GA - Pelvic and Perineal Neurology

Question 1

What spinal nerves contribute to the sacral plexus?

Answer 1

L4 - S4

Question 2

What nerves contribute to the coccygeal plexus, and what does this plexus innervate?

Answer 2

S5 and C1 (Coccygeal N.)

This nerves innervate the Levator Ani Ms. and the Coccygeus M.

Question 3

Which spinal nerves of the sacral plexus contribute to the Sciatic N.?

Answer 3

L4-S3

S4, while part of the sacral plexus, does NOT contribute to the Sciatic N.

Question 4

What spinal nerves contribute to the Superior Gluteal N.?

Answer 4

The 3 most superior spinal nerves of the sacral plexus contribute to the Superior Gluteal N.

L4, L5, S1

Question 5

What spinal nerves contribute to the Inferior Gluteal N.?

Answer 5

1 step down from the nerves that contribute to the Superior Gluteal N.

L5, S1, S2

Question 6

What spinal Nerves contribute to the Nerve to the Quadratus Femoris M.?

Answer 6

L4, L5, S1

Question 7

What spinal Nerves contribute to the Nerve to the Obturator Internus M.?

Answer 7

L5, S1, S2

Question 8

What spinal nerves contribute to the nerve to the Piriformis M.?

Answer 8

S1 and S2

Question 9

What spinal nerves contribute to the Posterior Femoral Cutaneous N.?

Answer 9

S1, S2, S3

Innervates skin on the posterior thigh

Question 10

What spinal nerves contribute to the Pudendal N.?

Answer 10

S2, S3, S4

S 2, 3, 4 keeps your penis off the floor

Question 11

What nerve is tucked right next to the obturator internus M. and makes a turn at the Greater Sciatic Notch?

Answer 11

Superior Gluteal N.

Question 12

What is the difference between the Obturator N. and the Nerve to the Obturator Internus?

Answer 12

Obturator N. travels through the obturator canal

Nerve to the Obturator goes directly to the Obturator internus M.

Question 13

What is the first branch off the Pudendal N. and what does it innervate?

Answer 13

Inferior Rectal N.

Innervates the anal canal and the external anal sphincter

Question 14

What nerve innervates the external anal sphincter?

Answer 14

Inferior Rectal N.

Question 15

What is the second branch off the Pudendal N. and what does it innervate?

Answer 15

The second branch off the Pudendal N. becomes the Deep and Superficial Perineal Ns.

Deep Perineal N. goes into muscle

Superficial Perineal N. goes into skin (posterior scrotum/posterior labia)

Question 16

From what viewpoint will the Inferior Rectal N. be visible?

Answer 16

From behind, you will see it head toward the external anal sphincter

Question 17

What nerve does the Pudendal N. ultimately become, at what point does this change occur, and what structures does it innervate?

Answer 17

The Pudendanl N. ultimately becomes the Dorsal N. of the Clitoris OR the Dorsal N. of the Penis.

The Pudendal N. becomes the Dorsal N. of the Clitoris/Penis once it reaches the Erectile Tissue

The Dorsal N. of the Clitoris innervates the clitoris, The Dorsal N. of the penis innervates the Penis

Both the Dorsal N. of the Clitoris and Dorsal N. of the Penis also innervate the External Urethral Sphincter M.

Question 18

How does a sympathetic signal travel from the spine to the genitals?

Answer 18

Signal leaves lumbar inferior lateral horn of the spinal cord

Enters the a paravertebral ganglia of the Lumbar Sympathetic Trunk, but does not synapse

Travels through the ganglia into a Lumbar Splanchnic N.

Lumbar Splanchnic N. sends signal to the Inferior Mesenteric Ganglion

Singal leaves the Inferior mesenteric Ganglion and goes to the following Plexuses in order:

• Inferior Mesenteric Plexus
• Superior Hypogastric Plexus
• Inferior Hypogastric Plexus

Question 19

Which part of the autonomic nervous system are the sacral splanchnic nerves part of?

Answer 19

Sacral Splanchnic Nerves are part of the Sympathetic NS

THINK SSSSSSSSSSSSSSSS
SSSacral and SSSSympathetic

Question 20

Which part of the autonomic nervous system are the Pelvic Splanchnic Nerves part of?

Answer 20

Pelvic Splanchnic Nerves are part of the Parasympthetic NS

THINK PPPPPP
PPPPPelvic and PPPPParasympathetic

Question 21

What part of the spinal cord is the Sympathetic Division?

Answer 21

Thoracolumbar (Thoracic and Lumbar)

Question 22

What part of the spinal cord is the Parasympathetic Division?

Answer 22

Craniosacral (Cranial nerves and the sacrum)

Question 23

Where are the presynaptic cell bodies of the Pelvic Splanchnic Nerves?

Answer 23

Sacral part of the Spinal cord (which is NOT in the in sacrum)

Spinal cord ends at L2/L3

They then run with anterior rami of sacral spinal nerves

Question 24

Where do the Pelvic Splachnic Nerves emerge and where do they go?

Answer 24

They break away from the Rami of Sacral Spinal Nerves 2, 3, and 4 after they exit the anterior sacral foraminae

They then enter the Inferior Hypogastric Plexus

Question 25

Where is the Intermesenteric Plexus, and why is it significant?

