B8-044 Pelvic Nerves, Vessels, and Lymphatics Flashcards
(173 cards)
1
Q
the ovarian/testicular arteries come off the aorta at what spinal level?
A
L2
2
Q
the right gonadal vein drains into the
A
IVC
3
Q
the left gonadal vein drains into the
A
left renal vein
4
Q
provides main blood supply to all of the structures in the pelvis/perineum
A
internal iliac a.
5
Q
branch of the posterior internal iliac a. that supplies the psoas, illiacus, quadratus lumbora, and cauda equina
A
iliolumbar a.
6
Q
branch of the posterior internal iliac a. that supplies piriformis, erector spinae and nerves in sacral canal
A
sup/inf lateral sacral a.
veins drain into lumbar plexus – infection can spread to brain
7
Q
branch of the posterior internal iliac a. that supplies the gluteal muscles, tensor fascilata, and piriformis
A
superior gluteal a.
8
Q
branch of the anterior internal iliac a. that is a fetal remnant
obliterates and forms medial umbilical ligament
A
umbilical a.
9
Q
branch of the anterior internal iliac a. that supplies superior bladder
A
superior vesical a. (via umbilical)
10
Q
branch of the anterior internal iliac a. travels through the obturator foramen
A
obturator a.
11
Q
branch of the anterior internal iliac a. that could be nicked during inguinal surgeries, leading to life threatening bleeding
A
obturator a.
12
Q
branch of the anterior internal iliac a. that supplies the base of the bladder
A
inferior vesical a.
13
Q
branch of the anterior internal iliac a. that supplies vas deferens, prostatic branches, and seminal vesicles in males
A
inferior vesical a.
14
Q
branch of the anterior internal iliac a. that travels in the cardinal ligament to supply the uterus and vagina
A
uterine a
15
Q
branch of the anterior internal iliac a. that is the main supply to perineal structures
A
internal pudendal a.
16
Q
branch of the anterior internal iliac a. that descends between piriformis and coccygeus
A
internal pudendal a.
17
Q
branch of the anterior internal iliac a. that supplies gluteus maximus, hamstrings, and pelvic diaphragm
A
inferior gluteal a.
18
Q
branch of the anterior internal iliac a. that supplies rectum
can also supply some of prostate, seminal vesicles, vagina
A
middle rectal a.
19
Q
artery that dives between the lumbosacral trunk and rami of S1
A
superior gluteal a.
(anterior internal iliac)
20
Q
artery that dives between the rami of S2 and S3
A
inferior gluteal a.
(anterior internal iliac)
21
Q
travels in the suspensory ligament
A
ovarian artery
22
Q
travels in the cardinal ligament
A
uterine artery
23
Q
superior rectal a. arises from
A
IMA
24
Q
middle rectal a. arises from
A
anterior internal iliac a
25
inferior rectal a. arises from
internal pudendal a.
26
superior rectal vein empties into the [...] system
portal
27
middle and inferior rectal vein empties into the [...] system
caval
28
formed where the hindgut endoderm and ectoderm met
pectinate line
29
anus below the pectinate line is under [...] muscle control
somatic
(inferior rectal n. via pudendal)
30
arterial supply below pectinate line
inferior rectal a.
31
lymphatics below pectinate line will go to
superficial inguinal lymph nodes
32
anus above the pectinate line is under [...] muscle control
autonomic
33
blood supply above pectinate line
superior and middle rectal a
34
lymphatics above pectinate line will go to
internal iliac lymph nodes
35
superior rectal vein drains into [...] system
portal
36
some lateral sacral veins drain into the [...] plexus
internal vertebral venous plexus
(valveless plexus that travels to brain)
37
gonads drain into the [...] lymph nodes
lumbar
38
bladder drains into the [...] lymph nodes
superior: external iliac
inferior: internal iliac
39
rectum drains into the [...] lymph nodes [4]
inferior mesenteric
pararectal
sacral
internal iliac
40
scrotum drains into the [...] lymph nodes
superficial inguinal
41
external genitalia drains into the [...] lymph nodes
superficial inguinal
42
prostate drains into the [...] lymph nodes
internal iliac
43
pudendal nerve arises from what spinal levels?
S2-4
44
pudendal nerve travels with [...] artery
internal pudendal
(exact same pathway and gives off the exact same branches)
45
exits pelvis through greater sciatic foramen between piriformis and coccygeus,
then dives deep to the sacrotuberous ligament
pudendal nerve
46
pudendal nerve lies deep to [...] ligament to enter the pudendal canal
sacrotuberous
47
pudendal canal is located between
obturator fascia and obturator muscle
48
branch of pudendal nerve that innervates the deep and superficial pouches of the perineum
deep perineal n.
49
branch of pudendal nerve that terminates as the posterior scrotal/labial nerves
superficial perineal n.
