Pelvic Viscera

Question 1

What is significant about the pudendal nerve?

Answer 1

Does not go through pelvic floor (outlet). Starts at posterior side of ischial spine. Out of pelvis through greater sciatic foreamen, goes around the spine, and comes in below the pelvic floor into perineum by entering the lesser sciatic foreamen.

Question 2

What makes lateral fold of anterial abdomenal wall?

Answer 2

Epigastric artery

Question 3

Where does ovarian/testical cancer spread? Cervical cancer? Scrotal?

Answer 3

1. Lateral aortic lymph nodes
2. Interal iliac lymph nodes
3. Inguinal lymph nodes

Question 4

Sympathetics for pelvis –>
Preganglionic source:
Postganglionic motor function:
Sensory function:

Answer 4

Sympathetics for pelvis –>
Preganglionic source: Thoracolumbar (T10-L2)
Postganglionic motor function: vasoconstrict, TONICALLY constrict sooth muscle scphincters, peristalsis in male reproductive tract (vas deferens)
Sensory function: PAIN from viscera ABOVE pelvic pain line (below = parasympathetic)

Question 5

Parasympathetics for pelvis –>
Preganglionic source:
Postganglionic motor function:
Sensory function:

Answer 5

Parasympathetics for pelvis –>
Preganglionic source: Craniosacral (S2, 3, 4)
Postganglionic motor function: Rectal peristalsis…opposite of sympathetic. Contracts detrusor muscle. INHIBITS smooth muscle sphincters
Sensory function: Pain from viscera below pelvic line + reflex…information about bladder state

Question 6

All viscera innervation in pelvis carries sensory afferent fibers, but this can be further divided. Which ones carry preganglionic ones? Postganglionic ones? Both?

Answer 6

Preganglionic: 
Thoracic splhanchnics (sympathetic) 
lumbar splanchnics (symp)
Pelvic splanchnic (para)

Post ganglionic:
Ovarian plexu (symp)

Both:
Superior hypogastric plexus (symp)
Hypogastric nerves (symp)
Inferior hypogastric plexus (symp + para)

Question 7

Lower uterine segment:

Answer 7

Location between body and cervix of uterus. C section incision is made here.

Question 8

What happens when paramesanephric ducts do not fuse?

Answer 8

You get 2 uteruses (uteri) (and 2 external osses)

Question 9

Blood supply of uterus? Where does it run?

Answer 9

Uterine artery (off of internal iliac). Found in transverse cervical ligament (Cardinal Ligament) note that it is tortuous (like splenic) because of baby potential size/uterus expansion

Question 10

Where does round ligament end?

Answer 10

Labia major (skin of vagina)

Question 11

Ovarian blood supply

Answer 11

Ovarian vessels OFF AORTA (not internal iliac like uterus)

Question 12

Blood supply of male pelvis? Venous return from erectile bodies?

Answer 12

Inferior vesical artery (again, from internal iliac). Venous return = Prostatic venous plexus (not pudendal system)