Organs, Vasculature and Innervation of the Pelvis Flashcards

1
Q

When do the common iliac arteries form?

A

When the abdominal aorta bifurcates at L4

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2
Q

When do the common iliac arteries divide? What do they form?

A

L5/S1 common iliac divides to produce external and internal arteries

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3
Q

What do the external iliac arteries form?

A

Femoral artery

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4
Q

What do the internal iliac arteries form?

A

Anterior and posterior branch which supply the pelvic organs, perineum and some of the gluteal region

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5
Q

What is the anagram for remembering branches of the internal iliac artery?

A
I - ileolumbar 
Love - lateral sacral 
Going - gluteal 
Places - internal pudenal 
In - inferior vesical 
My - middle rectal 
Very - vaginal 
Own - obturator 
Underwear - umbilical and uterine
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6
Q

What is the primary blood supply of the perineum?

A

Internal pudenal artery

a branch of the anterior division of internal iliac artery

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7
Q

What are 3 main veins involved in the venous drainage of the perineum?

A

External iliac vein
Internal iliac vein
Common iliac vein

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8
Q

What allows free communication between the portal and systemic venous systems?

A

The rectal venous plexus

It surrounds the rectum

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9
Q

Describe the lymphatic drainage pathway in the pelvis

A
Internal and external iliac vessel nodes
Common iliac nodes 
Lateral aortic and lumbar nodes 
Pre-aortic nodes 
Thoracic duct
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10
Q

Describe the path of the ureters

A

Run from the kidneys to the bladder
Cross over the pelvic brim
Pass anterior to the common iliac artery bifurcation
Turns medially to enter bladder base obliquely and posterosuperiorly

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11
Q

What are the 3 places the ureters can narrow?

A

Between ureters and renal pelvis
When passing over the pelvic brim
At the wall of the bladder

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12
Q

Where is the bladder located when empty? What about full?

A

When empty the bladder is located in the lesser pelvis

When it is full it extends into the abdominal cavity

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13
Q

Which urethra is longer, male or female?

A

Male urethra is longer than female and is divided into 4 parts

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14
Q

How much urine does the bladder contain when empty and when full?

A

When empty - contains 30ml urine

When full - contains 500ml-1L of urine at maximum

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15
Q

What epithelium is in the bladder?

A

Rigid transitional epithelium

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16
Q

Use 3 words to describe the urinary bladder?

A

Hollow, distensible and muscular

17
Q

What is the prostate?

A

An unpaired accessory structure of the male reproductive system that surrounds the urethra in the pelvic cavity

18
Q

What are pouches?

A

Reflections in the peritoneum

19
Q

Where is the male pouch?

A

Between the bladder and rectum (rectovesical pouch)

20
Q

Where are the female pouches?

A

Between bladder and uterus (vesicouterine pouch)

Between the uterus and rectum (pouch of Douglas)

21
Q

What 3 things is the pelvis innervated by?

A

The sacral plexus
The coccygeal spinal nerve plexus
The pelvic autonomic nerves

22
Q

What makes up the sacral plexus?

A

Sacral plexus is formed by the anterior rami of S1 to S4

With contributions from L4-5 (lumbosacral trunk)

23
Q

What forms the coccygeal plexus?

A

Coccygeal plexus formed by the anterior rami of S4-Co

24
Q

What happens to the pelvic autonomic nerves at the bifurcation of the aorta?

A

Changes name to the superior hypogastric plexus

25
Q

What is the sympathetic action of the splanchnic nerves in the pelvis?

A

Renal vasoconstriction to decrease urine
Inhibition of peristalsis in the rectum
Contraction of sphincters and genital organs during orgasm

26
Q

What is the parasympathetic action of the splanchnic nerves in the pelvis?

A
Increase peristalsis 
Detrusor muscle (bladder wall) and rectum contraction
27
Q

What nerve is blocked before vaginal childbirth? Why?

A

Pudendal nerve - innervates the skeletal muscles of the perineum

28
Q

What is significant about a pudendal nerve block?

A

Need to aspirate before injecting local anaesthetic because the pudendal nerve runs alongside the pudendal artery and otherwise the anaesthetic would be administered into the systemic circulation