Chapter 1 Osteo1ogy.............................1 Chapter 2



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6. The female genital organs consist of internal and external organs. The internal organs are situated within the pelvis, and consist of the ovaries, the uterine tubes, the uterus, and the vagina. The external organs comprise the mons pubis, the great lip of pudendum (labia majora), the lesser lip of pudendum (labia minora), the clitoris, the vaginal vestibule, the bulb of vestibule, the vestibular glands and the mammary glands.

The functions of the female reproductive system are (1) to produce ova; (2) to secrete sex hormones; (3) to receive the semen from the male during coitus; (4) to provide sites for fertilization, embryonic and fetal development; (5) to facilitate parturition, or delivery of the baby; and (6) to provide nourishment for the baby through the mammary glands in the breasts.

7. Each ovary lies in a shallow depression between internal and external iliac arteries, named the ovarian fossa, on the posterior wall of the pelvis.

Each ovary is secured by several membranous attachments. The principal supporting membrane of the female reproductive tract is the broad ligament. The mesovarium is a specialized posterior extension of the broad ligament that attaches to an ovary. Each ovary is additionally supported by a proper ligament of ovary (ovarian ligament), which is anchored to the uterus, and a suspensory ligament of ovary, which is attached to the pelvic wall.

8. The uterus is situated at the center of the pelvis between the urinary bladder and the rectum, and forms anteversion (about 90°angle) between the uterus and vagina; besides, the body of uterus and the cervix forms an angle about 170°called anteflexion. The anatomical regions of the uterus include 3 parts: (1) the uppermost dome-shaped portion superior to the entrance of the uterine tubes, called the fundus of uterus; (2) the enlarged main portion, called the body of uterus; and (3) the inferior constricted portion opening into the vagina, called the neck (cervix) of uterus. Approximately the upper third of the cervix has been termed the isthmus of uterus. The cavity of the uterus is small in comparison with the size of the organ, partly due to its thick wall. The cavity of uterus is the space within the fundus and body of the uterus. The narrow canal of cervix of uterus extends through the cervix and opens into the lumen of the vagina. The opening of the canal of cervix of uterus into the vagina is called the uterine orifice.

Four paired ligaments support the uterus in position within the pelvic cavity. (!) Broad ligaments, extend from the pelvic walls and floor to the lateral walls of the uterus. (2) Uterosacral ligaments, curve along the lateral pelvic wall on both sides of the rectum to connect the uterus to the sacrum. (3) Cardinal ligaments, locate at the base of the broad ligaments that extend laterally from the cervix and vagina across the pelvic floor to the wall of the pelvis. (4) round ligaments, extend from the lateral border of the uterus just below the point where the uterine tube attaches to the greater lips of pudendum.

9. ovum→peritoneal cavity → abdominal orifice of uterine tube → infundibulum of uterine tube → ampulla of uterine tube → fertilized ovum → isthmus of uterine tube →uterine part of uterine tube → uterine orifice of uterine tube → cavity of uterus → endometrium → fetus → orifice of uterus → vaginal orifice → outside of body.

10. Each mammary gland is composed of 15 to 20 lobes, each with its own drainagepathway to the outside. The lobes are separated by varying amounts of adipose tissue.The amount of adipose tissue determines the size and shape of the breast but has nothing to do with the ability ralveoli. The mammary alveoli are the structures that produce the milk of a lactating female. Suspensory ligaments between the lobules extend from the skin to the deep fascia overlying the pectoralis major muscle and support the breasts. The clustered mammary alveoli secrete milk into a series of mammary ducts that converge to form lactiferous ducts. The lumen of each lactiferous duct expands near the nipple to form a lactiferous sinus. Milk is stored in the lactiferous sinuses before draining at the tip of the nipple.

