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Anatomy Block 4 > Vasculature, Innervation, and Functional Anatomy of Pelvis and Perineum > Flashcards

Vasculature, Innervation, and Functional Anatomy of Pelvis and Perineum Flashcards

1
Q

What is another name for the internal iliac artery and what does it arise from

A

hypogastric artery

from common iliac anterior to the sacroiliac joint

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2
Q

What does the internal iliac divide into

A

Anterior and posterior internal iliac arteries

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3
Q

What does the posterior division of the internal iliac artery provide for

A

provides parietal branches to pelvic wall and gluteal region

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4
Q

What are the branches of the posterior division of the internal iliac

A

Illiolumbar
Lateral sacral
Superior Gluteal

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5
Q

Where does the illiolumbar branch go to/ what are its branches

A

passes superiorly into iliac fossa

divides into
iliac branch :to iliacus
lumbar branch: to psoas major and quadratus lumborum

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6
Q

How many lateral sacral arereies are there and what are they termed

A

Can be one or two

if two named superior and inferior

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7
Q

WHere do the lateral sacral arteries go (path)

A

descend down and usually enter anterior sacral foramina

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8
Q

Where does the superior gluteal branch from the posterior division of the internal iliac

A

Is the continuation of the posterior division of the internal iliac

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9
Q

Where does the Superior gluteal branch travel and where does it exit the pelvis

A

passes between the lumbosacral trunk and s1

exitsthe pelvis through the greater scieatitc foramen superior to the piriformis muscle

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10
Q

What does the superior gluteal artery supply

A

gluteus meiddus
gluteus minnimus
tnesor fasciae lateae
some branches to gluteus maximus

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11
Q

Which of the branches of the internal iliac is a direct continuation of the main stem

A

anterior division

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12
Q

What does the anterior division provide ateries to

A

thigh
perineum
gluteal region
branches to pelvic viscera

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13
Q

What are the branches of the anterior division of the internal iliac

A 
Obturator
internal pudendal
inferior gluteal
umbilical
inferior vesical
uterine
vaginal 
middle rectal
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14
Q

What is the first branch off of the anterior division of the internal iliac

A

Obturator

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15
Q

Where does the obturator exit the pevis and what does it supply

A

exits via the obturator foramen and supplies the adductor compartment of the thigh

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16
Q

What is the acetabular a branch of and what does it do

A

obturator

important artery supply to femoral head in children until closure of the epiphsyesal cartilage

(then done via vessels in retinacula along neck)

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17
Q

what arise together of a common stem of the anterior division of the internal iliac

A

internal pudendal and inferior gluteal

Inferior vesicle and middle rectal (sometimes)

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18
Q

WHere does the internal pudendal exit the pelvis and where does it go from there

A

through the greater sciatic foramen

crosses posterior to ischial spine and enters perinium via lesser sciatic foramen

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19
Q

Where does the inferior gluteal exit the pelvis

A

infgreater sciatic foramen inferior to the piriformis and may exit between s1 and s2 or s2 and s3 anterior rami

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20
Q

What does the inferior gluteal supply

A

Primary supply to the gluteus maximus but also supplies other muscles in that area

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21
Q

What happens when the umbilical cord is tied

A

Umbilical artery between pelvis and umbilicus degenerates and fomrs umbilical ligament

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22
Q

What arises from the the proximal part of the umblical artery in the pelvis

A

superior vesical branches : to urinary bladder

Artery to the ductus deferens

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23
Q

WHat can the inferior vesicle sometimes arise with

A

Middle rectal

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24
Q

What does the inferior vesicle supply

A

urinary bladder
prostate
seminal glands

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25
Q

What corresponds to the inferior vesicle artery in females

A

unnamed artery arising from the vaginal artery

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26
Q

What is the female homolog to the artery of the ductus defrerens in males

A

Uterine artery

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27
Q

What variations can the uterine artery arise with

A

may arise in common with middle rectal or vaginal

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28
Q

Where does the uterine artery pass and what passes under it

A

uterine artery passes to the side of the uterus at the base of the broad ligament

ureter passes under the uterine artery at the base of the broad ligament
(water under the bridge)

29
Q

Where can the vaginal artery arise

A

Directly from anterior division of the internal iliac

or as a branch of the uterine

30
Q

Where can the middle rectal artery arise

A

with inferior vesical or internal pudendal

31
Q

What is the genral rule of lymphatic drainage for individual organs

A

it follows their arteries and veins

32
Q

What drains to the superficial inguinal nodes in the superfical pelvis and peritoneum

A

llymphatic vessesls of th perineum (except glans pens and clit)
inferior 2/3rds of vagina
anal canal inferior to pectinate line

33
Q

What drains into the internal iliac nodes in the superfical pelvis and peritoneum

