4. Pelvic Vessels, Nerves, and Lymphatics (K. Tong) Flashcards
What branches of the aorta are relevant to this class?
Ovarian and testicular arteries.
Middle sacral artery.
Inferior mesenteric artery (-> superior rectal artery).
Common iliac artery.
What are the branches the posterior division of the internal iliac artery?
Iliolumbar artery.
Lateral sacral arteries.
Superior gluteal arteries.
What are the branches of the anterior division of the internal iliac artery in females?
Umbilical and superior vesical arteries.
Middle rectal artery.
Obturator artery.
Internal pudendal artery.
Inferior gluteal artery.
Uterine artery.
Vaginal artery.
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From what vessel does the middle rectal artery arise?
The anterior division of the internal iliac artery.
From what vessel does the superior gluteal artery arise?
From the posterior division of the internal iliac artery.
From what vessel does the uterine artery arise?
The anterior division of the internal iliac artery.
From what vessel does the obturator artery arise?
The anterior division of the internal iliac artery.
From what vessel does the superior rectal artery arise?
The inferior mesenteric artery.
From which vessel do the gonadal arteries arise?
The aorta.
From which vessel does the superior vesicle artery arise?
The umbilical artery.
Where to the superior rectal, middle rectal, and inferior rectal arteries come from respectively?
Inferior mesenteric artery -> superior rectal artery.
Anterior division of the internal iliac artery -> middle rectal artery.
Internal pudendal artery -> inferior rectal artery.
In the female, what are the branches of the internal pudendal artery?
Inferior rectal artery.
Perineal artery (-> posterior labial artery).
Artery of the vestibule of the vagina.
Deep artery of the clitoris.
Dorsal artery of the clitoris.
What are the branches of the anterior division of the internal iliac artery in males?
Umbilical and superior vesical arteries.
Inferior vesical artery.
Middle rectal artery.
Obturator artery.
Internal pudendal artery.
Inferior gluteal artery.
Artery to the ductus deferens.
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What are the branches of the internal pudendal artery in males?
Inferior rectal artery.
Perineal artery (-> posterior scrotal artery).
Artery of the bulb of the penis.
Deep artery of the penis.
Dorsal artery of the penis.
Which two arteries exit below the piriformis muscle and exit the greater sciatic foramen?
The inferior gluteal artery and the internal pudendal artery.
Which four arteries enter the lesser pelvis in both males and females?
Which two arteries enter the lesser pelvis in females only?
Paired internal iliac arteries. (2)
Median sacral artery.
Superior rectal artery.
Females also have the paired uterine arteries. (2)
In females, which arteries wrap around the ureter in the lesser pelvis?
The uterine arteries.
What two surgeries on females might damage the ureter?
Ligation of the uterine artery.
Oophorectomy.
Lymph from inguinal nodes and superior part of middle to anterior pelvic organs drain into which lymph nodes?
The external iliac lymph node.
Lymph from the inferior pelvic viscera, deep perineum and the gluteal region drains into which lymph nodes?
The internal iliac lymph nodes.
External and internal iliac lymph nodes drain into what other lymph nodes?
The common iliac lymph nodes.
From where do the sacral lymph nodes receive lymph?
Into what other lymph nodes do the sacral lymph nodes drain?
From the postero-inferior pelvic viscera.
Sacral lymph nodes drain into the internal or common iliac nodes.
Into which lymph nodes to the common iliac lymph nodes drain?
The lumbar nodes.
What regions do the external iliac lymph nodes drain?
The inguinal nodes and the superior part of the middle to anterior pelvic organs.
What regions do the internal iliac lymph nodes drain?
The inferior pelvic viscera, the deep perineum, and the gluteal region.
Which three lymph nodes drain into the common iliac lymph nodes?
External iliac lymph nodes.
Internal iliac lymph nodes.
Sacral lymph nodes.
Into what lymph nodes does lymph from the ovary, uterine tube, and fundus of uterus drain?
Lumbar lymph nodes.
Into what lymph nodes do the testes and epididymis drain?
Lumbar lymph nodes.
Into what lymph nodes do the middle and upper vagina, cervix, and body of uterus drain?
Internal and external iliac lymph nodes.
Into what lymph nodes does the prostate’s lymph drain?
Internal iliac lymph nodes.
Into which lymph nodes does lymph from the scrotum drain?
Superficial inguinal lymph nodes.
Into which lymph nodes does lymph from the glands clitoris and glans penis drain?
Deep inguinal lymph nodes.
From which spinal nerves do the somatic nerves of the lower limb, pelvis, and perineum arise?
L4-L5 (lumbar plexus contribution).
S1-Co
The lumbosacral plexus receives contributions from which anterior rami?
L4-L5 and S1-S4
Which anterior rami give rise to the sciatic nerve?
L4-S3
Which anterior rami give rise to the pudendal nerve?
S2-S4
Which anterior rami give rise to the superior gluteal nerve?
L4-S1
Which anterior rami give rise to the inferior gluteal nerve?
L5-S2
What is supplied by the superior gluteal nerve?
Gluteus medius and gluteus minimus.
The pudendal nerve enters the perineum via which structure?
The lesser sciatic foramen – contained in the pudendal canal.
What is the function of the pudendal nerve?
Innervation of the perineum, and sensory afferents for the external genitalia and anal canal (below the pectinate line).
Which anterior rami give rise to the nerve of the quadratus femoris?
L4-S1
Which anterior rami give rise to the nerve to the obturator internus and superior gemellus?
L5-S2
Which anterior rami give rise to the nerve to the piriformis?
S1-S2
Which anterior rami give rise to the perforating cutaneous nerve?
S2, S3
Which anterior rami give rise to the pelvic splanchnic nerve?
S2-S4
Which anterior rami give rise to the nerves to the levator ani and coccygeus?
S3, S4
What nerve contributions form the Coccygeal plexus?
S4 – S5 and coccygeal nerves.
What is the function of the coccygeal plexus?
Somatic innervation to the coccygeus muscle, part of the levator ani, and the sacral coccygeal joint.
The anococcygeal nerves branch off and supply a small area of skin between the tip of the coccyx and anus.
What are the branches of the sacral plexus?
Sciatic nerve.
Pudendal nerve.
Superior gluteal nerve.
Inferior gluteal nerve.
The pudendal nerve comes off of which plexus?
The sacral plexus.
What sort of nerve fibers do we find in the superior hypogastric plexus?
Sympathetic only.
The superior hypogastric plexus gives rise to what three other plexuses?
Ureteric plexus.
Testicular plexus.
Common iliac plexus.
What provides the sympathetic and parasympathetic contributions to the inferior hypogastric plexus?
Sympathetic: superior sacral sympathetic nerves.
Parasympathetic: pelvic splanchnic nerves.