4. Pelvic Vessels, Nerves, and Lymphatics (K. Tong) Flashcards

1
Q

What branches of the aorta are relevant to this class?

A

Ovarian and testicular arteries.

Middle sacral artery.

Inferior mesenteric artery (-> superior rectal artery).

Common iliac artery.

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2
Q

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

A

Iliolumbar artery.

Lateral sacral arteries.

Superior gluteal arteries.

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3
Q

What are the branches of the anterior division of the internal iliac artery in females?

A

Umbilical and superior vesical arteries.

Middle rectal artery.

Obturator artery.

Internal pudendal artery.

Inferior gluteal artery.

Uterine artery.

Vaginal artery.

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4
Q

From what vessel does the middle rectal artery arise?

A

The anterior division of the internal iliac artery.

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5
Q

From what vessel does the superior gluteal artery arise?

A

From the posterior division of the internal iliac artery.

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6
Q

From what vessel does the uterine artery arise?

A

The anterior division of the internal iliac artery.

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7
Q

From what vessel does the obturator artery arise?

A

The anterior division of the internal iliac artery.

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8
Q

From what vessel does the superior rectal artery arise?

A

The inferior mesenteric artery.

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9
Q

From which vessel do the gonadal arteries arise?

A

The aorta.

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10
Q

From which vessel does the superior vesicle artery arise?

A

The umbilical artery.

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11
Q

Where to the superior rectal, middle rectal, and inferior rectal arteries come from respectively?

A

Inferior mesenteric artery -> superior rectal artery.

Anterior division of the internal iliac artery -> middle rectal artery.

Internal pudendal artery -> inferior rectal artery.

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12
Q

In the female, what are the branches of the internal pudendal artery?

A

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.

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13
Q

What are the branches of the anterior division of the internal iliac artery in males?

A

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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14
Q

What are the branches of the internal pudendal artery in males?

A

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.

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15
Q

Which two arteries exit below the piriformis muscle and exit the greater sciatic foramen?

A

The inferior gluteal artery and the internal pudendal artery.

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16
Q

Which four arteries enter the lesser pelvis in both males and females?

Which two arteries enter the lesser pelvis in females only?

A

Paired internal iliac arteries. (2)

Median sacral artery.

Superior rectal artery.

Females also have the paired uterine arteries. (2)

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17
Q

In females, which arteries wrap around the ureter in the lesser pelvis?

A

The uterine arteries.

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18
Q

What two surgeries on females might damage the ureter?

A

Ligation of the uterine artery.

Oophorectomy.

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19
Q

Lymph from inguinal nodes and superior part of middle to anterior pelvic organs drain into which lymph nodes?

A

The external iliac lymph node.

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20
Q

Lymph from the inferior pelvic viscera, deep perineum and the gluteal region drains into which lymph nodes?

A

The internal iliac lymph nodes.

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21
Q

External and internal iliac lymph nodes drain into what other lymph nodes?

A

The common iliac lymph nodes.

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22
Q

From where do the sacral lymph nodes receive lymph?

Into what other lymph nodes do the sacral lymph nodes drain?

A

From the postero-inferior pelvic viscera.

Sacral lymph nodes drain into the internal or common iliac nodes.

23
Q

Into which lymph nodes to the common iliac lymph nodes drain?

A

The lumbar nodes.

24
Q

What regions do the external iliac lymph nodes drain?

A

The inguinal nodes and the superior part of the middle to anterior pelvic organs.

25
Q

What regions do the internal iliac lymph nodes drain?

A

The inferior pelvic viscera, the deep perineum, and the gluteal region.

26
Q

Which three lymph nodes drain into the common iliac lymph nodes?

A

External iliac lymph nodes.

Internal iliac lymph nodes.

Sacral lymph nodes.

27
Q

Into what lymph nodes does lymph from the ovary, uterine tube, and fundus of uterus drain?

A

Lumbar lymph nodes.

28
Q

Into what lymph nodes do the testes and epididymis drain?

A

Lumbar lymph nodes.

29
Q

Into what lymph nodes do the middle and upper vagina, cervix, and body of uterus drain?

A

Internal and external iliac lymph nodes.

30
Q

Into what lymph nodes does the prostate’s lymph drain?

A

Internal iliac lymph nodes.

31
Q

Into which lymph nodes does lymph from the scrotum drain?

A

Superficial inguinal lymph nodes.

32
Q

Into which lymph nodes does lymph from the glands clitoris and glans penis drain?

A

Deep inguinal lymph nodes.

33
Q

From which spinal nerves do the somatic nerves of the lower limb, pelvis, and perineum arise?

A

L4-L5 (lumbar plexus contribution).

S1-Co

34
Q

The lumbosacral plexus receives contributions from which anterior rami?

A

L4-L5 and S1-S4

35
Q

Which anterior rami give rise to the sciatic nerve?

A

L4-S3

36
Q

Which anterior rami give rise to the pudendal nerve?

A

S2-S4

37
Q

Which anterior rami give rise to the superior gluteal nerve?

A

L4-S1

38
Q

Which anterior rami give rise to the inferior gluteal nerve?

A

L5-S2

39
Q

What is supplied by the superior gluteal nerve?

A

Gluteus medius and gluteus minimus.

40
Q

The pudendal nerve enters the perineum via which structure?

A

The lesser sciatic foramen – contained in the pudendal canal.

41
Q

What is the function of the pudendal nerve?

A

Innervation of the perineum, and sensory afferents for the external genitalia and anal canal (below the pectinate line).

42
Q

Which anterior rami give rise to the nerve of the quadratus femoris?

A

L4-S1

43
Q

Which anterior rami give rise to the nerve to the obturator internus and superior gemellus?

A

L5-S2

44
Q

Which anterior rami give rise to the nerve to the piriformis?

A

S1-S2

45
Q

Which anterior rami give rise to the perforating cutaneous nerve?

A

S2, S3

46
Q

Which anterior rami give rise to the pelvic splanchnic nerve?

A

S2-S4

47
Q

Which anterior rami give rise to the nerves to the levator ani and coccygeus?

A

S3, S4

48
Q

What nerve contributions form the Coccygeal plexus?

A

S4 – S5 and coccygeal nerves.

49
Q

What is the function of the coccygeal plexus?

A

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.

50
Q

What are the branches of the sacral plexus?

A

Sciatic nerve.

Pudendal nerve.

Superior gluteal nerve.

Inferior gluteal nerve.

51
Q

The pudendal nerve comes off of which plexus?

A

The sacral plexus.

52
Q

What sort of nerve fibers do we find in the superior hypogastric plexus?

A

Sympathetic only.

53
Q

The superior hypogastric plexus gives rise to what three other plexuses?

A

Ureteric plexus.

Testicular plexus.

Common iliac plexus.

54
Q

What provides the sympathetic and parasympathetic contributions to the inferior hypogastric plexus?

A

Sympathetic: superior sacral sympathetic nerves.

Parasympathetic: pelvic splanchnic nerves.