(Liu Fang)

Appendix: The Perineum

Multiple Choice Questions

A1

1. Hepatoduodenal ligament contains .



A. hepatic veins

B. splenic vein

C. hepatic portal vein

D. left gastric vein

E. celiac trunk

2. Which structure divides the peritoneal cavity into supracolic and infracolic compartment?

A. lesser omentum

B. transverse mesocolon

C. greater omentum

D. greater omentum

E. mesentery

3. Which of the following organs doesn't belong to intraperitoneal organ?

A. stomach

B. uterus

C. jejunum

D. transverse colon

E. spleen

4. Which of the following organs doesn't belong to intraperitoneal organ?

A. ovary

B. liver


C. urinary bladder

D. ascending and descending colon

E. urinary bladder

5. Which of the following organs doesn't belong to retroperitoneal organ?

A. ureters

B. suprarenal glands

C. kidneys

D. lower part of the rectum

E. transverse colon

6. About the lesser omentum, which statement is not true?

A. It is a double layer of peritoneum.

B. It contains hepatogastric ligament, hepatoduodenal ligament and gastrocolic ligament.

C. The hepatogastric ligament contains the right and left gastric arteries.

D. The hepatoduodenal ligament encloses the bile duct, the proper hepatic artery, hepatic portal vein.

E. It connects the inferior surface of the liver to the lesser curvature of the stomach and the upper part of the duodenum.

7. About the greater omentum, which statement is not true?

A. It is a biggest fold of the peritoneum.

B. It always contains some adipose tissue, blood vessels and macrophages.

C. It reaches inferiorly as an apron-like double layer of the peritoneum.

D. It contains hepatogastric ligament, hepatoduodenal ligament.

E. The anterior and posterior leaves usually fuse.

8. Which of the following organs has no mesentery?

A. jejunum

B. ileum


C. vermiform appendix

D. sigmoid colon

E. ascending colon

9. Which of the following muscles is not contained in the urogenital triangle?

A. superficial transverse muscle of perineum

B. bulbocavernosus

C. sphincter of urethra

D. coccygeus

E. ischiocavernosus

A2

1. While performing a splenectomy (removal of the spleen) following an automobile accident, the surgeons were especially attentive to locate and preserve the tail of the pancreas, which is closely associated with the spleen. This they found in the .



A. gastrocolic ligament

B. gastrosplenic ligament

C. phrenicocolic ligament

D. splenorenal ligament

E. transverse mesocolon

2. During an emergency splenectomy, the surgeon accidentally tore the gastrosplenic ligament and its contents. The artery that is likely to be damaged in this event is(are) the .

A. left gastric

B. splenic

C. middle colic

D. short gastric

E. caudal pancreatic

BI

A. suspensory ligament of duodenum



B. hepatogastric ligament

C. falciform ligament of liver

D. ligamentum teres hepatis

E. gastrocolic ligament

1. The mark of the commencement of jejunum

2. Formed by lesser omentum

3. Formed by greater omentum

A. falciform ligament

B. coronary ligament

C. ligamentum teres hepatis

D. ligamentum venosum

E. hepatoduodenal ligament

4. It extends from the umbilicus to the notch for the ligamentum teres hepatic.

5. It contains the bile duct, the proper hepatic artery and hepatic portal vein.

6. Lower free border contains the ligamentum teres hepatic.

True or False Questions

1. The subphrenic peritoneum has greater absorptive capacity than other portions of the peritoneum. ( )

2. The stomach, jejunum, liver, vermiform appendix are all intraperitoneal organs.

( )

3. Kidneys, suprarenal glands, ureters are all retroperitoneal organs. ( )



4. The effect of levator ani is supporting pelvic floor and organs in the pelvic cavity. They also have an important sphincter action on the anal canal and vagina. ( )

5. Hepatogastric ligament encloses the bile duct, the proper hepatic artery, hepatic portal vein. ( )

6. The greater omentum is usually thin, and presents a cribriform appearance, but always contains some adipose tissue, blood vessels and macrophages. ( )

7. By the omental foramen the omental bursa communicates with the (greater) peritoneal cavity. ( )

8. The sigmoid mesocolon is a triangular peritoneal fold that attaches the sigmoid colon to the abdominal wall. ( )

9. The anterior layer of coronary ligament is continuous with the falciform ligament. ( )

10. Duodenal folds include the anterior duodenal fold and posterior duodenal fold. ( )

11. The rectouterine pouch in female or the rectovesical pouch in male is the lowest part of the peritoneal cavity in anatomical position. ( )

