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Anatomy Exam 4 > 39 and 40 - Pelvis I and II > Flashcards

39 and 40 - Pelvis I and II Flashcards

1
Q

What bones make up the belvis?

A
  • Os coxa (“hip bone”
  • Sacrum
  • Coccyx
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2
Q

What are the three bones that make up the os coxa or “hip bone” or “innominate?

A

1 - Ilium
2 - Ishium
3 - Pubis

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3
Q

What are the three regions of the articulated pelvis?

A

1 - Pelvic brim or pelvic inlet
2 - Greater pelvis or false pelvis
3 - Lesser pelvis or true pelvis

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4
Q

What makes up the pelvic brim )or pelvic inlet)?

A
  • Pectineal line of pubis
  • Arcuate line of ilium
  • Sacral promontory
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5
Q

What is the greater pelvis (of flase pelvis)?

A

Located in the lower part of the abdominal cavity - superior to the pelvic inlet

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6
Q

What is the lesser pelvis (or true pelvis)?

A

The actual pelvis

  • Inferior to the pelvic inlet
  • Superior to the pelvic outlet
  • Space is closed by the pelvic diaphragm
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7
Q

What four bony points are found on the ilium?

A
  • Anterior superior iliac spine (ASIS)
  • Anterior inferior iliac spine (AIIS)
  • Posterior superior iliac spine (PSIS)
  • Posterior inferior iliac spine (PIIS)
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8
Q

There are four joints of the pelvis. What are they?

A

1 - Sacroiliac
2 - Lumbosacral
3 - Sacrococcygeal
4 - Pubic symphysis

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9
Q

What type of joint is the sacroiliac joint? What is it important for?

A
  • Synovial joint
  • Binds the sacrum to the ilium
  • Transfers weight from the torso to the lower limb
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10
Q

What type of joint is the lumbosacral joint? Where is it located?

A
  • A secondary cartilaginous (fibrocartilaginous) joint with an IV disc
  • Lumbosacral joint is the juncture between L5 and S1
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11
Q

What type of joint is the sacrococcygeal joint? Is it a moveable joint?

A
  • Same as the lumbosacral joint - a secondary cartilaginous (fibrocartilaginous) joint with an IV disc
  • A partially moveable joint
  • Relaxin given during parturition increases mobility
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12
Q

What type of joint is the pubic symphysis?

A

A secondary cartilaginous (fibrocartilaginous) joint

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13
Q

What are the two ligaments of the pelvis?

A

1 - Sacrospinous ligament

2 - Sacrotuberous ligament

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14
Q

What does the sacrospinous ligament connect?

A

The sacrum to the ischial spine

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15
Q

What does the sacrotuberous ligament connect?

A

The sacrum to the ischial tuberosity

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16
Q

What are the functions of the two pelvic ligaments?

A
  • Help to prevent anteroinferior displacement of the superior sacrum
  • Convert the greater and lesser sciatic notches into greater and lesser sciatic foramina
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17
Q

How is the pelvic inlet different in males and females?

A

Males - heart shaped pelvic inlet

Females - round/oval shaped pelvic inlet

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18
Q

How is the pelvic canal different in males and females?

A

Males - long and funnel-shaped

Females - Short with parallel walls

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19
Q

How are the ishcial tuberosities and spines different in males and females?

A

Males - not everted

Females - everted

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20
Q

How are the greater sciatic notches different in males and females?

A

Males - narrower

Females - broader

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21
Q

How are the pubic arch and subpubic angle different in males and females?

A

Males - narrower (70 degrees)

Females - broader (90 degrees)

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22
Q

How is the sacrum different in males and females?

A

Males - long and narrow

Females - short and broad

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23
Q

What side of the ilium is the iliac fossa located on?

A

The anteromedial surface

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24
Q

What is the purpose of the arcuate line that is located on the anteromedial surface of the ilium?

A

Muscle attachment

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25
Q

What is the acetabulum?

A

A point of convergence of all three bony components - where the head of the femur meets the pelvis

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26
Q

Where is the ischium located?

A

The most posterior part of the pelvis “ishium = ashium”

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27
Q

What components make up the ishium?

