Pelvis Flashcards
What is the structure at the base of the bladder called and what is it made up of?
The trigone - 2 ureters and the urethra
Which arteries supply the bladder in males?
Superior and inferior vesical arteries
Which arteries supply the bladder in females?
Superior vesical, uterine and vaginal arteries
What veins drain the bladder?
Vesical plexus to internal iliac veins
Where does lymph from the bladder, urethra and ureters drain to?
Internal iliac nodes
Which arteries supply the rectum?
Superior, middle and inferior rectal arteries
Which veins drain the rectum?
Superior portion drained by inferior mesenteric vein (to portal system)
Inferior portion by internal iliac vein (to systemic system)
Lymphatic drainage of the rectum
Superior portion: pre-aortic nodes at L3 (inf. mesenteric)
Inferior portion: para-rectal nodes at internal iliac artery
Innervation of the bladder
Inferior hypogastric plexus (ANS)
Innervation of the rectum
Inferior hypogastric plexus
Name of the structure covering the uterus
The broad ligament
Blood supply to the uterus
Supplied by uterine artery from internal iliac
- anastomoses with ovarian artery
Arterial supply of the ovaries
Ovarian artery = from aorta at L2
Venous drainage of ovaries
Right ovarian vein to the IVC
Left ovarian vein to the left renal vein
Innervation of the ovaries
Aortic plexus
Arterial supply of uterine tubes
Ovarian artery
Blood supply of distal uterus
Vaginal artery
Blood supply of proximal vagina
Vaginal artery ( from uterine of anterior internal iliac)
Blood supply of distal vagina
Internal pudendal artery
Blood supply of perineum (female)
Internal pudendal artery
Which structure runs under the uterine artery, like water under a bridge?
The ureter
Lymphatic drainage of the ovaries, uterine tubes and fundus of uterus
Aortic nodes at root of ovarian artery, L2
Lymphatic drainage of the cervix and distal uterus
Internal iliac nodes
Lymphatic drainage of body of uterus
Internal iliac nodes
Which structure passes over the bifurcation of the common iliac vessels?
Ureter
In males, which structure passes over the external iliac vessels?
Vas deferens
Arterial supply of distal vas deferens and seminal vesicles
Inferior vesical artery
Arterial supply of prostate
Prostatic arteries
Venous drainage of prostate
Prostatic venous plexus drains to internal iliac veins
Lymphatic drainage of male pelvic organs
Mainly to internal iliac nodes
Testis to aortic nodes at root of testicular artery (L2)
Sacral plexus nerve roots
S1-4
Lumbosacral trunk roots
L4+5
Roots of the sciatic nerve
L4-S3
Sciatic nerve location
Lateral internal wall of pelvis, forms on anterior surface of piriformis muscle
Superior gluteal nerve roots
L4-S1
Inferior gluteal nerve roots
L5-S2
Nerves passing below and above piriformis
Inferior and superior gluteal nerves
What does the superior gluteal nerve innervate?
Gluteus medius and minimus muscles
What does the inferior gluteal nerve innervate?
Gluteus maximum muscle
Roots of nerve to obturator internus
L5-S1
What other muscle might nerve to obturator internus supply?
Superior gemellus muscle
Roots of nerve to piriformis
S1-2
Nerve to levator ani roots
S4 + pudendal nerve
Nerve to coccygeus roots
S4+5
Pudendal nerve roots
S2-4
What does the pudendal nerve supply?
Levator ani, bulbospongiosus and ischiocavernous muscles, external anal and urethral sphincters
Which nerve passes through both sciatic foramens?
Pudendal nerve
Which nerve wraps around the ischial spine?
Pudendal nerve
Ischioanal fossa contents
Branches of pudendal nerve, artery and vein
Innervation of the external anal sphincter
Inferior rectal branch of pudendal nerve (S2-4)
Arterial supply of the wall of the anal canal
Inferior and superior rectal artery (as they terminate)
What is the space between the layers of the urogenital membrane called?
