Question

1. In a tabular form, differentiate between the superior mesenteric artery and the inferior mesenteric artery.
2. Compare between the pelvic diaphragm and the thoracic diaphragm.
3. List any five specific areas of the body where neural block can be applied, with reference to the nerve targeted.
4. In a tabular form, compare between the pubis symphysis and the Sacro-iliac joint (position, formation, components, types of cartilage, clinical note).
5. In a tabular form, List the bony landmarks and ligaments of the pelvic girdle proper per piece of bone (ilium, ischium, pubis).
6. Differentiate between the anococcygeal body and the perineal body.
7. List out the components of the male genital organs (internal and external).
8. List out the components of the female genital organs (internal and external, and ligaments around the uterus).

Can someone do all questions pliz in detail. Question number 3 is where I face great difficulty. Please if someone can help me with all 8 questions. I posted this questions before but noone answered. Please help me.

Answer 1

Ans :

1. Diff between superior and inferior mesenteric arteries :

The inferior mesenteric artery is the last of the three major anterior branches of the abdominal aorta (the other two are the coeliac trunk and superior mesenteric artery). It arises at L3, near the inferior border of the duodenum, 3-4 cm above where the aorta bifurcates into the common iliac arteries

Superior mesenteric artery - The superior mesenteric artery arises from the anterior surface of the aorta, just inferior to the origin of the celiac trunk, and supplies the intestine from the duodenum and pancreas to the left colic flexure

Just after the superior mesenteric artery passes behind the neck of the pancreas, it starts giving off its branches (it is always possible to have slight variations to the branching pattern):

inferior pancreaticoduodenal - not shown on the image

middle colic - to the transverse colon

right colic - to ascending colon

ileocecal - to last part of ileum, cecum, and appendix

intestinal branches - to jejunum and ileum

Inferior mesenteric arteries :

The inferior mesenteric artery supplies the large intestine from the left colic (or splenic) flexure to the upper part of the rectum. Its does this through the following branches:

left colic

sigmoid branches

superior rectal

All these arterial branches further divide into arcades which then supply the colon at regular intervals

2. Pelvic diaphragm and thoracic diaphragm :

Thoracic diaphragm :

Structure -  The diaphragm is a C-shaped structure of muscle and fibrous tissue that separates the thoracic cavity from the abdomen. The dome curves upwards. The superior surface of the dome forms the floor of the thoracic cavity, and the inferior surface the roof of the abdominal cavity.

The muscle fibres of the diaphragm emerge from many surrounding structures. At the front, fibres insert into the xiphoid process and along the costal margin. Laterally, muscle fibers insert into ribs 6–12. In the back, muscle fibres insert into the vertebra at T12 and two appendages, the right and left crus, descend and insert into the lumbar vertebrae. Right crus arises from L1-L3 their intervertebral discs. Left crus from L1, L2 their intervertebral discs

Function -  The diaphragm is the main muscle of respiration and functions in breathing. During inhalation, the diaphragm contracts and moves in the inferior direction, enlarging the volume of the thoracic cavity and reducing intra-thoracic pressure (the external intercostal muscles also participate in this enlargement), forcing the lungs to expand.

The diaphragm is also involved in non-respiratory functions. It helps to expel vomit, feces, and urine from the body by increasing intra-abdominal pressure, aids in childbirth, and prevents acid reflux by exerting pressure on the esophagus as it passes through the esophageal hiatus.

Pelvic diaphragm :  

Structure -  The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during birth. Some fibers are inserted into the prostate, urethra.

Function - It is important in providing support for pelvic viscera (organs), e.g. the bladder, intestines, the uterus (in females), and in maintenance of continence as part of the urinary and anal sphincters. It facilitates birth by resisting the descent of the presenting part, causing the fetus to rotate forwards to navigate through the pelvic girdle. It helps maintain optimal intra-abdominal pressure.

3. Nerve block :  

Nerve block is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. Local anesthetic nerve block is a short-term block, usually lasting hours or days, involving the injection of an anesthetic, a corticosteroid, and other agents onto or near a nerve. Neurolytic block, the deliberate temporary degeneration of nerve fibers through the application of chemicals, heat, or freezing, produces a block that may persist for weeks, months, or indefinitely.

Areas :  People who suffer from either acute or chronic pain might have a nerve block injection to achieve temporary pain relief. Often, such pain originates from the spine, but other areas commonly affected include the neck, buttocks, legs and arms