A

The ishium is composed of a body and a ramus (column)

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28
Q

What foramen does the ramus of the ishium contribute to?

A

The obturator foramen - it extends from the body toward the inferior pubic ramus

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29
Q

What is the obturator foramen lined by?

A

Membrane and muscle that forms a portion of the lateral pelvic wall

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30
Q

What is the ischial spine important for?

A

Muscle attachment - especially those on the pelvic floor

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31
Q

What is the pubis bone composed of?

A

A body and TWO rami

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32
Q

What do the two rami of the pubis bone contribute to?

A

The obturator foramen

  • Superior ramus extends from body towards acetabulum
  • Inferior ramus extends from body towards ischial ramus
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33
Q

The pectineal line is continuous with the ________________.

A

Arcuate line o the ilium

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34
Q

What is the difference in the pelvic floor muscles between a bipedal human and our quadrapedal ancestors?

A
  • Muscle fibers now run in a different direction than if we were on four legs
  • Boney attachments are the same, but muscles have changed structure/function to adapt
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35
Q

What is the inferior border of the pelvis bounded by?

A

The pelvic floor muscles

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36
Q

What muscle lines the lateral wall of the pelvis?

A

The obturator internus

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37
Q

What is the path of the obturator internus muscle?

A
  • Arises from the lesser pelvis
  • Passes through the lesser sciatic foramen
  • Attaches to the femur’s greater trochanter
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38
Q

What else lines the lateral wall of the pelvis?

A

The obturator membrane

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39
Q

What does the obturator membrane do?

A

Lines the obturator internus muscle and forms the tendinous arch medially

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40
Q

What muscle lines the posterior wall of the pelvis?

A

Piriformis muscle

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41
Q

Describe the path of the piriformis muscle

A
  • Attaches to the sacrum within the lesser pelvis
  • Passes through the greater sciatic foramen
  • Attaches to the femur’s greater trochanter
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42
Q

What is the purpose of the piriformis muscle?

A

IT serves as a “bed” for the sacral nerve plexus

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43
Q

What is the muscle that lines the pelvic floor?

A

The pelvic diaphragm

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44
Q

What is the function of the pelvic diaphragm?

A
  • Functions to support the viscera (especially when there is increased intraabdominal pressure)
  • Aids in voluntary control of urination and fecal continence
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45
Q

What muscles make up the pelvic diaphragm?

A

The levator ani and the coccygeus

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46
Q

The levator ani is composed of three muscles. What are they?

A

1 - Puborectalis (most medial)
2 - Pubococcygeus (middle)
3 - Iliococcygeus (most lateral)

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47
Q

Describe the puborectalis muscle (origin, function)

A

It is a muscular sling that arises from the pubis and maintains fecal continence

(NOTE: this muscle is sometimes treated as part of the pucococccygeus)

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48
Q

Describe the pubococcygeus muscle (origin, insertion)

A
  • Arises from the pubis and tendinous arch

- Attaches to the coccyx

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49
Q

Describe the iliococcygeus muscle (origin, insertion)

A
  • Arises form the tendinous arch and ischial spine

- Blends into the pubococcygeus

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50
Q

What is the coccygeus muscle?

A

The second muscle that makes up the pelvic diaphragm

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51
Q

What is the origin and insertion of the coccygeus muscle?

A

AKA ischiococcygeus muscle

  • Origin: ischial spine
  • Insertion: coccygeus/sacrum
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52
Q

What is included in the “pelvic viscera”?

A
  • Urinary bladder
  • Parts of the ureters
  • Parts of the reproductive system
  • Rectum
  • Urinary system
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53
Q

What is the function of the urinary system?

A
  • Transport urine from kidneys to bladder
  • Store urine
  • Transfer urine to outside world
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54
Q

Are kidneys considered abdominal or pelvic organs?

A

Abdominal, however they were embryologically located in the pelvis

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55
Q

What are ureters?

A

Retroperitoneal muscular tubes that transport urine from the kidneys to the posterosuperior bladder

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56
Q

Describe the ureters entering the bladder

A

The ureters enter the bladder obliquely, forming flap valves so muscular contractions of the bladder can act as spincters which prevents urinary reflux into the ureters

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57
Q

In females, the ureters pass ________ to the uterine artery’s origin

A

Medial

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58
Q

In males, the ductus deferens rests between the ____________ and ______________.