50
the pudendal n. terminates as [...] nerve
dorsal nerve of penis/clitoris
51
branch of pudendal nerve that crosses the ischioanal fossa
inferior rectal n.
52
branch of pudendal nerve that innervates motor to external anal sphincter
inferior rectal n.
53
branch of pudendal nerve that innervates sensory to the anal canal inferior to pectinate line and skin around the anus
inferior rectal n.
54
branch of pudendal nerve that innervates sensory to skin around perineal body
and sensory to skin of scrotum/labia
superficial perineal n.
55
branch of pudendal nerve that innervates motor to the muscles of the deep and superficial perineum
deep perineal n.
56
branch of pudendal nerve that innervates sensory to the vestibule and inferior vagina
deep perineal n.
57
branch of pudendal nerve that innervates sensory to clitoris or dorsum of penis
dorsal nerve of clitoris/penis
58
branch of pudendal nerve that innervates motor to external urethral sphincter
dorsal nerve of clitoris/penis
59
pelvic splanchnics arise from what spinal levels?
S2-4
60
physiologic information travels with [parasympathetics/sympathetics]
parasympathetics
61
above the pelvic pain line, pain travels with [parasympathetics/sympathetics]
sympathetics
62
[parasympathetics/sympathetics] function to maintain internal tone of internal anal sphincter and inhibit peristalsis of rectum
sympathetics
63
[parasympathetics/sympathetics]
function to inhibit contraction of the internal anal sphincter and stimulate peristalsis of rectum
parasympathetics
64
[parasympathetics/sympathetics]
travel in lumbar splanchnics
sympathetics
65
[parasympathetics/sympathetics]
travel in pelvic splanchnics
parasympathetics
66
what nerve allows for conscious relaxation of the external anal sphincter when ready to defecate?
pudendal nerve (somatic motor of rectum)
67
[parasympathetics/sympathetics]
function to contract the internal urethral sphincter
prevents semen from entering the bladder during ejaculation
sympathetics
68
[parasympathetics/sympathetics]
contracts detrusor muscle
parasympathetics
69
[parasympathetics/sympathetics]
inhibit internal urethral sphincter
| (relaxes)
parasympathetics
70
[parasympathetics/sympathetics]
prevents semen from entering the bladder during ejaculation
sympathetics
71
allows for voluntary contraction of the external urethral sphincter
dorsal nerve of clitoris/penis (somatic motor of bladder)
72
[parasympathetics/sympathetics]
may cause uterine contractions and vasoconstriction but under hormonal control
sympathetic
73
[parasympathetics/sympathetics]
may cause uterine inhibition and vasodilation but under hormonal control
parasympathetics
74
above the pelvic pain line, pain travels with [parasympathetics/sympathetics]
sympathetics
75
below the pelvic pain line, pain travels with [parasympathetics/sympathetics]
parasympathetics
76
somatic motor fibers to the urethrovaginal sphincter are carried by the [...] nerve
dorsal nerve of clitoris (off pudendal)
77
pain from the fundus and body of the uterus will travel with [parasympathetics/sympathetics]
sympathetics
| above the pelvic pain line with sympathetics
78
pain from the cervix and most of vagina will travel with
[parasympathetics/sympathetics]
parasympathetics
79
[parasympathetics/sympathetics]
originate from T12-L2
sympathetics
80
[parasympathetics/sympathetics]
originate from S2-S4
parasympathetics
81
landmark for pudendal nerve block
ischial spine
82
innervates labia minora
superficial perineal n.
83
innervates labia majora
posterior labial n.
84
innervates vestibule of vagina
deep perineal n.
85
innervates perianal region of the skin
inferior anal (rectal) n.
86
damage to the [...] nerves that travel along the prostate can affect the ability to get an erection
cavernous n.
87
[parasympathetics/sympathetics]
responsible for producing penile erection
parasympathetic
88
[parasympathetics/sympathetics]
stimulate contraction of internal urethral sphincter to prevent retrograde flow of semen into bladder
sympathetics
89
[parasympathetics/sympathetics]
stimulates rapid peristalsis of vas deferens and discharge of sperm
sympathetic
90
[parasympathetics/sympathetics]
stimulates contraction of seminal glands and prostate
sympathetics
91
[...] nerve contracts the bulbospongiosus forcing semen from penis base
deep perineal n. (somatic motor)
92
[...] nerve contracts the bulbospongiosus and ischiocarvernousus muscles to limit venous blood flow from erectile tissue
deep perineal n. (somatic motor)
93
[parasympathetics/sympathetics]
constriction of helical arteries reducing blood flow into cavernous tissue during remission
sympathetic
94
[parasympathetics/sympathetics]erection
parasympathetic
95
[parasympathetics/sympathetics]
emission and ejaculation
sympathetic
96
[parasympathetics/sympathetics]
remission
sympathetic
97
[...] splanchnic nerves carry visceral pain fibers from pelvic organs above the pelvic pain line
lumbar
98
[...] splanchnic nerves carry visceral pain fibers from pelvic organs below the pelvic pain line
pelvic
| parasympathetic
99
[...] nerve provides sensation to most of the perineum
perineal n.
