Pelvic Vessels, Nerves, and Lymphatics

Question 1

What are the branches of the abdominal aorta that supply pelvic structures?

Answer 1

• ovarian arteries
• middle (median) sacral artery
• common iliac arteries
• inferior mesenteric artery

Question 2

What do the ovarian arteries supply?

Answer 2

ovaries

Question 3

What does the middle (median) sacral artery supply?

Answer 3

lower lumbar vertebrae
sacrum
coccyx

Question 4

What do the common iliac arteries bifurcate into? Where?

Answer 4

external and internal iliac arteries at L5-S1

Question 5

What does the external iliac artery become?

Answer 5

femoral a

Question 6

What does the internal iliac artery supply?

Answer 6

pelvic structures and peritoneum

Question 7

What is the terminal branch of the IMA?

Answer 7

superior rectal A

Question 8

What are the branches of the superior rectal A supplying?

Answer 8

both sides of the rectum as far inferiorly as the internal anal sphincter

Question 9

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

Answer 9

• lateral sacral arteries
• iliolumbar artery
• superior gluteal artery

Question 10

What do the lateral sacral arteries supply?

Answer 10

piriformis then enter the anterior sacral formina to supply the structures of the sacral canal. then exits the posterior sacral foramina to supply the erector spinae muscles and skin posterior to the sacrum

Question 11

What does the iliolumbar artery go between?

Answer 11

obturator N and lumbosacral trunk

Question 12

What does the illiolumbar A supply?

Answer 12

psoas major, iliacus, and quadratus lumborum plus cauda equina in the vertebral canal

Question 13

What does the superior gluteal artery exit?

Answer 13

greater sciatic foramen

Question 14

What does the superior gluteal artery supply?

Answer 14

piriformis, gluteal muscles, and tensor fascia lata

Question 15

What are the branches of the anterior division of the internal iliac artery?

Answer 15

• umbilical artery
• superior vesical arteries
• inferior vesical artery (males)
• middle rectal artery
• obturator artery
• internal pudendal artery
• inferior gluteal artery
• uterine artery
• vaginal artery

Question 16

What does the umbilical artery and superior vesical artery supply?

Answer 16

urinary bladder

-originate from same trunk

Question 17

Which artery’s distal portion is obliterated after birth?

Answer 17

umbilical artery

Question 18

What does the inferior vesical artery supply?

Answer 18

only in males

-urinary bladder, seminal vesicle, prostate, and ureter

Question 19

What does the middle rectal artery supply?

Answer 19

rectum, prostate, seminal vescile in males, and rectum and vagina in females

Question 20

What does the obturator artery supply?

Answer 20

pelvic muscles, head of femur then leaves pelvic cavity via the obturator canal to the medial thigh

Question 21

What does the internal pudendal artery supply?

Answer 21

all perineal structures

Question 22

What is the path of the internal pudendal artery?

Answer 22

exits the pelvis via greater sciatic foramen, loops around the spine of the ischium to enter the perineum via lesser sciatic foramen

Question 23

What does the inferior gluteal artery supply?

Answer 23

piriformis, pelvic diaphragm, quadratus femoris, gluteus maximus, and sciatic nerve

Question 24

What does the uterine artery supply?

-anastamosis

Answer 24

uterus and superior vagina and ligaments of the uterus

-anastamoses with the ovarian artery

Question 25

Whta does the vaginal artery supply?

Answer 25

anterior and posterior vaginal surfaces

Question 26

true or false: each pelvic organ has a venous plexus which freely communicates with venous plexuses of other organs

Answer 26

true

Question 27

Do the venous plexuses of the pelvic organs have valves?

Answer 27

no

Question 28

What are the connections of the pelvic venous plexuses with vertebral venous plexuses?

Answer 28

Batson's veins

Question 29

What do the pelvic venous plexuses drain into?

Answer 29

internal iliac veins, inferior mesenteric vein, and lateral sacral veins

Question 30

Where do the internal iliac veins form in relationship to the greater sciatic foramen? -internal iliac arteries

Answer 30

superior | lie posterior to internal iliac arteries

Question 31

Where do the internal and external iliac veins merge?

