Pelvic Organs Blood Supply Flashcards
Abdominal aorta bifurcates at level of ___.
Common iliac bifurcates at level of ___.
External iliac A becomes ____.
Internal iliac A supplies ____.
L4
L5-S1
Femoral A
Supply pelvic viscera and perineum
Four posterior division branches of internal iliac A and what they supply
- Iliolumbar A: runs between obturator nerve and lumbosacral trunk to supply iliacus, psoas major, quadratus lumborum, cauda equina in vertebral canal
- Lateral sacral A: supplies piriformis, enters anterior sacral foramina to supply spinal meninges, roots of sacral spinal nerves, exits posterior sacral foramina to supply erector spinae, and skin covering dorsal sacrum
- Superior gluteal A (terminal branch): supplies piriformis, goes through the greater sciatic foramen to get to gluteal muscles, tensor fascia lata
- Some people have inferior gluteal A come off posterior division (rare)
Nine anterior division branches of the internal iliac A and what they supply (first five)
- Superior vesical branches of umbilical A: supplies urinary bladder
- Obturator A: supplies pelvic muscles, head of femur, leaves pelvic cavity by obturator canal to enter medial thigh
- Accessory obturator A
- Inferior vesical A (males): supplies urinary bladder, ureter, prostate, seminal vesicles
- Uterine A (females): supplies uterus, ligaments of uterus, uterine tube, ovary, superior vagina (anastomoses with ovarian A)
Nine anterior division branches of internal iliac A and what they supply (last four)
- Vaginal A: supplies anterior and posterior vaginal surfaces
- Middle rectal A: supplies rectum, seminal vesicles, prostate, vagina
- Internal pudendal A: exit pelvis through greater sciatic foramen, loops around spine of ischium to enter perineum though lesser sciatic foramen; supplies perineum
- Inferior gluteal A: supplies pelvic diaphragm muscles, piriformis, quadratus femoris, gluteus maximus, and sciatic N
Where does the superior rectal A divide?
What do its branches supply?
What does the superior rectal A come off of?
S3; divides into two branches
Each branch descends on either side of rectum to supply it as far inferiorly as the internal anal sphincter
Inferior mesenteric A
What are the pelvic venous plexuses?
What drains theses veins?
What important connections do theses veins make?
Do theses venous plexuses have valves?
Pelvic veins associated with pelvic viscera
Drained by tributaries of internal iliac veins, inferior mesenteric vein (superior rectal V) and lateral sacral veins
Connect to vertebral venous plexuses
No valves
Where are the internal iliac veins?
What do they become?
Pelvic veins that form superior to the greater sciatic foramen and lie posterior-inferior to the internal iliac arteries
Merge with external iliac veins to form common iliac veins, which unite at L4/L5 intervertebral disc to form inferior vena cava
What are the lateral sacral veins?
What two pathways does it provide?
Pelvic veins on the anterior surface of the sacrum that anastomose with internal vertebral plexus (inside the vertebral canal)
Provide a collateral pathway to reach either the inferior or superior vena cava
Provide a metastatic pathway for prostatic or ovarian cancer cells to vertebrae or cranial cavity
What is the superior rectal vein?
Superior gluteal vein?
Testicular veins?
Pelvic veins; form a tributary to inferior mesenteric veins
Pelvic veins; largest tributaries to the internal iliac veins
Pelvic veins; exit deep to the inguinal ring and traverse pelvic cavity to travel to their terminations
Four groups of lymph nodes that do lymphatic drainage of the pelvic viscera
Where do they receive and send lymph?
External iliac LN: receive lymph from LE inguinal nodes and superior parts of middle to anterior pelvic organs; drain into common iliac nodes
Internal iliac LN: receive lymph from inferior pelvic viscera, deep perineum, and gluteal region; drain into common iliac nodes
Sacral LN: receive lymph from postero-inferior pelvic viscera; drain into internal or common iliac nodes
Common iliac LN: receive lymph from three previous groups; drain into lumbar nodes
Pelvic structures are innervated by ____ and ____ spinal nerves and ____ nerves.
Sacral and coccygeal spinal nerves (S1-S5, Co)
Pelvic splanchnic nerves (S2-S4)
Where is the sacral plexus located?
What are its branches and where do they exit?
Located on posterolateral wall of the lesser pelvis
Sciatic N, pudendal N, superior gluteal N, inferior gluteal N
Exit through greater sciatic foramen
Where is sciatic N and what does it supply?
Branch of sacral plexus at L4-S3
Passes inferior to pirifomis to enter gluteal region
Descends in the posterior thigh to supply the posterior compartment of the thigh and the entire leg and foot
Where is the pudendal N and what does it supply?
Branch of sacral plexus at S2-S4
Passes between the piriformis and coccygeus muscles accompanied by the internal pudendal A
It enters the perineum through the lesser sciatic foramen to supply the perineum
Three branches off the abdominal aorta and what they supply
Common iliac arteries
Ovarian arteries: ovaries
Median sacral A: lower lumbar vertebrae, sacrum, coccyx
