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Gross II Final > Vascular and Nerve Supply of the Pelvis > Flashcards

Vascular and Nerve Supply of the Pelvis Flashcards

1
Q

The abdominal aorta bifurcates at which vertebral location?

A

L4

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2
Q

What does the abdominal aorta bifurcate into?

A

Left and right common iliac arteries

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3
Q

Each common iliac artery bifurcates into which arteries?

A

External and internal iliac arteries

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4
Q

Where does the common iliac artery bifurcate?

A

Anterior to the sacroiliac joint

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5
Q

What are the two branches of the external iliac artery?

A

Deep circumflex iliac and inferior epigastric artery

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6
Q

The external iliac artery continues as what structure below the inguinal ligament?

A

Femoral artery

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7
Q

Which artery is specifically the major source of blood to structures within the pelvis?

A

Internal iliac artery

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8
Q

What crosses the external iliac artery at the pelvic brim?

A

Ureter

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9
Q

What are the branches of the internal iliac artery of the posterior trunk?

A

Iliolumbar, lateral sacral and superior gluteal arteries

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10
Q

What are the branches of the iliolumbar artery?

A

Iliac branch and lumbar branch

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11
Q

What branch of the iliolumbar artery supplies the iliacus muscle and ilium?

A

Iliac branch

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12
Q

Which branch of the iliolumbar artery supplies psoas major and quadratus lumborum muscles?

A

Lumbar branch

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13
Q

Which branch of the internal iliac artery anastomoses with the median sacral artery?

A

Lateral sacral artery

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14
Q

Which branch of the internal iliac artery exits the pelvis through the greater sciatic foramen superior to the piriformis muscle?

A

Superior gluteal artery

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15
Q

The superior gluteal artery usually passes through what structures?

A

Lumbosacral trunk and 1st sacral nerve

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16
Q

Which branch of the internal iliac artery is a part of the anterior trunk and exits the pelvis through the greater sciatic foramen inferior to the piriformis?

A

Inferior gluteal artery

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17
Q

Which branch of the internal iliac artery is a part of the anterior trunk and passes between the 1st and 2nd or 2nd and 3rd sacral nerves?

A

Inferior gluteal artery

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18
Q

Which branch of the internal iliac artery is a part of the anterior trunk and exits the pelvis through the greater sciatic foramen between the piriformis and coccygeus muscles?

A

Internal pudendal artery

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19
Q

Which branch of the internal iliac artery is a part of the anterior trunk and enters the perineum through the lesser sciatic foramen giving off important branches?

A

Internal pudendal artery

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20
Q

Which branch of the internal iliac artery is a part of the anterior trunk and gives off the superior vesical arteries?

A

Umbilical artery

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21
Q

What part of the umbilical artery gives off the superior vesical arteries?

A

Proximal (patent) portion

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22
Q

What do the superior vesical arteries supply?

A

Superior part of the bladder

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23
Q

What gives rise to the artery of the ductus deferens?

A

One of the superior vesical arteries

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24
Q

The distal portion of the umbilical artery is obliterated and gives rise to what structure?

A

Medial umbilical ligament

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25
Q

Which branch of the internal iliac artery is a part of the anterior trunk and exits the pelvis through the obturator foramen?

A

Obturator artery

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26
Q

What does the obturator artery supply?

A

Muscles of the thigh

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27
Q

Which branch of the internal iliac artery is a part of the anterior trunk and supplies the inferior part of the bladder (in both sexes) and the prostate gland and seminal vesicles (in males)?

A

Inferior vesical artery

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28
Q

Which branch of the internal iliac artery is a part of the anterior trunk and supplies the middle portion of the rectum as well as the prostate and vagina?

A

Middle rectal artery

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29
Q

Which branch of the internal iliac artery is a part of the anterior trunk and is homologous to the artery of the ductus deferens in males?

A

Uterine artery

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30
Q

The uterine artery can sometimes form a common trunk with which arteries?

A

Vaginal or middle rectal arteries

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31
Q

Which branch of the internal iliac artery is a part of the anterior trunk and arises from a common trunk with the uterine or directly off the internal iliac artery?

A

Vaginal artery

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32
Q

What is the major supplier of blood to the pelvis?

A

Internal iliac artery

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33
Q

From where does the gonadal (testicular or ovarian) artery arise?

A

Abdominal aorta

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34
Q

From where does the superior rectal artery arise?

A

Inferior mesenteric artery

35
Q

From where does the median sacral artery arise?

A

Behind the bifurcation of the abdominal aorta

36
Q

Which two veins make up the common iliac vein?

A

Internal and external iliac veins

37
Q

What veins unite to form the inferior vena cava?

A

Right and left common iliac veins

38
Q

In general, tributaries of the internal iliac vein correspond to branches of which artery?

A

Internal iliac artery

39
Q

Which pelvic structures have SOME portal drainage?

A

Rectum and anal canal

40
Q

Most pelvic structures have their drainage into which venous system?

A

Caval system

41
Q

What makes up the sacral plexus?

A

Lumbosacral trunk and the anterior primary rami of S1-S4

42
Q

What cord levels make up the lumbosacral trunk?

