Aldridge- Pelvic Vasculature

Question 1

What does the internal iliac artery supply blood to (x4)

Answer 1

Pelvic viscera

Pelvic walls

Perineum

Gluteal region

Question 2

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

(X3)

Answer 2

Iliolumbar

Lateral sacral

Superior gluteal

Question 3

The lateral sacral artery (a branch off of the internal iliac artery) passes ______ to the sacrum.

Answer 3

Anterior

Question 4

Describe the course of the lateral sacral artery

Answer 4

The lateral sacral artery branches from the posterior division of the internal iliac artery. It passes anterior to the sacrum, and then sends branches into the anterior sacral foramina to supply radicular branches to the anterior spinal artery

Question 5

What does the iliolumbar artery arise from and what does it supply blood to ?

Answer 5

The iliolumbar artery arrises from the posterior division of the internal iliac artery. It supplies blood to the lower lumbar region and the iliac fossa.

Question 6

Explain the course of the superior gluteal artery

Answer 6

The superior gluteal artery arises from the posterior division of the internal iliac artery. It passes posteriorly, between the lumbosacral trunk (ant rami L4, L5) and Ramus S1. It then exits the pelvis thru the greater sciatic foramen (superior to piriformis muscle) to supply gluteal muscles

Question 7

How does the internal iliac artery terminate?

Answer 7

As the internal pudendal artery and inferior gluteal artery

Question 8

Explain the course of the obturator artery

Answer 8

The obturator artery is a branch of the anterior division of the internal iliac A (75% of times). It travels laterally along pelvic wall w/ obturator nerve then goes thru obturator foramen to supply the muscles of the medial thigh

Question 9

What is formed form the obliterated part of the umbilical artery

Answer 9

The medial umbilical ligament

Question 10

Describe the course of the umbilical artery.

Answer 10

Branch of anterior division of internal iliac artery. The patent, proximal part of the umbilical artery sends 2-3 superior vesical arteries that supply the upper part of urinary bladder.

Question 11

The inferior vesical artery is found only in _____

Answer 11

Males

Question 12

What does the inferior vesical artery (branch of anterior division of internal iliac) supply

Answer 12

This artery is only found in males

Supplies the base (posterior) part of the urinary bladder, prostate, and seminal vesicles

Question 13

The middle rectal artery is a branch off of the anterior division of the internal iliac artery. It is often absent, especially in females, and in males can arise from the inferior vesical artery. What does this artery supply?

Answer 13

Lower rectum

Prostate

Seminal vesicals

Question 14

What is the vaginal artery a branch of and what does it supply?

Answer 14

Branch of anterior division of internal iliac artery

Sides of vagina

Question 15

Uterine artery passes _____ to ureter

Answer 15

Superior

Question 16

Course of the uterine artery?

Answer 16

This is a branch of the anterior division of the internal iliac artery.

Crosses superior to the ureter, lateral to the cervix, to enter the broad ligament of uterus.

Question 17

In hysterectomy, what structure do you have to be careful not to ligate and sever when ligating the uterine artery?

Answer 17

The ureter, which runs inferior to the artery.

Question 18

Explain the course of the inferior gluteal artery.

Answer 18

The inferior gluteal artery is a branch of the anterior division of the internal thoracic artery. It passes posteriorly, between the ant rami of S1/S2 or S2/S3. It then goes between the piriformis and coccygeal muscles and supplies the gluteal region

Question 19

Explain the course of the internal pudendal artery

Answer 19

Branch of the ant div int liliac, courses between piriformis and coccygeus muscles, thru sciatic foramen into gluteal region, the travels inferiorly, posterior to ischial spine, goes thru lesser sciatic foramen and supplies the structures of the perineum

Question 20

What are the boundaries of the perinuem?

Answer 20

Anterior - pubic symphisis

Posterior coccyx

Lateral; pubic arches, ischial rami, ischial tuberosities, sacrotuberous ligament

Question 21

Innervation to the external anal sphincter

Answer 21

Inferior rectal nerve

Voluntary control

Question 22

What is the anorectal ring?

Answer 22

A palpable landmark during rectal exam

Composed of deep part of external anal sphincter, puborectalis, and internal anal sphincter

Determines continence of pt

Question 23

What are the anal columns?

Answer 23

A characterisstic vertical fold of mucous membrane which contains the superior rectal vessels and is the location of the portal-caval anastamoses

Question 24

Where is the portal-caval anastamoses in the anus?

Answer 24

At the anal columns

Question 25

Where is somatic sensory information traveling from below the pectinate line of the anal canal?

Answer 25

Travels on the inferior rectal nerve which is a branch of the pudendal nerve

Question 26

Varicosities of tributaries of superior rectal veins in anal columns covered by mucous membrane of anal columns

Answer 26

Internal hemorrhoids

Question 27

Varicosities of tributaries of inferior rectal veins covered by skin Very painful due to innervation being from somatic fibers of inferior rectal nerve

Answer 27

External hemorrhoids

Question 28

Explain what happens in perianal abscess

Answer 28

Anal valves can become torn due to chronic constipation which has hard stool. This can lead to infection of anal canal and can form a fistula thru wall of anal canal into ischiorectal fossa. Infection can spread from one side to the other Can also spread anterior into the anterior recess of the ischiorectal fossa to affect urogenital structures

Question 29

Boundaries of the urogenital triangle

Answer 29

Posterior - imaginary line drawn between the ischial tuberosities Lateral; inferior rami of pubis and ramus of ischium

Question 30

What are the contents of the deep perineal pouch (male)

Answer 30

Deep transverse perineal muscle Sphincter urethrae (voluntary sphincter of urethra) Membranous urethra Bulbourethral glands Internal pudendal artery, vein, and nerve branches

Question 31

What are the contents of the deep perineal pouch? (Female)

Answer 31

Deep transverse perineal muscle Sphincter urethrae (voluntary sphincter of urethra) Urethra Vagina Internal pudendal artery, vein and nerve branches

Question 32

The space in the urogenital triangle that is between the inferior fascial layer of the urogenital diaphragm and the superficial perineal fascia

Answer 32

Superficial perineal pouch

Question 33

Contents of the superficial perineal pouch?

Answer 33

Root of penis and clitoris Greater vestibular glands (female) Muscles: Superficial transverse perineal muscle Bulbospongiosus Ischiocavernous muscle

Question 34

Where can extravasated urine enter in rupture of the penile urethra?

Answer 34

Superifical perineal pouch and scrotum Anterior abdominal wall

Question 35

Lumbar splanchinc nerves contain:

Answer 35

Preganglionic sympathetic fibers