Pelvis II Flashcards
largest nerve in the body, exits through greater sciatic foramen
sciatic n L4-S3
the sciatic nerves is the combination of what two nerves
common peroneal (fibular) and tibial nerves
nerve that runs with internal pudendal artery, exits through greater sciatic foramen, passes over the sacrospinous ligament into the lesser sciatic foramen to the ischiorectal fossa
pudendal n S2-4 (ventral rami)
the pudendal nerve when passing over the sacrospinous ligament into the lesser sciatic foramen passes though ____ to the ischiorectal fossa
alcocks canal
what are the 3 branches off the pudendal nerve
- perineal n
- dorsal nerve to penis or clitoris
- inferior rectal n
supplies the skin and muscles of perineum (between anus and genitalia)
perineal n
supplies sensory to external genitalia
dorsal n to penis or clitoris
external anal sphincter n
inferior rectal n
supplies gluteus medius and minimus muscles
superior gluteal n L4-S1
supplies gluteus maximus
inferior gluteal n L5-S2
supplies obturator internus and gemellus superior
n to obturator internus L5-S2
supplies piriformis
n to piriformis S1-2
supplies skin of buttocks, medial and posterior thigh
posterior femoral cutaneous n S1-3
motor to the adductors; sensory to inferior, medial thigh
obturator n L2-4
small network from S4-5 that lies on the pelvic surface of the coccyx to supply the coccygeus, part of levator ani, sacrococcygeal joint, and skin over the coccygeal area
coccygeal plexus
continue from the lumbar sympathetic trunks and joins to form the ganglion impar anterior to the coccyx (sympathetics to lower limbs)
sacral sympathetic trunks
supplies parasympathetics to pelvic viscera via the inferior hypogastric and pelvic plexus
pelvic splanchnic nerves S2-4
nerves to levator ani and coccygeus cord segments
S3-4
lies just inferior to the aortic bifurcation and descends into the pelvis along the anterior sacrum as they become right and left hypogastric nerves
superior hypogastric plexus
contain both p/s and sym fibers; supplies pelvic viscera
inferior hypogastric plexus
IHP supplies what in males
prostate, seminal vesicles, inferolateral bladder
IHP supplies what in females
cervix of uterus, lateral fornices of vagina
gives branches to inferior epigastric artery and deep circumflex iliac artery
external iliac artery
main branch which forms the lateral umbilical fold, anastomoses with the superior epigastric artery
inferior epigastric artery
anastomoses with iliolumbar artery
deep circumflex artery
artery that divides into an anterior and posterior division
internal iliac artery
branches off posterior division; ascends anterior to SI joints to supply iliopsoas and cauda equina
iliolumbar artery
branches off posterior division; travels down the anteromedial aspect of piriformis where it gives off branches that travel through the sacral foramina to supply bone, erector spinae, piriformis, and overlying skin
lateral sacral artery
branch off posterior division; exits pelvis via greater sciatic foramen, found between the lumbosacral trunk and S1 ventral ramus
superior gluteal artery
branch off anterior division; runs anteroinferiorly between urinary bladder and pelvis to give off _______
umbilical artery
superior vesical arteries
supply the superior bladder and lower ureter, continuation dies then becomes medial umbilical ligament
superior vesical arteries
branch off anterior division; runs anteroinferiorly on the obturator fascia between the nerve and vein and exits the pelvis via obturator canal to supply medial thigh
obturator artery
what is the variability when it comes to the obturator artery
obturator artery exits external iliac then wraps around pubic ramus to obturator canal (pelvis fracture can cause harm)
only seen in males; supplies the inferior bladder, inferior part of ureters, seminal vesicles, and prostate
inferior vesical artery
only seen in females; passes anterior and superior to the ureter (homologue of artery to vas deferens)
uterine artery
only seen in females; homologue of inferior vesical artery runs inferior to the ureter
vaginal artery
passes inferolaterally, anterior to the piriformis and sacral plexus
internal pudendal artery
supplies inferior rectum, prostate, vagina, and seminal vesicles
middle rectal artery
found between S2 and S3 or splitting S2 nerve root
inferior gluteal artery
drainage of venous blood from the pelvic region can either be ___ or ___
systemic or portal
lateral sacral veins eventually drain into the _________
internal vertebral venous plexus (batson’s channels)
how does prostate cancer get to the spine
lateral sacral veins draining into internal vertebral venous plexus
structure that carries sperm; ends by first enlarging to form an ampulla, then narrows to join the ducts of the seminal vesicles to from the _____
ductus deferens
ejaculatory ducts (intraprostatic structure)
secretes fructose and an alkaline substance that mixes with the sperm as they enter the ejaculatory ducts
seminal vesicles
union between the duct of the seminal vesicle and the vas deferens
ejaculatory ducts
dense walnut shaped gland located inferior to the bladder
prostate (3cm)
what does the prostate secrete
prostate specific antigen, citric acid, and fibrinolysin
pea sized glands that lie posterolaterally to the membranous urethra and have ducts that empty their musk like secretions into this part of the urethra
bulbourethral glands
what prevents an erected penis from explosion
deep fascia
what are the two “eyes” of the monkey face that perfuse the penis
corpus cavernosum
what is the urethra sitting in within the penis
corpus spongiosum
musculomembranous tube that extends from the vestibule to where it surrounds the cervix of the uterus
vagina
recess around the cervix formed by the vagina is called
vaginal fornix
what closely associates to the rectouterine pouch of douglas
posterior fornix of the vagina
what is the innervation of the vagina
uterovaginal plexus of nerves; parasym innervates this organ and the uterus
round superior aspect of the uterus
fundus of the uterus
constricted inferior aspect just superior to the cervix
isthmus of the uterus
cylindrical, narrow protrusion into the vagina
cervix
what 3 layers line the uterine wall
- perimetrium
- endometrium
- myometrium
attaches ovaries to the uterus
ovarian ligament
remnant of the gubernaculum along with the ovarian ligament, ends at labia majora
round ligament of the uterus
double layer mesentery that attaches the uterus to the lateral walls of the pelvis
broad ligament
mesentery of the broad ligament that surrounds the fallopian tube
mesosalpinx
mesentery of the broad ligament that suspends the ovaries on the POSTERIOR aspect
mesovarium
broad ligament that covers the ovarian artery and vein superiorly. attached to the lateral aspect of the ovary
suspensory ligaments
what 4 parts are within the uterine tubes
- isthmus
- ampulla
- infundibulum
- fimbriae
where does fertilization occur
ampulla of the uterus
how are the ovaries attached to the uterus
ovarian ligament proper
innervation of the ovaries
P/S: ovarian plexus from CN X and the inferior hypogastric plexus
afferent: T10
space between the rectum and the bladder; lowest point in the male pelvis
rectovesical pouch
fat filled space between the bladder and pubic bone
retropubic space
space between the bladder and the anteverted uterus
vesicouterine pouch
pouch between the rectum and the uterus extending down to the POSTERIOR FORNIX OF THE VAGINA
rectouterine pouch of douglas
what is the lowest point of the female pelvis
rectouterine pouch of douglas
