Nerves of the female pelvis Flashcards
What does the obturator nerve supply?
Sensory medial aspect of the thigh + motor innervation to pectineus and adductor muscles
Where does the obturator nerve arise from?
L2, L3, L4
Where does the sacral plexus arise from?
S1, S2, S3
Where does the pudendal nerve arise from?
S2 to S4
What does the pudendal nerve supply?
Motor and sensory function of the perineum
How does the pudendal nerve enter the perineum?
It exits the pelvis via the greater sciatic foramen
Where does the perineal nerve arise from?
The pudendal nerve
Where do the lumbar splanchnic nerves arise from?
Lumbar ganglia of the sympathetic trunk at the level L1 and 2
Where do the hypogastric nerves arise from?
The superior hypogastric plexus, which arise from the lumbar splanchnic nerves at L1 and L2
What forms the inferior hypogastric plexus?
The sympathetic supply comes from right and left hypogastric nerves arising from the superior hypogastric plexus, the parasympathetic supply comes the pelvic splanchnic nerves
Where does the middle rectal plexus arise form?
The inferior hypogastric plexus
Where does the uterovaginal plexus arise from?
The inferior hypogastric plexus
Which nerves supply the ovary and fallopian tubes?
The uterovaginal plexus
Where does the vesical plexus arise from?
The inferior hypogastric plexus
What are the branches of the inferior hypogastric plexus?
Uterovaginal, vesicle, middle rectal plexuses
Where do the pelvic splanchnic nerves arise from?
parasympathetic fibres from ventral rami S2-4
Where does the ilioinguinal nerve arise from?
L1 of the lumbar plexus
What does the ilioinguinal nerve supply
Transverse abdominus and internal oblique muscles as well as sensory supply to upper medial thigh, base of penis and top of scrotum and mons pubis and labia majora
Where does the iliohypogastric nerve arise from?
L1 of the lumbar plexus (first branch)
What does the iliohypogastric nerve supply?
Sensation - lateral gluteal region
Motor - transversus abdominus and internal oblique
Where does the genitofemoral nerve arise from?
L1 and 2 of the Lumbar plexus
What does the genitofemoral nerve supply?
Genital branch =The cremaster muscle
Sensation of scrotum, mons pubis and labia majora
Femoral branch = anterior thigh sensation
Where does the lateral femoral cutaneous nerve arise from and what does it supply?
L2 and L3 of lumbar plexus and supplies sensation to lateral thigh
Where does the obturator nerve arise from?
L2, L3, L4 of the lumbar plexus
Where does the femoral nerve arise from?
L2, L3, L4 of the lumbar plexus
What are the branches of the lumbar plexus?
Ilioinguinal and ilihypogastric (L1)
Genitofemoral (L1&2), Lateral cutaneous of the thigh (L2&L3), obturator and femoral (L2,3,4)
Which nerves supply the skin of the perineum?
Anococygeal and pudendal
Which nerves supply labia majora sensation?
Pudendal (via perineal nerve) to posterior labial nerves
Ilioinguinal nerve supplies anterior labial nerves
Genital branch of the genitofemoral nerve also supplies anterior labia
What nerve injury can lithotomy cause?
common peroneal nerve - compression at fibula head
What are the features of a common peroneal nerve injury?
Loss of anterior compartment extensor = foot drop
Loss of sensation to foot and antero-lateral leg
How would the obturator nerve be injured in labour?
Compression of fetal head against boney pelvis
What are the features of an obturator nerve injury?
Upper medial thigh sensation loss
Weakness of hip adductors
What are the features of a femoral nerve injury?
Absent knee reflex
Loss of sensation to anterior thigh and knee
Weak knee flexion
Which nerves control bladder neck closure and detrusor contraction?
Sympathetic (STORAGE) - L1 and L2
Which nerves control detrusor relaxation and bladder neck opening?
Parasympathetic (PEEING) - S2, 3 and 4
