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IKK - Anatomy Exam 2 > Pelvic ANS/Neurovasculature > Flashcards

Pelvic ANS/Neurovasculature Flashcards

1
Q

What are the divisions of the peripheral nervous system?

A

autonomic and somatic

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2
Q

What are the divisions of the autonomic nervous system?

A

sympathetic and parasympathetic

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3
Q

What are the structural divisions of the nervous system?

A

central and peripheral

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4
Q

What are the functional divisions of the nervous system?

A

somatic and visceral

somatic = body
visceral = organ
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5
Q

Where do CNS and PNS derive from?

A

CNS from neural tube

PNS from neural crest cells

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6
Q

Group of neuronal cell bodies in the CNS is called

A

nucleus

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7
Q

Group of neuronal cell bodies in the PNS called

A

Ganglion

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8
Q

Glia cells in CNS are called

A

astrocytes, oligodendroglia, microglia

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9
Q

Glia cells in PNS are called

A

Schwann

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10
Q

Sympathetic nervous system:

where are pre ganglionic cell bodies?

A

Pre-ganglionic cell bodies in lateral horn of thoracolumbar spinal cord (T1-L2)

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11
Q

Sympathetic nervous system

Where are post-ganglionic cell bodies?

A

3 options post-ganglion cell bodies:

  1. sympathetic chain ganglion
  2. collateral ganglion (pre-vertebral ganglion)
  3. chrommafin cells in adrenal gland
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12
Q

Parasympathetic nerouv system. Where are pre-ganglionic cell bodies?

A

CNs nuclei, S2-S4, lateral horns of craniosacral

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13
Q

Parasympathetic nervous system. Where are post-ganglionic cell bodies?

A

4 cranial ganglia

WALLS OF THE ORGANS THEY INNERVATE

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14
Q

What are the 4 collateral ganglia pairs?

A
  1. celiac ganglia
  2. superior mesenteric ganglia
  3. Aorticorenal ganglia
  4. Inferior Mesenteric ganglia
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15
Q

What is the pathway of sympathetic post-synaptic cells if they synapsed in the sympathetic chain?

A

leave sympathetic chain via gray ramus to enter the ventral or dorsal ramus eo serve the body.

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16
Q

If the sympathetic pre-ganglionic synapse does not occur in the sympathetic chain, how does it leave sympathetic chain?

A

pre-synaptic axons leave chain via SPLANCHNIC NERVE

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17
Q

What are the 5 splanchnic nerves coming off of the sympathetic chain?

A
  1. greater splanchnic nerve
  2. lesser splanchnic nerve
  3. least splanchnic nerve
  4. lumbar splanchnic nerve
  5. sacral splanchnic nerve
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18
Q

Describe the greater splanchnic nerve

A

sympathetic presynaptic axons exit sympathetic chain at levels of t5-t9 via greater splanchnic nerve.

They are going to synapse at celiac ganglion.

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19
Q

Describe the lesser splanchnic nerve

A

sympathetic presynaptic axons exit sympathetic chain at levels t10-t11 via lesser splanchnic nerve.

They are going to synapse at superior mesenteric ganglion.

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20
Q

Describe least splanchnic nerve

A

sympathetic presynaptic axons exit sympathetic chain at t12 via least splanchnic nerve.

They are going to synapse at the aorticorenal ganglion

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21
Q

Describe the lumbar splanchnic nerves

A

sympathetic presynaptic axons exit sympathetic chain at L1-L2 via lumbar splanchnic nerves

They are going to synapse at inferior mesenteric ganglion.

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22
Q

___ sacral splanchnics come together with ___ pelvic splanchnics to form the _____.

A

sympathetic sacral splanchnics and parasympathetic pelvic splanchnics come together to form mixed inferior hypogastric plexus

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23
Q

What are the two ways to exit the sympathetic chain ganglion in the sacral region?

A
  1. gray rami communcantes (to ventral ramust)

2. sacral splanchnic nerve to inferior hypogastric plexus

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24
Q

sacral splanchnic nerves contain what kind of axon?

A

sacral splanchnic nerves are going to inferior hypogastric.

pre-ganglionic axons.
BECAUSE THEY WILL SYNAPSE AT THE COLLATERAL GANGLION

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25
Q

gray ramus communicans carry what kind of axon in the sacral region?

A

post-synaptic sympathetic.

