Pelvic Neurovasculature

Question 1

The internal iliac artery has ___ branches. How many posterior and how many anterior?

Answer 1

10 branches
3 Posterior
7 Anterior

Question 2

What does the internal iliac supply?

Answer 2

The pelvic organs and gluteal region

Question 3

What does the iliolumbar artery supply?

Answer 3

Medial ilium and L5

Question 4

What does the lateral sacral artery supply?

Answer 4

Sacrum and ventral sacral nerves

Question 5

What does the superior gluteal artery supply?

Answer 5

supplies gluteal muscles with the superior gluteal nerve

Question 6

What does the inferior gluteal artery supply?

Answer 6

supplies gluteal muscles with inferior gluteal nerves

Question 7

T/F the superior and inferior gluteal arteries BOTH exit the pelvis via the greater sciatic foramen?

Answer 7

You know that’s right

Question 8

What are the spinal levels for the superior gluteal artery?

Answer 8

between L5 & S1 superior to the piriformis muscle

Question 9

What are the spinal levels for the inferior gluteal artery?

Answer 9

Between S2-S3 inferior to the piriformis muscle

Question 10

What does the internal pudendal artery supply?

Answer 10

the urogenital and anal triangles

Question 11

Where does the internal pudendal artery exit and enter the pelvis?

Answer 11

Exits via the greater sciatic foramen and enters via the lesser sciatic foramen

Question 12

T/F the internal pudendal artery runs with the pudendal nerve?

Answer 12

true!

Question 13

What forms the pudendal canal?

Answer 13

The fascia of obturator internus muscle

Question 14

What does the pudendal canal carry?

Answer 14

internal pudendal artery and pudendal nerve

Question 15

Where is the pudendal canal found?

Answer 15

It runs anteriorly along the ischiopubic ramus towards the urogential triangle (supplies it)

Question 16

The umbilical artery sends off 3-4 ____ ____ ____.

Answer 16

Superior vesical arteries

Question 17

The umbilical artery terminates as what?

Answer 17

The medial umbilical ligament

Question 18

What does the obturator artery supply?

Answer 18

The medial thigh, along with obturator nerve

Question 19

T/F- the obturator artery anastomoses with the inferior epigastric vessels?

Answer 19

True

Question 20

What is the anastomosing between the obturator and inferior epigastric arteries called? Why?

Answer 20

Corona mortis- the crown of death

Damage to it opens up both the internal and external iliac systems- death results in minutes

Question 21

What does the uterine artery supply?

Answer 21

The uterus, cervix, and superior vaginal canal.

Question 22

What does the uterine artery anastomose with?

Answer 22

Ovarian artery from the aorta

Question 23

What structure runs with the uterine artery?

Answer 23

The ureters, inferiorly

Question 24

The vaginal artery supplies what?

Answer 24

inferior vagina and adjacent bladder and rectum

Question 25

The inferior vesical artery supplies what?

Answer 25

the posterior inferior bladder, ureter, seminal vesical and prostate

Question 26

Where is the ureter in relation to the inferior vesical/vaginal artery?

Answer 26

it is superior to it

Question 27

What does the superior rectal artery supply?

Answer 27

the rectum

Question 28

What does the middle rectal artery anastomose with?

Answer 28

With the superior rectal artery (from the Inferior mesenteric artery) and inferior rectal artery (from the internal pudendal artery)

Question 29

During a hysterectomy, what can be cut, causing serious complications?

Answer 29

The ureter. The uterine artery is tied off and the ureter sits right between the uterine artery and the vaginal artery. You kind of need your ureters..

Question 30

The internal iliac vein is responsible for what?

Answer 30

the venous drainage of the pelvis

Question 31

T/F all arteries in the pelvis are accompanied by veins of the same name?

Answer 31

True

Question 32

In the pelvis, where does most venous return ultimately go?

Answer 32

to the inferior vena cava

Question 33

The pelvic venous plexus is a network of veins that surrounds the bladder, prostate/uterus, and rectum. Is there intercommunication and are there valves?

Answer 33

There is intercommunication and there are no valves, so venous hypertension can occur and tumor cells can be transported all over the place

Question 34

In the sacral plexus, which nerves are responsible for somatic innervation? (3)

Answer 34

Sciatic, gluteal, and pudendal nerves

Question 35

The sacral plexus comprises which vertebrae?

Answer 35

L4-S4

Question 36

Sympathetic fibers from the prevertebral plexus are at what spinal levels?

Answer 36

T10-L2(3)

Question 37

Sympathetic fibers from the sacral splanchnic nerves are at what spinal levels?

Answer 37

S2-S4

Question 38

Sacral parasympathetic fibers are found a which spinal levels?

Answer 38

S-2-S4

Question 39

Parasympathetics in the pelvis are carried by which nerves?

Answer 39

Pelvic splanchnic nerves

Question 40

The superior hypogastric plexus contains mostly ____ fibers.

Answer 40

sympathetic fibers

Question 41

What does the superior hypogastric plexus cover?

Answer 41

the bifurcation of the aorta and upper sacrum

Question 42

The superior hypogastric plexus condenses to form ___ hypogastric nerves

Answer 42

2

Question 43

The hypogastric nerve descends and becomes what?

Answer 43

The inferior hypogastric plexus

Question 44

T/F the inferior hypogastric plexus contains both sympathetic and parasympathetic fibers?

Answer 44

True

Question 45

What is the main autonomic plexus of the pelvis?

Answer 45

the inferior hypogastric plexus

Question 46

T/F the sympathetic chains are in line with the vertebrae?

Answer 46

True

Question 47

The pelvic sympathetic fibers converge and terminate where and become what?

Answer 47

Terminate anterior to the coccyx as the ganglion impar

Question 48

What are the Sacral splanchnic nerves?

Answer 48

Tiny Sympathetic fibers off the sympathetic chain

Question 49

What are the Pelvic splanchnic nerves?

Answer 49

Tiny Parasympathetic fibers off S2-S4

Question 50

Splanchnic nerve is closely related to which two structures?

Answer 50

Lateral rectum and uterus

Question 51

What can easily be injured during rectal surgery or a radical hysterectomy?

Answer 51

Splanchnic nerve

Question 52

What happens if your splanchnic nerve is damaged?

Answer 52

results in impaired bladder control or sexual function

Question 53

In which direction do lymphatics drain in the abdominal and pelvic regions?

Answer 53

Superficial to deep | - superficial below umbilicus- moves inferiorly to inguinal- then deep- then superiorly

Question 54

T/F each organ has its own lymphatic drainage?

Answer 54

True

Question 55

Lymphatic vessels and nodes lie along what?

Answer 55

the aorta, IVC and iliac vessels

Question 56

The lymphatics travel through what?

Answer 56

vessels, nodes, and cisterna

Question 57

Right lymphatic duct drains what?

Answer 57

Right head and neck Right upper limb Right upper thorax

Question 58

The Thoracic lymphatic duct drains what?

Answer 58

``` Left head and neck Left upper limb Remainder of thorax Abdomen Pelvis Lower limbs ```

Question 59

Which lymphatic duct drains the abdomen and pelvis?

Answer 59

The thoracic duct