T116 Pelvis and Perineum Flashcards

Nerves: a. motor target b. sensory target c. spinal contributions d. course

1
Q

sacral plexus

A

?

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2
Q

pelvic splanchnic nerves

A

?

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3
Q

sciatic nerve

A

?

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4
Q

pudendal nerve

a. motor target
b. sensory target
c. spinal contributions
d. course

A

a. motor target: skeletal muscles in perineum (external urethral sphincter, anal sphincter, levator ani)
b. sensory target: penis, clitoris, and skin of perineum
c. S2 to S4
d.
1. forms anteriorly to the lower part of the piriformis
2. passes through the greater sciatic foramen
3. around the sacropspinous ligament
4. through the lesser sciatic foramen

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5
Q

superior gluteal

a. motor target
b. sensory target
c. spinal contributions
d. course

A

a. motor target: gluteus mediu, gluteus minimus, tensor fasciae latae
b. none
c. L4-S1
d. 1. leaves pelvic cavity superior to piriformis through greater sciatic foramen

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6
Q

inferior gluteal

a. motor target
b. sensory target
c. spinal contributions
d. course

A

a. gluteus maximus
b. sensory: none
c. L5 to S2
d. leave pelvic cavity inferior to piriformis through greater sciatic foramen

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7
Q

nerve to obdurator internus and superior gemellus

a. motor target
b. sensory target
c. spinal contributions
d. course

A

a. motor target; obturator internus and sup. gell.
b. sensnory: none
c. L5-S2
d. leaves through greater sciatic foramen

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8
Q

nerve to quadratus femoris & inferior gellemus

a. motor target
b. sensory target
c. spinal contributions
d. course

A

a. motor: quadratus femoris and inferior gellemus
b. sensory: none
c. L4 to S1
d. 1. leave pelvic cavity through the greater sciatic foramen inferior to piriformis muscle 2. course to muslces and skin

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9
Q

posterior femoral cutaneous

a. motor target
b. sensory target
c. spinal contributions
d. course

A

a. motor: none
b. sensor; skin on the posterior aspect of the thigh
c. S1, S3
d. 1. leave pelvic cavity through the greater sciatic foramen inferior to piriformis muscle 2. course to muslces and skin

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10
Q

perorating cutaneous

a. motor target
b. sensory target
c. spinal contributions
d. course

A

a. motor: piriformis muscle
b. sensory: none
c. L5, S1, S2
d. 1. leaves pelvic cavity by penetrating directly through the sacrotuberous ligament 2. courses to skin over the inferior aspect of the buttock

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11
Q

nerve to piriformis

a. motor target
b. sensory target
c. spinal contributions
d. course

A

a. piriformis muscle, poserior pelvic wall
b. piriformis muscle
c.
d. S1, S2 sacral plexus and passes directly to its target

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12
Q

nerves to levator ani, coccygeus, and external anal sphincter

a. motor target
b. sensory target
c. spinal contributions
d. course

A

a. motor: overlaps with pudendal
b. sensory: cutaneous, between anus/ occyx
c. spinal contributions: S4
d. arise from sacral plexus and passes directly to its target

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13
Q

pelvic splanchnic nerves

a. motor target
b. sensory target
c. spinal contributions
d. course

A

a. preganglionic parasympathetic
stimulates erection, modulate mobility in gastrointestinal system distal to the left colic flexure, inhibitory to internal urethral sphincter

b. sensory: visceral afferent from pelvic viscera, pain from cervix, possibly bladder/ proximal urethra
c. S2, S3, sometimes S4
d.

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14
Q

coccygeal plexus

a. motor target
b. sensory target
c. spinal contributions
d. course

A

a. none
b. sensory: cutaneous innervation of perianal skin
c. S4 to Co
d.

