Structure and Compartmentation - Pelvis and Perineum III

Question 1

pelvic vasculature

Answer 1

internal iliac artery
-branch from common iliac artery

divides at upper border of piriformis

• posterior trunk
• anterior trunk

Question 2

posterior trunk of internal iliac

Answer 2

iliolumbar artery
lateral sacral artery
superior gluteal artery

Question 3

iliolumbar artery

Answer 3

first branch of posterior trunk internal iliac a

lumbar branch - psoas and quadratus lumborum
iliac branch - to iliacus m.

Question 4

lateral sacral artery

Answer 4

branch of posterior trunk internal iliac artery

2 from one trunk:

• 1st enter first anterior sacral foramen
• to vertebral canal and skin/muscles of dorsal sacrum
• anastomose with superior gluteal
• 2nd descends sacrum
• medial to anterior foraminae
• branches similar to first

Question 5

superior gluteal artery

Answer 5

continuation of posterior trunk of internal iliac

leaves pelvis - greater sciatic foramen
-exits above piriformis

Question 6

inferior gluteal artery

Answer 6

may be termination of posterior trunk internal iliac but usually terminal branch of anterior trunk

exits greater sciatic foramen below piriformis

Question 7

anterior trunk of internal iliac artery

Answer 7

arises along lateral pelvic wall lateral to pelvic plexus

typically give rise to all pelvic visceral branches

very variable**
-rely on where they go

Question 8

branches of anterior trunk

Answer 8

umbilical artery
middle rectal artery
inferior rectal artery
obturator artery
internal pudendal artery
superior vesicle artery
vaginal artery (F)
inferior vesicle artery (M)
middle vesicle artery
inferior gluteal artery

Question 9

middle sacral artery

Answer 9

arises from aorta along surface of sacrum

-small communicating branches to lateral sacral arteries

Question 10

superior rectal artery

Answer 10

branch of inferior mesenteric artery

-to posterior wall of rectum

Question 11

internal iliac vein

Answer 11

tributaries roughly follow arteries

Question 12

iliolumbar vein

Answer 12

companion of lumbar branch of iliolumbar artery

formation of ascending lumbar vein in abdominal region

Question 13

anastomotic venous connections

Answer 13

link:
visceral pelvis plexus
bony pelvic plexus
spinal venous plexus

possible routes of transmission - infections and metastatic cells

Question 14

cruciate collateral circulation

Answer 14

ovarian artery with uterine artery

in females

important if ligate during surgery

Question 15

innervation of pelvis

Answer 15

lumbar plexus

sacral plexus

Question 16

lumbar plexus

Answer 16

ventral rami - T12-L5

in substances of psoas major m.

linked superiorly to T12 and L1

lumbosacral trunk - ventral rami L4,5
-contribute to lumbosacral plexus

Question 17

sacral plexus

Answer 17

ventral rami S1,2,3
joined by lumbosacral trunk

forms within pelvis - anterior surface sacrum and lateral borders of sacrum

Question 18

lumbosacral trunk

Answer 18

ventral rami L4,5

Question 19

5 major nerves from lumbosacral plexus

Answer 19

anterior division:
obturator n.
tibial n. (medial and lateral plantar nn.)

posterior division:
femoral n.
common fibular n.

Question 20

sciatic nerve

Answer 20

largest nerve to exit plexus

-bundle of tibial and common fibular nerve**

Question 21

femoral nerve

Answer 21

posterior division of lumbar plexus

Question 22

obturator nerve

Answer 22

anterior division of lumbar plexus

Question 23

common fibular nerve

Answer 23

posterior division of sacral plexus

Question 24

tibial nerve

Answer 24

anterior division of sacral plexus

Question 25

both division of lumbar plexus

Answer 25

leaves pelvis on anterior aspect of thigh and posteriorly entering buttocks

Question 26

lumbar plexus

Answer 26

sacral and lumbar plexus

Question 27

anterior division of both plexuses

Answer 27

supply original flexor muscles

Question 28

posterior division of both plexues

Answer 28

supply original extensor muscles

Question 29

obturator nerve

Answer 29

L2-4

Question 30

iliohypogastric nerve

Answer 30

L1

Question 31

ilioinguinal nerve

Answer 31

L1

Question 32

genitofemoral nerve

Answer 32

L1-2

Question 33

lumbosacral trunk

Answer 33

L4,5

Question 34

femoral nerve

Answer 34

L2-4

Question 35

lateral femoral cutaneous nerve

Answer 35

L2-3

Question 36

accessory oburator nerve

Answer 36

L3,4

Question 37

anterior division of lumbar plexus

Answer 37

``` obturator nerve iliohypogastric nerve ilioinguinal nerve genitofemoral nerve lumbosacral trunk ```

Question 38

posterior division of lumbar plexus

Answer 38

femoral nerve lateral femoral cutaneous nerve accessory obturator nerve

Question 39

anterior division of sacral plexus

Answer 39

medial and lateral plantar nerves = tibial n nerve to quadratus femoris nerve to obturator internus pudendal nerve

Question 40

posterior division of sacral plexus

Answer 40

``` common peroneal nerve superior gluteal nerve inferior gluteal nerve nerve to piriformis posterior femoral cutaneous nerve ```

Question 41

tibial nerve

Answer 41

L4-S3

Question 42

nerve to quadratus femoris

Answer 42

L4-S1

Question 43

nerve to obturator internus

Answer 43

L5-S2

Question 44

pudendal nerve

Answer 44

S2-4

Question 45

common peroneal nerve

Answer 45

L4-S2

Question 46

superior gluteal nerve

Answer 46

L4-S1

Question 47

inferior gluteal nerve

Answer 47

L5-S2

Question 48

nerve to piriformis

Answer 48

S1,2

Question 49

posterior femoral cutaneous nerve

Answer 49

S2,3

Question 50

lymph drainage

Answer 50

``` internal iliac node > external iliac nodes > common iliac node > lumbar node > cisterna chyli > thoracic ductd ```

Question 51

bladder lymph

Answer 51

superior and lateral surface - external iliac nodes base - to internal iliac nodes neck - to sacral and common iliac nodes

Question 52

rectum lymph

Answer 52

below pectinate - superficial inguinal nodes above pectinate - parallel major arteries: - from rectal ampulla and superior anal canal - along inferior rectal artery to internal iliac nodes from most of rectum - pararectal nodes along middle rectal artery to internal iliac nodes from area of rectosigmoid junction - superior rectal artery to inferior mesenteric nodes

Question 53

male genitalia lymph

Answer 53

external iliac nodes internal and external iliac nodes sacral and common iliac nodes

Question 54

testes lymph

Answer 54

to lumbar nodes

Question 55

penis and scrotum lymph

Answer 55

to inguinal nodes

Question 56

prostate lymph

Answer 56

sacral nodes and internal iliac nodes

Question 57

ductus deferens lymph

Answer 57

drains with testes

Question 58

ovaries and uterine tube lymph

Answer 58

lumbar nodes

Question 59

uterus lymph

Answer 59

fundus - lumbar nodes body - external iliac, internal iliac, superficial inguinal nodes cervix - internal and external iliac nodes, sacral nodes, internal iliac and common iliac nodes

Question 60

vagina lymph

Answer 60

upper - internal and common iliac middle and lower - internal iliac perineal - superficial inguinal nodes