Pelvic Neurovasculature Flashcards
The internal iliac artery has ___ branches. How many posterior and how many anterior?
10 branches
3 Posterior
7 Anterior
What does the internal iliac supply?
The pelvic organs and gluteal region
What does the iliolumbar artery supply?
Medial ilium and L5
What does the lateral sacral artery supply?
Sacrum and ventral sacral nerves
What does the superior gluteal artery supply?
supplies gluteal muscles with the superior gluteal nerve
What does the inferior gluteal artery supply?
supplies gluteal muscles with inferior gluteal nerves
T/F the superior and inferior gluteal arteries BOTH exit the pelvis via the greater sciatic foramen?
You know that’s right
What are the spinal levels for the superior gluteal artery?
between L5 & S1 superior to the piriformis muscle
What are the spinal levels for the inferior gluteal artery?
Between S2-S3 inferior to the piriformis muscle
What does the internal pudendal artery supply?
the urogenital and anal triangles
Where does the internal pudendal artery exit and enter the pelvis?
Exits via the greater sciatic foramen and enters via the lesser sciatic foramen
T/F the internal pudendal artery runs with the pudendal nerve?
true!
What forms the pudendal canal?
The fascia of obturator internus muscle
What does the pudendal canal carry?
internal pudendal artery and pudendal nerve
Where is the pudendal canal found?
It runs anteriorly along the ischiopubic ramus towards the urogential triangle (supplies it)
The umbilical artery sends off 3-4 ____ ____ ____.
Superior vesical arteries
The umbilical artery terminates as what?
The medial umbilical ligament
What does the obturator artery supply?
The medial thigh, along with obturator nerve
T/F- the obturator artery anastomoses with the inferior epigastric vessels?
True
What is the anastomosing between the obturator and inferior epigastric arteries called? Why?
Corona mortis- the crown of death
Damage to it opens up both the internal and external iliac systems- death results in minutes
What does the uterine artery supply?
The uterus, cervix, and superior vaginal canal.
What does the uterine artery anastomose with?
Ovarian artery from the aorta
What structure runs with the uterine artery?
The ureters, inferiorly
The vaginal artery supplies what?
inferior vagina and adjacent bladder and rectum
The inferior vesical artery supplies what?
the posterior inferior bladder, ureter, seminal vesical and prostate
Where is the ureter in relation to the inferior vesical/vaginal artery?
it is superior to it
What does the superior rectal artery supply?
the rectum
What does the middle rectal artery anastomose with?
With the superior rectal artery (from the Inferior mesenteric artery) and inferior rectal artery (from the internal pudendal artery)
During a hysterectomy, what can be cut, causing serious complications?
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..
The internal iliac vein is responsible for what?
the venous drainage of the pelvis
T/F all arteries in the pelvis are accompanied by veins of the same name?
True
In the pelvis, where does most venous return ultimately go?
to the inferior vena cava
The pelvic venous plexus is a network of veins that surrounds the bladder, prostate/uterus, and rectum. Is there intercommunication and are there valves?
There is intercommunication and there are no valves, so venous hypertension can occur and tumor cells can be transported all over the place
In the sacral plexus, which nerves are responsible for somatic innervation? (3)
Sciatic, gluteal, and pudendal nerves
The sacral plexus comprises which vertebrae?
L4-S4
Sympathetic fibers from the prevertebral plexus are at what spinal levels?
T10-L2(3)
Sympathetic fibers from the sacral splanchnic nerves are at what spinal levels?
S2-S4
Sacral parasympathetic fibers are found a which spinal levels?
S-2-S4
Parasympathetics in the pelvis are carried by which nerves?
Pelvic splanchnic nerves
The superior hypogastric plexus contains mostly ____ fibers.
sympathetic fibers
What does the superior hypogastric plexus cover?
the bifurcation of the aorta and upper sacrum
The superior hypogastric plexus condenses to form ___ hypogastric nerves
2
The hypogastric nerve descends and becomes what?
The inferior hypogastric plexus
T/F the inferior hypogastric plexus contains both sympathetic and parasympathetic fibers?
True
What is the main autonomic plexus of the pelvis?
the inferior hypogastric plexus
T/F the sympathetic chains are in line with the vertebrae?
True
The pelvic sympathetic fibers converge and terminate where and become what?
Terminate anterior to the coccyx as the ganglion impar
What are the Sacral splanchnic nerves?
Tiny Sympathetic fibers off the sympathetic chain
What are the Pelvic splanchnic nerves?
Tiny Parasympathetic fibers off S2-S4
Splanchnic nerve is closely related to which two structures?
Lateral rectum and uterus
What can easily be injured during rectal surgery or a radical hysterectomy?
Splanchnic nerve
What happens if your splanchnic nerve is damaged?
results in impaired bladder control or sexual function
In which direction do lymphatics drain in the abdominal and pelvic regions?
Superficial to deep
- superficial below umbilicus- moves inferiorly to inguinal- then deep- then superiorly
T/F each organ has its own lymphatic drainage?
True
Lymphatic vessels and nodes lie along what?
the aorta, IVC and iliac vessels
The lymphatics travel through what?
vessels, nodes, and cisterna
Right lymphatic duct drains what?
Right head and neck
Right upper limb
Right upper thorax
The Thoracic lymphatic duct drains what?
Left head and neck Left upper limb Remainder of thorax Abdomen Pelvis Lower limbs
Which lymphatic duct drains the abdomen and pelvis?
The thoracic duct
