Anatomy 6: The Lateral Pelvic Wall and a Pelvic Mass

Question 1

What are the ligaments of the lateral pelvic wall?

Answer 1

Sacrospinous Ligament

Sacrotuberous Ligament

Question 2

What are the muscles of the lateral pelvic wall?

Answer 2

Obturator internus
Coccygeus
Piriformis
Levator Ani

Question 3

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

Answer 3

The internal iliac artery

Question 4

Which lateral pelvic wall arteries do not arise from the lateral pelvic wall?

Answer 4

Gonadal artery- from L2 abdominal aorta

Superior rectal artery- continuation of inferior mesenteric

Question 5

Approximately where does the common iliac artery bifurcate?

Answer 5

At L5/S1

Question 6

Where does the internal iliac artery divide into the anterior and posterior trunks?

Answer 6

At the superior border of the greater sciatic foramen

Question 7

What are some of the anterior trunk branches from the Internal Iliac artery?

Answer 7

Obturator artery
Umbilical artery
Inferior vesical artery
Vaginal artery
Uterine artery
Middle rectal artery
Internal pudendal artery
Inferior gluteal artery

Question 8

What are some of the posterior trunk branches from the Internal Iliac artery?

Answer 8

PILS

Posterior
Iliolumbar
Lateral sacral arteries
Superior gluteal artery

Question 9

What are the 3 folds in the internal aspect of the abdominal wall?

Answer 9

Lateral umbilical fold (inferior umbilical fold)

Medial umbilical fold (remnant of umbilical artery)

Median umbilical fold (Urachus)

Question 10

Where are there anastomoses in the female gonadal arteries?

Answer 10

An anastomosis occurs between the uterine artery and ovarian artery

An anatomosis occurs between the uterine artery and vaginal artery

Question 11

What is the pattern of venous drainage of the pelvis?

Answer 11

In the pelvis the veins form a number of venous plexuses

Drain mainly to the internal iliac vein.

Some will drain via superior rectal into hepatic portal system

Some will drain via lateral sacral veins into internal vertebral venous plexus

Question 12

What are some of the nerves of the lateral wall?

Answer 12

Obturator nerve
Sciatic nerve
Pudendal nerve
Sacral plexus
Pelvic Splanchnic nerves
Nerve to Levator Ani

Question 13

What is the course of the external iliac vein?

Answer 13

1. Begins as IVC
2. Becomes common iliac vein
3. Divides into external and internal iliac veins
4. External iliac becomes femoral vein
5. internal Iliac vein formed near the greater sciatic foramen

Question 14

Lymphatics: where does the superior pelvic viscera drain?

Answer 14

External iliac nodes

Common iliac nodes, aortic thoracic duct, venous system

Question 15

Lymphatics: where does the inferior pelvic viscera drain?

Answer 15

Deep perineum
Internal iliac nodes
Common iliac, aortic, thoracic duct, venous system

Question 16

Lymphatics: where does the superficial perineum drain?

Answer 16

Superficial inguinal nodes

Question 17

Where does the ovarian artery leave the aorta?

Answer 17

At L2

Question 18

What is the Mesosalpinx?

Answer 18

The part of the broad ligament that acts as a mesentery for the uterine tube

Question 19

Where do the deep perineal structures and those within the pelvis drain to?

Answer 19

The pelvic nodes

Question 20

Lymph drainage: rectum?

Answer 20

Sacral and internal iliac

Question 21

Lymph drainage: anal canal?

Answer 21

Internal iliac, but lower canal to superficial inguinal

Question 22

Lymph drainage: bladder?

Answer 22

Internal and external iliac

Question 23

Lymph drainage: Prostate and proximal urethra (male and female)?

Answer 23

Internal iliac

Question 24

Lymph drainage: distal, penile urethra, penis and clitoris

Answer 24

Superficial inguinal

Question 25

Lymph drainage: uterine tube, uterine funds and upper uterine body?

Answer 25

Para-aortic

Question 26

Lymph drainage: lower uterus, cervix and proximal vagina?

Answer 26

Internal and external iliac and sacral

Question 27

Lymph drainage: distal vagina and vulva?

Answer 27

Superficial inguinal