Pelvis and Perineum Flashcards
Neurovascular supply for testes?
The main arterial supply to the testes and epididymis is via the paired testicular arteries, which arise directly from the abdominal aorta. They descend down the abdomen, and pass into the scrotum via the inguinal canal, contained within the spermatic cord.
However, the testes are also supplied by branches of the cremasteric artery (from the inferior epigastric artery) and the artery of the vas deferens (from the inferior vesical artery). These branches give anastomoses to the main testicular artery.
Venous drainage is achieved via the paired testicular veins. They are formed from the pampiniform plexus in the scrotum. the left testicular vein drains into the left renal vein, while the right testicular vein drains directly into the inferior vena cava.
Since the testes are originally retroperitoneal organs, the lymphatic drainage is to the lumbar and para-aortic nodes, along the lumbar vertebrae.
Neurovascular supply for ovaries
Arterial supply: Ovarian arteries from aorta (paired)
Veins: paired ovarian veins. The left ovarian vein drains into the left renal vein, and the right ovarian vein drains directly into the inferior vena cava
Lymph: Paraaortic nodes
Neurovascular supply for cervix
cervix drains into three potential nodal stations; laterally through the broad ligament to the external iliac nodes, along the lymphatics of the uterosacral fold to the presacral nodes and posterolaterally along lymphatics lying alongside the uterine vessels to the internal iliac nodes.
Neurovascular supply for Vagina
The arterial supply to the vagina is via the uterine and vaginal arteries – both branches of the internal iliac artery.
Venous return is by the vaginal venous plexus, which drains into the internal iliac veins via the uterine vein.
Lymphatic drainage is divided into three sections:
Superior – drains to external iliac nodes
Middle – drains to internal iliac nodes
Inferior – drains to superficial inguinal lymph nodes.
Neurovascular supply for scrotum
Composed of skin and closely attached dartos fascia.
Parietal layer of the tunica vaginalis is the innermost layer
Arterial supply from the anterior (external pudendal) and posterior scrotal arteries (internal pudendal)
Lymphatic drainage to the superficial inguinal lymph nodes
Nerves:
Anterior and anterolateral aspect – Anterior scrotal nerves derived from the genital branch of genitofemoral nerve and ilioinguinal nerve
Posterior aspect – Posterior scrotal nerves derived from the perineal branches of the pudendal nerve and posterior femoral cutaneous nerve.
Neurovascular supply for uterus
The uterine fundus has a lymphatic drainage that runs with the ovarian vessels and may thus drain to the para-aortic nodes. Some drainage may also pass along the round ligament to the inguinal nodes.
The body of the uterus drains through lymphatics contained within the broad ligament to the iliac lymph nodes.
What ligaments hold up uterus
Superior aspect – supported by the broad ligament and the round ligaments.
Middle aspect – supported by the cardinal, pubocervical and uterosacral ligaments.
Uterine prolapse is caused by damage to the cardinal and uterosacral ligaments
Neurovascular supply to rectum
The rectum receives arterial supply through three main arteries:
Superior rectal artery
Middle rectal artery (from the internal iliac)
Inferior rectal artery (from the pudendal vessels)
Lymphatic drainage of the rectum is via the pararectal lymph nodes, which drain into the inferior mesenteric nodes.
Additionally, the lymph from the lower aspect of the rectum drains directly into the internal iliac lymph nodes.
Neurovascular supply to prostate
Arterial supply Inferior vesical artery (from internal iliac)
Venous drainage Prostatic venous plexus (to paravertebral veins)
Lymphatic drainage Internal iliac nodes
Innervation Inferior hypogastric plexus
neurovascular supply to vulva
The arterial supply to the vulva is from the paired internal and external pudendal arteries (branches of the internal iliac artery and femoral artery, respectively).
Venous drainage is achieved via the pudendal veins, with smaller labial veins contributing as tributaries.
Lymph drains to the nearby superficial inguinal lymph nodes.
Nerves:
Anterior – ilioinguinal nerve, genital branch of the genitofemoral nerve
Posterior – pudendal nerve, posterior cutaneous nerve of the thigh.
Neurovascular supply to anus?
Above dentate line:
Artery: Superior rectal artery (from IMA)
Vein: SRV
Lymph: internal iliac nodes
Below dentate line:
Artery: inferior rectal artery (internal pudendal artery)
Vein: IRV
Lymph: superficial inguinal nodes
Difference between male and female pelvis?
When comparing the two, the gynaecoid pelvis has:
A wider and broader structure yet it is lighter in weight
An oval-shaped inlet compared with the heart-shaped android pelvis.
Less prominent ischial spines, allowing for a greater bispinous diameter
A greater angled sub-pubic arch, more than 80-90 degrees.
A sacrum which is shorter, more curved and with a less pronounced sacral promontory.
In addition to the bony adaptations, the sacrotuberous and sacrospinous ligaments can stretch under the influence of progesterone and increase the size of the outlet further.
lymphatic drainage of urethra?
prostatic and membranous urethra drain to the internal iliac nodes.
Penile urethra- drains into superficial and deep inguinal nodes
In females the whole urethra drains to the internal iliac nodes
Contents of the greater sciatic foramen?
Nerves:
- Sciatic Nerve
- Superior and inferior gluteal nerves
- Pudendal nerve
- Posterior Femoral cutaneous nerve
- nerve to quadratics femoris and obturator internus
Vessels:
- Superior gluteal artery and vein
- inferior gluteal artery and vein
- internal pudendal artery and vein
Contents of the lesser sciatic foramen?
Tendon of obturator internus
Pudendal nerve
Internal pudendal artery and vein
Nerve to obturator internus