A

upper 1/3rd of the vagna and pelvic viscera

34
Q

Where do lymphatics from the ovaries and testis drain

A

para aortic lumbar nodes

35
Q

Where is the superior hyogastric plexus

A

contiunuation of inferior mesenteric plexus before the aortic bifurcation

36
Q

What is contained in the superior hypogastric plexus and what makes up most of it

A

contains parsympathetic and sympathetic compoonents

but principally sympthetic vasomotor and sensory

37
Q

What feeds into the Superior hyopgastric plexus

A

parasympthetic from pelvic splanchnic nerves

lower two lumbar splanchnic nerves (sympathetic)

38
Q

What happens caudally to the hypogastric plexus

A

contiues on the promontory of the sacrum and desncends into each side of pelvis as right and left hypogastric nerves

39
Q

What do the left and right hypogastric nerves contribute to

A

join parasympathetic pelvic splanchnic nerves to form the inferior hypogastric plexus

40
Q

What proides innervation to the pelvic viscera

A

inferior hypogastric plexus

41
Q

Where is the inferior hypogastric plexus located

A

each side of the
rectum
urinary bladder
uterinecervix (or prostate)

42
Q

what do extensions of theinferior hypogasttric pleus follow

A

branches of internal illiac

rectal, vesical, prostatic, uterine, vaginal, and cavernous

43
Q

what do the branches of the inferior hypogastric plexus do once they reach the viscera

A

form visceral plexuses in the walls of pelvic viscera

44
Q

Where do preganglionic sympathetic (splanchnic) contributions to pelvic plexuses synapse

A

in the ganglion cells within the plexuses

postganglionics distribute along vessels

45
Q

Where do preganglionic parasympathetic (splanchnic) contributions to pelvic plexuses synapse

A

do not synapse in ganglion
distribute along vessels
synapse on postanglionic nerve cell bodies in the walls of organ to be innervated

46
Q

What forms the pudendal nerve and what does it provide

A

anterior divisions of S2 S3 and S4

principle nerve to peritoneum

47
Q

What types of spinal nerves are contained in the pudendal nerve

A 
all 4 components
voluntary motor GSE
visceral motor (sympathtetic) GVE
visceral sensory 
somatic sensory

NO PARASYMPATHETIC AUTONOMICS

48
Q

Where does the perinieum get parasympathetic autonomics

A

from the prostatic plexus (male)

or uterovaginal plexus (female)

49
Q

What types of spinal inervation does sexual functioninvolve

A

all of them
sensory
autonomic (sym parasym)
and somatic

50
Q

What is the sexual response cycle divided into (4)

A

excitement
plateau
orgasm
resolution

51
Q

What may be extragenital reactions may be included in an orgasm reaction(5)

A 
breasts
skin
cv system
resp system
digestive system
52
Q

What characterizes the exitement phase in male

A

erection

53
Q

What characterizes the exitement phase in female

A

vaginal wetness

54
Q

What causes engorgement of the erictile tissue on errection

A

dilation and straghtening of arteries from parasympattheitc innervation (activated by sensory stimuli [thoughts,visual, tactile])

55
Q

What helps maintain errections and how/with what innervation

A

Bulbospongiosus and ischiovavernosus via pudendal

contract and interfere with venous return of blood from cavernous tissues

56
Q

What is wetness in females and what causes it

A

fluid passing across vaginal wall

increased bloodflow and vasocongestion to vagina

57
Q

What is also seen alongside wetness in female excitement and how

A

enlargement of clitoris from vasocongestion

58
Q

What mediates the vaginal and clitoral excitement responses in females

A

parasympathetic nervous

59
Q

What happens in the plateu phase of males and what innervation mediates it

A

Further engorgement of the penis

parasympathetic nervous

60
Q

What happens in the plateu phase of females and what innervation mediates it

A

additional vasocongestion of vagina

parasympathetic nervous

61
Q

What is the orgasm phase synonymous with in males

A

ejaculation

62
Q

What is the emission phase of orgasm in males and what mediates it

A

peristaltic like contractions of
ductus defrens
seminal glands
prostate

this delivers sperm and glandular secretion to prostatic urethra

sympathetic nervous

63
Q

What does contraction of the internal urethral sphincter do during ejaculation and what mediates it

A

prevent retrograde ejaculation

sympathetic nervous

64
Q

What accomplishes the actual ejaculation in males

A

rapid succession of alternating contractions of
bulbospongiousus and ischiocavernosus muscles

expels semen from tip of penis

65
Q

What does orgasm in females involve and what innervation is it mediated by

A

rhytmic contractions of the vagina and uterine fundus

sympathetic

66
Q

what my orgasm in females cause and where is its origin

A

fluid gush from urethra

likely from paraurethral glands

67
Q

What is the resolution phase of sexual response characterized by

A

return to the normal or pre excitement condition

68
Q

what is the refractory period and which phase of sexual response is it associated with

A

state in which no amount of stimulation will cause an erection

associated with resolution phase

Anatomy Block 4 (16 decks)

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