12. The suprahepatic space is divided into right and left suprahepatic spaces by the coronary ligament. ( )

13. Mesenteric sinuses lie between the radix of the mesentery and the ascending and descending colons. ( )

14. The right paracolic sulcus lies along the lateral side of the ascending colon, inferiorly it continues with the right subhepatic space. ( )

15. Suprahepatic space lies between the superior surface of liver and the diaphragm. ( )

16. In anal triangle there are the levator ani, coccygeus, bulbocavernosus and sphincter ani externus. ( )

Explanation of Terms

1. peritoneal cavity

2. intraperitoneal organ

3. intraperitoneal organ(2、3重复)

4. retroperitoneal organ

5. lesser omentum

6. greater omentum

7. omental bursa

8. mesentery

9. ischioanal fossae

10. pelvic diaphragm

11. urogenital diaphragm

Answer the Following Questions

1. Give at least 5 examples of intraperitoneal organ..

2. Give at least 5 examples of intraperitoneal organ.(1、2重复)

3. Give at least 5 examples of retroperitoneal organ.

4. Describe briefly the division of the levator ani.

5. Describe briefly the walls of omental bursa.

6. What is mesentery? And take some examples.

7. Describe briefly the divisions of suprahepatic space.

8. Describe briefly the divisions of subhepatic space.

9. Describe briefly the borders of the broad sense of the perineum.

ANSWERS


Multiple Choice Questions

A1

1. C 2. B 3. B 4. A 5. E 6. B 7. D 8. E 9. D



A2

1. D 2. D

BI

1. A 2. B 3. E 4. C 5. E 6. A



True or False Questions

1. T 2. T 3. T 4. T 5. F 6. T 7. T 8. F 9. T 10. F

11. T 12. F 13. T 14. F 15. T 16. F

Explanation of Terms

1. The potential space between the parietal and visceral peritonea is the peritoneal cavity.

2. If an organ is almost completely surrounded with peritoneum which in the abdominal and pelvic cavity, it is called the intraperitoneal organ.

3. The intraperitoneal organ is covered by peritoneum on their three aspects.

4. Only the anterior part of these organs covered by the peritoneum is called the retroperitoneal organ.

5. It is a double-layer of peritoneum that connects the inferior surface of the liver to the lesser curvature of the stomach and the upper part of the duodenum.

6. It is a biggest fold of the peritoneum extending downwards from the greater curvature of the stomach to lie anteriorly within the abdominal cavity.

7. There is a potential, narrow space between the lesser omentum, the posterior wall of the stomach and the posterior wall of the abdomen, which is called omental bursa.

8. The mesentery is a large, fan-shaped fold of peritoneum connecting the coils of jejunum and ileum to the posterior abdominal wall.

9. In anal triangle there are two 'large spaces on both sides of the anal canal, which are called the ischioanal fossae.

10. The levator ani and coccygeus together with the superior and inferior fascia of pelvic diaphragm form the pelvic diaphragm which encloses the anal triangle. The anus passes through the center of pelvic diaphragm.

11. The superior and inferior fasciae of urogenital diaphragm, the deep transverse muscle of perineum, and the urethral sphincter muscle form the urogenital diaphragm, which encloses the urogenital triangle.

Answer the Following Questions

l. Stomach, superior part of duodenum, jejunum, cecum, vermiform appendix, transverse colon, sigmoid colon, spleen, ovary, uterine tube.

2. Liver, gallbladder, urinary bladder, uterus, upper part of the rectum, ascending and descending colons.

3. Kidneys, suprarenal glands, ureters, major part of duodenum, pancreas (except for its tail), and lower part of the rectum.

4. Levator ani is divided into pubovaginalis (in female), puborectalis, pubococcygeus and iliococcygeus.

5. Its anterior wall is formed by the lesser omentum, the posterior wall of the stomach and the gastrocolic ligament. The posterior wall is formed by the peritoneum covering the pancreas, the left kidney and left suprarenal gland. The superior wall is the inferior surface of the caudate lobe of the liver and the peritoneum covering diaphragm. The inferior wall is the transverse mesocolon and the site that the anterior and posterior layers of the greater omentum fuse. On the left, it is bounded by he spleen, the gastrosplenic and splenorenal ligaments. On the right, the omental bursa communicates with the greater sac through the omental foramen.

