other

Question 1

prostate secretions

Answer 1

1. proteolytic enzymes
2. PAP
3. β-microseminoprotein
4. PSA
5. zinc

Question 2

ejaculatory ducts?

Answer 2

formed by the union of the vas deferens with the duct of the seminal vesicle –> pass through the prostate, and open into the urethra at the Colliculus seminalis.

Question 3

Ampulla of vans deferens

Answer 3

enlargement of the vas deferens at the fundus of the bladder.

Question 4

seminal vesicle

Answer 4

pair of glands which open into the vas deferens near to its junction with the urethra (before prostate) and secrete many of the components of semen

Question 5

failure of processus vaginalis to close –>

Answer 5

1. indirect inguinal

2. hydrocele

Question 6

fate of vitelline duct

Answer 6

obliteration at 7 weeks

Question 7

Urachus - everything

Answer 7

in 3rd week the yolk sac forms the allantois –> extentds into urogenital sinus –> Allantois becomes the urachus, a duct between fetal bladder and umbilicus

Question 8

Amniotic band syndrome?

Answer 8

congenital disorder caused by entrapment of fetal parts (usually a limb or digits) in fibrous amniotic bands while in utero.

Question 9

position of uterus

Answer 9

50% –> anterverted
25% retroverted
25% midverted
due to uterosacral ligament –> loss of the ligament –> prolapse into vagina

Question 10

fructose rich compoment of sperm, and area

area of Bulbourethral gland of Cowper

Answer 10

seminal vesicle (posteriolateral of bladder) 
seminal vesicle in ductus deferans (behind bladder) --> ejaculation duct 
cowper: junction between membranous + boublous urethra

Question 11

epistomy - definition + types

Answer 11

it is an incision of the posterior wall of the vagina during labor:

1. medline: extend posteriorly in the midline throught perineal body but not to the external anal sphincter (vertical)
2. mediolateral: extend througth the bulbospongiosus + transcerus perineus muscle (less risk of damage fibers of external anal sphincter)

Question 12

branches of internal iliac artery

Answer 12

1. pelvic visceral branches: umbilical ar, uterine ar, ductus deferens, vaginal art, inferior vesical ar, middle rectal ar
2. perineal branches: internal pubendal –> inf rectal, perineal branch, artery to bulb, deep ar of penis, dorsal ar of penis
3. pelvic wall branches –> iliolumbar, lateral sacral
4. lower limb branches –> superior glut, inf glut, oburator ar

Question 13

pudendal nerve - branches

Answer 13

3 main branches –> inf rectal, perineal nerve, dorsal nerve of penis + clitoris

Question 14

unresponsive to medical management postpartum hemorrhage –>

Answer 14

bilateral ligation of the internal iliax artery (aka as hypogasric artery)
the uterus has collateral blood flow (from ovarian art) –> sufficient to maintain uterine function

Question 15

fibrinoids of uterus may located

Answer 15

1. serosal surface (subserosal) –> IRREGULAR ENLARGED UTERUS –> bulk symptoms (eg. constipation)
2. within uteral wall (intramural) –> reproductive difficulties
3. below endometrium (SUBMUCOSAL) –> reproductive difficulties, bleeding

Question 16

main target of kegel exercise

Answer 16

levator ani:

1. iliococcygeus
2. pubococcygeus
3. puborectalis

Question 17

levator ani injury –>

Answer 17

1. urethral hypermobility

2. pelvic organ prolapse

Question 18

inscision in cesarea delivery

Answer 18

1. midline vertical sepration of the rectus abdominis muscle
2. when additionally space necessary –> horizontal transection of the rectus abdominis –> risk for inferior epigastric arteries

Question 19

arcuate line?

Answer 19

horizontal line below the umbilicus that demarcates the lower limit of the posterior rectus sheath. Above that, the rectus abdominis is sourounded by anterior + posterior sheath. Below only by anterior sheath

Question 20

lymphatic system of lower extremities

Answer 20

1. superficial lymphatic vessels (follow venous system)
2. deep lymphatic vessels (follow arterial system)
   the superficial lymphatic system is also divided to medial + lateral
   medial bypass the popliteal nodes (like saphenus) –> inguinal area
   lateral do not bypass –> popliteal AND inguinal area

Question 21

gonadal arteries course

Answer 21

right travels in front of IVC + behind ileum + left ar behind left colic + sigmoid art + iliac colon –> cross anteror the ureter –> paraller the external iliac vessels –> inguinal canal –> testes

Question 22

endometriosis in pouch of douglas

Answer 22

painful defecation, dyspareunia, plpable nodularity on rectpvaginal examination

Question 23

perineal body?

