Glossary of 4-Pelvic Arteries, Veins and Nerves

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From where do the arteries of the pelvis arise?
most from the internal iliac, several directly off the abdominal aorta
At what level does the aorta bifurcate? What else is located at this level?
iliac crest, where a spinal tap can be done
What are 3 branches off the abdominal aorta that supply the pelvis?
superior rectal artery, median sacral artery, ovarian & testicular arteries
Which main branch of the abdominal aorta does the superior rectal artery branch from?
The left testicular or ovarian vein returns blood to the _____ and the right testicular vein returns blood to the _____.
L renal vein
What is a varicocele? One what side is it more likely? Why?
abnormal pooling of venous blood in and around the L testicle is more frequent b/c the L renal vein is higher pressure than the IVC
Name the branches that stem from the posterior division of the internal iliac arteries.
superior gluteal, iliolumbar, lateral sacral
Where is the superior gluteal artery located w/ respect to the piriformis muscle?
exits superior to piriformis
What does the iliolumbar artery supply?
iliacus, psoas, & quadratus lumborum muscles
What does the lateral sacral artery supply?
pelvic diaphragm & sacral spinal cord
Name the two terminal branches of the internal iliac arteries.
inferior gluteal and internal pudendal arteries
Which muscles are located superior and inferior to the inferior gluteal artery?
inferior gluteal A is inferior to piriformis but superior to ischiococcygeus
Where does the internal pudendal artery exit?
around the ischial spine along the pudendal canal
Name the 7 branches that can stem from the anterior division of the internal iliac.
obturator, umbilical, superior vesicular, uterine, vaginal, inferior vesicular, middle rectal
20% of the time the internal iliac can have a middle division. What branches would stem from it?
middle rectal, inferior gluteal, internal pudendal
Name the 3 arteries that supply the rectum and anal canal.
superior rectal, middle rectal, inferior rectal
What branch does the superior rectal artery branch from?
What branch does the middle rectal artery branch from?
anterior division of internal iliac
What branch does the inferior rectal artery branch from?
internal pudendal artery
Name the rectal vein(s) that return blood to the portal system.
superior rectal veins
Name the rectal vein(s) that return blood to systemic or IVC system.
middle and inferior rectal
What is the plexus located above the pectinate line? below?
internal rectal plexus
external rectal
Why are external hemorrhoids usually painful, but internal ones are not?
external area has somatic innervation
Name the collateral arteries that branch directly from the aorta.
ovarian, lumbar and vertebral, middle sacral arteries
What does the ovarian artery anaastomose with?
uterine artery (a branch from the internal iliac)
What artery forms the superior hemorrhoidal arteries?
What do the superior hemorrhoidal arteries anastomose with?
middle and inferior hemorrhoidal arteries
What do middle and inferior hemorrhoidal arteries branch from?
hypogastric and internal pudendal arteries
Name 2 branches from the external iliac artery.
deep iliac circumflex
inferior epigastric
What does the deep iliac circumflex artery anastomose with?
iliolumbar and superior gluteal (branches of the posterior division of the internal iliac)
What does the inferior epigastric artery give off in 27% of cases? What does this anastomose with?
obturator artery
external iliac and medial femoral circumflex
Name 2 branches of the femoral artery.
midial and lateral femoral circumflex
What does the medial femoral circumflex artery anastomose with?
obturator and inferior gluteal arteries
What does the lateral femoral circumflex artery anastomose with?
superior gluteal and iliolumbar arteries
What spinal levels combine to form the lumbosacral trunk?
What artery leaves the pelvis by passing between the lumbosacral trunk and S1 ventral ramus?
superior gluteal artery
What artery passes out of the pelvis between the S2&3 ventral rami?
inferior gluteal artery
What artery exits the pelvis with the sciatic nerve?
internal pudendal artery
What spinal levels does the sciatic nerve originate from? What does it supply?
flexors of knee and all muscle of leg and foot
What spinal levels does the superior gluteal nerve originate from? What does it supply?
gluteus medius and minimus
What spinal levels does the inferior gluteal nerve originate from? What does it supply?
gluteus maximus
What spinal levels does the pudendal nerve originate from? What does it supply?
external urethral and anal sphincters, motor and sensory to external genitalia
At what level do the preganglionic sympathetic fibers stop exiting from the spinal cord?
Where does the smpathetic chain continue down to? What do they join together at?
tip of coccyx
ganglion impar (coccygeal ganglion)
What type of innervation is needed at every spinal level? As a result, what must continue to leave at each spinal level?
sympathetic (vasomotor, pilomotor, and sudomotor)
postganglionic sympathetic axons
What are the pelvic parasympathetic fibers called? What spinal levels do they stem from?
pelvic splanchnic nerves
What are the mixed autonomic nerve plexuses in the pelvis called?
hypogastric plexuses
What plexus wraps around the inferior part of the aorta?
superior hypogastric plexus
What type of innervation PSNS or SNS is the inferior hypogastric plexus?
Name the plexuses that stem from the inferior hypogastric plexus.
vesicle and rectal plexuses
prostatic plexus in males
uterovaginal plexus in females
What supports the middle third of the vagina?
levator ani muscles
What supports the lower portion of the vagina?
cardinal ligaments
The pain fibers from the cerivx accompany what nerves?
parasympathetic fibers of S2,3,4
What nerve supplies the majority of both motor and sensory fibers to the muscles and skin of the vulva?
pudendal nerve
What is the importance of the pelvic diaphragm?
supports both abdominal and pelvic viscera and facilitates distribution of intraabdominal pressure
What is one of the major functions of the urogenital diaphragm?
support urethra and maintain urethrovesical junction
How can the ureter be distinguished from pelvic vessels during surgery?
ID peristalsis after touching it, or ID Aberbach's nerve plexuses

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