iliac nodes are 8 to 10 in number

internal iliac nodes______along the internal iliac vessels, a:lymphatic vessels from the pelvic viscera
common iliac nodes, e:external iliac nodes, rd:pelvis, perineum and gluteal region, internal iliac
nodes are 4 to 8 in number

intestinal lymphatic trunk_______left side of the abdominal aorta or between the abdominal aorta and
the inferior vena cava near the level of the superior mesenteric artery, a:union of efferent lymphatic
vessels from the celiac nodes and superior mesenteric nodes, e:left lumbar trunk or the cisterna
chyli/thoracic duct, rd:large and small intestines, intestinal lymph trunk carries lymph that is rich in fat;
drains into the left lumbar trunk (70%), cisterna chyli (25%) or right lumbar trunk (5%)

lateral aortic nodes________along the inferior vena cava and abdominal aorta from the aortic
bifurcation to the aortic hiatus of the diaphragm, a:common iliac nodes; lymphatic vessels from the
posterior abdominal wall and viscera, e:efferents form one lumbar trunk on each side, rd:lower limb;
pelvic organs; perineum; anterior and posterior abdominal wall; kidney; suprarenal gland; respiratory
diaphragm also known as: lumbar nodes; the intestinal trunk drains into to the left lumbar trunk;
the lumbar trunks unite to form the thoracic duct/cisterna chyli

lumbar nodes_______also known as: lateral aortic nodes

lumbar trunk________between the lumbar vertebral bodies and inferior vena cava (right) or aorta (left)
at the upper end of the lumbar chain of nodes lumbar (lateral aortic) nodes; the intestinal trunk joins
the left lumbar trunk, a:thoracic duct/cisterna chyli, e:left lumbar trunk -, rd:left side of the body below
the respiratory diaphragm, gut; right lumbar trunk - right side of body below the diaphragm lumbar
trunks unite to form the lower end of the thoracic duct; an enlargement of the lower end of the thoracic
duct (called the cisterna chyli) occurs in about 25% of individuals, and when it is present, the lumbar
trunks drain into it

thoracic duct_______between the esophagus anteriorly and the thoracic vertebral bodies posteriorly,
a:formed by the union of the lumbar lymph trunks, sometimes dilated to form a cisterna chyli, e:junction
of the left subclavian v. and the left internal jugular v., rd:all of the body and limbs below the respiratory
diaphragm; the left side of the chest, left upper limb and the left side of the head and neck above the
diaphragm, thoracic duct is the largest lymphatic vessel; it passes through the aortic hiatus on the right
side of aorta; it swings to the left side of the esophagus at the T4-T5 intervertebral disc (at the level of
the sternal angle)

D:

Clinical Terms

Term Definition

femoral nerve iatrogenic injury_______During open abdominal surgeries (i.e., hysterectomy), rectractor
blades are used to keep the cavity open. The blade may come to rest on the femoral nerve, crushing it as
it lies in the groove between the iliacus and psoas major muscles.

renal calculus (kidney stone)________The presence of calculi in the kidney or collecting system. The
calculi are usually small (2-12mm) solid, crystalline, concretions that develop in the kidney and
eventually pass through the genitourinary tract. Stones may be calcium (75-80% of all stones), uric acid,
struvite, or cystine.

cystic kidney________polycystic kidney disease (PKD) is a disorder that is characterized by the growth of
numerous cysts in the kidneys. The cysts are filled with fluid. PKD cysts can replace much of the mass of
the kidneys, thereby reducing kidney function and leading to kidney failure. When PKD causes kidneys to
fail, which usually happens only after many years, the patient requires dialysis or kidney transplantation.
About one-half of people with the primary form of PKD progress to kidney failure or end-stage renal
disease (ESRD). PKD can cause cysts in the liver and problems in other organs, such as the heart and
blood vessels in the brain. These complications help doctors distinguish PKD from the usually harmless
"simple" cysts that often form in the kidneys in later years of life. (Greek, cystic/kystis = a bladder or
pouch)

horseshoe/pelvic kidney_______A congenital abnormality in which the kidneys are united at the inferior
poles (shaped like a horseshoe) and migrate up until stopped by the inferior mesenteric artery.

hiatal hernia_______A type of hernia that occurs when a portion of the stomach protrudes through the
diaphragm (where the esophagus normally passes through). Obesity and smoking are considered risk
factors. Hiatal hernia is often associated with reflux esophagitis. Symptoms include heartburn, difficulty
swallowing, chest pain and belching. Treatment includes H2 antagonists, proton pump inhibitors, and
antacids. (Latin, hernia = to rupture)

congenital diaphragmatic hernia_______A condition present at birth in which there is abnormal

protrusion of abdominal contents upward through a defect in the diaphragm. This condition is treated as
a surgical emergency due to interference with the infant's breathing. This compromises development of
the lungs. It most commonly occurs on the left side (due to the liver's position on the right). Smaller, less
serious diaphragmatic hernias may also be seen in adults. (Latin, hernia = to rupture)

abdominal aortic aneurysm (AAA)_______A distended and weakened area in the wall of the abdominal
aorta, more common in those who suffer from atherosclerosis. The aneurysm is usually located below
the renal arteries and above the aortic bifurcation. Symptoms include sudden, severe abdominal pain
with radiation to the back. (Greek, aneurysm = a dilation)