A

Ureters and peritoneum

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59
Q

What is the arterial supply to the ureters?

A

Nearby arteries

  • Uterine artery in females
  • Inferior vesicular artery in males
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60
Q

What is the innervation of the ureters?

A

Nearby autonomic plexuses

  • Renal
  • Aortic
  • Superior hypogastric
  • Inferior hypogastric
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61
Q

What is the function of the bladder?

A

A temporary reservoir for urine

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62
Q

What is the position of the bladder?

A

Variable - it depends on the age and the individual’s state

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63
Q

What is the general location of an adult bladder?

A
  • Empty bladder - rests in the lesser pelvis

- Full bladder - may extend to the umbilicus

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64
Q

What is the general location of a child’s bladder?

A

An empty bladder may rest in the abdomen, even when it is empty

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65
Q

What are the five parts of the bladder?

A 
1 - Apex
2 - Fundus
3 - Body
4 - Neck
5 - Trigone
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66
Q

Where is the apex of the bladder located?

A

Anterosuperior aspect

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67
Q

Where is the fundus of the bladder located?

A

Posterior wall of the bladder

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68
Q

Where is the body of the bladder located?

A

Area between the apex and fundus

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69
Q

What is the purpose of the neck of the bladder?

A

Constriction

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70
Q

What is the trigone of the bladder?

A

The triangle between the ureteric and urethral openings of the bladder

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71
Q

What is the uvula of the bladder?

A

A projection of the trigone that is visible in older men

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72
Q

What are the walls of the bladder composed of?

A

Primarily detrusor muscle

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73
Q

In females, what is the muscle of the bladder continuous with?

A

The muscle of the bladder’s neck is continuous with the urethra muscle

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74
Q

In males, what is the muscle of the bladder continuous with?

A

The muscle of the bladder’s neck is continuous with the prostate’s fibromuscular tissue - Muscle fibers from the involuntary internal urethral spincter

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75
Q

What is the function of the male’s internal urethral spincter?

A

Prevent semen from entering the bladder

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76
Q

What is the urethra?

A

A muscular tube that conveys urine from the bladder to the outside world

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77
Q

Describe the path of the urethra in females

A

The urethra descends anterior to the vagina (partially pelvic, partially perineal)

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78
Q

What does the urine exit through in females?

A

The external urethral orifice

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79
Q

Where do glands exist in females?

A

Adjacent to the urethra - we will discuss this in the perineum)

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80
Q

How is the male urethra different from the female urethra?

A

It is much longer and more complex than the female urethra

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81
Q

How many curves will you find in the urethra of a male?

A
  • When penis is flaccid, 2 urethral curves

- When penis is erect, 1 urethral curve

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82
Q

There are four parts of the male urethra. What are they?

A
  • Preprostatic
  • Prostatic
  • Intermediate/membranous
  • Spongy
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83
Q

Where is the preprostatic region located?

A

From the neck of the bladder to the prostate

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84
Q

Where is the prostatic region located?

A

Within the prostate - it has a gentle curvature

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85
Q

Where is the intermediate/membranous region located?

A

It passes through the external urethral sphincter

  • Short
  • Narrow
  • Least distensible

Note: located in perineum, NOT pelvis

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86
Q

Where is the spongy region located?

A

It ends at the external urethral orifice of the penis - longest portion of the urethra

Note: located in perineum, NOT pelvis

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87
Q

The prostatic urethra has some specialization/structures/features that aid in function. What are these specializations?

A
  • Urethral crest
  • Seminal collicus
  • Prostatic uricle
  • Opening of the ejaculatory ducts
  • Opening of the prostatic ducts
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88
Q

What is the urethral crest of the urethra?

A
  • Found in male urethra - prostatic region

- It is the median ridge

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89
Q

What is the seminal colliculus of the urethra?

A
  • Found in male urethra - prostatic region

- It is a rounded eminence

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90
Q

What is the prostatic utricle of the urethra?

