Title: Anatomy / part 3

Q: Intestinum latin
A: small bowels (intestinum tenue )
large bowels ( intestinum crassum)

Q: small bowels
A: intestinum tenue
Starts after stomach, then goes towards caecum of the colon. It is 3-5 m long, longest organ (length wise) in the body and it consists of 3 parts:
- duodenum (red, Zwölffingerdarm): retroperitoneal. It is the shortest part and it`s the bile duct and excretory duct of the pancreas
- jejunum (green): intraperitoneal
- ileum (blue): intraperitoneal
The surface area of the walls is enlargement by folds, villi, crypts, microvilli.
The role of the jejunum and ileum are to absorb nutrients. We can not exactly say where the border between the 2 is.

Q: large bowels
A: intestinume crassum
It starts at the end of the ileum, has a length of 1,5 - 1,8m and consists of different parts:
ascending colong (aufsteigend) intraperitoneal
transverse colon (gerade) retroperitoneal
descending colon (absteigend) intraperitoneal
sigmoid colon (letzter Teil) retroperitoneal
The main goal of the large bowels is to absorb water (not nutrients). To help with that, the wall surface is enlarged.
haustrae, plicae semilunares, epiploic appendices, taeniae (longitudinal muscle fibers along the outside of the walls (white line))

Q: large/small bowels - bacteria
A: In comparison to the small bowels, the large bowels also contain
bacteria such as E. coli (the word coli comes from colon). The largest part of the small bowels is bacteria free. Bacteria in the small bowels cause gastritis.

Q: large bowel - rectum
A: The last part of the large bowels is the rectum (intra-/subperitoneal). A main characteristic are 3 folds. Be aware to not distinguish between the rectum and the rectal ampulla (tells you when to go to toilet (Kohlrauschʼs fold)).
The anal canal (anus) can be diveded into:
internal (involuntary) sphincter (sphincter = muscles), this relaxes when the ampulla is full.
external (voluntary) sphincter, always part of the pelvic floor

Q: pancreas
A: secondary retroperitoneal
The pancreas is an exocrine (enzymes for lipids/fats, proteins and carbohydrates) and endocrine (insulin and glucagon) gland, its about 15cm long and weighs around 90g.
Parts: head, corpus, cauda
The excretory duct is called pancreatic duct ends in major duodenal papilla.
Islets of Langerhans: location of endocrine glands (cells). They especially produce insulin and glucagon.

Q: liver
A: intraperitoneal
The liver is the largest gland of human body. It weighs 1,5kg and has 4 lobes (right, left, caudate, quadrate).
Ligaments divide the lobes: teres hepatis ligament (fetal vein), falciform hepatis.
Bile is produced by the liver, that`s why we have a hepatic duct. We also have a division between circulations: functional (portal vein) and nutritional circulation
The liver has a higher number of cells in it, which have have 2-3 nucleus (special in livers) and are very organized
Since a liver can regrow, during transplantation the left part of liver is used and then regenerates.

Q: gall bladder
A: It`s a storage of bile (30-35ml).
People can live without a gall blatter, they just can`t consume large fatty meals.
It is connected by a cystic duct and has a common bile duct goes towards duoduenum
(Zwölffingerdarm). Very common are gall bladder stones (caused by crystallisation) may be a problem: bladder then can be removed
“Fun factˮ: small stones are more problematic, because it can travel through the duct and can block bile or can enter your pancreatic duct (very painful!)

Q: urinary system - parts
A: It gets rid of stuff the body can`t handle.
kidneys, ureter, urinary bladder, urethra

Q: kidney
A: The kidney is a retroperitoneal organ that produces urin.
It is bean-shaped and has a length of 10cm. It is located; left: caudal of spleen, right: caudal of liver.
Renal casings around the kidney: renal fascia, adipose capsule, renal capsule (ren = lat. kidney)  It is very strong with a large fiber component.)
The kidney has fat, it's important for the function of the kidney and NOT a storage of fat.
Renal cortex (dark brown, outer part of kidney) and renal medulla (=inside of kidney), renal pelvis (green part)

Q: kidney - nephron
A: The smallest functional component of the kidney is the nephron (subdivided into 2 parts)
- renal corpuscle and tubules: first filter of blood for production of urine; 15l per day as primary urine, all tubules after the nephron absorb water and thereby produce secondary urine (approx. 1,5l per day)
- tubules: proxiaml tubule, loop of henle, distal tubule: absorb water and produce secondary urine

