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Anatomy Exam 2 > Pelvic Neurovasculature > Flashcards

Pelvic Neurovasculature Flashcards

1
Q

Describe the arterial supply of the pelvis, perineum and gluteal region

A
  • Abdominal aorta
    • splits to common iliac aa.
  • Common Iliac aa.
    • split to external & internal iliac aa.
  • External iliac aa.
    • exits pelvis as femoral aa.
  • Internal iliac aa.
    • enter true pelvis & branches
      • 3 posterior & 7 anterior
    • supplies pelvic organs & gluteal region
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2
Q

Describe the corona mortis & its clinical significance

A
  • Corona Mortis “crown of death”
  • Obturator a.
    • anastomoses with inferior epigastric vessels
    • variable & may be arterial, venous or both
    • damage opens internal & external iliac systems
    • can cause death in minutes
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3
Q

Describe the venous drainage of the pelvis, perineum and gluteal region

A
  • Internal iliac vv.
    • venous drainage of pelvis
    • Pelvic venous plexus
  • All aa accompanied by vv. of same name
  • Most venous return ultimately to IVC
  • Pelvic Venous Plexuses
    • venous networks surround bladder, prostate or uterus, & rectum

Plexuses intercommunicate prior to forming named vv.

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4
Q

Explain the clinical significance of the pelvic venous plexuses

A
  • Intercommunication has clinical consequences
    • transportation of tumor cells
    • venous hypertension
  • Venous plexuses - valveless
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5
Q

Describe the pattern of nerves making up the sacral plexus

A
  • Somatic innervation
    • Sciatic & Gluteal nn
    • Pudendal n.
  • L4-S4
    • L4-L5 forms LS trunk & crosses over sacral ala
    • S1 emerges above piriformis m.
    • S2 & S3 emerges thru piriformis m.
    • S2-S4 contributes to pudendal n.
    • L4-S3 form sciatic & gluteal nn.
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6
Q

Compare and contrast the sympathetic and parasympathetic innervation of the pelvis

A

Sympathetic

  • Sacral splanchnic nn
    • tiny symp. fibers off symp chain

Parasympathetic

  • Pelvic splanchnic nn
    • tiny p-symp. fibers off S2-S4

Both enter inferior hypogastric plexus
Fibers travel on arterial brs. to pelvic organs

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7
Q

Describe the various autonomic plexuses of the pelvis

A

Sympathetic fibers

  • T10 – L2(3) – prevertebral plexus
  • Symp. S2-S4 = Sacral splanchnic nn.

Parasympathetic fibers

  • S2 – S4
  • P-symp = Pelvic splanchnic nn.
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8
Q

Describe the consequences of damage to the pelvic splanchnic nerves

A
  • Splanchnic nn. closely related to lateral rectum & uterus
  • Easily injured during rectal surgery or radical hysterectomy
  • Results in impaired bladder control or sexual function
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9
Q

Describe the branches of internal iliac a

A
  • Iliolumbar a.
  • Lateral Sacral a.
  • Superior Gluteal a.
  • Inferior Gluteal a.
  • Internal pudendal a.
  • Umbilical a. & Superior Vesical a.
  • Obturator a.
  • Uterine a.
  • Vaginal a. OR Inferior Vesical a.
  • Middle Rectal a.

NOTE: both Sup. & Inf. Gluteal aa. exit pelvis via greater sciatic foramen

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10
Q

Iliolumbar a.

A
  • between iliac crest & L5
  • supplies medial ilium & L5
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11
Q

Lateral Sacral a.

A
  • enters ventral sacral foramina
  • supplies sacrum & ventral sacral nn.
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12
Q

Superior Gluteal a.

A
  • between L5 & S1
  • enters gluteal region superior to piriformis m.
  • supplies gluteal mm. with superior gluteal nn.
  • exits greater sciatic foramen

NOTE: both Sup. & Inf. Gluteal aa. exit pelvis via greater sciatic foramen

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13
Q

Inferior Gluteal a.

A
  • Between S2 & S3(S1 & S2)
  • inferior to piriformis m.
  • supplies gluteal mm with inferior gluteal nn.

NOTE: both Sup. & Inf. Gluteal aa. exit pelvis via greater sciatic foramen

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14
Q

Internal pudendal a.

A
  • runs with pudendal n.
  • exits pelvis thru greater sciatic foramen
  • enters gluteal region inferomedial to piriformis
  • crosses over sacrospinous ligament
  • re-enters pelvis thru lesser sciatic foramen
  • supplies UG & anal Δs
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15
Q

Pudendal Canal

A
  • contains internal pudendal a. & pudendal n. back in pelvis
  • formed by fascia of obturator internus m.
  • runs anteriorly along ischiopubic ramus (toward UG Δ)
  • supplies UG
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16
Q

Umbilical a. & Superior Vesical a.

A
  • runs toward ant. abd. wall
  • sends of 3-4 Superior Vesical aa. to bladder
  • terminates as medial umbilical ligament
17
Q

Obturator a.

A
  • runs thru obturator canal
  • supplies medial thigh with obturator n
18
Q

Uterine a.

A
  • in females
  • anastomoses with ovarian a. from aorta
  • supplies uterus, cervix & superior vaginal canal

Note: ureter runs immediately below this artery

19
Q

Vaginal a. OR Inferior Vesical a.

A
  • in females: supplies inferior vagina & adjacent bladder and rectum
  • in males: supplies posterior inferior bladder, ureter, seminal vesicle and prostate

Note: ureter runs above this artery

20
Q

Middle Rectal a.

A
  • supplies rectum
  • anastomoses with superior rectal from IMA & inferior rectal from internal pudendal a.
21
Q

Superior Hypogastric Plexus

A
  • Contains mostly sympathetic fibers
  • Covers bifurcation of aorta & upper sacrum
  • Condenses to form 2 hypogastric nn.
22
Q

Hypogastric Nerve to Inferior Plexus

A
  • Contains mostly sympathetic fibers
  • Diverge & curve outward bilateral to rectum
  • Expands to form inferior hypogastric plexus
23
Q

Inferior Hypogastric Plexus

A
  • Contains both sympathetic & parasympathetic fibers
  • Found covering pelvic viscera bilaterally
  • Serves as main autonomic plexus of pelvis
24
Q

Sympathetic Chains & Ganglia

A
  • In thorax, chains are lateral to vertebrae
  • Move medially as they descend
  • Pelvic Sympathetic fibers
    • chains are medial to sacral foramen
    • converge & terminate anterior to coccyx as ganglion impar
25
Q

Abdominopelvic lymphatics

A
  • Lymphatic vessels and nodes lie along aorta, IVC & iliac vessels
  • drainage moves
    • superficial to deep
      • superficial below umbilicus moves inferiorly to inguinal, then deep then superiorly
    • superiorly
  • thru vessels, nodes and cisterna
  • each organ has its own lymphatic drainage
26
Q

Lymphatic drainage

A

Right lymphatic duct

  • drains
    • R head & neck
    • R UL
    • R upper thorax

Thoracic duct

  • drains
    • L head & neck
    • L UL
    • remainder of thorax
    • abdomen
    • pelvis
    • LLs
27
Q

NetAnatomy Pelvis #6

A

Anatomy Exam 2 (13 decks)

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