A
  • Found in male urethra - prostatic region

- It is a cul-de-sac remnant of a uterovaginal canal in the seminal colliculus

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91
Q

Where is the opening of the ejaculatory duct in the urethra?

A
  • Found in male urethra - prostatic region

- It is in the seminal colliculus which is located inferior to the prostatic urticle

92
Q

Where is the opening of the prostatic duct?

A
  • Found in male urethra - prostatic region

- Lateral to the seminal colliculus

93
Q

What are the organs of the female reproductive system?

A
  • Ovaries
  • Uterine tubes
  • Uterus
  • Vagina
94
Q

What are ovaries?

A

Female glands that house and release ova

95
Q

There are four parts of the female uterine tubes. What are they?

A

1 - Infundibulum
2 - Ampulla
3 - Isthmus
4 - Uterine part

96
Q

What is the infundibulum?

A

The funnel-shaped part of the female uterine tube that has fimbrae at the opening

97
Q

What is the ampulla?

A

The widest and longest part of the female uterine tube

98
Q

What is the isthmus?

A

The part of the female uterine tube that enters the uterine horns

99
Q

What is the uterine part?

A

The short segment of the female uterine tube that inserts into the uterine wall

100
Q

There are two parts of the uterus. What are they?

A
  • Body

- Cervix

101
Q

What makes up the body of the uterus?

A
  • Upper 2/3
102
Q

The body of the uterus has three regions. What are they?

A

1 - Fundus
2 - Uterine horns
4 - Isthmus

103
Q

What is the fundus of the uterine body?

A

The area superior to the uterine tubes

104
Q

What are the uterine horns?

A

The entrance of the uterine tubes into the uterus (can see this in radiographs)

105
Q

What is the isthmus of the uterine body?

A

The constricted region found just superior to the cervix

106
Q

What is the cervix?

A

The neck of the uterus

107
Q

What two structures make up the cervix?

A
  • Internal Os

- External Os

108
Q

What is the internal O?

A

The opening to the uterus

109
Q

What is the external O?

A

The opening to the vagina

110
Q

What four structures of the pelvis would be considered “supporting structures” to the uterus?

A

1 - Ovarian ligament
2 - Round ligament
3 - Broad ligament
4 - Pelvic diaphragm

111
Q

What does the ovarian ligament connect?

A

Connects the ovary to the uterus

posteroinferior to uterotubal junction

112
Q

What does the round ligament connect?

A

Uterus (posteroinferior to uterotubular junction) to labia majora

113
Q

What is another name for the round ligament?

A

Ligamentum teres

114
Q

What is the broad ligament? What are the four subdivisions of the broad ligament?

A 
The broad ligament is the mesentery of the uterus 
1 - Suspensory ligament
2 - Mesovarium
3 - Mesosalpinx 
4 - Mesometrium
115
Q

What does the suspensory ligament do?

A

Conveys the ovarian vessels, lymphatics and nerves

116
Q

What does the mesovarium do?

A

Suspends the ovary

117
Q

What does the mesosalpinx do?

A

Suspends the uterine tue

118
Q

What does the mesometrium do?

A

Suspends most of the uterus

119
Q

What is the general position of the uterus?

A
  • Anteverted

- Anteflexed

120
Q

What is the vagina?

A

A musculomembranous tue that runs from the cervix to the vestibule

121
Q

Is the vagina in the pelvic region or the perineum?

A

Both - partly in the pelvic region, partly in the perineum

122
Q

Where is the vagina located?

A
  • Posterior to the urethra and bladder

- Anterior to the rectum

123
Q

What muscles compress the vagina?

A

Several muscles compress the vagina, including…

  • External urethral spincter
  • Bulbospongious muscle
124
Q

The superior most part of the vagina surrounds the ___________.

A

Cervix

125
Q

What is a fornix? What do they do?

A

A fornix is a projection of vaginal tissue that connects to the cervix of the uterus - the vagina has four fornices

  • Anterior
  • Posterior
  • Lateral (2)
126
Q

What innervates the vagina?

