Rectum, bladder, female urethra Flashcards
Depression superior to the bladder
Supravesical fossa, elevates when bladder is filled
Depression b/t the rectum and bladder in males
Rectovesical pouch
Depression b/t the bladder and uterus in females
Uterovesical pouch
Depression b/t the rectum and uterus in females
Rectouterine pouch
Where “things” collect in the peritoneal cavity?
Males: rectovesical pouch, Females: rectouterine pouch
At what level does the abdominal aorta bifurcate?
L4
When does the common iliac artery bifurcate and into what?
Internal and external iliac arteries b/t L5 and S1
Branches of the internal iliac POSTERIOR division
Iliolumbar, lateral sacral, superior gluteal arteries
Exits lesser pelvis into iliac fossa (artery)
Iliolumbar a.
Passes thru sacral foramina to provide sacral spinal arteries and branches to erector spinae muscles
Lateral sacral artery
What nerves does the superior gluteal artery usually pass thru?
Lumbosacral trunk (L4/L5) and S1. Exits superior to piriformis
Branches of the internal iliac ANTERIOR division
Umbilical, obturator, Inferior vesical, uterine, middle rectal, internalpudendal/gluteal arteries
What does the obliterated part form with the medial umbilical fold?
Medial umbilical ligament
What other place can the obturator artery arise from?
Inferior epigastric A. making it susceptible to damage during hernia repairs
Supplies blood to the roof of the bladder
Superior vesical artery
Supplies blood to the fundus of the bladder, seminal vesicles, and prostate in males
Inferior vesicle arteries
Path of uterine artery
Passes superior to the ureter near the lateral edge of vagina, so is in danger during pelvic proceedures
Branches of the uterine artery
Vaginal branch (cervix/vagina), Uterine a. proper (uterine tubes/ovaries), vaginal artery
Artery that usually passes b/t S2/S3 to exit pelvis via greater sciatic foramen, inferior to piriformis
Inferior gluteal artery
Paired arteries off of the abdominal aorta to the gonads
Ovarian or Testicular arteries
Unpaired artery off posterior surface of AA just superior to the bifurcation
Median sacral artery
Terminal branch of inferior mesenteric artery that supplies the rectum
Superior rectal artery
Where do the pelvic venous plexuses mainly drain into?
Internal iliac veins
Lumbar plexus branches
L1-L4
L2-L4 nerve that traverses pelvis and exits vis the obturator canal to supply the medial thigh
Obturator nerve
Lumbosacral trunk
L4-L5 to join sacral plexus
Nerves and levels of the sacral plexus
L4-S4, Sciate, pudendal, superior/inferior gluteal nerve
Exits pelvis via greater sciatic foramen inferior to piriformis to supply posterior thigh, entire leg, and foot
Sciatic Nerve (L4-S3)
Supplies nerves to the perineum/external gentialia
Pudendal nerve (S2-S4)
Nerve to gluteus medius/minimus and TFL
Superior gluteal nerve
Nerve to glutes maximus
Inferior gluteal nerve
Inferior sympathetic trunks that usually fuse together to form ganglion anterior to the coccyx
Sacral sympathetic trunks
Continuation of prevertebral plexus below the bifurcation of the aorta
Hypogastric plexuses
Where are the pelvis splanchnic nerves and what do they supply?
Presynaptic parasymp to viscera distal to the left colic flexure
General area of pelvic pain line
Lower limit of peritoneum
Above the pelvic pain line
Sympath to T11-L2/3
Below the pelvis pain line
Parasymp to S2-S4
Path of ureters in males
Pass inferior to the ductus deferens & enter the bladder superior to the seminal vesicles
Path of ureters in females
Directly inferior to uterine artery
5 parts of the bladder
Apex, fundus, Body, neck, trigone
Location of external urethral orifice in females
Vestibule of the vagina
Do females have an internal urethral sphincter?
No
Portion of the rectum that can dilate and distend
Rectal ampulla
Extends from the anorectal flexure to the anus
Anal canal
Surrounds the upper 2/3 of the anal canal
Internal anal sphincter (symp maintainance)
Surrounds the lower 1/3 of anal canal
External anal sphincter (inferior rectal nerve via pudendal)
Supplies the superior portion inf the rectum
Superior rectal artery
Supplies the lower part of the rectum
middle rectal arteries
Supply the anal canal
Inferior rectal arteries
What is important about the drainage of the superior rectal vein?
Portocaval venous anastomosis into the portal venous system
Pain in the rectum is conveyed via what?
Parasymp to S2-S4
What type of hemorrhoids are painful?
External