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MGA > Pelvic Neurovasculature > Flashcards

Pelvic Neurovasculature Flashcards

1
Q

components of the sacral plexus

A
  1. superior gluteal
  2. inferior gluteal
  3. sciatic
  4. posterior femoral cutaneous
  5. nerves to obturator internus
  6. nerves to quadratus femoris
  7. pudendal
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2
Q

nerve roots of superior gluteal nerve

A

L4-S1

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3
Q

nerve roots inferior gluteal n

A

L5-S2

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4
Q

nerve roots sciatic nerve

A

L4-S3

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5
Q

nerve root posterior cutaneous

A

S1-S3

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6
Q

nerve root nerve to obturator internus

A

L5-S2

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7
Q

nerve root nerve to quadratus femoris

A

L4-S1

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8
Q

nerve root pudendal nerve

A

S2-S4

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9
Q

nerve root lumbosacral trunk

A

L4-L5

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10
Q

positions of S2-S3

A

are usually joined or close together

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11
Q

path of the superior gluteal nerve

A

above piriformis

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12
Q

path of inferior gluteal nerve

A

below piriformis (or at piriformis?)

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13
Q

path of pudendal nerve

A

out of the greater sciatic foramen back into the lesser sciatic foramen under the sacrospinous ligament, then through the pudendal canal along the inferior ischial ramus

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14
Q

where is pudendal canal located

A

within fascia of obturator internus muscle

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15
Q

what does the pudendal canal contain

A

pudendal nerve, pudendal artery, pudendal vein

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16
Q

branches of pudendal nerve

A
  1. inferior rectal
  2. perineal
  3. dorsal nerve of penis or clitoris
  4. posterior scrotal or labial
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17
Q

what does the inferior rectal nerve supply

A

motor: external anal sphincter
sensory: skin around anus

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18
Q

what does the perineal nerve supply

A

motor: all superficial and deep space muscles
sensory: perineum

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19
Q

what does the dorsal nerve of penis or clitoris supply

A

sensory for penis or clit

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20
Q

what does the posterior scrotal or labial supply

A

sensory for scrotum or labia

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21
Q

test for pudendal neuropathies

A

bulbocavernosus/bulbispongiosus reflex (pull on penis and external anal sphincter contracts)

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22
Q

sympathetic innervation of the pelvic cavity

A

sacral splanchnics and hypogastric nerves from the lumbar splanchnics

23
Q

explain where the hypogastric nerves come from to innervate the pelvic cavity

A

they come from superior hypogastric plexus, which arises from the lumbar splanchnics (L3-L4), and then post synaptic fibers travel with the blood vessels to pelvic viscera

24
Q

parasympathetic innervation pelvic cavity

A

pelvic splanchnics (S2-S4)

25
Q

what is the (superior) hypogastric plexus composed of

A

networks of sympathetic and visceral afferent fibers

26
Q

describe the autonomic innervation of the pelvic cavity

A
  1. the superior hypogastric plexus made up of sympathetic and visceral afferents splits into the right and left hypogastric nerves
  2. this combination of sympathetic sacral splanchnics meets up with parasympathetic pelvic splanchnic to make the inferior hypogastric plexus
27
Q

what are the hypogastric plexusus made of

A

sympathetic fibers, parasympathetic fibers, and visceral afferents

28
Q

function of the sympathetic portion of the hypogastric plexus

A
  1. vasoconstriction
  2. contract internal urethral and anal sphincters
  3. ejaculation
29
Q

function of the parasympathetic portion of the hypogastric plexus

A
  1. vasodilation
  2. stimulate bladder contraction for urination
  3. stimulate rectum/anal canal for defecation
  4. stimulate erection
30
Q

explain point and shoot

A

P=parasympathetics=vasodilation and erection

S=sympathetics=ejaculation

31
Q

describe the pelvic pain line/sensory information in the pelvis

A

sensory information travels into the pelvis with sympathetic vessel up until the perineum, then under the perineum sensory travels with parasympathetics

32
Q

relate pelvic pain line and pectinate line of the anus

A

sensory information travels into the pelvis with the sympathetic system, but under the pelvic pain line, sensory travels with parasympathetics. once the pectinate line is crossed, it becomes somatic via inferior rectal branches of pudendal nerve

33
Q

where does the IVC bifurcate

A

L5

34
Q

what does the anterior trunk of the internal iliac artery supply

A

primarily visceral branches supplying pelvic viscera, perineum, gluteal region, and adductor region

35
Q

branches off the anterior trunk of the internal iliac artery

A
  1. obturator
  2. umbilical
  3. middle rectal
  4. vesical
  5. inferior gluteal
  6. internal pudendal
36
Q

what does the posterior trunk of the internal iliac artery supplly

A

parietal branches, posterior pelvic wall, lower posterior abdominal wall, gluteal region

37
Q

branches off the posterior trunk of the internal iliac artery

A
  1. iliolumbar
  2. superior gluteal
  3. lateral sacral branches
38
Q

where does the superior gluteal artery exit

A

through the greater sciatic foramen ABOVE piriformis, usually between lumbosacral trunk and S1

39
Q

where does the iliolumbar artery travel

A

runs with lumbosacral trunk upward

40
Q

how to identify the umbilical artery

A

runs toward the anterior abdominal wall and obliterates into connective tissue as the medial umbilical ligament

41
Q

describe the course of the internal pudendal artery

A

continues off of the anterior trunk through the pudendal canal with the pudendal nerve between obturator internus and levator ani

42
Q

what branches does the vesical artery give off

A

seminal and prostatic

43
Q

what are the anastamoses of the rectal arteries?

A
  1. superior rectal from IMA
  2. middle rectal from internal iliac
  3. inferior rectal from internal pudendal
44
Q

what vasculature is different in males and females?

A

males have inferior vesical artery that gives off ductus deferens, seminal and prostatic branches; females have the the vaginal artery (equivalent of inferior vesical) and uterine artery

45
Q

describe the position of the ureter in female vasculature

A

ureter travels UNDER the uterine artery

46
Q

what is a common deviance from normal anatomy in the anterior of the pelvis

A

sometimes the obturator gives off accessory obturator artery which meets up with the inferior epigastric artery

47
Q

describe lymph flow in the gonads

A

gonads (ovaries and testes) and kidneys do not follow normal lymph flow, they flow straight up to the lumbar nodes

48
Q

describe lymph flow in the gonads

A

gonads (ovaries and testes) and kidneys do not follow normal lymph flow, they flow straight up to the lumbar nodes/trunk

49
Q

describe lymph flow in the uterus

A

body and cervix flow into pelvic lymph nodes/internal iliac nodes, then up to lateral aortic/lumbar nodes

50
Q

what structures drain into the deep inguinal nodes

A
  1. glans penis/clitoris
  2. labia minor
  3. lower part of vagina
51
Q

what structures drain into the superficial inguinal nodes

A
  1. superficial tissues of penis and scrotum

2. superficial tissues of clitoris and labia majora

52
Q

trace flow of lymph from the external genitalia

A

superficial inguinal nodes to the external iliac nodes, to the lateral aortic lumbar nodes, to the thoracic duct

53
Q

trace flow of lymph from the gonads

A

gonadal vessels take lymph from testes and ovaries straight to the lumbar nodes

MGA (27 decks)

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