vessels of pelvis og pudendal nerve

Question 1

internal iliac a

Answer 1

from common iliac a
-milli S5 og L1, in front of sacro-iliac joint
-runs down over pelvic inlet og divides into anterior og posterior trunks

Question 2

internal iliac a

Answer 2

supplies:
-post. pelvic wall
-glut region (mm and hip joint)
-adductor region of thigh
-pelvic viscera
-perineum
-some parts of ext. genitals
-sacral canal + cauda equina

Question 3

br of internal iliac a

Answer 3

Parietal br:
1. iliolumbar a
2. lateral sacral aa
3. superior gluteal a
4. inferior gluteal a
5. obturator a

Visceral br:
1. umblical a
2. superior vesical a
3. a of def. duct (men)
4. inf. vesical a (men) eða vaginal og uterine aa (women)
5. middle rectal a
6. internal pudendal a

Question 4

parietal br. internal iliac a

Answer 4

1. iliolumbar a:
   -runs superolaterally to iliac fossa, deep tp psoas major m.
   -gives off:
   a. lumbar br (post. abd. wall)
   b. spinal br (for cauda equina)
   c. iliac br (for iliac fossa)
2. lateral sacral aa
   -run medially og inf. along post pelvic wall
   -give off spinal br into anterior sacral foramina (supply related sacrum + soft tissues, structures in sacral canal + overlying mm og skin)

Question 5

parietal br. internal iliac a

Answer 5

3. superior gluteal a
   -terminal br of posterior trunk
   -passes posteriorly milli sacral plx
   -leaves pelvic cav thru gr.sciatic foramen
   above piriformis
   (mm og skin in glut region)
4. inf. gluteal a
   -terminal br of anterior trunk
   -passes milli sacral plx
   -leaves pelvic cav thru lesser sciatic for.
   below piriformis
   (mm og skin in glut region)
5. obturator a
   -runs anteriorly along pelvic wall
   -leaves pelvic cav thru obturator canal
   (með obt. n og v)
   -enters og supplies adductor thigh reg)

*pubic br of obturator a anastomoses w inferior epigastric a

Question 6

visceral br. internal iliac a

Answer 6

1. umblical a
   -runs forward along lateral pelvic wall
   along side of bladder

-proximal p: gives rise to sup vesical a (sup part bladder og ureter)
og sometimes a of def. duct (def duct, seminal vesicles, lower p ureter + bladder)

-distal p: obliterated after birth og cont. forward as medial umbl ligg.

2. inferior vesical a
   -in male corresponds to vaginal a in female
   -supplies fundus of bladder, ureter, seminal vesicles, def duct og prostate
3. vaginal a
   -corresp. to inferior vesical a in male
   -supplies vagina og adj p of bladder og rectum
4. uterine a
   -corresp. to a of def. duct
   -runs medially in broad ligg of uterus,
   to reach cervix of uterus and crosses ureter
   -and asc along margin uterus og ends up anastomosing w ovarian a
   -supplies: uterus, uterine tube, vagina
   ovary og ureter

5.middle rectal a
-runs medially
-supplies rectum (also prostate + seminal vesicles or vagina)
-anastomoses w sup. rectal a (from inf. mesenteric a) and inferior rectal a (from internal pudendal a)

Question 7

internal pudedal a (visceral br internal iliac a)

Answer 7

leaves pelvis thru gr. sciatic foramen
undir piriformis m
-and enters perineum thru lesser sciatic foramen (acc. by pudendal n)
-traverses pudendal canal in lateral wall of ischiorectal fossa
-finally it pierces urogenital diaphragm to enter perineum

Question 8

internal pudendal a (visceral br of internal iliac a)

Answer 8

gives off:
1. mm br for pelvic diaphragm
2. inferior rectal a
3. perineal a (main a of perineum, supplies urogenital diaphragm) og gives of br for external genital organs:
a. post scrotal/labial aa
b. a of bulb of penis/vestibule
c. dorsal a of penis/clitoris
d. deep a of penis/clitoris

Question 9

median sacral a

Answer 9

unpaired a, arising from abd aorta just before bifurcation
-it desc in the midline, crosses pelvic inlet og svo across ant surf of sacrum og coccyx
-supplies:
post portion rectum
-ends in coccygeal body

Question 10

pelvic veins

Answer 10

1. internal iliac vein:
   -is a short trunk, that unites w ext. iliac vein
   to form common iliac vein
2. common iliac vein:
   -in general, its tributaries correspond to br of the internal iliac a
3. pelvic venous plexuses:
   tributaries from the organ form them, and they are around the organs w.in the pelvis

Question 11

pelvic venous plexuses

Answer 11

organs of pelvis surr. by network of of rather large thin walled veins:
1. rectal v plx (important portocaval shunt. Via sup. rectal veins to portal system and via middle og inf rectal vv to caval system)

2. vesical v plx
3. prostatic v plx
4. uterine v plx
5. vaginal v plx
6. sacral v plx

*plexuses interconn w each other and give rise to visceral tributaries of internal iliac vein.
They provide easy route for infections

Question 12

pudendal nerve

Answer 12

same course as internal pudendal vessels

motor fibers: for pelvic diaphragm (og ext. anal sphincter) og urogenital diaphragm

sensory fibers: skin around anus, skin of scrotum, penis
labia majora, clitoris