Vessels, Nerves and Lymphatics of the Pelvis Flashcards
branches of which arteries distribute blood to most of the pelvic organs, perineum and gluteal region except the testis, ovary and upper part of rectum?
right and left internal iliac artery
what is the distribution of the superior and inferior vesical arteries?
- bladder
- seminal gland and prostate in males
what is the origin of the superior vesical artery?
patent part of umbilical artery
what is the origin of the inferior vesical artery?
anterior division of internal iliac artery
what is the distribution of the uterine artery?
- pelvic part of ureter
- uterus
- ligament of uterus
- uterine tube
- vagina
what is the origin of the uterine artery?
anterior division of internal iliac artery
what is the distribution of the gonadal (testicular or ovarian) arteries?
testis and ovary
what is the origin of the gonadal (testicular and ovarian) arteries?
abdominal aorta
what is the distribution of the superior rectal artery?
- upper 2/3rds of the rectum, down to the level of levator ani
what is the origin of the superior rectal artery?
inferior mesenteric artery
what is the distribution of the middle and inferior rectal arteries?
- seminal gland, prostate and rectum (lower 1/3).
what is the origin of the middle and inferior rectal arteries?
internal iliac artery
what is the origin of the vaginal artery?
anterior division of internal iliac artery (uterine artery)
what is the distribution of the vaginal artery?
vagina and branches to inferior part of urinary bladder
what is the distribution of the internal pudendal artery?
main branch to perineum
what is the origin of the internal pudenal artery?
anterior division of internal iliac artery
what is the distribution of the obturator artery?
- pelvic muscles
- nutrient artery to ilium and head of femur
what is the origin of the obturator artery?
internal iliac artery
which part of the rectum drains into the portal circulation?
superior 2/3rds
which part of the rectum drains into the systemic circulation?
lower 1/3rd
what is the significance of understanding the venous drainage of the rectum?
As there is a portocaval anastomosis, there is an alternative route of circulation whhen there is a blockage in the liver or portal vein.
This is a means to reduce portal venous pressure.
why might haemorrhoids be associated with cirrhosis of the liver?
increased portal venous pressure due to poor liver function can result in varices (abnormally dilated veins) at sites of anastomoses, such as haemorrhoids
with which venous plexus does the prostatic venous plexus communicate with on its posterior side?
Batson venous plexus, to the internal vertebral venous plexus (significant in prostate cancer spread to the spine)
what does the ilioinguinal nerve originate from and what is its distribution?
- L1 and enters the inguinal canal at the superficial inguinal ring
- supplies skin at the root of the penis in males and labia in the female.
where does the genitofemoral nerve originate from and where does it enter?
L1-2 and enters at the deep inguinal ring
what structures in the male are supplied by the genital branch of the genitofemoral nerve? what is the clinical significance of this?
- cremaster muscle
- sensation to lateral aspect of scrotum
- It is responsible for efferent limb of the cremasteric reflex – contraction of cremaster muscle and resulting elevation of testis upon sensory stimulation of the ilioinguinal nerve.
The pudendal nerve arises from which plexus?
sacral plexus
from which segmental level does the pudendal nerve arise?
anterior rami of spinal nerves S2-4
what bony landmarks are used when performing a pudendal nerve block during labour?
ischial spine, palpated transvaginally
the autonomic nerve supply to the pelvis originates from which plexus?
pelvic plexus (or inferior hypogastric)
the sympathetic nerve fibres supplying the pelvis originate from
L1-2 via the hypogastric nerve and terminal aspect of the sympathetic trunk.
The autonomic nerve supply to the pelvis originates from the pelvic plexus (or inferior hypogastric)
The sympathetic fibres originate from L1 and L2 via the hypogastric nerve and terminal aspect of the sympathetic trunk.
They provide sympathetic supply to all internal pelvic organs.
In a male they supply the?
vas deferens
seminal vesicles
prostate
epididymis
The autonomic nerve supply to the pelvis originates from the pelvic plexus (or inferior hypogastric)
The sympathetic fibres originate from L1 and L2 via the hypogastric nerve and terminal aspect of the sympathetic trunk.
They provide sympathetic supply to all internal pelvic organs.
In a female they supply the?
ovaries
uterus
fallopian tubes
vagina
parasympathetic fibres in the pelvis originate from?
pelvic splanchnic nerves (S2 to S4). In addition to providing parasympathetic supply to all the internal pelvic organs, they innervate erectile tissues in both male and female.
after rectal surgery, why are some men unable to ejaculate?
because the surgery can damage the nerves in the pelvic region that are responsible for controlling ejaculation, particularly the sympathetic nerves, which can lead to a condition called retrograde ejaculation where semen travels backwards into the bladder instead of being expelled during orgasm
what are the four primary groups of lymph nodes present in the pelvis?
- external iliac
- internal iliac
- sacral
- common iliac
external iliac lymph nodes drain which area of the pelvis?
- mainly from inguinal lymph nodes
- also recieve lymph from pelvic viscera, especially superior parts of anterior pelvic organs.
- drain into common iliac nodes.
internal iliac lymph nodes drain which pelvic area?
- gluteal region
- deep perineum
- inferior pelvic viscera
sacral lymoph nodes drain which pelvic area?
posteroinferior pelvic viscera and drain to either internal or common iliac nodes
common iliac lymph nodes drain which pelvic areas?
- drainage from external, internal and sacral lymph nodes
