GA - Pelvic and Perineal Neurology Flashcards

1
Q

What spinal nerves contribute to the sacral plexus?

A

L4 - S4

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2
Q

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

A

S5 and C1 (Coccygeal N.)

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

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3
Q

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

A

L4-S3

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

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4
Q

What spinal nerves contribute to the Superior Gluteal N.?

A

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

L4, L5, S1

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5
Q

What spinal nerves contribute to the Inferior Gluteal N.?

A

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

L5, S1, S2

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6
Q

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

A

L4, L5, S1

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7
Q

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

A

L5, S1, S2

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8
Q

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

A

S1 and S2

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9
Q

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

A

S1, S2, S3

Innervates skin on the posterior thigh

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10
Q

What spinal nerves contribute to the Pudendal N.?

A

S2, S3, S4

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

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11
Q

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

A

Superior Gluteal N.

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12
Q

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

A

Obturator N. travels through the obturator canal

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

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13
Q

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

A

Inferior Rectal N.

Innervates the anal canal and the external anal sphincter

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14
Q

What nerve innervates the external anal sphincter?

A

Inferior Rectal N.

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15
Q

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

A

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)

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16
Q

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

A

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

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17
Q

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

A

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.

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18
Q

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

A

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
19
Q

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

A

Sacral Splanchnic Nerves are part of the Sympathetic NS

THINK SSSSSSSSSSSSSSSS
SSSacral and SSSSympathetic

20
Q

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

A

Pelvic Splanchnic Nerves are part of the Parasympthetic NS

THINK PPPPPP
PPPPPelvic and PPPPParasympathetic

21
Q

What part of the spinal cord is the Sympathetic Division?

A

Thoracolumbar (Thoracic and Lumbar)

22
Q

What part of the spinal cord is the Parasympathetic Division?

A

Craniosacral (Cranial nerves and the sacrum)

23
Q

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

A

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

24
Q

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

A

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

25
Q

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

A

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

26
Q

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

A

Sympathetic NS

27
Q

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

A

Sympathetic NS

28
Q

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

A

Sympathetic NS

29
Q

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

A

It is MIXED

Has nerves that are part of the Sympathetic NS and the Parasympathetic NS

30
Q

How do sympathetics reach the Superior Hypogastric Plexus?

A

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

31
Q

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

A

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

32
Q

How do nerve signals arrive to the Inferior Hypogastric Plexus?

A

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

33
Q

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

A

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

34
Q

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

A

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

35
Q

What does the Vesical Plexus innervate?

A

Vesical Plexus provides Sympathetic and Parasympathetic innervation of:

  • Detrusor M. of the urinary bladder
  • External Urethral Sphincter M.
36
Q

What does the Uterovaginal Plexus innervate?

A

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)
37
Q

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

A

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

38
Q

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

A

The Inferior Hypogastric Plexus sends sympathetic and parasympathetic nerves to:

  • Vesical Plexus
  • Prostatic Plexus
39
Q

What does the Prostatic Gland innervate?

A

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)
40
Q

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?

A

Rami communicants, sympathetic innervation

41
Q

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?

A

Hypogastric Nerves, sympathetic innervation

42
Q

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?

A

Pelvic Splanchnic Nerves, Parasympathetic innervation

43
Q

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?

A

Sacral Splanchnic Nerves, Sympathetic Innervation