Answer 23

central tendon of the perineum –> lies in the midline between urogenital + anal triangle
the following structures are anchored to it:
1. bulbospongiosus muscle
2. external anal sphincter
3. superficial + deep transverse perinal muscle
4. fibers from external urethral sphincter, levator ani + muscular coat of rectum

Question 24

prostatic plexus - lies … / origin /

Answer 24

• lies within the fascia of prostate
• origin: inferior hypogastric plexus
• gives rise to lesser + greater carvenous nerves
  risk for injury in prostatectomy –> erectile dysfunctin

Question 25

vesicouterine vs rectovesical pouch

Answer 25

females --> peritoneum onto anterior aspect of uterus (between uterus + bladder) --> vesicouterine pouch males --> peritoneum onto anterior aspect of the rectum (between rectum + uterus --> rectovesical pouch

Question 26

ext iliac artery branches

Answer 26

1. inf epigastric | 2. deep circumflex iliac

Question 27

inf epigastric artery - course

Answer 27

branch of ext iliac immediately proximal to inguinal ligament --> supply to lower anterior abdominal wall as it rans superiorlu + and medially up to abdomen

Question 28

hypospandias - association

Answer 28

1. inguinal hernia | 2. cryptorhidism

Question 29

endometrial carcinoma - risk factors

Answer 29

1. prolong use of estrogen without progestins 2. obesity 3. diabetes 4. hypertension 5. nulliparity 6. late menopause 7. Lynch syndrome

Question 30

Medulary carcinoma mimics ... in mammograpy

Answer 30

fibroadenona

Question 31

Male female genital homologs - everything (embriogenic structure, derivatives - right for estrogen and left for dihydrotestosterone

Answer 31

1. glans penis - genital tubercle - glans clitoris (ESG) 2. Corpus cavernosum and spongiosum - genital tubercle - vestibular bulbs 3. Balboulerthral glands of Cowper - urogenital sinus - greater vestibular glands of Bartholin 4. Prostate gland - urogenital sinus - Urethral and paraourethral glands of skene 5. ventral shaft of penis (penile urethra) - urogenital folds - labia minora 6. scrotum - Labioscrotal swelling - Labia majora

Question 32

carpal tunnel contains

Answer 32

1. tendos of flexor digitorum profandus, superficialis, pollicis longus (thumb flexor) 2. median nerve

Question 33

major muscles responsible for hip motion

Answer 33

1. flexion: ilipsoas, rectus femoris, tensor fascia lata 2. extension: gluteus maximus, semitendinosus, semimembranosus, long head of biceps 3. abduction medius/minimus 4. adduction: adductor brevis/longus/magnus

Question 34

piriformis location / action / clinical significance

Answer 34

passes through the greater sciatic foramen + is involved with external rotation --> muscle injury or hypertrophy --> compress sciatic nerve in the foramen --> PIRIFORMIS SYNDROME --> tender muscle in deep palpation or on adduction + internal location structure passing above piriformis: superior gluteal vessels + nerves structure passing below piriformis: inferior gluteal vessels, internal pupendal vessels, multiple nerves (esp sciatic)

Question 35

sciatic foramen is divided to ... by

Answer 35

greater + lesser foramen by sacrospinous ligament

Question 36

liver - posterior ribs renal - posterior rbs Spleen

Answer 36

8-11 11-12 9-11

Question 37

Kidney location

Answer 37

- T12-L3 - right is lower (because of the liver) - left is slightly larger

Question 38

Alkaline sperm secretions - from

Answer 38

Prostate

Question 39

The larger volume of secretions in sperm - from

Answer 39

Seminal vesicles

Question 40

Cleft lip - mechanism/presentation

Answer 40

failure of fusion of the maxillary and medial nasal process (formation of 1ry palate) --> split in the upper lip on one or both sides of the centre

Question 41

Cleft palate - mechanism

Answer 41

failure of fusion of the 2 lateral palatine shelves or failure of fusion of lateral palatine shelves with the nasal septum and/or median palatine shelf (formation of 2ry palate)

Question 42

1. Cleft lip - when | 2. Cleft palate - when

Answer 42

1. 5-6 weeks | 2. 7-8 weeks

Question 43

Peak height velocity (when)

Answer 43

1 year after initiation of breast development (turner 3)

Question 44

also in fetal alcohol manifestation

Answer 44

low ear | increased space between eyes

Question 45

tamoxifen - lipid profile

Answer 45

decreases LDL no change in HDL increases TG in some patients

Question 46

pregnancy - hair

Answer 46

high estrogen + progest -> increased hair growth | topical only minimal

Question 47

absolute contraindication for OCPs

Answer 47

1. prior hostory of thromboembolic event or stroke 2. History of estrogen-dep tumor 3. women over 35 who smoke heavily 4. Hypertriglyceredimea 5. Pregnancy 6. decompresated or active liver disease (would impair steroid metabolism)

Question 48

clonidine, β-blockers, thiazides - in pregnancy

Answer 48

clonidine - safe but 2nd line β-blockers - safe thiazides - fetal thrombocytopenia + jundice, but safe (you can continue, but not start)

Question 49

phenytoin vs valproic acid according to teratogenesis

Answer 49

phenytoin --> hydantoid syndrome | valproic acid --> spina bifida

Question 50

women whoo benefits extend extend the risk of tamoxifen

Answer 50

patients B --> women more than 50 with hysterctomy

Question 51

medications used for pregnancy termination

Answer 51

1. misoprostol (PGL E1 agonist) --> cervical softening and uterine contraction 2. Mifepristome (prog antagonist --> necrosis of uterine decidua, glucocortic antag) 3. Methotrexate

Question 52

actin of progestins in contraception

Answer 52

1. if local (noethndrone pill or levnorgestrel IUD) --> thickness of cervial mucus --> impair sperm penetration 2. systemic -(impant/injection, pill, patch, vaginal ring) --> suppresses axon