Pelvic Vessels, Nerves, and Lymphatics Flashcards
What are the branches of the abdominal aorta that supply pelvic structures?
- ovarian arteries
- middle (median) sacral artery
- common iliac arteries
- inferior mesenteric artery
What do the ovarian arteries supply?
ovaries
What does the middle (median) sacral artery supply?
lower lumbar vertebrae
sacrum
coccyx
What do the common iliac arteries bifurcate into? Where?
external and internal iliac arteries at L5-S1
What does the external iliac artery become?
femoral a
What does the internal iliac artery supply?
pelvic structures and peritoneum
What is the terminal branch of the IMA?
superior rectal A
What are the branches of the superior rectal A supplying?
both sides of the rectum as far inferiorly as the internal anal sphincter
What are branches of the posterior division of the internal iliac artery?
- lateral sacral arteries
- iliolumbar artery
- superior gluteal artery
What do the lateral sacral arteries supply?
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
What does the iliolumbar artery go between?
obturator N and lumbosacral trunk
What does the illiolumbar A supply?
psoas major, iliacus, and quadratus lumborum plus cauda equina in the vertebral canal
What does the superior gluteal artery exit?
greater sciatic foramen
What does the superior gluteal artery supply?
piriformis, gluteal muscles, and tensor fascia lata
What are the branches of the anterior division of the internal iliac artery?
- umbilical artery
- superior vesical arteries
- inferior vesical artery (males)
- middle rectal artery
- obturator artery
- internal pudendal artery
- inferior gluteal artery
- uterine artery
- vaginal artery
What does the umbilical artery and superior vesical artery supply?
urinary bladder
-originate from same trunk
Which artery’s distal portion is obliterated after birth?
umbilical artery
What does the inferior vesical artery supply?
only in males
-urinary bladder, seminal vesicle, prostate, and ureter
What does the middle rectal artery supply?
rectum, prostate, seminal vescile in males, and rectum and vagina in females
What does the obturator artery supply?
pelvic muscles, head of femur then leaves pelvic cavity via the obturator canal to the medial thigh
What does the internal pudendal artery supply?
all perineal structures
What is the path of the internal pudendal artery?
exits the pelvis via greater sciatic foramen, loops around the spine of the ischium to enter the perineum via lesser sciatic foramen
What does the inferior gluteal artery supply?
piriformis, pelvic diaphragm, quadratus femoris, gluteus maximus, and sciatic nerve
What does the uterine artery supply?
-anastamosis
uterus and superior vagina and ligaments of the uterus
-anastamoses with the ovarian artery
Whta does the vaginal artery supply?
anterior and posterior vaginal surfaces
true or false: each pelvic organ has a venous plexus which freely communicates with venous plexuses of other organs
true
Do the venous plexuses of the pelvic organs have valves?
no
What are the connections of the pelvic venous plexuses with vertebral venous plexuses?
Batson’s veins
What do the pelvic venous plexuses drain into?
internal iliac veins, inferior mesenteric vein, and lateral sacral veins
Where do the internal iliac veins form in relationship to the greater sciatic foramen?
-internal iliac arteries
superior
lie posterior to internal iliac arteries
Where do the internal and external iliac veins merge?
L4/L5 IV disc to form inferior vena cava
What vessels are included in pelvic veins?
- lateral sacral veins anastamose with internal vertebral plexus
- superior rectal vein
- superior gluteal veins
- testicular veins
What veins provide a metastatic pathway for prostatic or ovarian cancer cells to the vertebrae or cranial cavity?
lateral sacral veins anastamosing with internal vertebral plexus to inferior or superior vena cava
What does the superior rectal vein drain?
What is it a tributary to?
drains the rectum
tributary to the inferior mesenteric vein
What are the superior gluteal veins tributaries to?
largest tributaries to internal iliac veins
What is the path of the testicular veins?
exit deep inguinal ring and transverse the pelvic cavity to travel to their terminations
What are the 4 groups of lymph nodes associated with the pelvic viscera?
- external iliac lymph nodes
- internal iliac lymph nodes
- sacral lymph nodes
- common iliac lymph nodes
What do the external iliac lymph nodes receive lymph from? Drain to?
inguinal nodes and superior parts of middle to anterior pelvic organs
drain to common iliac nodes
What do the internal iliac lymph nodes receive lymph from? Drain to?
lymph from inferior pelvic viscera, deep perineum and the gluteal region
-drain to common iliac nodes
What do the sacral lymph nodes receive lymph from? Drain to?
postero-inferior pelvic viscera
-drain to internal or common iliac nodes
What do the common iliac nodes receive lymph from? Drain to?
- from external iliac, internal iliac, and sacral lymph nodes
- drain to lumbar lymph nodes
What are pelvic structures innervated by?
- sacral and coccygeal spinal nerves (S1-S5, Co)
- pelvic splanchnic nerves (S2-S4)
Where is the sacral plexus located?
on the posterlateral wall of the pelvic cavity
What are the branches of the sacral plexus which exit the pelvic cavity through the greater sciatic foramen?
- sciatic nerve (L4-S3)
- pudendal nerve (S2-S4)
- superior gluteal nerve (L4-S1)
- inferior gluteal nerve (L4-S2)
What is the path of the sciatic nerve?
-supply
inferior to piriformis to enter gluteal region. descends in posterior thigh to supply hamstring muscles, leg, and foot
What is the path of the pudendal nerve?
-supply
enters the peritoneum via the lesser sciatic formaen and is contained in the pudendal canal
-supplies all perineal structures
What is the path of the superior gluteal nerve?
-supplies
enters gluteal region
gluteus mediaus and gluteus minimus
What is the path of the inferior gluteal nerve?
-supplies
enters gluteal region
gluteus maximus
What is the coccygeal plexus?
- nerves
- location
- supplies
- gives rise to
- 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
what does the anococcygeal nerves supply?
skin between the tip of the coccyx and anus
hypogastric plexus
- type of nerves
- supplies
- what passes through
- autonomic nerves
- pelvis viscera
- visceral afferent fibers pass through
pelvic splanchnic nerves
- type of nerve
- supplies
- parasymptathetic innervation
- pelvic viscera including rectum and proximal anal canal (internal anal sphincter)
pelvic nerve plexus
- branches from
- supplies
- 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
What nerves produce an erection?
pelvic nerve plexus parasympathetic fibers in the prostatic plexus