A
  • Lower 1/4: somatic (deep perineal branch of pudendal)

- Upper 3/4: autonomic

127
Q

What are the seven components of the male reproductive system?

A 
1 - Testes
2 - Epididymis
3 - Ductus deferentes 
4 - Seminal vesicles
5 - Ejaculatory ducts
6 - Prostate
7 - Bulbourethral glands
128
Q

What is the ductus deferens?

A

(ductus deferens = singular)

The ductus deferens is a continuation of the duct of the epididymis

129
Q

What is the ampulla of the ductus deferens

A

An expansion of the ductus deferens

130
Q

The ductus deferens joins the ___________ to form the ____________.

A

Seminal vesicle, Ejaculatory duct

131
Q

What are the seminal vesicles?

A

Paired glands that secrete a thick fluid into the ejaculatory ducts

132
Q

What are the ejaculatory ducts?

A
  • Two ducts that are formed by the joining of the seminal vesicle ducts and the ductus deferens
  • The ducts converge at the seminal colliculus of the prostatic urethra
133
Q

What is the course of the ejaculatory duct?

A

It descends through the posterior prostate

134
Q

What is the prostate?

A

An accessory gland for male reproduction which contains the prostatic urethra

135
Q

How is the prostate divided?

A

Into lobes - anterior, posterior, middle, lateral

136
Q

What are the prostatic ducts?

A

There are 20-30 prostatic ducts in the prostate gland which empty into the prostatic sinuses on either side of the seminal colliculus

137
Q

What are the bulbourethral glands?

A
  • Small glands which secrete their secretions during sexual arousal
138
Q

What is semen?

A

A mixture of secretions by the testes, seminal vesicles, prostate and bulbourethral glands which usually contains sperm

139
Q

Where are the bulbourethral glands located?

A

Posterolateral to the intermediate/membranous urethra

140
Q

Where do the ducts of the bulbourethral glands open into?

A

The spongy urethra in the bulb of the penis

141
Q

What is a retroverted uterus?

A
  • A uterus that is tilted posteriorly
  • This is in contrast to the slightly “anteverted” uterus that most women have, which is tipped forward toward the bladder, with the anterior end slightly concave
142
Q

How common is a retroverted uterus?

A

Between 1 in 3 and 1 in 5 women has a retroverted uterus, which is tipped backwards towards the spine.

143
Q

What is benign prostatic hyperplasia?

A
  • Aging males face a problem known as benign prostatic hyperplasia (also sometimes called benign prostatic hypertrophy)
  • One or more lobes of the prostate are affected
  • Middle and lateral lobes of the prostate exist
  • When a lobe is enlarged, it can impinge the urethra
  • Affects the sphincter urethrae
  • Complications include urgency to urinate and difficulty urinating
144
Q

What is the surgical intervention used in patients with benign prostatic hyperplasia?

A

TURP (transurethral resection of the prostate)

- This allows both the external (voluntary) and internal (involuntary) sphincters to be free of obstruction

145
Q

The pelvic fascia is a continuation of the ___________ fascia.

A

Endoabdominal fascia

146
Q

The ________ lines the walls of the pelvic floor while the ________ lines the walls of the pelvic surfaces

A

Parietal

Visceral

147
Q

What are the three peritoneal reflections of the pelvic region?

A
  • Extraperitoneal (or subperitoneal)
  • Primarily retroperitoneal (PRP)
  • Intraperitoneal (IP)
148
Q

What does the extraperitoneal (or subperitoneal) reflection include?

A

Most of the pelvic viscera

Note that the extraperitoneal reflection is actually outside of the peritoneal cavity

149
Q

What does the primarily retroperitoneal (PRP) reflection include?

A

PRP

  • Kidneys
  • Urethers
  • Rectum
  • Anal canal
  • Prostate (male)
  • Seminal vesicles (male)
  • Vas deferens (male)
150
Q

What does the intraperitoneal reflection include?

A

IP

  • Uterus
  • Ovaries
  • Uterine tubes
151
Q

The uterus could also be considered secondarily intraperitoneal. Why is that?

A

The uterus is complicated

152
Q

What are the five spaces of the pelvis?

