Pelvis/Perineum ANS Flashcards
What does the pelvic pain line refer to?
Organs that are in peritoneum are “above the pain line” and have pain fibers travel with sympathetic nerves. Organs below the peritoneum are “below the pain line” and have pain fibers travel with parasympathetic nerves.
What is the main source of sympathetic innervation in the pelvis/perineum?
The lumbar splanchnic nerves (T11-L2) and the sacral splanchnic nerves.
What is the curse of the lumbar splanchnic nerves?
Enter the superior hypogastric plexus and then enter the inferior hypogastric plexus via the hypogastric nerves.
Is the bladder below or above the pelvic pain line?
The superior portion of the bladder (one covered in peritoneum) is above the pain line. The rest of the bladder is below.
Is the prostate above or below the pelvic pain line?
It is below (makes sense since it is below the bladder).
Is the uterus above or below the pelvic pain line?
It is above (remember it is covered in peritoneum i.e. the broad ligament, ect).
Are the cervix and vagina above or below the pelvic pain canal?
The cervix and vagina are below the pain line (pain travels with parasympathetic fibers).
What will a lumbar epidural do?
Will anesthetize T11 downward, so all of the FRT is numbed (cannot feel uterine contractions).
What will a caudal epidural do?
Will only anesthetize S2 downwards, so the uterus (above the pain line) will be unaffected (uterine contraction felt) while everything downward will be nimb.
What will referred pain from uterine contraction refer to?
T11-L2 dermatomes (i.e back pain radiating into the groin). Remember that the uterus is above the pain line and pain will refer along sympathetic fibers (i.e. lumbar splanchnics, T11-L2).
What are the parasympathetic fibers from the pelvic splanchnic berves called once in the perineum?
Cavernous nerves.
