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LECOM MS1 Gross Anatomy Exam 2 > Pelvic Nerves, ANS, Lymphatics > Flashcards

Pelvic Nerves, ANS, Lymphatics Flashcards

1
Q

What spinal levels are found in the lumbosacral trunk

A

L4-L5

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2
Q

What is the sacral plexus

A

Lumbosacral trunk and ventral rami S1-S4

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3
Q

What are the levels of the sacral plexus

A

L4-S4

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4
Q

Where is the sacral plexus located

A

anterior to piriformis, exits the sacral foramina

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5
Q

What spinal levels are seen in the obturator nerve

A

L2-L4

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6
Q

What are the nerves of the sacral plexus

A 
pudendal
nerve to levator ani, coccygeus, and external anal sphincter
nerve to piriformis
sciatic
superior gluteal
inferior gluteal
pelvic spanchnics
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7
Q

What spinal level is Pudendal nerve

A

S2-S4

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8
Q

What spinal level is nerve to levator ani, coccygeus, and external anal sphincter

A

S4

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9
Q

What spinal level is nerve to piriformis

A

S2

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10
Q

What spinal level is sciatic enrve

A

L4-S3

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11
Q

What is the spinal level for superior gluteal

A

L4-S1

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12
Q

What is the spinal level for inferior gluteal

A

L5-S2

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13
Q

What is the spinal level for splanchnic nerves

A

S2-S4

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14
Q

What is the course of the pudendal nerve

A

exits GSF and enters perineum through LSF

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15
Q

Where does the pudendal nerve travel

A

in pudendal canal

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16
Q

What are the branches of the pudendal nerve in males

A

Perineal
dorsal nerve of penis
inferior rectal

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17
Q

What are the branches of the pudendal nerve in females

A

perineal
dorsal nerve of clitoris
inferior rectal

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18
Q

What are the branches of the perineal nerve

A

superficial and deep

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19
Q

Where does the perineal nerve divide

A

UGD

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20
Q

What does the deep perineal nerve innervate

A

mainly muscles: transverse perinei, bulbospongiosus, ischiocavernosus

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21
Q

What does the superficial perineal nerve supply

A

scrotal skin and labia majora

posterior scrotal nerves

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22
Q

What is the course of the dorsal nerve of the penis

A

runs a long ischial and pubic rami within deep perineal space

branch to corpus cavernosum, pierces perineal membrane

runs between corpus cavernosa and pubic symphysis onto dorsum of penis (clitoris)

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23
Q

What skeletal muscle is supplied by the dorsal nerve of the penis (clitoris)

A

none

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24
Q

What anatomical landmarks can be used for a pudendal nerve block

A

ischial spine

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25
Q

Why is the ischial spine used as a landmark for pudendal nerve block

A

pudendal nerve runs over ischial spine

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26
Q

Where will parasympathetics and sympathetics distribute

A

sympathetics: superficial and deep
parasympathethetics: only deep

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27
Q

What is the ganglion impar

A

swelling over the coccyx where the two sympathetic trunks unite

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28
Q

Where is the superior hypogastric plexus found

A

around the branch of the aorta

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29
Q

What is contained within white and gray rami and what levels will they be seen at

A

white rami: preganglionic
gray rami: pre/post ganglionic

white: T12-L2
Gray: all levels

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30
Q

Where will lumbar and sacral splanchinc nerve cell bodies be found

A

IML L1-L2

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31
Q

Where will the postganglionic cell bodies of lumbar and sacral splanchnic nerves be found

A

hypogastric plexus

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32
Q

Where do lumbar splanchnic nerves originate from

A

from chain at lumbar levels

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33
Q

Where do sacral splanchnic enrves originate from

A

chain at sacral levels

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34
Q

Where are preganglionic cell bodies of pelvic splanchnic nerves found

A

IML-like area of S2-S4

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35
Q

What are the two places in which sacral splanchnics may travel after leaving the sympathetic chain