A 
1 - Retropubic space
2 - Retrorectal space
3 - Rectovesical pouch
4 - Vesicouterine pouch
5 - Rectouterine pouch
153
Q

What is the retropubic space also known as?

A

Space of Retzius

154
Q

Where is the retropubic space located?

A

Behind the pubis

155
Q

What is the purpose of having a retropubic space?

A

It accommodates for bladder distension

156
Q

Where is the retrorectal space located?

A

Behind the rectum

157
Q

What is the purpose of having a retrorectal space?

A

It accommodates for rectal expansion

158
Q

Is the rectovesical pouch found in males, females or both?

A

Males only

159
Q

Where is the rectovesical pouch located?

A

Between the male bladder/prostate and the rectum

160
Q

Is the vesicouterine pouch found in males, females or both?

A

Females only

161
Q

Where is the vesicouterine pouch located?

A

Between the female bladder and the uterus

162
Q

What is the rectouterine pouch also known as?

A

The Pouch of Douglas

163
Q

Is the rectouterine pouch found in males, females or both?

A

Females only

164
Q

Where is the rectouterine pouch located?

A

Between the uterus and rectum

165
Q

How can you access the rectouterine pouch for surgical/treatment purposes?

A

The rectouterine pouch may be easily accessed via posterior fornix (connection between vagina and cervix)

166
Q

Where is the rectouterine pouch located in relation to the vesicouterine pouch?

A

The rectouterine pouch is located a little lower than the vesicouterin pouch

167
Q

What does this mean for clinical purposes?

A

If fluid is accumulating in the pouches of the pelvis, there will be more fluid accumulation in the rectouterine pouch than in the vesicouterine pouch

168
Q

What is the main arterial supply to the pelvic region?

A

The common iliac arteries

169
Q

Each common iliac artery splits into an _________ artery and an _________ artery

A

Internal iliac artery

External iliac artery

170
Q

The internal iliac artery has two divisions. What are they?

A
  • Anterior division

- Posterior division

171
Q

What are the seven branches off of the anterior division of the internal iliac artery?

A 
1 - Umbilical artery
2 - Obturator artery
3 - Inferior vesicular
4 - Middle rectal artery
5 - Internal pudendal artery
6 - Inferior gluteal artery
5 - Uterine artery
172
Q

What branch does the umbilical artery give off?

A

The superior vesicular artery that goes to the ductus deferens (variable)

173
Q

What branch does the uterine artery give off?

A

The vaginal artery

174
Q

What are the three branches of the posterior division of the internal iliac artery?

A
  • Iliolumbar artery
  • Lateral sacral artery
  • Superior gluteal artery
175
Q

What is the path of the lateral sacral artery?

A

It runs laterally across the sacrum

176
Q

What is the path of the superior gluteal artery?

A

Runs between L5 and S1 nerves and is a KEY landmark

177
Q

Which branch off of the posterior division of the internal iliac artery is the largest?

A

Superior gluteal artery

178
Q

From the anterior division, where does the obturator artery run?

A

Through the obturator foramen

179
Q

The umbilical artery has two parts. What are they?

A
  • A living component that still conveys blood

- A ligament known as the obliterated umbilical artery that runs on the anterior wall

180
Q

Describe the path of the inferior gluteal artery

A

The inferior gluteal artery travels on the sacral plexus to the gluteal region between S2 and S3

181
Q

Describe the path of the internal pudendal artery

A

It travels near the inferior gluteal but tranvels into the perineum

182
Q

Where do the gonadal arteries branch from (the testicular or ovarian arteries)

A

Directly from the abdominal aorta

183
Q

What four lymph nodes are found in the pelvic region?

A

1 - Inguinal nodes
2 - External and internal iliac nodes
3 - Common iliac nodes
4 - Lumbar nodes

184
Q

Describe the inguinal nodes

A
  • There are superficial and deep inguinal nodes
  • They receive lymph from the lower limb and the lowest part of the body wall
  • This includes the genetalia
185
Q

Describe the external and internal iliac nodes

A
  • Receive lymph from the pelvis and from the inguinal nodes
186
Q

Describe the common iliac nodes

A
  • They receive lymph from the external and internal iliac nodes
187
Q

Describe the lumbar nodes

A

They receive lymph from the common iliac nodes

188
Q

Describe the venous drainage in the pelvic region

A

Pelvic venous drainage generally follows the arterial pattern

189
Q

What components are there of the venous plexus?

