Pelvic Neurovascular Flashcards

1
Q

Pelvic arteries
* Abdominal arteries: (3)

A
  • Gonadal a.
  • Median sacral artery
  • Superior rectal artery
    (IMA)
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2
Q
  • Gonadal a.
  • Ovarian a. – internal =
  • Testicular a. - external =
A
  • Ovarian a. – internal
  • Testicular a. - external
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3
Q

What are the pelvic arteries? (4)

A
  • Internal iliac artery
  • Middle rectal a.
  • Inferior gluteal a.
  • Internal pudendal a.
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4
Q

Pelvic arteries
Anterior…(2)
Umbilical artery :

A
  • Superior vesical a.
  • Medial umbilical lig.
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5
Q

Pelvic arteries
Anterior…
* Obturator a. (branch) :

A
  • Pubic branch
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6
Q

Pelvic arteries
* Internal iliac artery
* Anterior
- Inferior vesical a. (MALES) : (2)

A
  • Artery to ductus deferens
  • Prostatic branches
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7
Q

Pelvic arteries
* Internal iliac artery
* Anterior
FEMALES: (2)

A
  • Uterine a.
  • Vaginal a.
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8
Q

Pelvic arteries
* Internal iliac artery
* Posterior: (3)

A
  • Iliolumbar artery
  • Lateral sacral artery
  • Superior gluteal artery
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9
Q

Pelvic veins
* Rectal venous plexus –

A

superior, middle and
inferior rectal veins.

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10
Q

Pelvic veins
* Prostatic venous plexus –

A

drains to vesical plexus

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11
Q

Pelvic veins
* Vesical venous plexus –

A

inferior vesical vein

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12
Q

Pelvic veins
* Vaginal venous plexus –

A

uterovaginal plexus

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13
Q

Pelvic veins
* Uterine venous plexus –

A

uterine vein

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14
Q

Lymphatic drainage: Pelvis
* External iliac nodes
* Afferent:

A

pelvic viscera and inguinal nodes

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15
Q

Lymphatic drainage: Pelvis
* Internal iliac nodes
* Afferent:

A

inferior pelvic viscera, deep perineum, gluteal

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16
Q

Lymphatic drainage: Pelvis
* Sacral lymph nodes
* Afferent:

A

inferior pelvic
viscera, deep perineum,
gluteal

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17
Q

Lymphatic drainage: Pelvis
* Sacral lymph nodes
* Efferent:

A

common iliac nodes

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18
Q

Lymphatic drainage: Pelvis
* Common iliac nodes
* Efferent:

A

lumbar nodes

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19
Q

Lymphatic drainage: BLADDER
* External iliac nodes
* Afferent:

A

superolateral aspects of bladder; ureter

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20
Q

Lymphatic drainage: BLADDER
* External iliac nodes
* Efferent:

A

common iliac nodes

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21
Q

Lymphatic drainage: BLADDER
* Internal iliac nodes
* Afferent:

A

fundus and neck of bladder

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22
Q

Lymphatic drainage: BLADDER
* Internal iliac nodes
* Efferent:

A

common iliac nodes

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23
Q

Lymphatic drainage: BLADDER
* Common iliac nodes
* Afferent:

A

neck of bladder (some)

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24
Q

Lymphatic drainage: BLADDER
* Common iliac nodes
* Efferent:

A

lumbar nodes

25
Q

Lymphatic drainage:
Male intrapelvic organs
* Internal iliac nodes
* Afferents:

A

majority of prostate,
proximal urethra, inferior part of seminal glands

26
Q

Lymphatic drainage:
Male intrapelvic organs
* Internal iliac nodes
* Efferents:

A

common iliac nodes →
lumbar

27
Q

Lymphatic drainage:
Male intrapelvic organs
Sacral nodes
* Afferents:

A

some of prostate

28
Q

Lymphatic drainage:
Male intrapelvic organs
Sacral nodes
* Efferents:

A

internal iliac nodes

29
Q

Lymphatic drainage:
Male intrapelvic organs
* External iliac nodes
* Afferents:

A

proximal urethra (some),
ductus deferens, ejaculatory ducts, superior part of seminal glands

30
Q

Lymphatic drainage:
Male intrapelvic organs
* External iliac nodes
* Efferent:

A

common iliac nodes →
lumbar

31
Q

Lymphatic drainage:
Male intrapelvic organs
* Deep inguinal nodes
* Afferents:

