Vessels and Nerves of Pelvis - Anatomy

Question 1

Where does abdominal aorta sit?

Answer 1

Just to left of midline

Question 2

Where do the common iliac arteries branch into external and internal iliac arteries?

Answer 2

Roughly at level of pelvic brim

Question 3

Where does the external iliac artery pass?

Answer 3

Underneath inguinal ligament

Question 4

What branch does the external iliac artery give off just before passing under the inguinal ligament?

Answer 4

Inferior epigastric artery

Question 5

Where does the inferior epigastric artery course?

Answer 5

Ascends towards anterior abdominal wall and pierces transveralis fascia

Question 6

What is the interior epigastric artery covered by?

Answer 6

Layer of peritoneum –> forming the lateral umbilical fold/ligament

Question 7

What does the interior epigastric artery anastamose with?

Answer 7

The superior epigastric artery

Question 8

What is the superior epigastric artery?

Answer 8

One of the two terminal branches of the internal thoracic artery

Question 9

What does the internal iliac artery supply?

Answer 9

Viscera of pelvis

Question 10

Where do the iliac veins drain into?

Answer 10

Drain the lower limb and pelvis into the IVC

Question 11

What does the IVC give rise to?

Answer 11

Right and left common iliac vein (and then internal and external iliac vein)

Question 12

Where does the vas deferens pass? What does it transport?

Answer 12

Passes from testes, through inguinal canal, on superior surface of bladder

Transports sperm to the prostatic urethra

Question 13

What muscle is found just superior to the iliac crest?

Answer 13

Quadratus lumborum

Question 14

What nerve passes on top of the psoas major? What is this nerve a branch of?

Answer 14

Genitofemoral nerve –> branch of the lumbar plexus

Question 15

Where does the right gonadal vein drain into?

Answer 15

Directly into IVC

Question 16

Where does the left gonadal vein drain into?

Answer 16

Into the left renal vein

Question 17

What is the sacral promontory?

Answer 17

Inwardly projecting anterior part of the body of the first sacral vertebra

Forms the posteriorly margin of the pelvic inlet

Question 18

Once the inferior epigastric artery passes under the inguinal ligament, what does it become?

Answer 18

Changes name to femoral artery

Question 19

What is the 1st branch of the internal iliac artery?

Answer 19

Umbilical artery

Question 20

Where does the umbilical artery course towards? What happens to it?

Answer 20

Courses towards the anterior abdominal wall but becomes obliterated towards distal end

Question 21

What does the umbilical artery give rise to?

Answer 21

Numerous superior vesical arteries

Question 22

What do the superior vesical arteries supply?

Answer 22

Superior part of bladder and pelvic part of ureter

Question 23

What is the 2nd branch of the internal iliac artery?

Answer 23

Obturator artery

Question 24

Describe the course of the obturator artery

Answer 24

Courses towards obturator foramen where it passes through defect (canal) in muscle and fascia with the obturator nerve

Question 25

What does the obturator artery supply?

Answer 25

Medial aspect of thigh

Question 26

What is the 3rd branch of the internal iliac artery?

Answer 26

Uterine artery (in females) Inferior vesical artery (in males)

Question 27

Describe the course of the uterine artery (mention the ureter)

Answer 27

Passes over top of ureter (water travels under the bridge) Supplies uterus

Question 28

What branch does the uterine artery give off?

Answer 28

Vaginal branch

Question 29

What does the inferior vesical artery supply?

Answer 29

The prostate gland and the seminal vesicles

Question 30

What are the branches of the internal iliac artery?

Answer 30

1. Umbilical artery 2. Obturator artery 3. Uterine artery/superior vesical artery 4. Vaginal artery 5. Internal pudendal artery 6. Middle rectal artery 7. Inferior gluteal artery 8. (Superior gluteal artery)

Question 31

Describe the course of the internal pudendal artery

Answer 31

Leaves pelvic cavity just behind the sacrospinous ligament and leaves via the greater sciatic foramen Enters perineum via the lesser sciatic foreamen

Question 32

What does the internal pudendal artery supply?

Answer 32

Structures of the perineum

Question 33

Just before it leaves the pelvic cavity, what branch does the internal pudendal artery give off?

Answer 33

Middle rectal artery

Question 34

What is the most posterior branch of the internal iliac artery?