Because they descended the chain and synapsed IN THE CHAIN.

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26
Q

Pelvic splanchnics exit ___ to enter inferior hypogastric plexus

A

VENTRAL RAMI at S2 S3 S4

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27
Q

why is hypogastric plexus pre-vertebral?

A

it is in front of the vertebrae.

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28
Q

What portions of the abdomen does the pelvic splanchnics innervate?

A

hindgut (distal 1/3 transverse colon)

through pelvic splanchnics coming off ventral ramus going to inferior hypogastric plexus and ascending

THIS IS PARASYMPATHETIC

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29
Q

external iliac exits pelvis as ___

A

femoral artery

at ilio-inguinal ligament

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30
Q

interna iliac enters ___ and branches into what?

A

enters true pelvis

3 posterior and 7 anterior branches

supplies pelvic organs, gluteal region, perineum

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31
Q

3 posterior branches

A
  1. iliolumbar artery
  2. lateral sacral artery
  3. superior gluteal artery
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32
Q

7 anterior branches

A
  1. inferior gluteal artery
  2. internal pudendal artery
  3. umbilical artery
  4. superior vesical artery
  5. obturator artery
  6. Middle rectal
  7. vaginal artery OR inferior versical artery

and in women - uterine artery

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33
Q

Iliolumbar artery

  • where does it enter?
  • what does it supply?
A

between iliac crest and L5

supplies medial ilium and L5

moves superiorly in cadaver

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34
Q

Lateral sacral

  • where does it enter?
  • what does it supply?
A

enter ventral sacral foramina

supplies sacrum and ventral sacral nerves

often comes off as multiple branches

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35
Q

iliolumbar ultimately branches into ____ and ____

A

ilial branch and lumbar branch

36
Q

Superior gluteal artery

  • where does it enter?
  • what does it supply?
A

between L5 and S1

enters gluteal region superior to piriformis muscle

supplies gluteal muscle with superior gluteal nerve

exits greater sciatic foramen

37
Q

Inferior gluteal artery- where does it enter?

- what does it supply?

A

Between S2 and S3

inferior to piriformis muscle

supplies gluteal muscle with inferior gluteal nerve

38
Q

Both inferior and superior gluteal artery exit pelvis via ____

A

greater sciatic foramen

superior gluteal exits superior to piriformis; inferior gluteal exits inferior to piriformis

39
Q

Internal pudendal

  • where does it enter?
  • what does it supply?
A

runs with pudendal nerve

supplies urogenital triangle and anal triangle

40
Q

Internal pudendal: trace path

A

exits pelvis thru greater sciatic foramen

enters gluteal region inferomedial to piriformis

crosses over sacrospinous ligament

re-enters pelvis thru lesser sciatic foramen

41
Q

What is within the pudendal canal?

A

internal pudendal artery and pudendal nerve

42
Q

What is the pudendal canal formed by?

A

fascia of obturator internus muscle

43
Q

Pudendal canal runs ___ along _____ towards ____

A

runs anteriorly along ischiopubic ramus toward urogenital triangle

44
Q

On a cadaver, how are internal pedundal artery and inferior gluteal artery in relation to each other?

A

internal pedundal artery is mored medial than inferior gluteal artery

45
Q

Umbilical artery

  • What is it’s orientation?
  • What does it terminate into?
A

runs towards anterior abdominal wall

terminates as medial umbilical ligament (under medial umbilical folds)

46
Q

What branches off of umbilical artery?

A

3-4 superior vesical arteries

47
Q

Superior vesical arteries

  • where do they come from
  • what do they supply
A

3-4 branches of superior vesical arteries branch off of umbilical arteries

supply bladder, distal ureter and (males = proximal vas deferens and seminal vesicals)

48
Q

Obturator artery

  • runs through what?
  • What does it supply?
A

runs through obturator canal

supplies medial thigh with obturator nerve

49
Q

What is the corona mortis?

A

Crown of death

anastomose between obturator artery and inferior epigastric vessels

damage opens internal and external iliac systems

causes death in minutes

MAY BE ARTERIAL MAY BE VENOUS MAY BE BOTH

50
Q

Uterine artery anastomoses with ____.

A

ovarian artery

51
Q

Uterine artery supplies what?

A

uterus, cervix, superior vaginal canal

52
Q

What is the orientation of ureter and uterine artery?