A

distal urethra

32
Q

Lymphatic drainage:
Male intrapelvic organs
* Deep inguinal nodes
* Efferent:

A

external iliac nodes

33
Q

Lymphatic drainage:
Female intrapelvic organs
Internal iliac nodes
* Afferents:

A

cervix of uterus, sup. & mid parts of vagina, proximal urethra

34
Q

Lymphatic drainage:
Female intrapelvic organs
Internal iliac nodes
* Efferent:

A

common iliac nodes → lumbar

35
Q

Lymphatic drainage:
Female intrapelvic organs
Sacral nodes
* Afferents:

A

cervix of uterus, inferior part of vagina

36
Q

Lymphatic drainage:
Female intrapelvic organs
Sacral nodes
* Efferent:

A

internal iliac nodes

37
Q

Lymphatic drainage:
Female intrapelvic organs
External iliac nodes
* Afferents:

A

body & cervix of uterus, superior part of vagina

38
Q

Lymphatic drainage:
Female intrapelvic organs
External iliac nodes
* Efferent:

A

common iliac nodes → lumbar

39
Q

Lymphatic drainage:
Female intrapelvic organs
Superficial inguinal nodes
* Afferents:

A

external orifice of vagina, fundus (uterus)

40
Q

Lymphatic drainage:
Female intrapelvic organs
Superficial inguinal nodes
* Efferent:

A

external iliac nodes or deep inguinal nodes

41
Q

Lymphatic drainage:
Female intrapelvic organs
Lumbar nodes
* Afferents:

A

ovaries & uterine tubes, fundus of uterus

42
Q

Lymphatic drainage:
Female intrapelvic organs
Lumbar nodes
* Efferent:

A

cisterna chyli

43
Q

Lymphatic drainage: Rectum
* Pararectal nodes

Location:

A
  • Directly on muscle layer of
    rectum
44
Q

Lymphatic drainage: Rectum
* Pararectal nodes

Afferent:

A

superior ½ of rectum

45
Q

Lymphatic drainage: Rectum
* Pararectal nodes

Efferent:

A

inf. mesenteric nodes (via sacral nodes or direct)

46
Q

Lymphatic drainage: Rectum

  • Sacral nodes
  • Afferent:
A

inferior ½ of rectum

46
Q

Lymphatic drainage: Rectum

  • Sacral nodes
  • Efferent:
A

internal iliac nodes (some vessels may drain directly into internal iliac nodes)

47
Q

Innervation
Autonomic -
* Sacral sympathetic trunks:

A
  • Sympathetic innervation to
    the lower limbs
47
Q

Innervation
Autonomic -
* Peri-arterial plexuses:

A
  • Sympathetic, vasomotor
    fibres to superior rectal,
    ovarian, internal iliac aa.
48
Q

Innervation
Autonomic -
* Pelvic splanchnic nerves:

A
  • Parasympathetic innervation of pelvic viscera
49
Q

Innervation
Autonomic -
* Hypogastric plexuses:

A
  • Most important route by
    which sympathetic fibres are
    conveyed to the pelvic viscera
50
Q

Innervation:
* ______ plexus

A

Sacral

51
Q
  • Pudendal nerve
    Origin:
    Structures:
A
  • Ant. rami of spinal nerves S2-S4
  • Structures: perineum, sensory to genitalia, perineal muscles, external urethra & anal sphincter
52
Q
  • Sciatic nerve
    Origin:
    Structures:
A
  • Ant. rami of spinal nerves L4-S3
  • Hip joint, flexors of knee in thigh & all muscles in leg and foot
53
Q
  • Superior gluteal nerve
    Origin:
    Structures:
A
  • Ant. rami of spinal nerves L4-S1
  • Gluteus medius & minimus
    muscles
54
Q
  • Inferior gluteal nerve
    Origin:
    Structures:
A
  • Ant. rami of spinal nerves L5-S2
  • Gluteus maximus muscle
55
Q
  • Coccygeal plexus
    Origin:
    Supplies:
A
  • Ant. rami: S4-S5; coccygeal
    nerves
  • Supplies coccygeus muscle
56
Q
  • Somatic nerves:
  • Nerve to _____ ______ (L5,S1-S2)
  • Nerve to _______ (S1-S2)
  • Nerve to _____ ____ &
    coccygeus (S3-S4)
A
  • obturator internus
  • piriformis
  • levator ani
57
Q
A