Vessels, nerves & lymph nodes of the Pelvis Flashcards
Which major vessel supplies most of the pelvic organs, perineum and gluteal region except testis, ovaries and upper part of rectum?
Right and Left Internal Iliac Arteries
From where do the internal iliac arteries originate?
Common Iliac arteries, which bifurcate into internal and external iliac arteries at around L5,S1 vertebral level
At what structure do the internal iliac arteries split into anterior and posterior trunks?
Greater sciatic foramen
What are the branches of anterior trunk of the internal iliac artery?
Obturator
Superior Vesical
Inferior Vesical
Middle Rectal
Inferior Gluteal
What are the branches of the posterior trunk of the internal iliac artery?
Superior gluteal artery
Lateral sacral artery
Which part of the rectum drains into the portal circulation?
Superior
Which part of the rectum drains into the systemic circulation?
Inferior
Why might haemorrhoids be associated with liver cirrhosis?
Portal Hypertension
With which venous plexus does the prostatic venous plexus communicate on its posterior side?
Batson venous plexus
What is the clinical significance of knowing about the venous drainage of the prostate?
Prostate cancer can spread via the Batson venous plexus
What are the two broad categories of nerve supply to the reproductive organs?
Somatic
Autonomic
What nerves form the somatic nerve supply to the reporductive organs and at what vertebral level do they originate?
Ilioinguinal (L1)
Genitofemoral (L1,L2)
Pudendal (S2,S3,S4)
What nerve innervates the scortum?
Genitofemoral nerve
Where does the pudendal nerve arise from, what course does it take and what does it innervate?
Origin - Sacral plexus
Course - Follows pudendal artery
Innervates - Skin & muscles of perineum
In what clinical scenario is the course of the pudendal nerve important to understand?
A difficult childbirth using an instrument (e.g. forceps delivery)
What procedre is carried out on the pudendal nerve to assist with a difficult birth?
A bilateral pudendal nerve block will provide pain relief during an instrument assisted childbirth
What bony landmarks are used for guidance during a pudendal nerve block procedure?
Ischial spine
Which nerves innervate the vas deferens, seminal vesicles, prostate and epiddidymis in males?
Sympathetic fibres from L1,2 via hypogastric plexus
Which nerves supply the female genital tract?
Sympathetic nerves from the ovarian plexus
Parasympathetic nerves from the pelvic splanchnic nerves
Which nerves innervate the erectile tissues in both males and females?
Parasympathetic fibres from hypogastric plexus
What structures drain lymph into the external iliac lymph nodes?
Glans of the Penis
Clitoris
Prostate
Cervix
Into which lymph nodes does the gluteal region, deep perineum and inferior pelvic viscera drain?
Internal iliac lymph nodes
Which group of lymph nodes drain the rectum and posterior wall of the pelvis?
Sacral lymph nodes
Into which group of lymph nodes does the lymph from the external, internal iliac and sacral lymph nodes drain into?
Common Iliac lymph nodes
