Pelvic vessels, nerves and lymphatics Flashcards
What are the main branches of abdominal aorta that supply the pelvis?
Common iliac artery
Gonadal artery
Median sacral artery
Inferior mesenteric artery
At which level does common iliac artery bifurcate?
L5/S1
What is the fate of external iliac a?
Becomes femoral a
Median sacral artery supplies what structures?
Lower lumbar vertebrae
Sacrum
Coccyx
What is the terminal branch of inferior mesenteric a?
Superior rectal a
Superior rectal a supplies what?
Rectum as far inferiorly as the internal anal sphincter
What is the fate of internal iliac a?
Has anterior and posterior divisions
What are the branches of the posterior division of internal iliac a?
Iliolumbar a
Lateral sacral aa
Superior gluteal a
Between what two structures does the iliolumbar a ascend?
Obturator n and lumbosacral trunk
Iliolumbar a supplies what structures?
Psoas major m
Iliacus m
Quadratus lumborum m
Cauda equina in vertebral canal
Lateral sacral a supplies what structures?
Piriformis m Spinal meninges Roots of sacral nerves Erector spinae Skin covering dorsal sacrum
Through which structures do lateral sacral arteries pass?
Enter anterior sacral foramina and exit posterior sacral foramina
Superior gluteal a supplies what structures?
Piriformis
Gluteal mm
Tensor fascia lata
What artery if the terminal branch of the posterior division of Internal iliac a?
Superior gluteal a
What are the nine branches of Anterior division of Internal iliac a?
- Umbilical a
- Superior vesical aa
- Obturator a
- Inferior vesical a
- Uterine a
- Vaginal a
- Middle rectal a
- Internal pudental a
- Inferior gluteal a
Superior vesical aa that are branches of the umbilical a supply what structure?
Urinary bladder
Obturator a supplies which structures?
Pelvic muscles
Head of the femur
Medial thigh
Accessory obturator a is present in what percent of the population?
20%
Inferior vesical a supplies what structures?
Urinary bladder
Ureter
Prostate
Seminal vesicles
Uterine a supplies what structures?
Uterus
Uterine ligaments
Uterine tubes
Ovaries
Uterine artery anastomoses with what artery?
Ovarian a
Middle rectal a supplies what structures?
Rectum
Prostate and seminal vesicles in males
Vagina in females
Internal pudental a
Perineum
Internal pudental a exits the pelvis via ______ ________ ________ , loops around the ischial spine to enter the perineum via ______ ________ _______.
Greater sciatic foramen
Lesser sciatic foramen
Inferior gluteal a supplies what structures?
Piriformis m Gluteus maximus m Quadratus femoris Pelvic diaphragm Sciatic nerve
T/F: Pelvic Venous plexuses have no valves.
True
Pelvic venous plexuses have important communications with which venous plexuses?
Vertebral (Batson’s veins)
Pelvic plexuses are drained by the tributaries of which veins?
Internal iliac v
Inferior mesenteric v
Lateral sacral v
Internal iliac veins form ________ to the greater sciatic foramen and lie ________-_________ to the internal iliac arteries.
Superior; Postero-inferior
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
Which vessels are included in the term ‘pelvic veins?’
Lateral sacral veins
Superior gluteal vein
Superior rectal vein
Testicular/ovarian vein
Lateral sacral vein is a tributary to which vein?
Internal iliac v
Lateral sacral vein anastomoses with which plexus?
Internal vertebral plexus
Lateral sacral vein provides a _________ pathway to reach both SVC and IVC.
collateral
What vein is a pathway for metastatic cells of ovarian and prostate cancer to get to the vertebrae and cranial cavity.
Lateral sacral vein
Superior gluteal vein is a tributary of which vein?
Internal iliac vein
Superior rectal vein is a tributary of which vein?
Inferior mesenteric vein
What are the four groups of lymph nodes draining the pelvic viscera?
External iliac
Internal iliac
Sacral
Common iliac
Which nodes drain into external iliac lymph nodes?
Inguinal nodes
Superior parts of middle to anterior pelvic viscera
Which nodes drain into internal iliac lymph nodes?
Inferior pelvic viscera
Deep perineum
Gluteal region
Which lymph nodes drain into sacral lymph nodes?
Postero-inferior pelvic viscera
Which lymph nodes do all the lymph nodes drained by pelvic viscera drain into?
Common iliac nodes
Which lymph nodes do the common iliac lymph nodes drain into?
Lumbar nodes
What somatic nerve plexuses innervate pelvis? Which spinal nerves do each include?
Sacral plexus; (S1-S4)
Coccygeal plexus; (S4-S5)+Co
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)
Structures innervated by sciatic n
Hamstrings
Leg
Foot
Structures innervated by the pudental n
Perineum
Which structure does the pudental n pass through to enter perineum?
Lesser sciatic foramen
Structures innervated by superior gluteal n
Gluteus medius m
Gluteus minimus m
Structures innervated by inferior gluteal n
Gluteus maximus m
What structures supply autonomic innervation to the pelvic viscera?
Hypogastric plexuses (superior and inferior)
Pelvic Splanchnic Nerves
Coccygeal plexus innervates what structures?
Coccygeus m
Part of levator ani
Sacrococcigeal joint
Which plexus supply sympathetic innervation to pelvic viscera?
Hypogastric plexuses
Which nerves supply parasympathetic innervation to pelvic viscera?
Pelvic Splanchnic Nerves
Which spinal cord levels do pelvic splanchnic nerves arise?
S2, S3, S4
Which structures are associated with pelvic plexuses in males?
prostate and seminal vesicles
In males, _____________ prostatic fibers of pelvic plexus penetrate the pelvic diaphragm to reach the erectile tissues in the penis, producing an erection.
Parasympathetic
Which structures are associated with pelvic plexuses in females?
Cervix of the uterus
Lateral fornices of the vagina
