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*Anatomy - Reproductive > 1.3 - Vessels, Nerves and Lymph Nodes of the Pelvis > Flashcards

1.3 - Vessels, Nerves and Lymph Nodes of the Pelvis Flashcards

1
Q

Branches of which arteries supply blood to most of the pelvic organs, perineum and gluteal region? Which organs do they not supply?

A

Branches of the right and left internal iliac artery
They do not supply the testis, ovary (gonadal via abdominal aorta) and upper part of the rectum (superior rectal via inferior mesenteric)

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2
Q

What is the distribution/organ supply of the superior and inferior vesical arteries of the pelvis? What is the origin?

A

Bladder, seminal gland and prostate in males

Originated from the internal iliac artery (anterior trunk)

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3
Q

What is the distribution/organ supply of the uterine artery of the pelvis? What is the origin?

A

Pelvic ureter, uterus (and ligament), uterine tube, vagina

Originated from internal iliac artery

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4
Q

What is the distribution/organ supply of the gonadal (testicular or ovarian) arteries of the pelvis? What is the origin?

A

Epididymis, testis/ovaries

Originated from abdominal aorta

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5
Q

What is the distribution/organ supply of the superior rectal artery of the pelvis? What is the origin?

A

Rectum (proximal)

Originated from inferior mesenteric artery

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6
Q

What is the distribution/organ supply of the middle and inferior rectal arteries of the pelvis? What is the origin?

A

Middle = seminal gland, prostate, mid/inf rectum; inferior = anal canal
Originated from internal iliac artery

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7
Q

What is the distribution/organ supply of the vaginal artery of the pelvis? What is the origin?

A

Vagina, inferior part of bladder

Originated from uterine artery

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8
Q

What is the distribution/organ supply of the internal pudendal artery of the pelvis? What is the origin?

A

Main artery to perineum

Originated from internal iliac artery

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9
Q

What is the distribution/organ supply of the obturator artery of the pelvis? What is the origin?

A 
Obturator externus (and pelvic muscles), medial thigh, femur 
Originated from internal iliac
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10
Q

The venous drainage of the pelvic structures consists of which 5 veins?

A
  1. Internal iliac veins
  2. Superior rectal veins
  3. Median sacral vein
  4. Gonadal veins
  5. Internal vertebral venous plexus
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11
Q

Give 2 examples of venous plexuses formed in relation to pelvic organs

A

Rectal

Prostatic

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12
Q

Which part of the rectum is drained into the portal circulation?

A

Upper 1/3rd

Via superior rectal vein

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13
Q

Which part of the rectum is drained into the systemic circulation?

A

Middle and lower thirds

Via middle and inferior rental veins

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14
Q

What is the significance of understanding the venous drainage of the rectum?

A

Understanding haemorrhoids

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15
Q

Why might haemorrhoids be associated with cirrhosis of the liver?

A

Portal hypertension

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16
Q

The veins along the sides and base of the prostate join to form what?

A

The prostatic venous plexus

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17
Q

With which venous plexus does the prostatic venous plexus communicate with on its posterior side? What is the clinical significance of knowing this?

A

Internal vertebral venous plexus

Cancer can spread to vertebral column and skull

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18
Q

Which somatic nerve to the reproductive organs supplies the skin at the root of the penis in males and the labia in females? What is it’s origin and where does it enter the inguinal canal?

A

Ilioinguinal nerve
Originated L1
Enters inguinal canal at superficial inguinal ring

19
Q

Where does the somatic genitofemoral nerve originate and where does it enter the inguinal canal?

A

Originates at L1-2

Enters at deep inguinal ring

20
Q

What structure(s) in the male are supplied by the genital branch of the genito-femoral nerve?

A

Cremaster muscle

Anterior scrotal skin

21
Q

What is the clinical significance of the genital branch of the genito-femoral nerve?

A

Responsible for the motor portion of the cremasteric reflex
(describes contraction of the cremaster muscle when the skin of the superior medial thigh is touched - pulls up testes ipsilaterally; sensory portion is ilioinguinal nerve)
(cremasteric reflex may be absent with testicular torsion, upper and lower motor neuron disorders, as well as a spine injury of L1-L2; can also occur if the ilioinguinal nerve has accidentally been cut during a hernia repair)

22
Q

What muscle does the genitofemoral nerve run along?

A

Psoas major

23
Q

Which plexus does the pudendal nerve arise from?

A

Sacral plexus

24
Q

Which segmental level(s) does the pudendal nerve arise from?

A

S2-S4

25
Q

Which vessel’s course does the pudendal nerve follow?

A

Pudendal artery

26
Q

Where does the pudendal nerve innervate?

A

The skin and muscles of the perineum

27
Q

Why is it essential to understand how the pudendal nerve tracked from pelvis to perineum? (I.e. via the gluteal region)

A

Essential to understand in bilateral pudendal nerve block for pain relief during childbirth, particularly for an instrumental (e.g. forceps) assisted vagina birth

28
Q

What bony landmarks are used when performing a pudendal nerve block during labour?

A

Ischial spine/ischial tuberosity

Palpate transvaginally

29
Q

What provides the autonomic supply to the vas deferens, seminal vesicles, prostate and epididymis in males? Via which plexus?

A

Sympathetic fibres from L1-L2

Via the hypogastric plexus

30
Q

Sympathetic fibres from where supply the female genital tract?

A

Pelvic and ovarian plexuses

31
Q

Parasympathetic fibres from where supply the female genital tract?

A

Pelvic splanchnic nerves (S2, S3 and S4)

32
Q

Parasympathetic fibres from where innervate the erectile tissues in both males and females? What are the erectile tissues?

A

S2, S3 and S4 via the hypogastric plexus

Clitoris and labia minora in females; corpus cavernosum in males

33
Q

Why are some men unable to ejaculate after rectal surgery?

A

Damage to the pudendal nerve

34
Q

What are the four primary nodes present in the pelvis?

A

External iliac
Internal iliac
Sacral
Common iliac

35
Q

Where does the inguinal region drain?

A

External iliac nodes

36
Q

Where does the penis drain?

A

External iliac nodes

37
Q

Where does the prostate drain?

A

Internal iliac and sacral nodes

38
Q

Where does the gluteal region drain?

A

Internal iliac nodes

39
Q

Where does the deep perineum drain?

A

Internal iliac nodes

40
Q

Where does the inferior pelvic viscera drain?

A

Internal iliac nodes

41
Q

Where does the rectum drain?

A

Sacral nodes

42
Q

Where does the posterior pelvic wall drain?

A

Sacral nodes

43
Q

What do the common iliac nodes drain?

A

The 3 other groups - external iliac, internal iliac and sacral nodes

*Anatomy - Reproductive (12 decks)

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