Lab 11 Peritoneum Flashcards
The internal iliac divides into an ___ and ___ division.
ant. and pos.
Anterior iliac mainly distributes to the ____ while the posterior division distributes to the _____.
ant. - pelvic visera and gluteal region
pos. - pelvic wall and gluteal region
What are the branches of the anterior divison of the internal iliac artery? (6 in both, 7 in males, 8 in females)
-umbilical artery, superior vesical artery, obturator artery, inferior vesical artery, uterine artery, vaginal artery, middle rectal artery, internal pudendal artery, inferior gluteal artery
What is the most superior and anterior branch of the anterior division of the internal iliac artery? It crosses horizontally toward the anterior abdominal wall where it forms what?
umbilical artery
obliterated to form the medial umbilical ligament
What forms numerous branches from the umbilical artery that pass toward the superior surface of the urinary bladder?
superior vesical artery
What is found inferior to the umbilical artery and parallels the nerve of the same name passing toward the inferior surface of the superior pubic ramus?
obturator artery and obturator nerve
What courses toward the fundus/posterior/base of the bladder to supply the bladder, seminal vesicles and prostate?
inferior vesicle artery
This courses along the inferior attachment of the broad ligament, passes superior to the ureter, can be traced to the lateral aspect of the uterus..
uterine artery- usually branches into a larger superior branch to the body/fundus and a smaller inferior branch to the cervix and vagina
This courses along the pelvic floor, passes inferior to the ureter, and supplies the vagina and urinary bladder.
vaginal artery
the ureter is between the uterine and vaginal arteries
This is found intermingling with the inferior vesical artery and its branches.
middle rectal artery
This exits the pelvis by passing through the greater sciatic foramen inferior to the piriformis muscle.
internal pudendal artery
What passes between the s2/s3 ventral rami to exit the pelvis through the greater sciatic foramen inferior to the piriformis muscle?
inferior gluteal artery
What are the branches of the posterior division of the internal iliac artery? (3)
iliolumbar artery, lateral sacral artery, superior gluteal artery
What passes posterior to ascend between the lumbosacral trunk and the obturator nerve?
iliolumbar artery
What gives superior and inferior branches , whith the infeiror passing along the sacral ventral rami?
lateral sacral artery
What exits the pelvic cavity by passing between the lumbosacral trunk and S1 ventral ramus?
superior gluteal artery
What is found just inferior to the pubic symphysis in males?
deep dorsal vein of the penis
What 3 veins drain into the internal iliac vein?
prostatic, vesical, and rectal
Somatic: the ___ and ____ plexuses are located between the pelvic viscera and the posterolateral pelvic wall within the ____ fascia. Formed by contributions of the ventral rami of ___ to ___ spinal nerves.
sacral and coccygeal plexuses
endopelvic fascia
L4-S4 spinal nerves
Visceral- the _____ plexus (aka pelvic plexus) is formed by contributions from the ___ nerves, _____ nerves (sympathetic), and ____ nerves (parasympathetic).
inferior hypogastric plexus
-hypogastric nerves, sacral splanchnic nerves, and pelvic splanchnic nerves
The sacral plexus of nerves passes between segments of what muscle?
piriformis
What are the nerves of the sacral plexus?
lumbosacral trunk, sciatic nerve, ventral ramus of S1 S2 and S3, and pudendal nerve
The lumbosacral trunk (L4-S3) crosses __ to the sacral ala to join the sacral plexus after crossing the ____ gluteal artery.
anterior
superior gluteal artery
The sciatic nerve (L4-S3) is continuous with the ___ and its convergence with ___ to ___ rami. It exits the pelvis through the _____ inferior to piriformis.
lumbosacral trunk
S1-S3 rami
greater sciatic foramen
What emerges from its anterior sacral foramen above the piriformis and below the lumbosacral trunk and superior gluteal artery?
ventral ramus of S1
S2 is down from S1, S3 is down from S2
The pudendal nerves (S2-S4) exits the pelvis through the _____ inferior to the piriformis.
greater sciatic foramen
_____ nerves (S2-S4, parasym.) pass horizontally between the s2-s4 ventral rami to the ____ plexus in the endopelvic fascia around the pelvic organs.
pelvic splanchnic nerves
inferior hypogastric plexus
What is continuous with the lumbar section, on the anterior of the sacrum, medial to the ventral sacral foramina?
sacral sympathetic trunk with ganglia
What connects the sympathetic ganglia to the sacral anterior rami?
gray rami communicantes
What connects 2 or 3 of the sympathetic ganglia to the inferior hypogastric plexus?
sacral splanchnic nerves
What 3 muscles form the levator ani?
puborectalis, pubococcygeus, and iliococcygeus
From the body of the pubis, this is the most medial with fibers that wrap around the rectum posteriorly
puborectalis
From the body of the pubis, this is more lateral and wider than puborectalis, it attaches to anococcygeal ligament
pubococcygeus
From the tendinous arch to the anococcygeal ligament and coccyx, most lateral and widest of the 3 levator ani muscles.
iliococcygeus
This is the most posterior pelvic diaphragm muscle, attaching between the ischial spine and the coccyx/lower sacrum. Found inferior to the piriformis muscle.
coccygeus
Superior to the tendinous arch, through the fascia, this forms the lateral wall of the pelvic cavity. Inferior to the tendinous arch, this forms the lateral wall of the perineum.
obturator internus
