Anatomy 11 - Anatomy of the Lateral Pelvic Wall and Pelvic Masses

Question 1

What is the name of the membrane that covers the obturator foramen?

Answer 1

Obturator membrane

Question 2

2 main pelvic ligaments?

Answer 2

Sacrospinous ligament

Sacrotuberous ligament

Question 3

What muscle attaches between the sacrum and greater trochanter?

Answer 3

Piriformis

Question 4

What muscle attaches between the coccyx and ischial spine/ sacrotuberous ligament?

Answer 4

Coccygeus

Question 5

What muscle attaches between the obturator membrane, ischium and pubis and the greater trochanter?

Answer 5

Obturator internus

Question 6

What nerve plexus is seen in the lateral pelvic wall?

Answer 6

Sacral plexus

Question 7

Which branch of the common iliac is bigger - external iliac or internal iliac?

Answer 7

External iliac

Question 8

Where do the majority of arteries of the pelvis and perineum arise from?

Answer 8

Internal iliac artery

Question 9

Where do the gonadal arteries arise from?

Answer 9

L2 abdominal aorta

Question 10

Where does the superior rectal artery arise from?

Answer 10

Continuation of inferior mesenteric

Question 11

There is few anastomoses between pelvic arteries. True or false?

Answer 11

False - extensive anastomoses

Question 12

At what level does the common iliac artery tend to split into the external and internal iliac arteries?

Answer 12

S5, L1

Question 13

What does the internal iliac artery split into?

Answer 13

Anterior division

Posterior division

Question 14

What does the posterior division of the internal iliac artery continue as?

Answer 14

Gluteal arteries

Question 15

In the male, what arteries branch from the anterior division of the internal iliac artery? (5)

Answer 15

Obturator artery
Superior and inferior vesical arteries
Middle rectal artery
Internal pudendal artery

Question 16

What artery branches from the inferior vesical artery in males?

Answer 16

Prostatic brach

Question 17

What type of structures does the anterior division and the posterior division of the internal iliac artery tend to supply?

Answer 17

Anterior = visceral
Posterior = parietal

Question 18

What is the remnant of the umbilical artery?

Answer 18

Medial umbilical ligamnet

Question 19

What is the inferior vesical artery replaced by in females?

Answer 19

Vaginal artery (females don’t have an inferior vesical artery)

Question 20

What does the internal pudendal artery supply?

Answer 20

Perineum

Question 21

What is the name of the only artery which passes through the obturator foramen?

Answer 21

Obturator artery

Question 22

What forms the lateral umbilical fold on the internal aspect of the abdominal wall?

Answer 22

Inferior epigastric vessels

Question 23

What forms the medial umbilical fold on the internal aspect of the abdominal wall?

Answer 23

Remnant of the umbilical artery

Question 24

What forms the median umbilical fold?

Answer 24

Urachus (a fibrous foetal remnant)

Question 25

What is the internal pudendal artery a continuation of?

Answer 25

Internal iliac artery

Question 26

What does the perineal artery branch from in males?

Answer 26

Internal pudendal artery

Question 27

What does the posterior scrotal artery branch from?

Answer 27

Perineal artery (-> internal pudendal artery)

Question 28

What does the anterior scrotal artery branch from?

Answer 28

External iliac artery

Question 29

What are the 2 main arteries of the penis?

Answer 29

Dorsal artery of the penis | Deep artery

Question 30

What are the dorsal artery of the penis and the deep artery branches from?

Answer 30

Internal pudendal nerve

Question 31

In the female, what arteries branch from the anterior division of the internal iliac artery? (5)