A

ureter runs immediately below uterine artery

53
Q

Vaginal artery supplies what?

A

IN FEMALES

supplies inferior vagina and adjacent bladder and rectum

54
Q

Inferior vesical artery supplies what?

A

IN MALES

supplies posterior inferior bladder, ureter, seminal vesicle and prostate

55
Q

Ureter runs above what? (male and female)

A

vaginal artery in females

inferior vesical artery in males

56
Q

Middle Rectal artery

  • supplies what?
  • anastomoses with what?
A

supplies rectum

anastomoses with superior rectal from IMA na dinferior rectal from internal pudendal

57
Q

Inferior rectal is a branch of what?

A

internal pudendal artery

58
Q

Ureter runs between what two arteries?

A

uterine artery and vaginal artery

59
Q

What makes up the pelvic venous plexus?

A

bladder, rectum, prostate in males and vagina/uterus in females

60
Q

Do venous plexueses have valves?

A

No.

Downfall: transortation of tumor cells or venous hypertension

61
Q

What is the somatic innervation of the sacral nerve plexus from?

A

sciatic n, gluteal n, pudendal n

62
Q

Somatix plexus also called ____

A

sacral plexus

63
Q

What are the level of nerves that make up the somatic (sacral) plexus?

A

L4-S4

Levels:
L4-L5
S1
S2-S3
S2-S4
L4-S3
64
Q

Somatic Sacral plexus L4-L5 pathway

A

crosses over sacral ala to join rest of sacral plexus

forms lumbosacral trunk

65
Q

Somatic Sacral plexus S1 pathway

A

emerges above piriformis

66
Q

Somatic Sacral plexus S2/S3 pathway

A

thru body of pifiromis

67
Q

Somatic Sacral plexus S2-S4 pathway

A

contributes to pudendal nerve

68
Q

Somatic Sacral plexus L4-S3 pathway

A

forms sciatic and gluteal nerve (both superior and inferior)

69
Q

Sympathetic fibers of pelvis come from what vertebral levels?

A

come from sympathetic chain T10-L2(3)

or come from sacral splanchnic nns of S2-S4

70
Q

Parasympathetic fibers of pelvis come from what vertebral levels?

A

pelvic splanchnic nerves of S2-S4

71
Q

Superior hypogastric plexus contains mostly ____ fibers.

A

sympathetic fibers.

but also parasympathetic fibers for the hindgut

72
Q

Superior hypogastric plexus birfurcates into ____

A

2 right/left hypogastric nerves

73
Q

Each hypogastric nerve fans out to form _____

A

inferior hypogastric plexus

74
Q

Hypogastric nerve contains mostly _____

A

sympathetic fibers

but also parasympathetic fibers for hindgut

75
Q

Hypogastric nerve diverges and curves in which direction?

A

outward bilaterally to the rectum

76
Q

Inferior hypogastric plexus contains ____ fibers.

A

Sympathetic and parasympathetic

77
Q

Inferior hypogastric is found where?

A

covering pelvis viscera bilaterally

78
Q

What serves as the main autonomic plexus of the pelvis?

A

inferior hypogastric plexus

79
Q

Sympathetic chain moves ___ as it descends in the pelvis and ultimately converges Where?

A

medial

Converges and terminates anterior to coccyx as GANGLION IMPAR

80
Q

Splanchnic nerves innervate what structures? what happens if injured during surgery?

A

lateral rectum and uterus

injured during hysterectonomy, rectal surgery, prostate surgery

result = impaired bladder control/sexual function

81
Q

Lymphatic drainage moves in what direction?

A

superficial to deep and ultimately superiorly

superficial below umbilicus moves inferiorly to inguinal region then deep then superiorly

82
Q

What are the two ducts that drain the lympahtic system?

A

right lymphatic duct

thoracic duct

83
Q

What does the right lymphatic duct drain?

A

Drains right head, neck, right upper limb, right upper thorax

84
Q

What does the thoracic duct drain?

A

lymphatic system

left head and neck
left upper limb
most of thorax
abdomen, pelvis, lower limbs

85
Q

Where are the right lymphatic ducts and thoracic ducts located?

A

thoracic duct at left venous angle

right lymphatic duct at right venous angle

86
Q

How does the lymphatic system fix edema?

A

connection of ECM and venous system

IKK - Anatomy Exam 2 (13 decks)

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