6. Mesenteries are peritoneal folds that attach viscera to the posterior abdominal wall. They allow some movement and provide a conduit for vessels, nerves and lymphatics to reach the viscera and include the mesentery, mesoappendix, transverse mesocolon and sigmoid mesocolon.

7. This space is divided into suprahepatic space and subhepatic space by the liver. The suprahepatic space is divided into right and left suprahepatic spaces by the falciform ligament. The right and left suprahepatic spaces are subdivided into right anterior and posterior suprahepatic spaces, left anterior and posterior suprahepatic spaces by the coronary ligament.

8. This space is divided into right and left subhepatic spaces by the ligamentum teres hepatis, the right subhepatic space is usually called hepatorenal recess, the left subhepatic space is subdivided into the left anterior and left posterior subhepatic spaces by the lesser omentum and stomach.

9. Its anterior margin is formed by the inferior border of the pubic symphysis, the posterior margin is the apex of coccyx, the lateral margin is surrounded by the inferior rami of pubis, rami of ischium, ischial tuberosities, sacrotuberous ligaments.

(Zhang Yafang, Li Xiaodong)

Multiple Choice Questions

A1

1. The components of vascular system are .



A. the cardiovascular system and the lymphatic system

B. the heart, the artery, the capillary and the vein

C. the cardiovascular system and the lymphatic organ

D. the heart, the artery, the vein and the lymphatic vessel

E. the cardiovascular system and the lymphatic vessel

2. Which is the accurate describing about the shape of the heart?

A. the cardiac apex consists of left and right ventricles

B. the whole cardiac base consists of the left atrium

C. the posterior of the aortic root is the left atrium

D. the coronary sulcus locate between right and left ventricles

E. the sulcus terminalis separates the left atrium and right atrium

3. The valves forcing antidromic blood during the ventricular diastole are .

A. the aortic valve and the tricuspid valve

B. the aortic valve and the mitral valve

C. the tricuspid valve and the mitral valve

D. the aortic valve and valve of pulmonary trunk

E. the valve of pulmonary trunk and the tricuspid valve

4. Which consists of the fight border of the heart?

A. the right ventricle

B. the right atrium

C. the right ventricle and right atrium

D. the right ventricle and the inferior vena cava

E. the right atrium and the inferior vena cava

5. Which consists of the cardiac valve?

A. the endocardium and fibrous connective tissue

B. the epicardium

C. the cardiac muscle

D. the fibrous membrane

E. the connective tissue

6. The left fibrous trigone is between .

A. the left fibrous ring of aortic valve and the fibrous ring of tricuspid valve

B. the left fibrous ring of aortic valve and the fibrous ring of mitral valve

C. the fibrous ring of tricuspid valve and the fibrous ring of mitral valve

D. the left fibrous ring of the aortic valve, the fibrous ring of tricuspid valve and the fibrous ring of mitral valve

E. none of the above

7. The heart muscle contractions are coordinated by .

A. mechanical timing devices throughout the heart

B. chemical signals.

C. electrical impulses through the conduction system

D. a single electrical signal since the entire heart contracts at once

E. none of the above

8. The sinoatrial node in the heart receives ks blood supply principally from .

A. the right coronary artery

B. the circumflex branch of the left coronary artery

C. the posterior interventricular branch of the right coronary artery

D. the anterior interventricular branch of the left coronary

E. none of the above

9. In a normal cardiac cycle, the first site to receive an impulse is .

A. the sinuatrial node

B. the atrioventricular node

C. the atrioventricular bundle

D. the bundle branch

E. the Purkinje fiber

10. The atrioventricular node receives its blood supply principally from .

A. the initial segment of the right coronary artery

B. the initial segment of the left coronary artery

C. the right coronary artery (in atrioventricular junction)

D. the anterior interventricular branch of the left coronary artery

E. the anterior interventricular branch of the right coronary artery

11. The pulmonary trunk arises from .

A. the left atrium

B. the right atrium

C. the left ventricle

D. the right ventricle

E. none of the above

12. The atrioventricular node .