Deep perineal pouch
Space between the superficial fascia of the urogenital diaphragm and the skin
Superficial perineal pouch
Nerve supply of the ischiocavernous muscle
Perineal branches of the pudendal nerve
Nerve supply of the bulbospongiosus muscle
Perineal branches of the pudendal nerve
Blood supply to the clitoris
Branches of internal pudendal artery
Innervation of the clitoris
Dorsal nerve of clitoris from pudendal nerve
Innervation of the penis
Dorsal nerve of penis from perineal branch of pudendal nerve
Innervation of iliacus muscle
Femoral nerve (L2-4)
Innervation of Psoas muscle
Anterior rami of L2-4 from lumbar plexus
Innervation of obturator internus
Nerve to obturator internus (L5,S1)
Action of iliacus
Hip flexion
Action of Psoas
Hip flexion
Action of obturator internus
Lateral rotation of hip
Where does the tendon of obturator internus pass through?
Lesser sciatic notch
Innervation of coccygeus
Direct branches from sacral plexus (S4,5)
Innervation of levator ani
Pudendal nerve (S2-4) + nerve to levator ani (S4)
Action of coccygeus
Supports pelvic viscera
Action of pubococcygeus
Supports vagina/prostate
Action of puborectalis
Maintains faecal continence
Action of iliococcygeus
Supports pelvic viscera
Where does the rectum begin?
Where the colon crosses the 3rd sacral vertebrae to the tip of the coccyx
What is the dilation near the termination of the rectum called?
The rectal ampulla
3 sections of the broad ligament
- Mesovarium
- Mesosalpinx
- Mesometrium
Mesovarium function
Holds ovaries to posterior wall
Mesosalpinx function
Supports the uterine tubes, lies between the tubes and the ovaries
Mesometrium function
Associated with the body of the uterus
Name structure A
Posterior fornix (lateral fornix)
Name structure A
Anterior fornix (lateral fornix)
Name structure A
Ampulla
Name structure A
Isthmus
Name structure A
Infundibulum
Name structure A
Fundus of uterus
What are the finger-like projections on the end of the uterine tube called?
Fimbriae
Which ligament carries the ovarian artery and vein?
The suspensory ligament of the ovary
Lymphatic drainage of the testis
Aortic nodes at root of testicular artery (L2)
Name structure A
Vas deferens
Name structure A
Seminal vesicle
What are the spaces either side of the rectum called?
Ischioanal fossa
What does the pectinate line indicate?
Separation of visceral and parietal
Name of layer of fascia below fat, superior to the labia/scrotum?
Scarpa’s fascia
Name of layer of fascia below fat, in/below the labia/scrotum?
Colles fascia
Ligament of the ovary location
Runs between ovaries and uterus
Name structure A
Mesometrium
Name structure A
Mesosalpinx
Name structure A
Round ligament of uterus
Name structure A
Mesovarium
Name structure A
Round ligament of uterus
Name of the pouch located between the bladder and rectum in males?
Vesicorectal pouch
Name of the pouch located between the rectum and the uterus?
Rectouterine pouch
Name of the pouch located between the uterus and the bladder?
Vesicouterine pouch
What does the ischiocavernous muscle overlie?
The crura
What does the bulbospongiosus muscle overlie?
The bulb of the penis/vestibule
Name structure A
Ischiocavernous muscle
Name structure A
Bulbospongiosus muscle
Name structure A
Prostate
Name structure A
Crura
Name structure A
Bulb of vestibule
Name structure A
Bulb of penis
What does the crura form in males?
Corpus cavernosus
What does the bulb form in males?
Corpus spongiosum
Name structure A
Genitofemoral nerve roots
L1+2
Lateral cutaneous nerve of the thigh roots
L2+3
Name structure A
Sciatic nerve
Name structure A
Lumbosacral trunk
Name structure A
Superior gluteal nerve and vessels
Name structure A
Inferior gluteal nerve and vessels
Name structure A
Posterior cutaneous nerve of the thigh
Name structure A
Obturator nerve (L2,3,4)
Name structure A
Superior gluteal nerve (L4-S1)
Name structure A
Inferior gluteal nerve (L5-S2)
Name structure A
Pudendal nerve (S2-4)
At what level does the aorta divide into the common iliac arteries?
L4
Name muscle A
Iliacus
Name muscle A
Psoas
Name muscle A
Piriformis
Name muscle A
Obturator internus
Name muscle A
Coccygeus (lies next to piriformis, close to sacrum)
Name muscle A
Iliococcygeus (lateral to pubococcygeus, in between sacrum and pubic bone)
Location of pubococcygeus
Most medial, lies closest to pubic bone + attaches
Obturator nerve roots
L2-4
Parasympathetic Innervation of pelvic viscera
Pelvic splanchnic nerves