Pelvic Nerves and Vessels Flashcards
What does the common iliac artery divide into?
Internal and external branches
What vessel is highlighted?
The posterior division of the internal iliac artery
What vessels are highlighted?
The common iliac veins
What area does the inferior vesical artery supply?
Urinary bladder, ureter, seminal vesicle, prostate
At which vertebral level does the aorta bifurcate into common iliac arteries?
L4
What are the roots of the pudendal nerve?
S2, S3, S4
What area does the middle rectal artery supply?
Rectum, seminal vesicle and prostate
What type of nerve fibres are found in the inferior hypogastric plexus?
Sympathetic and Parasympathetic
What are the roots of the lumbosacral plexus?
L4 and L5
S1-S4
What are the nerve roots of the nerve to piriformis?
S1-S2
What area does the inferior gluteal nerve supply?
Levator ani, coccygeus, piriformis and gluteal region
What nerves innervate the gluteal muscles?
Superior gluteal - gluteus medius and minimus
Inferior gluteal - gluteus maximus
What is the innervation of Levator Ani?
Some direct fibres of S4 and the pudendal nerve
What are the nerve roots of nerve to the obturator internus?
L5-S1
What area does the uterine artery supply?
Ureter, uterus and vagina
What artery supplies blood to the pelvis?
The internal iliac arteries
Describe the path taken by the sciatic nerve from pelvis to leg
The sciatic nerve forms on the anterior surface of the piriformis muscle on the lateral internal wall of the pelvis
Passes out of the pelvis through the greater sciatic notch to reach the gluteal region
Passes down the posterior surface of the thigh
Where does the superior hypogastric plexus sit?
At the bifurcation of the aorta into the common iliac arteries
What is the root value of the sciatic nerve?
L4, L5, S1, S2, S3
L4-S3
What bony landmark is used as a reference point during a pudendal nerve block?
The ischial spine
What is the equivilent of the inferior vesical artery in females?
Replaced by vaginal or uterine branches that also supply the bladder
What are the branches of the posterior division of the internal iliac?
PILS
- iliolumbar artery
- lateral sacral artery
- superior gluteal artery
What are the branches of the anterior division of the internal iliac?
SOI VU MR PIG
- Superior vesicle (a branch of the umbilical)
- Obturator
- Inferior vesical (males) / vaginal (females)
- Uterine
- Middle rectal
- Inferior gluteal artery
What artery is highlighted?
The external iliac artery
Where do the inferior hypogastric plexuses sit?
Sits on the internal lateral wall of the pelvis (one on each side)
What vessel is highlighted?
Internal iliac artery
What area does the lateral sacral artery supply?
Vertebral canal and piriformis
What area does the superior gluteal artery supply?
Levator ani, piriformis and gluteal region
What are the nerve roots of the gluteal nerves?
Superior gluteal - L4, L5, S1
Inferior gluteal - L5, S1, S2
What vessel is highlighted?
The anterior division of the internal iliac artery
What vessel is highlighted in green?
The common iliac artery
What type of nerve fibres are found in the inferior hypogastric plexus?
Sympathetic and Parasympathetic
What does the pudendal nerve supply?
Levator Ani
External anal and External urethral sphincters
Bulbospongiosus
Ischiocavernosus
True or False?
The superior hypogastric plexus contains both sympathetic and parasympathetic nerve fibres
False - contains just sympathetic fibres
What area does the obturator artery supply?
Pelvic muscles, head of femur, ilium
True or False?
The ovarian artery is a branch of the anterior division of the internal iliac
False
The ovarian artery is a direct branch of the abdominal aorta at level L2
What area does the internal pudendal artery supply?
Perineum and anal canal
What is the largest nerve of the sacral plexus?
Sciatic nerve
Describe the path of the pudendal nerve to reach the perineum
It forms from nerve roots S2, S4 in the pelvis close to the pelvic floor
Passes through the greater sciatic foramen, around the ischial spine then through the lesser sciatic foramen where it then reaches the anal triangle and perineum
What area does the iliolumbar artery supply?
Cauda equina, iliacus, psoas, quadratus lumborum
What area does the vaginal artery supply?
Vagina and bladder
What nerve roots supply the coccygeus muscle of the pelvic floor?
Direct fibres from S4, S5
What area does the superior vesical artery supply?
Superior aspect of bladder and in males gives off a branch to supply the ductus deferens
What regions does the sciatic nerve supply?
Posterior compartment of the thigh, and branches supply all of the muscles of the leg and foot