A. is the pacemaker when the cardiac muscle contract

B. is supplied by the anterior interventricular branch of the left coronary artery

C. locates in the membranous part of interventricular septum

D. locates in the muscular part of interventricular septum

E. none of the above

13. The coronary sinus enters .

A. the left atrium

B. the right atrium

C. the right ventricle

D. the left ventricle

E. the inferior yens cava

14. Which is the first branch from the right of the aortic arch?

A. the right common carotid artery

B. the left subclavian artery

C. the brachiocephalic trunk

D. the left common carotid artery

E. the right subclavian artery

15. The complex of the heart valve doesn't include .

A. the mitral annulus and the tricuspid annulus

B. the tip of valve

C. the chordae tendineae

D. the papillary muscles

E. the trabeculae carneae

16. The function of the papillary muscles is .

A. to open the atrioventricular valve when the ventricles diastole

B. to close the atrioventricular valve when the ventricles contract

C. to fix the chordae tendineae on the atrioventricular valve

D. to participate the construction of the complex 0f the heart valve

E. none of the above

17. The transverse sinus of pericardium locates .

A. in the antero-lower part of the pericardial cavity

B. between the inferior yen& cava and the posterior wall of the pericardium

C. between the superior vena cava and right pulmonary artery

D. between the ascending aorta and the pulmonary artery

E. none of the above

18. The branches of the aortic arch from right to left are .

A. the brachiocephalic trunk, the right common carotid artery and the right subclavian artery

B. the brachiocephalic trunk, the right common carotid artery and the left subclavian artery

C. the right subclavian artery, the right common carotid artery and the brachiocephalic trunk

D. the brachiocephalic trunk, the left common carotid artery and the left subclavian artery

E. the left mn carotid artery, the left subclavian artery and the brachiocephalic trunk

19. The internal carotid artery .

A. arises from the brachiocephalic trunk

B. nutrition the brain and visual organ

C. enter the cranial cavity through the foramen magnum

D. has branches in the outside of the cranium

E. none of the above

20. The middle meningeal artery arises from .

A. the common carotid artery

B. the internal carotid artery

C. the maxillary artery

D. the mandibular artery

E. the superficial temporal artery

21. Which is the branch of the maxillary artery?

A. the ascending pharyngeal artery

B. the superior thyroid artery

C. the lingual artery

D. the facial artery

E. the middle meningeal artery

22. The branches of the external carotid artery do not include .

A. the vertebral artery

B. the occipital artery and the posterior auricular artery

C. the lingual artery and the facial artery

D. the superior thyroid artery

E. the superficial temporal artery and the maxillary artery

23. When the temporal region is bleeding, in order to stop bleeding we can press .

A. the maxillary artery

B. the superficial temporal artery

C. the facial artery

D. the external carotid artery

E. the angular artery

24. Which is correct as follows about the internal thoracic artery?

A. The last branch is the inferior epigastric artery.

B. The internal thoracic artery is the continuation of the subclavian artery.

C. The branches of the internal thoracic artery divisions to the pericardium and the diaphragm.

D. The internal thoracic artery arises from the subclavian artery through the spatium intermusculare of the scalenus muscle.

E. The internal thoracic artery arises from the external carotid artery.

25. Which is correct as follows about the brachial artery?

A. The brachial artery is the continuation of the subclavian artery.

B. The brachial artery courses on the back side of the radius.

C. The brachial artery closely follows the medial border of the biceps brachii.

D. The brachial artery locates in the lateral of the biceps brachii in the cubital fossa.

E. The brachial artery accompanies the median nerve to the cubital fossa.

26. The components of the conduction system are .

A. the sinoatrial node, atrioventricular node, atrioventricular bundle

B. the sinoatrial node, atrioventricular node

C. the sinoatrial node, atrioventricular bundle

D. the sinoatrial node, atrioventricular node, conduction myofibers

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