Answer 34

Inferior gluteal artery

Question 35

What does the inferior gluteal artery supply?

Answer 35

Some of muscles within the gluteal region

Question 36

Where does the inferior gluteal artery leave the pelvic cavity?

Answer 36

Greater sciatic foramen

Question 37

Why is the piriformis muscle an important landmark?

Answer 37

Both the internal pudendal artery and the inferior gluteal artery leave the pelvic cavity just inferior to the piriformis muscle The superior gluteal artery is found superiorly to the piriformis

Question 38

What vessel leaves the pelvis just superior to the piriformis?

Answer 38

Superior gluteal artery

Question 39

How does the superior gluteal artery leave the pelvis?

Answer 39

Via the greater sciatic foramen

Question 40

What is the sacral foramina?

Answer 40

On the transverse processes of the lower sacral vertebrae, on each side, are a series of four openings (sacral foramina); the sacral nerves and blood vessels pass through these openings.

Question 41

What do the nerves emerging from the sacral foramina merge to form?

Answer 41

Sacral plexus

Question 42

What is the sciatic nerve?

Answer 42

One of major nerves of sacral plexus: supplies posterior compartment of leg

Question 43

What covers the obturator foramen?

Answer 43

It is covered by thin fibrous membrane, the obturator membrane, which is covered on the internal and external surfaces by the muscles obturator internus and obturator externus respectively.

Question 44

What does the obturator internus go on to attach to?

Answer 44

Femur

Question 45

What is found in the covering of the obturator foramen?

Answer 45

Defect (forms obturator canal)

Question 46

Where is the piriformis muscle found?

Answer 46

Just posterior to the nerve roots from the sacral foramina

Question 47

What is the piriformis?

Answer 47

Is a pyramid shape muscle that attaches from the sacrum and passes through the greater sciatic foramen to attach to the femur

Question 48

Where does the piriformis muscle pass through?

Answer 48

The greater sciatic foramen

Question 49

Where does the coccygeus muscle originate from? Where does it pass?

Answer 49

It originates from the ischial spines and travels to the lateral aspect of the sacrum and coccyx, along the sacrospinous ligament.

Question 50

What does the pelvic diaphragm/floor separate?

Answer 50

Pelvic cavity (superiorly) from the perineum (inferiorly)

Question 51

What is the obturator fascia?

Answer 51

Fascia that covers the pelvic surface of the obturator internus muscle

Question 52

What is a particular thickening of the obturator fascia called?

Answer 52

Tendinous arch

Question 53

What does the tendinous arch act as?

Answer 53

An attachment point for the pelvic diaphragm and the pelvic floor muscles

Question 54

Where does the piriformis muscle attach to? Describe its course

Answer 54

Passes through the greater sciatic foramen to attach to the femur

Question 55

Where does the sacrospinous ligament run from/to?

Answer 55

From the sacrum to the ischial spine

Question 56

Where does the sacrotuberous ligament run from/to?

Answer 56

From the sacrum to the ischial tuberosity

Question 57

What is the pelvic floor made up of?

Answer 57

Levator ani muscles and coccygeus muscle

Question 58

What is found deep to the obturator fascia?

Answer 58

Obturator internus muscle covering the obturator foramen

Question 59

What is the levator ani?

Answer 59

Used to describe 3 muscles of the pelvic floor 1. Puborectalis 2. Pubococcygeus 3. Iliococcygeus

Question 60

Describe the puborectalis muscle

Answer 60

Most medial muscle runs from pubic part of tendinous arch and loops around the rectum like a sling (fibres from left and right converge) Some fibres converge just anterior to the rectum as well

Question 61

What does the puborectalis muscle form?

Answer 61

The anorectal junction/angle

Question 62

What is job of levator ani and coccygeus?

Answer 62

1. Acts to keep all of pelvic viscera within pelvis and also contribute to continence 2. Help with formation of external sphincters

Question 63

Describe the pubococcygeus muscle

Answer 63

Attaching from pubic region of tendinous arch to the coccyx Fibres from either side converge and join onto the coccyx

Question 64

Describe the iliococcygeus muscle

Answer 64

Runs from ilio part of tendinous arch to the coccyx Fibres from either side converge and attach to coccyx