Anatomy 11 - Anatomy of the Lateral Pelvic Wall and Pelvic Masses Flashcards
What is the name of the membrane that covers the obturator foramen?
Obturator membrane
2 main pelvic ligaments?
Sacrospinous ligament
Sacrotuberous ligament
What muscle attaches between the sacrum and greater trochanter?
Piriformis
What muscle attaches between the coccyx and ischial spine/ sacrotuberous ligament?
Coccygeus
What muscle attaches between the obturator membrane, ischium and pubis and the greater trochanter?
Obturator internus
What nerve plexus is seen in the lateral pelvic wall?
Sacral plexus
Which branch of the common iliac is bigger - external iliac or internal iliac?
External iliac
Where do the majority of arteries of the pelvis and perineum arise from?
Internal iliac artery
Where do the gonadal arteries arise from?
L2 abdominal aorta
Where does the superior rectal artery arise from?
Continuation of inferior mesenteric
There is few anastomoses between pelvic arteries. True or false?
False - extensive anastomoses
At what level does the common iliac artery tend to split into the external and internal iliac arteries?
S5, L1
What does the internal iliac artery split into?
Anterior division
Posterior division
What does the posterior division of the internal iliac artery continue as?
Gluteal arteries
In the male, what arteries branch from the anterior division of the internal iliac artery? (5)
Obturator artery
Superior and inferior vesical arteries
Middle rectal artery
Internal pudendal artery
What artery branches from the inferior vesical artery in males?
Prostatic brach
What type of structures does the anterior division and the posterior division of the internal iliac artery tend to supply?
Anterior = visceral Posterior = parietal
What is the remnant of the umbilical artery?
Medial umbilical ligamnet
What is the inferior vesical artery replaced by in females?
Vaginal artery (females don’t have an inferior vesical artery)
What does the internal pudendal artery supply?
Perineum
What is the name of the only artery which passes through the obturator foramen?
Obturator artery
What forms the lateral umbilical fold on the internal aspect of the abdominal wall?
Inferior epigastric vessels
What forms the medial umbilical fold on the internal aspect of the abdominal wall?
Remnant of the umbilical artery
What forms the median umbilical fold?
Urachus (a fibrous foetal remnant)
What is the internal pudendal artery a continuation of?
Internal iliac artery
What does the perineal artery branch from in males?
Internal pudendal artery
What does the posterior scrotal artery branch from?
Perineal artery (-> internal pudendal artery)
What does the anterior scrotal artery branch from?
External iliac artery
What are the 2 main arteries of the penis?
Dorsal artery of the penis
Deep artery
What are the dorsal artery of the penis and the deep artery branches from?
Internal pudendal nerve
In the female, what arteries branch from the anterior division of the internal iliac artery? (5)
Obturator artery Superior vesical arteries Uterine artery Middle rectal artery Internal pudendal artery
What artery arises from the uterine artery in females?
Vaginal artery
What is the inferior vesical artery replaced by in females?
Vaginal artery
How does the inferior bladder get a blood supply in females?
The vaginal artery gives off branches to this
What does the ovarian artery branch to?
Tubal branch
Ovarian branch
Where do anastomoses occur between the arteries to the female pelvic organs?
Between the uterine artery and ovarian artery
Between the uterine artery and vaginal artery
Apart from the vaginal artery, what other artery provides a blood supply to the vagina?
Internal pudendal artery
What structure passes under the uterine artery?
Ureter
What arteries branch from the internal pudendal arteries in females? (4)
Inferior rectal artery
Perineal artery
Labial artery
Dorsal artery of the clitoris
What do the labial arteries branch from?
Perineal arteries
How does venous drainage of the pelvis compare to the arterial system?
Follows it - named the same as the arteries
What do the veins form a number of in the pelvis?
Venous plexuses
What do the veins of the pelvis mainly drain to?
What are the 2 other options?
Internal iliac vein
Some will drain via superior rectal into hepatic portal system
Some will drain via lateral sacral veins into internal cerebral venous plexus
Gonadal veins drain into renal/ IVC
Roots of the sciatic nerve?
L4-S3
What does the sciatic nerve arise from?
Sacral plexus
What nerve supplies the muscles of the medial compartment of the thigh?
Obturator nerve
Is the obturator or pudendal nerve more anterior?
Obturator
Nerve roots of obturator nerve?
L2, 3, 4
Nerve roots of pudendal nerve?
S2, 3, 4
Apart from obturator, pudendal, sciatic nerve and the sacral plexus, what nerves are seen in the lateral wall of the pelvis?
Pelvic splanchnic nerves
Nerves to levator ani
Nerve to levator ani roots?
S3, 4, 5
Name of main group of lymph nodes on the lower abdominal aorta/
Lumbar nodes
Group of lymph nodes below the lumbar nodes?
Inferior mesenteric
Name of lymph nodes on the common iliac arteries?
Common iliac
Name of lymph nodes on the external iliac artery?
External iliac
Name of lymph nodes that can be felt in the groin?
Superficial inguinal
Name of lymph nodes on the sacrum?
Sacral
Name of lymph nodes on the internal iliac arteries?
Internal iliac nodes
Name of lymph nodes below the superficial inguinal nodes?
Deep inguinal nodes
What is another name for the lumbar lymph nodes?
Para-aortic
What lymph nodes does the superior pelvic viscera drain to?
External iliac nodes -> common iliac nodes -> aortic -> thoracic duct -> venous system
What lymph nodes does the inferior pelvic viscera drain to?
Deep perineum -> internal iliac nodes -> common iliac -> aortic -> thoracic duct -> venous system
What is the name of the lymph nodes located around the rectum?
Pararectal nodes
What lymph nodes does lymph from the superficial perineum drain to?
Superficial inguinal nodes
Where does the thoracic duct drain to?
Left venous angle
Is lymph drainage from the pelvis very specific?
No, there is lots of crossover = cancer can spread in any direction
What lymph nodes does cancer in the ovaries and testes tend to spread to?
Lumbar (para-aortic/ caval) nodes
What happens if cancer spreads through the peritoneal layer?
It can disseminate throughout the peritoneal cavity
What artery is the dorsal artery of the clitoris a continuation of?
Internal pudendal artery
4 branches of the internal pudendal artery in females?
Perineal artery
Dorsal artery of the clitoris
Inferior rectal artery
Labial artery