Pelvic and Perineal Neurology Flashcards
List the main neural contributions to structures in the pelvis from the Lumbar Plexus. (4)
- Ilioingunial N.
- Genitofemoral N.
- Obturator N.
- Lumbosacral Trunk
What are the vertebral segments for the Sacral Plexus?
L4-S4
List the Nerves that are part of the Sacral Plexus. (8)
- Superior Gluteal N.
- Inferior Gluteal N.
- Muscular Branches (Nerve to Quadratus Femoris M., Oturator Internus M. and Piriformis M.)
- Posterior Femoral Cutaneous N.
- Perforating Cutaneous Branches
- Pudendal N.
- Sciatic N.
- Pelvic Splanchnic N.
List the vertebral contributions that are part of the Superior and Inferior Gluteal Ns. and state which muscles they are going to innervate.
They go in 3’s
Superior Gluteal N. - L4-S1 (Gluetus Medius M. and Minimus M.)
Inferior Gluteal N. - L5-S2 (Gluteus Maximus M.)
Relate the vertebral contributions of Nerve to Quadratus Femoris M. and Obturator Internus M. to the Gluteal Ns.
Quadratus Femoris - L4-S1 (Same as Superior Gluteal N.)
Obturator Internus - L5-S2 (Sames as Inferior Gluteal N.)
What are the vertebral contributions to the Nerve to Piriformis M.?
S1-S2
Which Nerves innervate the Superior and Inferior Gemelli Ms.?
Nerve to Obturator Internus M. (Superior Gemellus M.)
Nerve to Quadratus Femoris M. (Inferior Gemellus M.)
What are the vertebral contributions to the Posterior Femoral Cutaneous N.?
S1-S3
What is the branch off of the Posterior Femoral Cutaneous N.? (Different in Male and Female)
Perineal Branch to the Scrotum (Male)
Perineal Branch to the Labia Majora (Female)
List the Branch that comes off of the Ilioinguinal N. (Different in Male and Female)
Anterior Scrotal N. (Male)
Anterior Labial N. (Female)
List the Branches off of the Pudendal N. (5) (Different in Males and Females)
- Inferior Rectal N.
- Dorsal N. of Penis (Male)
- Dorsal N. of Clitoris (Female)
- Deep Perineal N.
- Superficial Perineal N.
Name the terminal branch of the Perineal N. (Different in Males and Females)
Posterior Scrotal N. (Male)
Posterior Labial N. (Female)
Name the vertebral contributions to the Coccygeal Plexus.
S4-S5
What are the two muscular branches that are part of the Coccygeal Plexus?
- Nerve to Levator Ani M. (S4)
2. Nerve to the Coccygeus M. (S4-S5)
What are the vertebral contributions to the Sciatic N.?
L4-S3
Name the two branches of the Sciatic N. and their vertebral contributions.
Tibial N. (L4-S3)
Common Fibular N. (L4-S2)
Abdominal Sympathetic trunk will give rise to presynaptic __________ which will synapse in the _____________ and send postsynaptic fibers to the _____________ . This is considered part of which branch of the Autonomic Nervous System?
Lumbar Splanchnic Ns.
Inferior Mesenteric Ganglion
Superior Hypogastric Plexus
Sympathetic Nervous System
The Sacral Sympathetic Trunk is going to terminate as which structure?
Ganglion Impar
Which nerves supply parasympatheics to structures in the pelvic region?
Pelvic Splanchnic Ns.
Explain the difference between the Rami Communicantes in the Thoracic and upper Lumbar areas when compared to the Sacral area.
Thoracic and upper lumbar are going to have white rami communicantes. This means that a presynaptic fiber can approach the paravertebral ganglion and “choice” its destiny.
There are NO white Rami Communicantes in the sacral region so all of the Rami Communicantes are going to be grey and going out of the Sacral Sympathetic Trunk and into the ventral rami of sacral/coccygeal spinal nerves to proved sympathetics to the lower extremity.
Describe where Sacral Splanchnic Ns. are arising from and where they are going. Which mode of innervation do they carry?
Postsynaptic Sympathetic Fibers from the Sacral Sympathetic Trunk
Feed into Inferior Hypogastric Plexus
Sympathetic Innervation
Where do Pelvic Splanchnic Ns. originate from and where are they going?
Origin: Presynaptic Fibers from the 2nd-4th levels of the Sacral part of the Spinal Cord and they travel in the Anterior Roots of the Cauda Equina.
Destination: Meet with Sympathetic Fibers of the Hyogastric N. (from the Superior Hypogastric Plexus) to form the Inferior Hypogastric Plexus
Differentiate between Superior and Inferior Hypogastric Plexuses in regards to their innervation.
Superior Hypogastric Plexus - Exclusively Sympathetics
Inferior Hypogastric Plexus - Mixed Sympathetics and Parasympathetics
What is the name of the plexus that will run along the Gonadal As? Which form of innervation does it have?
Periarterial Plexus
Mixed Sympathetic and Parasympathetic
What is the mode of innervation for the Inferior Mesenteric Plexus?
ONLY Sympathetic Ns.
Where do Sympathetics and Parasympathetics come from to form the Inferior Hypogastric Plexus?
Sympathetics: Hypogastric N. and Sacral Splanchnic Ns.
Parasympathetics: Pelvic Splanchnic Ns.
List the target muscles for the nerves in the Vesical Plexus.
Detrusor M.
Internal Urethral Sphincter M.
The Uterovaginal Plexus has an interesting pattern. Describe the branching pattern and name the target tissues.
Uterine Plexus - Uterus and Uterine Tubes (Mixed)
Cavernous Ns. - Bulbs of the Vestibule, Clitoris and Vestibular Glands (ONLY Parasympathetics)
The Prostatic Plexus is going to give rise to which nerves? (4) What are their target tissues?
- Cavernous N. (ONLY Parasympathetic) - Eretile Tissue
- Ns. to the Ductus Deferens (Mixed)
- Ns. of the Ejaculatory Ducts (Mixed)
- Ns. of the Seminal Vesicles (Mixed)
It will also innervate the Prostate Gland and much of the male urethra.