Q: urether
A: The ureter connects the kidneys to the urinary bladder and has a length of 25 cm and a diameter of 5 mm. The lumen is star shaped.
The ureter has 3 constrictions:
- start of ureter at renal pelvis
- crossing of pelvic vessels
- passage through bladder wall
If we have kidney stones, they most often stop in one of those 3 constrictions
Looking at the cross-section of the ureter it has 3 layers:
- mucosa with urothelium (the cells are not as strictly ordered)
- muscle layer
- adventitia (not as prominent as the muscle layer)

Q: urinary bladder
A: subperitoneal
The bladder is a muscular hollow organ with a mucosa (urothelium) lining and a holding capacity of 1l
(can vary with age and sex, in women the uterus lays on the urinary bladder reducing its capacity, especially
during pregnancy).
Parts: fundus (top), corpus, apex.
Similar to the anal canal, the urinary bladder has an internal (involuntary) and external (voluntary) sphincter.
In contrast this is a closed system. There is only a small possibility of delay.
A main difference between males and females is the distance of the bladder to the pelvic floor and the presence of the prostate.

Q: urethra - male
A: length of 20 cm
3 parts: (prostatic part, membranaceous part, spongious part), 2 curvatures
constant (at symphysis) and flexible

Q: urethra - female
A: length of 3-5 cm (reason why females are more susceptible to bladder infections)
directly ventral of vagina, opens into vaginal vestibule

Q: genital system - general
A: - Primary genital organs (are there right from the start): gonads (ovaries, testicles)
- secondary genital organs (develop later): efferent genital organs, outer genitalia, sexual characteristics apart from genitalia
Genetically they differ in the X/Y chromosomes.

Q: female genital tract - external genital organs
A: Vulva (labia minora and majora, clitoris, vaginal vestibule, Bartholin‘s and Skene‘s glands (Vorstufe Prostata))

Q: female genital tract - internal genital organs
A: ovary, salpinges (Eileiter), uterus, vagina

Q: female genitalia tract
A: - There is an opening of the body into the abdominal cavity through vulva - vagina - ovary
- A tubal pregnancy quite dangerous, because there is no space for the embryo to develop and there are important organs that cant much out of the way
- Pouch of Douglas (rectouterine excavation, between uterus and rectum). If there is any sign of free fluid (eg. because of infection) it will be there)
- Uterus (3 layers: endometrium, myometrium, perimetrium; Parts: fundus, corpus, isthmus, cervix - portio)
- anteflexion (angulation between red and blue)
- anteversion (angulation between red and green)

Q: male genital tract - external genital organs
A: scrotum, penis (NOT the testicles)

Q: male genital tract - internal genital organs
A: testicles, epididymides Nebenhoden), deferent duct, seminal vesicles, prostate

Q: male genital tract - fluid / penis bodies
A: The accessory gonadal glands produce ejaculation fluid: 25% prostate, 75% seminal vesicles
Penis: 2 cavernous bodies (can “inflateˮ via blood), 1 spongious body (urethra in the middle)

Q: nervous system - overview
A: We possess 2 nervous systems: primitive vs. differentiated nervous system, which also have different parts:
- vegetative (output) / visceral (input) / autonome nervous system (involuntary)
- somatic nervous system (voluntary)
But we mainly differentiate between the central and peripheral nervous system.

Q: central nervous system
A: It consists mostly of the brain and spinal cord and it consists of gray (nerve cells) and white matter (nerve fibers).
Brain: gray matter on the outside (exeption: cerebral nuclei), white matter on the inside
Spinal cord: grey matter on the inside, white matter on the outside
This means that the only way that information can travel between the brain and the spinal chord is the brain stem.

Q: brain
A: weights 1,3kg
gyri and sulci is just the description of the surface of the persencephalon and the cerebellum

Q: telencephalon
A: = Großhirn
has different lobes and fiber tracts;
Sulcus are the borders between the lobes.

Q: basal ganglia
A: For the exam it is important to know the difference between the basal
ganglia and the encephalon. Answer: The encephalon is the entire brain, while the basal ganglia are a small group of nuclei inside the brain that help control movement and habits.

Q: limbic system
A: EBMM
Limbic system is a group of structures in your brain that regulate your emotions, behaviour, motivation and memory. (amygdala, hippocampus, dentate gyrus (microscopically they look like teeth), cingular gyrus, induseum griseum, fornix, mamillary body).