Answer 31

``` Obturator artery Superior vesical arteries Uterine artery Middle rectal artery Internal pudendal artery ```

Question 32

What artery arises from the uterine artery in females?

Answer 32

Vaginal artery

Question 33

What is the inferior vesical artery replaced by in females?

Answer 33

Vaginal artery

Question 34

How does the inferior bladder get a blood supply in females?

Answer 34

The vaginal artery gives off branches to this

Question 35

What does the ovarian artery branch to?

Answer 35

Tubal branch | Ovarian branch

Question 36

Where do anastomoses occur between the arteries to the female pelvic organs?

Answer 36

Between the uterine artery and ovarian artery | Between the uterine artery and vaginal artery

Question 37

Apart from the vaginal artery, what other artery provides a blood supply to the vagina?

Answer 37

Internal pudendal artery

Question 38

What structure passes under the uterine artery?

Answer 38

Ureter

Question 39

What arteries branch from the internal pudendal arteries in females? (4)

Answer 39

Inferior rectal artery Perineal artery Labial artery Dorsal artery of the clitoris

Question 40

What do the labial arteries branch from?

Answer 40

Perineal arteries

Question 41

How does venous drainage of the pelvis compare to the arterial system?

Answer 41

Follows it - named the same as the arteries

Question 42

What do the veins form a number of in the pelvis?

Answer 42

Venous plexuses

Question 43

What do the veins of the pelvis mainly drain to? | What are the 2 other options?

Answer 43

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

Question 44

Roots of the sciatic nerve?

Answer 44

L4-S3

Question 45

What does the sciatic nerve arise from?

Answer 45

Sacral plexus

Question 46

What nerve supplies the muscles of the medial compartment of the thigh?

Answer 46

Obturator nerve

Question 47

Is the obturator or pudendal nerve more anterior?

Answer 47

Obturator

Question 48

Nerve roots of obturator nerve?

Answer 48

L2, 3, 4

Question 49

Nerve roots of pudendal nerve?

Answer 49

S2, 3, 4

Question 50

Apart from obturator, pudendal, sciatic nerve and the sacral plexus, what nerves are seen in the lateral wall of the pelvis?

Answer 50

Pelvic splanchnic nerves | Nerves to levator ani

Question 51

Nerve to levator ani roots?

Answer 51

S3, 4, 5

Question 52

Name of main group of lymph nodes on the lower abdominal aorta/

Answer 52

Lumbar nodes

Question 53

Group of lymph nodes below the lumbar nodes?

Answer 53

Inferior mesenteric

Question 54

Name of lymph nodes on the common iliac arteries?

Answer 54

Common iliac

Question 55

Name of lymph nodes on the external iliac artery?

Answer 55

External iliac

Question 56

Name of lymph nodes that can be felt in the groin?

Answer 56

Superficial inguinal

Question 57

Name of lymph nodes on the sacrum?

Answer 57

Sacral

Question 58

Name of lymph nodes on the internal iliac arteries?

Answer 58

Internal iliac nodes

Question 59

Name of lymph nodes below the superficial inguinal nodes?

Answer 59

Deep inguinal nodes

Question 60

What is another name for the lumbar lymph nodes?

Answer 60

Para-aortic

Question 61

What lymph nodes does the superior pelvic viscera drain to?

Answer 61

External iliac nodes -> common iliac nodes -> aortic -> thoracic duct -> venous system

Question 62

What lymph nodes does the inferior pelvic viscera drain to?

Answer 62

Deep perineum -> internal iliac nodes -> common iliac -> aortic -> thoracic duct -> venous system

Question 63

What is the name of the lymph nodes located around the rectum?

Answer 63

Pararectal nodes

Question 64

What lymph nodes does lymph from the superficial perineum drain to?

Answer 64

Superficial inguinal nodes

Question 65

Where does the thoracic duct drain to?

Answer 65

Left venous angle

Question 66

Is lymph drainage from the pelvis very specific?

Answer 66

No, there is lots of crossover = cancer can spread in any direction

Question 67

What lymph nodes does cancer in the ovaries and testes tend to spread to?

Answer 67

Lumbar (para-aortic/ caval) nodes

Question 68

What happens if cancer spreads through the peritoneal layer?

Answer 68

It can disseminate throughout the peritoneal cavity

Question 69

What artery is the dorsal artery of the clitoris a continuation of?

Answer 69

Internal pudendal artery

Question 70

4 branches of the internal pudendal artery in females?

Answer 70

Perineal artery Dorsal artery of the clitoris Inferior rectal artery Labial artery