Answer 25

The intermesenteric plexus is found on the anterior surface of the abdominal aorta between the Superior and Inferior Mesenteric Arteries and Plexuses The gonadal Arteries originate from the region of the abdominal aorta between the Superior and Inferior Mesenteric Arteries The Intermesenteric Plexus sends nerves to follow these arteries to the gonads

Question 26

What division of the autonomic nervous system are the LUMBAR splanchnic nerves part of?

Answer 26

Sympathetic NS

Question 27

What division of the autonomic nervous system is the Inferior Mesenteric Plexus part of?

Answer 27

Sympathetic NS

Question 28

What division of the autonomic nervous system is the Superior Hypogastric Plexus part of?

Answer 28

Sympathetic NS

Question 29

What division of the autonomic nervous system is the Inferior hypogastric Plexus part of?

Answer 29

It is MIXED Has nerves that are part of the Sympathetic NS and the Parasympathetic NS

Question 30

How do sympathetics reach the Superior Hypogastric Plexus?

Answer 30

Sympathetic signals from the Intermesenteric Plexus and the Lumbar Splanchnic Nerves travel through the Inferior Mesenteric Plexus before ultimately arriving at the Superior Hypogastric plexus

Question 31

What division of the autonomic nervous system are the Hypogastric nerves part of and where do they come from?

Answer 31

Hypogastric nerves are paired nerves that come from the Superior Hypogastric Plexus Since the Superior Hypogastric plexus recieves only sympathetic signals, so too do the Hypogastric Nerves

Question 32

How do nerve signals arrive to the Inferior Hypogastric Plexus?

Answer 32

Sympathetics: - Lumbar Splanchnic Nerves and nerves from the Intermesenteric Plexus travel to the Superior Hypogastric Plexus - Superior Hypogastric plexus sends paired Hypogastric nerves to the Inferior Hypogastric Plexus - Sacral Splanchnic Nerves also travel directly to the Inferior Hypogastric Plexus directly from the spine Parasympathetics: - Pelvic Splanchnic Nerves from the Anterior Rami of the 2nd, 3rd, and 4th Sacral Spinal Nerves travel to the Inferior Hypogastric Plexus

Question 33

Where do the nerves to the Ovarian Plexus come from, why, and what division of the autonomic nervous system do these nerves belong to?

Answer 33

Nerves to the ovarian plexus come from the Intermesenteric Plexus, where the Gonadal arteries originate from the abdominal aorta. Nerves from the Intermesenteric Plexus follow the gonadal arteries to the gonads, in this case, the Ovarian Plexus The Ovarian Plexus is a mixed plexus. It receives both sympathetic and parasympathetic nerves from the Intermesenteric Plexus

Question 34

What plexuses receives nerves from the Inferior Hypogastric plexus in women?

Answer 34

The Inferior Hypogastric plexus feeds nerves to the Vesical plexus and the Uterovaginal Plexus

Question 35

What does the Vesical Plexus innervate?

Answer 35

Vesical Plexus provides Sympathetic and Parasympathetic innervation of: - Detrusor M. of the urinary bladder - External Urethral Sphincter M.

Question 36

What does the Uterovaginal Plexus innervate?

Answer 36

Uterovaginal Plexus provides Sympathetic and Parasympathetic innervation to: - Uterus - Vagina ADDITIONALLY The Uterovaginal Plexus provides PARASYMPATHETIC innervation only via Cavernous Ns. to the: - Vestibular Glands - Erectile Tissue (Clitoris, and the two Bulbs of the Vestibule)

Question 37

Where do the nerves to the Testicular Plexus come from, why, and what division of the autonomic nervous system do these nerves belong to?

Answer 37

The Testicular Plexus receives Sympathetic and Parasympathetic nerves from the Intermesenteric Plexus The gonadal arteries originate in the same region off the abdominal aorta Intermesenteric plexus sends nerves that follow the gonadal arteries to the testicular plexus

Question 38

What plexuses receive nerves from the Inferior Hypogastric Plexus in men?

Answer 38

The Inferior Hypogastric Plexus sends sympathetic and parasympathetic nerves to: - Vesical Plexus - Prostatic Plexus

Question 39

What does the Prostatic Gland innervate?

Answer 39

Prostatic Gland sends sympathetic and parasympathetic nerves to: - Prostate Gland - Proximal Urethra - Ductus Deferens - Seminal Vesicles - Ejaculatory Duct ADDITIONALLY Prostatin gland sends PARASYMPATHETIC nerves only, via Cavernous Ns., to the: - Erectile Tissue (Corpus Spongiosum, and the two Corpora Cavernosa)

Question 40

What are the nerves going from sacral sympathetic trunk to the somatic anterior rami of the sacral spinal nerves, and what division of the autonomic nervous system are they part of?

Answer 40

Rami communicants, sympathetic innervation

Question 41

What are the nerves going from the Superior Hypogastric Plexus to the Inferior hypogastric plexus and what division of the autonomic nervous system are they part of?

Answer 41

Hypogastric Nerves, sympathetic innervation

Question 42

What are the nerves going from the Anterior Rami of the Sacral Spinal nerves 2, 3, and 4 to the Inferior Hypogastric Plexus and what division of the autonomic nervous system are they part of?

Answer 42

Pelvic Splanchnic Nerves, Parasympathetic innervation

Question 43

What are the nerves going from the Sacral Sympathetic Trunk to the Inferior Hypogastric Plexus and what division of the autonomic nervous system are they part of?

Answer 43

Sacral Splanchnic Nerves, Sympathetic Innervation