Anatomy Part 2 Flashcards
Bones of the pelvis
Ilium
Ischium
Pubis
Name x3 coccygeus muscles from ant to post + 1 other
Pubococcygeus - levator ani
Ileococcygeus - levator ani
Ischiococcygeus
Piriformis
Median and medial umbilical ligaments: position and remnant of?
Median in the middle, remnant of urachus
Medial is Lateral, occluded umbiLical artery
3 muscles of anterior urogenital triangle (superficial)
Ischiocavernosus
Bulbospongiosus
Superficial Transverse perineal
3 muscles of deep perineal space
Compressor urethrae
Sphincter urethrovaginalis
(These 2 combined = external urethral sphincter)
Deep transverse perineal space
3 Posterior branches of internal iliac
Ileolumbar artery
Lateral sacral artery
Superior gluteal artery
3 anterior branches of internal iliac related to the bladder
Umbilical artery
Superior vesicle artery
Inferior vesicle artery
3 anterior branches of internal iliac related to the visceral structures
Uterine artery
Vaginal artery
Middle rectal artery
3 anterior branches of internal iliac related to the body wall
Obturator artery
Inferior gluteal artery
Internal pudendal artery ->
gives inferior rectal branch
Internal pudendal artery 2 key branches
1 further sub branch
Internal pudendal artery
- inferior rectal branch
- Perineal branch -> labial branch
Innervation of perineum
4 key nerves
3 sub branches of the first nerve
Perineal nerve
- inferior rectal branch
- labial branch
- clitoral branch
Pudendal nerve (s234)
Ilioinguinal nerve
Genital branch of genitofemoral nerve
Aponeuroses above the arcuate line
Relative to rectus abdominis
External oblique - anterior
Internal oblique - anterior and posterior
Transversus abdominis - posterior
Aponeuroses below the arcuate line
Relative to rectus abdominis
External oblique, internal oblique and transversus all pass anterior to rectus abdominis
Origin of external oblique
Digitisations of lower 8 ribs
From higher up goes down
Origins of internus oblique
Thoraco-lumbar fascia
Lateral inguinal ligament
Medial half iliac crest
From bottom goes up
Inner stain of anterior abdominal wall
Ext oblique
Int oblique / transversus
Obstetric surgery area of innervation
Ext oblique - T7 - T12
Int oblique / transversus - T7 - T12 + L1
Obstetric surgery area of innervation - T11, T12, L1
Vasculature of abdo wall
X2 key vessels
External iliac -> *inferior epigastric artery
Internal thoracic artery -> *superior epigastric artery
Posterior abdo wall
3 key muscles
Psoas major
Erector spinae
Quadratus lumborum
Lymph drainage of ovarian and Fallopian tube
Para aortic
Lymph drainage of fundus of uterus
Para aortic / lumbar / superficial inguinal
Lymph drainage of body of uterus
Internal iliac
Lymph drainage of cervix
External iliac
Lymph drainage of upper vagina
Internal and external iliac
Lymph drainage of lower vagina
Inguinal
Lymph drainage of bladder
External, internal and common iliac lymph nodes
Inguinal canal borders
Posterior: conjoint tendon, transversalis fascia
Superior: internal oblique, transversus abdominis
Anterior: external oblique Aponeuroses, internal oblique muscle
Floor: inguinal ligament
Femoral triangle contents
NAV(node) Y fronts
Fermoral nerve,
Femoral Artery
Femoral Vein
Deep inguinal nodes
Femoral triangle boundaries
SAiL
Lateral medial superior:
Sartorius
Adductor Longus
Inguinal ligament
Femoral RING boundaries
NAV(ring) Y fronts
Lateral: vein
Posterior: pectineus, pectineal ligament, Astley cooper ligament
Medial: lacunar ligament
Anterior: inguinal ligament
What is inside the femoral RING or CANAL
Fat
Cloquet’s node
What is inside femoral SHEATH
Artery
Vein
Canal/ring
Lumbar Plexus
T12 - L4
(5 nerve roots)
Come in pairs of roots or less
T12, L1 Iliohypograstric nerve
L1 Ilioinguinal nerve
L1, L2 Genitofemoral nerve
L2, L3 Lateral femoral cutaneous nerve
L2, L4 Femoral nerve
L2, L4 Obturator nerve
Sacral Plexus
L4 - S4
(6 nerve roots)
Come in triplets of roots or more
L4, L5, S1 Superior gluteal nerve
L5, S1, S2 Inferior gluteal nerve
L4, L5, S1, S2, S3 Sciatic nerve
S1, S2, S3 Posterior femoral cutaneous
S2, S3, S4 Pudendal nerve
Path of ureters
Infero-medically along psoas
Posterior pelvic brim
Anterior to bifurcation of common iliac vessels
Crossed by the uterine arteries
Pierce the cardinal and broad ligament
Boundaries of ovarian fossa
Superior - external iliac vessel
Posterior - internal iliac vessels and ureters
Floor - Obturator nerv
Anterior - obliterated umbilical artery
Boundaries of greater sciatic foramen
Superior - sacroiliac ligament
Medial - sacrotuberous ligament
Inferior - sacrospinous ligament
Lateral - greater sciatic notch
Boundaries of lesser sciatic foramen
Anterior (/inferior) - ischial tuberosity
Lateral - lesser sciatic notch
Superior - sacrospinous ligament
POSTERIOmedial - sacrotuberous ligament
Contents of greater sciatic foramen
1 muscle, 3 vessels
Piriformis
Superior gluteal A&V
Inferior gluteal A&V
Internal Pudendal A&V
Contents of greater sciatic foramen
7 Nerves
Sciatic
—> (superior gluteal, inferior gluteal, pudendal)
Posterior femoral cutaneous nerve
Nerve to quadratus femoris
Nerve to obturator internus
Contents of lesser sciatic foramen
Internal pudendal artery and vein
Pudendal nerve (re entering)
Nerve to obturator internus
Obturator internus tendon
Where does the ovarian vein return to on the right and left respectively?
Right –> inferior vena cava
Left –> left renal vein
What arteries supply the:
foregut
midgut (ascending colon to proximal 2/3 transverse colon)
hindgut
foregut - coeliac artery
midgut - superior mesenteric artery
hindgut - inferior mesenteric artery
Branches of coeliac trunk
Left gastric artery
Splenic artery
Common hepatic artery (on the right)
Branches of SMA - superior mesenteric artery
middle colic
right colic
ileocolic
Branches of IMA - inferior mesenteric artery
left colic
sigmoid branches
superior rectal artery
Rectum lower 1/3
Anal canal
Rectum lower 1/3 - internal iliac (middle rectal)
Anal canal - Internal pudendal (inferior rectal) artery)
Generally veins follow arteries in GI system except 2 key exceptions
mid/hind gut –> hepatic portal vein
inferior mesenteric vein –> splenic vein
Which nerve plexus carries mixed autonomic signals to pelvis
Inferior hypogastric plexus
Which nerve plexus / nerve carries sympathetic autonomic signals to pelvis
thoracolumbar splanchnic nerves –> superior hypogastric plexus
Sacral splanchnic nerve
Which nerve plexus / nerve carries parasympathetic autonomic signals to pelvis
Pelvic splanchnic nerves