A

L4, L5

43
Q

What part of L4 makes up the lumbo sacral trunk?

A

Lower half

44
Q

What part of S4 makes up the sacral plexus?

A

Upper half

45
Q

The sacral plexus lies primarily on the anterior surface of which muscle?

A

Piriformis

46
Q

The anterior primary rami of S1-S4 enter the pelvis through what structures?

A

Anterior sacral foramina

47
Q

What are the branches of the sacral plexus that supply the buttock and lower limb?

A

Superior and inferior gluteal nerves, sciatic nerve, nerve to obturator internus muscle, nerve to quadratus femoris muscle, and posterior cutaneous nerve of thigh

48
Q

What are the cord levels of the superior gluteal nerve?

A

L4-S1

49
Q

What branch of the sacral plexus is the only nerve to exit SUPERIOR to the piriformis?

A

Superior gluteal nerve

50
Q

What does the superior gluteal nerve supply?

A

Gluteus medius, gluteus minimus, and tensor fasciae latae muscles

51
Q

What are the functions of the anterior gluteal muscles (medius, minimus, and tensor fasciae latae)?

A

Abductors, prevent pelvis from slumping to unsupported side during gait

52
Q

What is the term for the type of gait that occurs when the anterior gluteal muscles are dysfunctional?

A

Trendelenburg’s Gait

53
Q

What are the cord levels for the inferior gluteal nerve?

A

L5-S2

54
Q

What does the inferior gluteal nerve supply?

A

Gluteus maximus

55
Q

What are the cord levels of the sciatic nerve?

A

L4-S3

56
Q

What is the largest nerve in the body?

A

Sciatic nerve

57
Q

What is the condition where the sciatic nerve is compromised?

A

Sciatica

58
Q

What are the cord levels of the nerve to obturator internus muscle?

A

L5-S2

59
Q

What does the nerve to obturator internus supply?

A

Obturator internus and superior gemellus muscles

60
Q

What are the functions of the gluteus maximus muscle?

A

Trunk control and standing form a seated position

61
Q

What are the cord levels for nerve to quadratus femoris muscle?

A

L5-S1

62
Q

What does the nerve to quadratus femoris supply?

A

Quadratus femoris and inferior gemellus muscles

63
Q

What are the cord levels for the posterior cutaneous nerve of thigh?

A

S1-S3

64
Q

What does the posterior cutaneous nerve of the thigh supply?

A

Sensory to part of the gluteal region and perineum

65
Q

What are the branches of the sacral plexus that supply the pelvis?

A

Nerve to piriformis muscle, nerves to levator ani and coccygeus muscles, nerve to external anal sphincter muscle, and pudendal nerve

66
Q

What are the cord levels for the nerve to piriformis muscle?

A

S1, S2

67
Q

Impingement of the nerve to piriformis muscle can lead to what condition?

A

Sciatica (“Piriformis Syndrome”)

68
Q

What are the cord levels for nerves to levator ani and coccygeus muscles?

A

S3, S4

69
Q

What issues can arise from damage to the nerves to levator ani and coccygeus muscles?

A

Urinary and fecal continence and parturition issues

70
Q

What are the cord levels for nerve to external anal sphincter muscle?

A

S4

71
Q

What are the cord levels of the pudendal nerve?

A

S2-S4

72
Q

The pudendal nerve gives off important branches to what structure?

A

Perineum

73
Q

Impingement of the pudendal nerve can lead to what issue?

A

Erectile dysfunction

74
Q

What forms the coccygeal plexus?

A

Ventral primary rami of S4, S5 and the coccygeal nerve

75
Q

What does the coccygeal plexus supply?

A

Sacrococcygeal joint, the coccyx, and the overlying skin

76
Q

What are the two ways in which sympathetic fibers reach the pelvis?

A

Downward continuation of both the sympathetic trunk and the aortic plexus (as the superior hypogastric plexus)

77
Q

What forms as the left and right sympathetic trunks join together in front of the coccyx?

A

Ganglion impar

78
Q

What mostly makes up the superior hypogastric plexus?

A

Sympathetic fibers from the lumbar splanchnic nerve and visceral afferent fibers

79
Q

What long, narrow nerve plexuses connect the superior hypogastric plexus to the inferior hypogastric plexus?

A

Left and right hypogastric nerves

80
Q

What plexuses are formed by the union of the hypogastric, pelvic splanchnic, and sacral splanchnic nerves?

A

Left and right inferior hypogastric plexuses

81
Q

What makes up the left and right inferior hypogastric plexuses?

A

Sympathetic fibers, parasympathetic fibers, and visceral afferent fibers

82
Q

The inferior hypogastric plexuses give rise to what structures that supply pelvic viscera?

A

Subsidiary plexuses

83
Q

What are the preganglionic sympathetic nerves which arise from the sympathetic trunk and synapse in the inferior hypogastric plexus?

A

Sacral splanchnic nerves

84
Q

What are the parasympathetic nerves which arise from the sacral segments of the spinal cord (S2-S4) and contribute to form the inferior hypogastric plexuses and supply pelvic viscera?

A

Pelvic splanchnic nerves

Gross II Final (9 decks)

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