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15
Q

ganglion impar

A

wh: a single small ganlion at the union of the two sympathetic trunks in front of the coccyx

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16
Q

sacral splanchnic nerves

A

? connect the sympathetic trunk and inferior hypogastric plexus

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17
Q

hypogastric nerves

A

branches of the superior hypogastric plexus that meet preganglionic parasympathetic fibers from S2 to S4 to form the inferior hypogastric plexus

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18
Q

superior hypogastric plexus

A

whr: anterior to vertebra LV
fibers: sympathetic, parasympathetic, visceral afferent
descent: form hypogastric “nervs”

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19
Q

pelvic plexuses (inferior hypogastric plexuses)

A

whr: inferior around the pelvic wall, medial to major vessels
formation: superior hypogastric plexus + preganlgionic parasympathetic fibers, S2 to S4

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20
Q

rectal plexus

A

a branch of the hypogastric plexus that innervates the rectum

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21
Q

uterovaginal plexus

A

a branch of the hypogastric plexus that innervates the uterus/ vagina

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22
Q

prostatic plexus

A

a branch of the hypogastric plexus that innervates the prostate

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23
Q

vesical plexus

A

?

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24
Q

cavernous nerves

A

inferior hypogastric plexus> prostatic plexus> cavernous nerves

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25
Q

internal iliac artery

A

posterior trunk

a. iliolumbar artery
b. lateral sacral artery
c. superior gluteal artery

anterior trunk

a. umbilical artery
b. superior vesicular artery
c. inferior vesical artery
d. vaginal artery
e. middle rectal
f. obturator artery
g. internal pudendal artery
h. inferior gluteal artery
i. uterine artery

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26
Q

suspensory ligament of the ovary carries ?

A

gonadal vessels, the vaginal and ovarian arteries, both branches of the anterior trunk of the internal iliac artery

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27
Q

median sacral artery

A

origin: posterior surface of aorta superior to bifurcation (L4)
course: inferior down the midline of sacrum/ cocyx
branches: last pair of lumbar arteries and anastomose with iliolumbar and lateral sacral arteries

28
Q

iliolumbar artery

A

origin: internal iliac, posterior trunk
course: ascends laterally out of the pelvis
branches:
lumbar- posterior abdominal wall, poas, quadratus lumborum, cauda equina
iliac- iliac fossa, supplies muscle/ bone
spinal

29
Q

lateral sacral arteries

A

origin: internal iliac, posterior trunk
course: medially and inferiorly along the posterior pelvic wall
branches: pass into anterior sacral foramina and supply related branches

30
Q

superior gluteal artery

A

origin: internal iliac, posterior trunk
course: terminal branch, courses posteriorly, leaves the pelvic cavity through the greater sciatic foramen above the piriformis
branches: supplies muscles and skin in gluteal region as well as adjacent muscles

31
Q

umbilical artery

A

origin: internal iliac artery, anterior trunk
course: travels inferior to the margin of the pelvic inlet
branches: superior vesical artery

32
Q

obturator artery

A

origin: internal iliac artery, anterior trunk
course:
branches:

33
Q

superior vesical artery

A

origin: internal iliac artery, anterior trunk
course: courses medially and inferiorly after originating from the umbilical artery
branches: superior bladder, ureter, ductus deferens

34
Q

inferior vesicular artery

A

origin: internal iliac artery, anterior trunk
course:
branches: bladder, ureter, seminal vesicle, prostate, vaginal artery= inferior vesicular

35
Q

vaginal artery

A

origin: internal iliac artery, anterior trunk
course:
branches: vagina, bladder, rectum

36
Q

middle rectal artery

A

origin: internal iliac artery, anterior trunk
course: medially and superiorly to the rectum
* ANASTOMOSES with the superior rectal artery, a branch of the INFERIOR MESENTERIC ARTERY
branches: supplies the rectum

37
Q

obturator artery

A

origin: internal iliac artery, anterior trunk
course: anteriorly along the pelvic wall leaving via the obturator canal
branches: adductor region of the thigh

38
Q

internal pudendal artery

A

origin: internal iliac artery, anterior trunk
course:
branches: MAIN artery of the PERINEUM, supplies erectile tissue

39
Q

inferior gluteal artery

A

origin: internal iliac artery, anterior trunk
course: it passes between anterior rami of S1 and S2 and leaves the pelvic cavity through the greater sciatic foramen
branches: contributes to the blood supply of the gluteal region and anastomoses with vessels around hip