Answer 31

L4/L5 IV disc to form inferior vena cava

Question 32

What vessels are included in pelvic veins?

Answer 32

- lateral sacral veins anastamose with internal vertebral plexus - superior rectal vein - superior gluteal veins - testicular veins

Question 33

What veins provide a metastatic pathway for prostatic or ovarian cancer cells to the vertebrae or cranial cavity?

Answer 33

lateral sacral veins anastamosing with internal vertebral plexus to inferior or superior vena cava

Question 34

What does the superior rectal vein drain? | What is it a tributary to?

Answer 34

drains the rectum | tributary to the inferior mesenteric vein

Question 35

What are the superior gluteal veins tributaries to?

Answer 35

largest tributaries to internal iliac veins

Question 36

What is the path of the testicular veins?

Answer 36

exit deep inguinal ring and transverse the pelvic cavity to travel to their terminations

Question 37

What are the 4 groups of lymph nodes associated with the pelvic viscera?

Answer 37

- external iliac lymph nodes - internal iliac lymph nodes - sacral lymph nodes - common iliac lymph nodes

Question 38

What do the external iliac lymph nodes receive lymph from? Drain to?

Answer 38

inguinal nodes and superior parts of middle to anterior pelvic organs drain to common iliac nodes

Question 39

What do the internal iliac lymph nodes receive lymph from? Drain to?

Answer 39

lymph from inferior pelvic viscera, deep perineum and the gluteal region -drain to common iliac nodes

Question 40

What do the sacral lymph nodes receive lymph from? Drain to?

Answer 40

postero-inferior pelvic viscera | -drain to internal or common iliac nodes

Question 41

What do the common iliac nodes receive lymph from? Drain to?

Answer 41

- from external iliac, internal iliac, and sacral lymph nodes - drain to lumbar lymph nodes

Question 42

What are pelvic structures innervated by?

Answer 42

- sacral and coccygeal spinal nerves (S1-S5, Co) | - pelvic splanchnic nerves (S2-S4)

Question 43

Where is the sacral plexus located?

Answer 43

on the posterlateral wall of the pelvic cavity

Question 44

What are the branches of the sacral plexus which exit the pelvic cavity through the greater sciatic foramen?

Answer 44

- sciatic nerve (L4-S3) - pudendal nerve (S2-S4) - superior gluteal nerve (L4-S1) - inferior gluteal nerve (L4-S2)

Question 45

What is the path of the sciatic nerve? | -supply

Answer 45

inferior to piriformis to enter gluteal region. descends in posterior thigh to supply hamstring muscles, leg, and foot

Question 46

What is the path of the pudendal nerve? | -supply

Answer 46

enters the peritoneum via the lesser sciatic formaen and is contained in the pudendal canal -supplies all perineal structures

Question 47

What is the path of the superior gluteal nerve? | -supplies

Answer 47

enters gluteal region | gluteus mediaus and gluteus minimus

Question 48

What is the path of the inferior gluteal nerve? | -supplies

Answer 48

enters gluteal region | gluteus maximus

Question 49

What is the coccygeal plexus? - nerves - location - supplies - gives rise to

Answer 49

- anterior rami of S4-S5 - pelvic surface of the coccygeus muscle - supplies coccygeus, part of levator ani and sacrococcygeal joint - anococcygeal nerves arise from plexus

Question 50

what does the anococcygeal nerves supply?

Answer 50

skin between the tip of the coccyx and anus

Question 51

hypogastric plexus - type of nerves - supplies - what passes through

Answer 51

- autonomic nerves - pelvis viscera - visceral afferent fibers pass through

Question 52

pelvic splanchnic nerves - type of nerve - supplies

Answer 52

- parasymptathetic innervation | - pelvic viscera including rectum and proximal anal canal (internal anal sphincter)

Question 53

pelvic nerve plexus - branches from - supplies

Answer 53

- branches from inferior hypogastric plexus - lateral rectum, inferolateral urinary bladder (both sexes) - prostate and seminal vesicles (male), erictile tissues in penis - cervix of uterus and lateral fornicles of the vagina in females

Question 54

What nerves produce an erection?

Answer 54

pelvic nerve plexus parasympathetic fibers in the prostatic plexus