Pelvic nerves and vessels Flashcards
What works with the lumbar plexus to supply innervation to the lower limbs?
Sacral plexus
What nerve roots form the sacral plexus
L4, L5, S1, S2, S3, S4
What is the largest nerve from the sacral plexus?
Sciatic nerve
What are the nerve root values of the sciatic nerve?
L4-S3
What nerve carries nerve fibres from the lumbosacral trunk into the pelvis?
Sciatic nerve
Where does the sciatic nerve form?
The anterior surface of piriformus muscle on the lateral internal wall of the pelvis
How does the sciatic nerve reach the pelvis?
Passes out the pelvis via the greater sciatic notch
What side of the thigh does the sciatic nerve travel down?
Posterior surface of thigh
What nerve supplies the posterior compartment of the thigh and the hamstring muscles?
Sciatic nerve
What nerve supplies all the muscles of the leg and foot?
Sciatic nerve
What nerve supplies the gluteal muscles?
Gluteal nerve
Name the two branches of the gluteal nerve
- Inferior branch
- Superior branch
What are the nerve roots for the superior gluteal nerve and what do they innervate?
- L4, L5, S1
- Gluteus medius and minimus
What are the nerve roots of the inferior gluteal nerve and what does it innervate?
- L5, S1, S2
- Gluteus maximus
The nerve to obturator internus is a direct branch of what nerve roots?
L5-S1
Levator ani and coccygeal muscles both receive direct fibres from what nerve roots?
S4
What nerve supplies the external voluntary sphincters of the urethra and the anal canal?
Pudendal nerve
What nerve carries sensory fibres to the perineum?
Pudendal nerve
Describe the path take by the pudendal nerve
- Forms from nerve roots S2-S4 in pelvis
- Passes through the greater sciatic foramen around the ischial spine
- Passes through the lesser sciatic foramen to reach anal triangle, then perineum
What can be used as a landmark for pudendal nerve blocks?
Ischial spine
What type of nerves supply the internal organs of the pelvis and the erectile tissues of the perineum?
Autonomic nerves
What type of nerve fibres does the superior hypogastric plexus have?
Sympathetic
Where does the superior hypogastric plexus sit?
The bifurcation of the aorta into the iliac iliac arteries
What type of nerve fibres does the inferior hypogastric plexus have?
Sympathetic and parasympathetic
Where does the inferior hypogastric plexus sit?
On the internal lateral wall of the pelvis
Sympathetic supply to the pelvic organs is from?
Lumbar and pelvic splanchnic nerves from the sympathetic chain
What nerves supply parasympathetic innervation to the pelvis?
Pelvic splanchnic nerves S2-S4
What nervous system involves fight or flight?
Sympathetic
What nervous system involves rest and digest?
Parasympathetic
Give some examples of sympathetic responses from the pelvis?
- Decreased movement of rectum
- Internal anal and urethra sphincters are contracted
- Bladder detruser relaxes
- Ductus deferens and seminal vesicle contract
Give some examples of parasympathetic responses from the pelvis?
- Increased mobility of the rectum
- Relaxation of the internal anal sphincter
- Contraction of the detruser muscle
- No effect on the seminal vesicles, ductus deferens or uterus
What vertebral levels supply the perineum?
Sacral
How does sensory innervation reach the anterior skin of the pelvis?
Via ilioinguinal, pudendal and genitofemoral nerves
What nerve gives sensory innervation to the genitalia?
Pudendal nerve
What large vessel does the main arterial supply of the pelvis come from?
Internal iliac artery
What two branches does the aorta divide into? and at what level?
The common iliac arteries at L4
What does each common iliac artery further divide into?
Internal and external iliac branches
What branch of the common iliac artery supplies the lower limb?
External iliac
What branch of the common iliac artery supplies the pelvis?
Internal iliac
The internal iliac artery divides into what branches?
Anterior and posterior division of the internal iliac artery
What are the 9 branches of the anterior division of the internal iliac artery?
- Umbillical artery
- Superior vesicle arteries
- Obturator artery
- Inferior vesicle artery
- Middle rectal artery
- Inferior gluteal artery
- Internal pudendal artery
- Vaginal artery
- Uterine artery
What arteries supply the bladder?
Superior vesicle arteries
What artery passes through the obturator foramen and into the medial compartment of the thigh?
Obturator artery
What artery in males is replaced by the vaginal artery in females?
Inferior vesicle artery
What artery supplies the rectum in both sexes and the prostate in males?
Middle rectal artery
What artery passes through the greater sciatic notch to supply the gluteal region?
Inferior gluteal artery
Blood supply to the internal male reproductive organs and tissues of the perineum are from which local artery?
The internal iliac artery
Blood supply to the testes comes from where?
Directly from the abdominal aorta
Blood supply to the ovaries come from where?
Directly from the abdominal aorta
What are the 3 branches of the posterior division of the internal iliac artery?
- Iliolumbar artery
- Lateral sacral artery
- Superior gluteal artery
Whatdoes the superior gluteal atery supply?
Parts of the gluteal region