40
Q

uterine artery

A

origin: internal iliac artery, anterior trunk
course: the vessel courses the ureter and passes superiorly to the lateral vaginal fornix
branches: major supply of the uterus, enlarges during pregnancy

41
Q

inferior rectal nerve

A

origin: pudendal nerve
course: penetrates through the fascia of the pudendal canal and courses medially across the ischio-anal fossa
branches: external anal sphincter and leavtor ani muscles

42
Q

perineal nerve

A

origin: pudendal nerve
course: passes into the urogenital triangle
branches: posterior scrotal nerve in men; the posterior labial nerve in women

43
Q

dorsal nerve of penis/ clitoris

A

origin: pudendal nerve
course: enters the deep perineal pouch and exits by passing inferiorly through the perineal membrane
branches: sensory o the penis and clitoris, especially the glans in men

44
Q

internal pudendal artery

A

origin: anterior branch of the internal iliac artery
course:
branches

45
Q

inferior rectal arteries

A

origin: internal pudendal arery
course:
branches: network of vessels that supply the rectum and anal canal
ANASTOMOSE with middle and superior rectal arteries from the internal iliac artery and inferior mesenteric artery

46
Q

artery of bulb of penis

A

origin: internal pudendal artery, terminal part
course:
branches: suplies the bulbourethral gland, perineal membrane, and corpus spongiosum

47
Q

urethral artery

A

origin: internal pudendal artery, terminal part
course:
branches: supplies penile urethra and surrounding eretical tissues to the glans

48
Q

deep artery of penis

A

origin: internal pudendal artery, terminal part
course:
branches: crus and corpus cavernosum

49
Q

dorsal artery of penis

A

origin: internal pudendal artery, terminal part
course:
branches: supplies glans penis and other superficial tissues, it anastomoses with the deep artery

50
Q

arteries of bulb of vestibule

A

origin: pudendal artery
course:
branches: supplies the bulb of the vesitbule and related vagina

51
Q

deep arteries of the clitoris

A

origin: pudendal artery
course:
branches: supply the crura and corpus cavernosum

52
Q

dorsal arteries of the clitoris

A

origin: pudendal artery
course:
branches: supply surround tissues and glans

53
Q

external pudendal arteries

A

origin: femoral artery in thigh
course: originate in femoral artery and course medially to enter the perineum anteriorly
branches: related skin of the penis and scortum or the clitoris and labia majora

54
Q

testicular arteries

A

origin: abdominal aorta
course: inguinal canal
branches

55
Q

cremasteric arteries

A

origin: inferior epigastric branch of external iliac artery
course: accompany spermatic chord
branches:

56
Q

internal pudendal veins

A

origin: generally veins follow arteries (the deep vein of the penis/ clitoris is an exception)
course:
branches: drains into the internal iliac vein

57
Q

internal iliac vein

A

origin: receives from most of perineum
course:
branches

58
Q

deep dorsal vein of penis or clitoris

A

origin:
course: drains glans and corpus cavernosum

59
Q

median sacral vein

A

coalesce to form a single vein that joins the left common iliac vein or junction
origin:
course:
branches

60
Q

ovarian veins

A

join the inferior vena cava on the right, and on the left they join the left renal vein

origin:
course:
branches

61
Q

which two pelvic veins do not follow the course of the branches of the internal iliac artery?

A

umbilical artery and iliolumbar (they drain into the internal iliac veins)

62
Q

lymphatics from most pelvic viscera drain into

A

lymph nodes along the internal iliac and external iliac arteries

63
Q

lymphatics from ovaries and related parts of the uterus and uterine tube drain into

A

directly into lateral aortic or lumbar nodes

64
Q

lymphatic vessels from the deep parts of the perineum drain into

A

the internal iliac nodes

65
Q

lymphatic channels from the superficial tissues of the penis or clitoris drain into

A

superficial inguinal nodes

66
Q

lymphatic channels from the glans penis, the glans clitoris, labia minora, and terminal inferior end of the vagina drain into

A

deep inguinal nodes and external iliac nodes

67
Q

lymphatics from the testes

A

drain into the lateral aortic or lumbar nodes