Pelvic vessels, nerves and lymphatics Flashcards

1
Q

What are the main branches of abdominal aorta that supply the pelvis?

A

Common iliac artery
Gonadal artery
Median sacral artery
Inferior mesenteric artery

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2
Q

At which level does common iliac artery bifurcate?

A

L5/S1

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3
Q

What is the fate of external iliac a?

A

Becomes femoral a

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4
Q

Median sacral artery supplies what structures?

A

Lower lumbar vertebrae
Sacrum
Coccyx

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5
Q

What is the terminal branch of inferior mesenteric a?

A

Superior rectal a

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6
Q

Superior rectal a supplies what?

A

Rectum as far inferiorly as the internal anal sphincter

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7
Q

What is the fate of internal iliac a?

A

Has anterior and posterior divisions

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8
Q

What are the branches of the posterior division of internal iliac a?

A

Iliolumbar a
Lateral sacral aa
Superior gluteal a

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9
Q

Between what two structures does the iliolumbar a ascend?

A

Obturator n and lumbosacral trunk

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10
Q

Iliolumbar a supplies what structures?

A

Psoas major m
Iliacus m
Quadratus lumborum m
Cauda equina in vertebral canal

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11
Q

Lateral sacral a supplies what structures?

A
Piriformis m
Spinal meninges 
Roots of sacral nerves 
Erector spinae 
Skin covering dorsal sacrum
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12
Q

Through which structures do lateral sacral arteries pass?

A

Enter anterior sacral foramina and exit posterior sacral foramina

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13
Q

Superior gluteal a supplies what structures?

A

Piriformis
Gluteal mm
Tensor fascia lata

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14
Q

What artery if the terminal branch of the posterior division of Internal iliac a?

A

Superior gluteal a

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15
Q

What are the nine branches of Anterior division of Internal iliac a?

A
  1. Umbilical a
  2. Superior vesical aa
  3. Obturator a
  4. Inferior vesical a
  5. Uterine a
  6. Vaginal a
  7. Middle rectal a
  8. Internal pudental a
  9. Inferior gluteal a
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16
Q

Superior vesical aa that are branches of the umbilical a supply what structure?

A

Urinary bladder

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17
Q

Obturator a supplies which structures?

A

Pelvic muscles
Head of the femur
Medial thigh

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18
Q

Accessory obturator a is present in what percent of the population?

A

20%

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19
Q

Inferior vesical a supplies what structures?

A

Urinary bladder
Ureter
Prostate
Seminal vesicles

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20
Q

Uterine a supplies what structures?

A

Uterus
Uterine ligaments
Uterine tubes
Ovaries

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21
Q

Uterine artery anastomoses with what artery?

A

Ovarian a

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22
Q

Middle rectal a supplies what structures?

A

Rectum
Prostate and seminal vesicles in males
Vagina in females

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23
Q

Internal pudental a

A

Perineum

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24
Q

Internal pudental a exits the pelvis via ______ ________ ________ , loops around the ischial spine to enter the perineum via ______ ________ _______.

A

Greater sciatic foramen

Lesser sciatic foramen

25
Inferior gluteal a supplies what structures?
``` Piriformis m Gluteus maximus m Quadratus femoris Pelvic diaphragm Sciatic nerve ```
26
T/F: Pelvic Venous plexuses have no valves.
True
27
Pelvic venous plexuses have important communications with which venous plexuses?
Vertebral (Batson's veins)
28
Pelvic plexuses are drained by the tributaries of which veins?
Internal iliac v Inferior mesenteric v Lateral sacral v
29
Internal iliac veins form ________ to the greater sciatic foramen and lie ________-_________ to the internal iliac arteries.
Superior; Postero-inferior
30
Internal iliac veins merge with ______ _____ _____ to form common iliac veins, which unite at the level of __/__ disk and drain into IVC.
External Iliac V; L4/L5
31
Which vessels are included in the term 'pelvic veins?'
Lateral sacral veins Superior gluteal vein Superior rectal vein Testicular/ovarian vein
32
Lateral sacral vein is a tributary to which vein?
Internal iliac v
33
Lateral sacral vein anastomoses with which plexus?
Internal vertebral plexus
34
Lateral sacral vein provides a _________ pathway to reach both SVC and IVC.
collateral
35
What vein is a pathway for metastatic cells of ovarian and prostate cancer to get to the vertebrae and cranial cavity.
Lateral sacral vein
36
Superior gluteal vein is a tributary of which vein?
Internal iliac vein
37
Superior rectal vein is a tributary of which vein?
Inferior mesenteric vein
38
What are the four groups of lymph nodes draining the pelvic viscera?
External iliac Internal iliac Sacral Common iliac
39
Which nodes drain into external iliac lymph nodes?
Inguinal nodes | Superior parts of middle to anterior pelvic viscera
40
Which nodes drain into internal iliac lymph nodes?
Inferior pelvic viscera Deep perineum Gluteal region
41
Which lymph nodes drain into sacral lymph nodes?
Postero-inferior pelvic viscera
42
Which lymph nodes do all the lymph nodes drained by pelvic viscera drain into?
Common iliac nodes
43
Which lymph nodes do the common iliac lymph nodes drain into?
Lumbar nodes
44
What somatic nerve plexuses innervate pelvis? Which spinal nerves do each include?
Sacral plexus; (S1-S4) | Coccygeal plexus; (S4-S5)+Co
45
What are the nerves in the sacral plexus? What spinal nerves do each include?
Sciatic n; (L4-S3) Pudental n; (S2-S4) Superior gluteal n; (L4-S1) Inferior gluteal n; (L4-S2)
46
Structures innervated by sciatic n
Hamstrings Leg Foot
47
Structures innervated by the pudental n
Perineum
48
Which structure does the pudental n pass through to enter perineum?
Lesser sciatic foramen
49
Structures innervated by superior gluteal n
Gluteus medius m | Gluteus minimus m
50
Structures innervated by inferior gluteal n
Gluteus maximus m
51
What structures supply autonomic innervation to the pelvic viscera?
Hypogastric plexuses (superior and inferior) Pelvic Splanchnic Nerves
52
Coccygeal plexus innervates what structures?
Coccygeus m Part of levator ani Sacrococcigeal joint
53
Which plexus supply sympathetic innervation to pelvic viscera?
Hypogastric plexuses
54
Which nerves supply parasympathetic innervation to pelvic viscera?
Pelvic Splanchnic Nerves
55
Which spinal cord levels do pelvic splanchnic nerves arise?
S2, S3, S4
56
Which structures are associated with pelvic plexuses in males?
prostate and seminal vesicles
57
In males, _____________ prostatic fibers of pelvic plexus penetrate the pelvic diaphragm to reach the erectile tissues in the penis, producing an erection.
Parasympathetic
58
Which structures are associated with pelvic plexuses in females?
Cervix of the uterus | Lateral fornices of the vagina