A

Pelvic venous plexuses…

  • Rectal
  • Vesical
  • Prostatic
  • Uterine
  • Vaginal
190
Q

What two nerves of the pelvic region are branches of the lumbar plexus?

A
  • Lumbosacral trunk

- Obturator nerve

191
Q

What spinal levels does the lumbosacral trunk arise from?

A

L4-L5

192
Q

What spinal levels does the obturator nerve arise from?

A

L2-L4

193
Q

Is the accessory obturator always present?

A

No

194
Q

When the accessory obturator is present, what does it arise from?

A

L3-L4

195
Q

There are four components of the sacral plexus. What are they?

A
  • Sciatic nerve
  • Pudendal nerve
  • Superior gluteal nerve
  • Inferior gluteal nerve
196
Q

What spinal levels does the sciatic nerve arise from?

A

L4-L5

197
Q

What does the sciatic nerve divide into?

A

The anterior and posterior divisions

198
Q

What does the sciatic nerve exit the pelvis through?

A

The greater sciatic foramen

199
Q

What does the sciatic nerve supply?

A

The lower limb

200
Q

What spinal levels does the pudendal nerve arise from?

A

S2-S4

201
Q

What division does the pudendal nerve have?

A

An anterior division

202
Q

What does the pudendal nerve exit the pelvis through?

A

The greater sciatic foramen

203
Q

What does the pudendal nerve then enter the perineum through?

A

The lesser sciatic foramen

204
Q

What does the pudendal nerve supply?

A

The skin and muscles of the perineum - it is the main sensory nerve for the external genetalia

205
Q

What spinal levels does the superior gluteal nerve arise from?

A

L4-S1

206
Q

What division does the superior gluteal nerve contribute to?

A

The posterior division

207
Q

What does the superior gluteal nerve exit the pelvis through?

A

The greater sciatic foramen

208
Q

What does the superior gluteal nerve supply?

A
  • Gluteus medius
  • Gluteus minimus
  • Tensor fascia latae
209
Q

What spinal levels does the inferior gluteal nerve arise from?

A

L5-S2

210
Q

What does the inferior gluteal nerve exit the pelvis through?

A

The greater sciatic foamen

211
Q

What does the inferior gluteal nerve supply?

A

The gluteus maximus

212
Q

What is the coccygeal plexus/

A

A small plexus from the ventral rami of S4-S5 and the coccygeal nerves

213
Q

What are the two branches of the autonomic nervous system?

A

Sympathetics and parasympathetics

214
Q

How many sympathetic ganglia are typically found in the anterior sacrum?

A

Usually 4 on each side

215
Q

Where do the sympathetic ganglia converge?

A

At the ganglion impar (the end of the sympathetic trunk)

216
Q

Where do the sympathetics arise from?

A

T11-L2

217
Q

What do the sympathetics pass through?

A

The sympathetic chain

218
Q

What two nerves do the sympathetics pass through?

A

Lumbar and sacral splanchnic nerves

219
Q

Where do the sympathetics synapse?

A

In the inferior mesenteric ganglion

220
Q

Where do the postsynaptics travel?

A
  • Through the superior hypogastric plexus
  • Through the right and left hypogastric nerves
  • (and/or) Through the inferior hypogastric (pelvic) plexus
221
Q

What do the sympathetics follow to the target organs?

A

Pelvic arteries

222
Q

What spinal levels do the parasympathetics arise from?

A

S2-S4

223
Q

What nerves do the parasympathetics pass through?

A

They ascend mainly through the inferior and superior hypogastric plexuses

224
Q

What do the parasympathetics follow to the target organs?

A

Arteries

225
Q

Where do the parasympathetics synapse?

A

In the ganglia of the organs or the gut plexuses

226
Q

How do parasympathetics read the target organs?

A

Via short postsynaptic fibers

Para = long pre, short post

Anatomy Exam 4 (9 decks)

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