A

hypogastric nerve

hypogastric plexus

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36
Q

What is stimulated by sympathetics from the hypogastric plexus

A

contraction of smooth muscle to move fluid and blood through structures

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37
Q

What is stimulated by parasympathetics from the hypogastric plexus

A

vasodilation
bladder contraction
erection
digestion

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38
Q

How is the inferior hypogastric plexus named

A

the viscera it is surrounding

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39
Q

What are the names of the inferior hypogastric plexus

A

middle rectal
vesical
prostatic
uterovaginal

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40
Q

What is the sympathetic innervation of the upper ureter

A

T10-L1

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41
Q

What is the sympathetic innervation of the lower ureter

A

L1-L2

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42
Q

What is the sympathetic innervation of the gonad

A

T10-T11

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43
Q

What is the sympathetic innervation of the bladder

A

L1-L2

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44
Q

What is the sympathetic innervation of the prostate

A

L1-L2

45
Q

What is the sympathetic innervation of the uterus

A

L1-L2

46
Q

What is the sympathetic innervation of the uterine tube

A

L1-L2

47
Q

What are cavernous nerves

A

nerves that are extensions from prostatic plexus

48
Q

Where do cavernous nerves pass

A

between arcuate ligament and perineal membrane to innervate erectile tissue

49
Q

What stimulates stretch receptors involved in defecation

A

increased pressure in rectal ampulla

50
Q

What aspects of defecation are under parasympathetic control

A

internal anal sphincter relaxation

contraction of circular muscle fibers

51
Q

What aspects of defecation are under voluntary control

A

relaxation of puborectal sling
increase in intra-abdominal pressure
relaxation of external anal sphinctor
contraction of levator ani

52
Q

What affect do parasympathetics have on micturition

A

excite detrusor muscle

inhibit internal sphincter

53
Q

What affect do sympathetics have on micturition

A

inhibit detrusor muscle

excite internal sphincter

54
Q

What control is the external urethral sphincter under

A

voluntary

55
Q

Where will pain fibers associated with micturition run

A

sympathetics and parasympathetics

56
Q

How will bladder control be altered if there is damage to peripheral ANS routes

A

inability to void

cannot sense fullness

57
Q

How will bladder control be altered if there is destruction of the sacral spinal cord

A

autonomous bladder: continuous dribbling

-all parts are paralyzed

58
Q

How is an erection obtained

A

Parasympathetic muscles stimulate the coiled arteries to relax and fill with blood. Cavernous spaces inside erectile tissue fill with blood

59
Q

What muscles aid in getting an erection and how

A

bulbospongiosus and ischiocavernosus compress the venous plexus

60
Q

What is the mechanism of emission

A

peristaltic movement of semen through ejaculatory ducts

61
Q

What nerves aid in emission

A

sacral splanchnic nerves (L1-L2)

62
Q

What is the mechanism of ejaculation

A

closure of internal urethral sphincter
contraction of urethral muscles
contraction of bulbospongiosus

63
Q

What nerves aid in closure of the internal urethral sphincter

A

sympathetic

64
Q

What nerves aid in contraction of urethral muscles

A

parasympathetic

65
Q

What nerve aids in contractio of bulbospongiosus

A

pudendal

66
Q

What are the branches of the anterior division of teh internal iliac artery

A 
obturator
internal pudendal
inferior gluteal
umbilical
middle rectal
inferior vesical
uterine
67
Q