IVP (intravenous pyelogram)_________a diagnostic test that follows the time course of excretion of a
radiopaque contrast dye through the kidneys, ureters, and bladder after injection into a cutaneous vein.

ileus________an obstruction of the intestines. (Greek, eileos = intestinal colic)

hemorrhoids_______General: A varicose dilatation of a vein of the superior or inferior hemorrhoidal

plexus, resulting from a persistent increase in venous pressure. Presents as a swelling formed by the
dilation of the blood vessels around the margin of, or within, the anus, from which blood or mucus is
occasionally discharged. (Greek, haimorrhos = veins likely to bleed)
External: hemorrhoids that occur below the dentate (also known as the pectinate) line and are generally
painful. They are sometimes called skin tags, or can be seen or felt as extra skin around the anus.
External hemorrhoids can become very distressing when the blood in the external hemorrhoid clots, and
inflammation irritates the nearby pain-sensitive skin. This condition is called a thrombosed external
hemorrhoid and is quite painful.

Internal: hemorrhoids that occur above the pectinate line in the anal canal which separates two types of
anal skin. The skin above the pectinate line is not sensitive to pain. Internal hemorrhoids, being above
the pectinate line, are therefore usually painless. They can cause bleeding or they may push out of
(prolapse) the anal opening when they become quite large.

imperforate anus (anal atresia)________a congenital obstruction of the anal opening. Occurs in
approximately 1 in 5,000 infants. This condition is corrected through surgery.

sigmoidoscopy_______a procedure in which a scope is used to view the sigmoid flexure, a part of the
colon that is shaped like the letter "s."

benign prostatic hypertrophy_________it is important to note that hypertrophy is the enlargement of

existing cells whereas as hyperplasia is an increase in the number of normal cells. A benign enlargement
of the prostate gland which begins normally after age 50, probably secondary to the effects of male
hormones. If significant enlargement occurs, it may pinch off the urethra making urination difficult or
impossible. The hyperplasia is typically periurethral.

trans-urethral prostatectomy (turp)________the surgical removal of the prostate gland. Transurethral

prostatectomy is performed through the urethral canal of the penis.

prostate cancer________the second most common malignancy in men. A malignant tumor of glandular
origin in the prostate. Over 95% are adenocarcinomas. Most commonly seen in older men, with the age
of 73 being the average age at the time of diagnosis. A family history for prostate cancer and perhaps a
diet that is high in fat are considered to be risk factors for this malignancy. Early detection is possible
through annual digital rectal examinations and routine PSA testing. The cancer is typically at the
periphery of the prostate (not periurethral like BPH).

cervical cancer________cancer of the cervix of the uterus. Very highly correlated with HPV infection.

hysterectomy________the operation of excising the uterus, performed either through the abdominal
wall or through the vagina.

oophorectomy________the removal of an ovary or ovaries.

ectopic pregnancy________a gestation elsewhere than in the uterus. Often occurring in the uterine
tube. Presents with abdominal pain, fainting, and/or vaginal bleeding.
STD infection resulting in infertility________chlamydia is probably the STD most often associated with
infertility. Gonorrhea is as well. Both can cause scarring and therefore infertility (e.g., ovarian tubes
blocked, etc.). PID (Pelvic Inflammatory Disease) is a description of a disease process in the pelvis (just
what is sounds like -- inflammation). It can be caused by Chlamydia as well as other STDs and some
unknown anaerobic organisms. Most OB/Gyn people refer to the specific part of the viscera that is
inflamed (e.g., salpingitis, endometritis, etc.) instead of the generic PID. However, many other clinicians
(internists, ER docs) use the term PID.

hysterosalpingography________radiography of the uterus and uterine tubes after the injection of a

contrast medium.

prolapse of uterus________falling down or sinking of the uterus; the cervix may protrude from the
introitus.

cesarean (c-section)________a surgical procedure that involves the delivery of the fetus through an
abdominal incision. C-sections account for about 1/5 of all births in the US. Indications include: failure to
progress, fetal distress, cephalopelvic disproportion (baby too big for birth canal), placenta previa,
placental abruption, placental insufficiency, breech baby, active genital herpes, multiple gestation,
preeclampsia and excessive scarring from previous surgeries. The average hospital stay is about 4 days.
The maternal death rate with C-section is three times higher than with natural delivery.

menstrual pain_______lower abdominal and pelvic pain that is associated with menses. Recurrent
monthly menstrual pains (not explained by other causes) are often referred to as primary
dysmenorrhoea.

cystocele________a condition where the bladder herniates into the vaginal canal and usually results in
stress incontinence. (Greek, -cele = hernia)

colporrhaphy________repair of a rupture of the vagina by suturing the edges of the tear.

laparotomy_______general term for abdominal surgery.

leiomyomas________benign uterine tumors also referred to as uterine fibroids that can cause pelvic
pain and bleeding in some females. (Greek, -oma = tumor or neoplasm)

enterocele_______a hernial protrusion of bowel through a defect in the rectouterine or vesicouterine

pouch (Greek, -cele = hernia)

rectocele/proctocele________prolapse or herniation of the rectum (Greek, -cele = hernia).

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