Pelvic Vasculature Flashcards
Clinical significance of atherosclerosis of right common iliac artery – why is this (anatomic-wise?)
Right common iliac artery crosses over the left common iliac vein - atherosclerosis may cause compression of this vein = stasis of venous return from the left lower limb = thrombus formation and pain during exercise
What does the anterior division of the internal iliac vessels supply?
VISCERAL branches to all pelvic and perineal viscera except the ovaries and testes
What does the posterior division of the internal iliac vessels supply?
PARIETAL branches to abdominal wall, gluteal region, lower back, spinal meninges
Internal pudendal artery is a branch of what artery and what does it supply?
Internal iliac artery
Supplies all of the perineum
Obturator artery is a branch of what artery? Does it supply pelvic structures?
Internal iliac artery
NO pelvic structure supply
In the female, where do the arteries of the abdomen, pelvis, and perineum anastomose?
Within the walls of the uterus and vagina
What does the superior rectal artery (only 1) supply?
Upper rectum and anal canal
What do the right and left inferior arteries (2 of them!) supply?
The anal canal below the pectinate line
Function of middle rectal arteries
Anastomoses between superior and inferior rectal arteries
What 2 arteries supply blood to the gonads (testes and ovaries)? Describe their path
- Ovarian artery - crosses the pelvic brim within the suspensory ligament
- Testicular artery - transverses the inguinal canal within the spermatic cord
Venous drainage of gonads?
Pampiniform venous plexus - converges to form ovarian and testicular veins which drain to IVC (on the right) and left renal vein
Most pelvic viscera are surrounded by what plexuses? Where do these plexuses drain?
Visceral venous plexuses - drain to the internal iliac and common iliac veins – then to the IVC
How can the visceral pelvic plexus drain to the azygous system? Why is this significant?
Can drain via the vertebral venous plexus
Significant in the spread of prostate cancer to vertebrae and brain
How do the rectum/anal canal drain into the portal and caval system?
Why is this significant?
Portal system via superior rectal vein
Caval system via middle and inferior rectal veins
- anastomoses between the systems is significant in portal hypertension
What are the 2 branches of the submucosal rectal venous plexus?
external and internal
What does the external rectal plexus communicate with? Thromboses of these veins is called what?
- Communicates with other pelvic visceral venous plexuses
- external hemorrhoids
What does the internal rectal plexus communicate with and what does this form?
- Communicates with rectal arteries via arterio-venous anastomosis to form an internal hemorrhoidal plexus that surrounds the anorectal junction – forms anal cushions (prolapse of these cushions = internal hemorrhoids)
Blood supply and venous drainage to most perineal structures
What is the exception?
Blood supply: internal pudendal artery
Venous drainage: internal pudendal vein to the internal iliac veins
Exception: erectile tissues drain via deep dorsal veins that don’t join the internal pudendal vein – instead they pass under the pubic symphysis to join venous plexuses in the pelvis
