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
- 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
- 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?
- 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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