What are the branches of the psoterior division of the internal iliac

A

lateral sacral
superior gluteal
iliolumbar

68
Q

What does Iliolumbar artery supply

A

ascends out of pelvis and divides into iliac and lumbar branches

69
Q

What does lateral sacral artery supply

A

courses along posterior pelvic wall

70
Q

What does superior gluteal artery supply

A

passes between lumbosacral trunk and S1 through GSF

71
Q

What is the first branch off of internal iliac anterior

A

umbilical artery

72
Q

What does the inferior vesical artery supply

A

fundus of bladder, prostate, seminal vesical

73
Q

What is the inferior vesical artery related to in female

A

vaginal artery

74
Q

What does the middle rectal artery supply

A

seminal vesicals, rectum, and prostate

75
Q

What are the pelvis arterial anastomoses

A

deep circumflex to iliolumbar
median sacral to lateral sacral
superior rectal to middle rectal
profundis femoris to inferior gluteal

76
Q

Where will an aberrant obturator artery be seen

A

when obturator artery goes over pubic bone rather than through obturator canal

77
Q

What are the main sources of blood supply to the female internal genitalia

A

uterine and vaginal arteries

78
Q

Where does the uterine artery arise from

A

anterior trunk

79
Q

Where does the vaginal artery arise from

A

internal iliac or branch off of uterine artery

80
Q

How is the penis venously drained

A

superficial dorsal veins

deep dorsal veins

81
Q

What do the superficial dorsal veins drain on the penis

A

skin and prepuce

82
Q

Where do the superficial dorsal veins of the penis dump

A

into superficial external pudendal

83
Q

What do the deep dorsal veins on the penis drain

A

glans and corpora cavernosa

84
Q

Where do teh deep dorsal veins on the penis empty into

A

prostatic plexus

85
Q

What is the venous drainage of the rectum

A

internal and external venous plexus

86
Q

What are possible causes of internal hemorrhoids

A

portal hypertension

hepatic cirrhosis

87
Q

What type of pain do internal hemorrhoids have

A

no pain

88
Q

What are internal hemorrhoids

A

prolapsed anal mucosa which contain dilated veins from internal rectal venous plexus

89
Q

What are possible causes of external hemorrhoids

A

pregnancy

constipation

90
Q

What are external hemorrhoids

A

blood clots in the external rectal venous plexus covered by skin

91
Q

What type of pain do external hemorrhoids have

A

a lot

92
Q

What is the pain of external hemorrhoids carried by

A

inferior rectal nerve

93
Q

What are the general rules of lymphatics of the pelvis

A

follows blood supply in retrograde

connections made in development so if organ migrates it takes its lymphatics along

94
Q

Where will all lymph from the pelvis end up

A

lumbar nodes that form lumbar trunks and lead to cisterna chyli

95
Q

How are pelvic lymph nodes named

A

location

96
Q

What are the pelvic lymph nodes

A 
pre-aortic: inferior mesenteric
lumbar
common iliac
internal iliac
external iliac
sacral
97
Q

What will drain to superficial inguinal lymph nodes

A 
body wall below umbilicus
scrotum
labia majora
bottom of vagina
anus below pectinate line
98
Q

What is the lymphatic drainage of the anal canal

A

above pectinate: internal iliac

below pectinate: superficial inguinal

99
Q

What is the lymph drainage of the ductus deferens and seminal vesicals

A

iliac nodes

100
Q

WHat is lymphatic drainage of the penis

A

internal iliac

distal glans: deep inguinal

101
Q

What is the lymphatic drainage of the prostate

A

internal iliac and sacral nodes

102
Q

What is teh lymph drainage of the testes

A

lumbar

103
Q

What is the lymph drainage of the scrotum and the skin over the penis/perineum

A

superficial inguinal nodes

104
Q

What is the lymphatic drainage of the uterine tubes and ovaries

A

lumbar

105
Q

What is the lymphatic drainage of the fundus and body of uterus

A

lumbar and external iliac

106
Q

What is the lymphatic drainage of the cervix

A

external and internal iliac, sacral

107
Q

What is lymphatic drainage of the vagina

A

upper 2/3 internal and external iliac

lower 1/3 superficial inguinal

108
Q

What is the lymph drainage of the clitoris and labia minora

A

deep inguinal and external iliac

LECOM MS1 Gross Anatomy Exam 2 (22 decks)

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