| Title | Male Pelvic Contents: Superior View |
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| Comment | Comment: The male peritoneum passes from the anterior abdominalwall over the superior surface of the urinary bladder and inferiorly onthe posterior surface of the bladder. It also passes over the superiorends of the seminal vesicles, and it posteriorly lines the rectovesicalpouch, the space between the rectum and urinary bladder. It thenreflects onto the superior part of the rectum. Posteriorly andsuperiorly, it becomes the sigmoid mesocolon.The testicular vessels and lymphatics lie in a retroperitoneal positionand course to and from the deep inguinal ring. At the ring, notice theretroperitoneal pathway of the ductus deferens as it courses towardthe seminal vesicle. |
| Clinical | Clinical: Note the retroperitoneal course of the ureters as theypass to the urinary bladder. They course beneath the testicularvessels but over the iliac vessels. They then pass deep to theductus deferens as they approach the bladder. Surgeons operatingin the abdominopelvic cavity must be aware of the retroperitonealcourse of the ureters because they can be easily damaged, leadingto the extravasation of urine into adjacent retroperitoneal andintraperitoneal spaces. |
| 1a | 1. Ductus (vas) deferens (in peritoneal fold) |
| 2a | 2. Deep inguinal ring |
| 3a | 3. Testicular vessels (in peritoneal fold) |
| 4a | 4. Descending colon |
| 5a | 5. Ureter |
| 6a | 6. Cecum |
| 7a | 7. Rectovesical pouch |
| 8a | 8. Urinary bladder |
| 9a | 9. Rectum |
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| Title | Roof of Mouth 2 |
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| Origin | Tensor veli palatini muscle arises from the scaphoid fossaof the medial pterygoid plate, spine of the sphenoid bone, andcartilage of the auditory tube. |
| Insertion | Tensor veli palatini muscle attaches to the palatineaponeurosis of the soft palate and the palatine crest on the horizontalplate of the palatine bone. |
| Actions | Tensor veli palatini muscle tenses the soft palate and, bycontracting, opens the auditory tube during swallowing and yawningto equalize pressure in the middle ear. |
| Innervation | Mandibular division of the trigeminal nerve. |
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| Comment | The tensor veli palatini muscle tenses the fibers of thesoft palate so that the levator veli palatini muscle can act on them. |
| Clinical | The tensor not only tenses the soft palate during elevationby the levator veli palatini but also opens the auditory(pharyngotympanic, eustachian) tube during swallowing andyawning. This helps equalize the pressure in the middle ear andexplains why chewing gum, swallowing, or yawning can relieve thepressure and pain in the middle ear when landing in an airplane. |
| 1a | 1. Tensor veli palatini muscle |
| 2a | 2. Basilar part of occipital bone |
| 3a | 3. Cartilaginous part of auditory tube (eustachian) |
| 4a | 4. Superior pharyngeal constrictor muscle |
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| Title | Gallbladder and Extrahepatic Bile Ducts |
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| Comment | Comment: Bile leaves the liver by the right and left hepatic ducts,draining into a common hepatic duct. The latter drains via the cysticduct into the gallbladder, which concentrates and stores bile. Whenstimulated by autonomic nerves and cholecystokinin, the gallbladdercontracts, sending bile down the cystic duct. The bile flows throughthe common bile duct to the major duodenal papilla, which emptiesinto the descending duodenum. At this location, the common bileduct joins the main pancreatic duct to form the hepatopancreaticampulla of Vater. |
| Clinical | Clinical: Gallstones occur in 10% to 20% of adults; risk factorsinclude increased age, obesity, and being female. About 80% ofgallstones are cholesterol stones, and about 20% are pigment(bilirubin calcium salts) stones. Gallstones can block the flow of bilefrom the gallbladder to the duodenum and cause inflammation(cholecystitis) or block the hepatopancreatic ampulla and impedeexocrine secretion from the pancreas. The pain of acutecholecystitis may be felt in the right upper abdominal quadrant,radiating laterally just beneath the right breast to the back justbelow the inferior angle of the right scapula. |
| 1a | 1. Common hepatic duct |
| 2a | 2. Cystic duct |
| 3a | 3. Superior (1st) part of duodenum |
| 4a | 4. Hepatic ducts (Right; Left) |
| 5a | 5. Cystic duct (Spiral fold; Smooth part) |
| 6a | 6. (Common) bile duct |
| 7a | 7. Pancreatic duct |
| 8a | 8. Hepatopancreatic ampulla (of Vater) |
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