100
provides sensation to the skin and glans of the penis
and innervates the external urethral sphincter
dorsal n. of penis
101
provides sensory and motor innervation to the inferior anus below the pectinate line
inferior rectal n.
102
provides sensory and motor innervation to external anal sphincter
inferior rectal n.
103
provides sensory and motor innervation to skin around the anus
inferior rectal n.
104
the bulbospongiosus muscle receives blood from the [...] artery
perineal branches of internal pudendal
105
the inferior bladder, prostate, seminal vesicles, and ejaculatory ducts are supplied by [...] artery
inferior vesicle
106
receive lymphatic drainage from all of the perineum and external genitalia
superficial inguinal nodes
107
receive lymph from the upper anal canal, gluteal region, and pelvic viscera
internal iliac nodes
108
receive lymph from the pelvic organs in direct contact with the peritoneum
(superior bladder, superior ureters, superior seminal vesicle)
external iliac nodes
109
receive lymph from ovaries, uterine tubes, and fundus of uterus
lumbar lymph nodes
110
receive lymph from glans clitoris
deep inguinal lymph nodes
111
[...] splachnic nerves provide parasympathetic innervation to the detrusor muscle and inhibit the urethral sphincter
pelvic
112
[...] splachnic nerves cause contraction of the internal urethral sphincter and prevent semen from entering the bladder during ejaculation
lumbar
113
[...] splachnic nerves carry sympathetic fibers for innervation of the lower limbs for vasomotor, pilomotor, and sudomotor function
sacral
114
[...] artery supplies blood to the corpus cavernosum during erection
deep artery of penis
115
[...] artery supples blood to the inferior anus below the pectinate line
inferior rectal
116
the lumbar splanchnics carry [...] fibers into the pelvis
sympathetic
117
Colle's fascia is continuous with [3]
dartos
penile
scarpas
(allows for accumulation of fluid)
118
boundaries of superficial pouch
perineal membrane
colles fascia
119
boundaries of deep pouch
pelvic floor fascia (levator ani fascia)
perineal membrane
120
[deep or superficial pouch]
bulb of penis
superficial
121
[deep or superficial pouch]
crus of penis
superficial
122
[deep or superficial pouch]
ischiocavernosus muscle
superficial
123
[deep or superficial pouch]
bulbospongiosus muscle
superficial
124
[deep or superficial pouch]
spongy urethra
superficial
125
[deep or superficial pouch]
superficial transverse perineal muscles
superficial
126
[deep or superficial pouch]
deep perineal branches of the internal pudendal vessels/nerves
superficial
127
[deep or superficial pouch]
body of clitoris
superficial
128
[deep or superficial pouch]
crus of clitoris
superficial
129
[deep or superficial pouch]
bulb of vestibule
superficial
130
[deep or superficial pouch]
greater vestibular glands
superficial
131
[deep or superficial pouch]
urethra
deep
132
[deep or superficial pouch]
external urethral sphincter
deep
133
[deep or superficial pouch]
anterior recess of ischioanal fossa
deep
134
[deep or superficial pouch]
deep transverse perineal muscles
deep
135
[deep or superficial pouch]
bulbo-urethral glands (Cowpers)
deep
136
[deep or superficial pouch]
dorsal nerve of penis/clitoris
deep
137
[deep or superficial pouch]
dorsal artery of penis/clitoris
deep
138
[deep or superficial pouch]
smooth muscle (in place of deep perineal muscles in females)
deep
139
what vessels lie in proximity to the sacro-iliac joint? [2]
common iliac a. bifurcates into external/internal there
gondal arteries
140
what structure lies in proximity to the sacro-iliac joint?
(medial to gonadal arteries)
ureter
141
what nerves lie in proximity to the sacro-iliac joint?
lumbo-sacral trunk of sacral plexus
| L5-S1ish area
142
what nerve lies in proximity to the pelvic rami?
obturator
143
what structures lie in proximity to the pelvic rami? [4]
vas deferens
bladder
urethra
prostate
144
what vessels lie in proximity to the sacrum? [2]
median sacral
inf. and sup. gluteal
145
muscles of the external urethral sphincter that are stretched in childbirth and can lead to incontinence [2]
compressor urethra
urethro-vaginal sphinter
146
what branch of pudendal innervates the external urethral sphincter?
dorsal nerve of clitoris/penis
147
[sympathetic/parasympathetics] control the internal urethral sphincter
sympathetics
via lumbar splanchnics
148
[sympathetic/parasympathetics]
contract detrusor muscle
parasympathetics
via pelvic splanchnics
149
sense stretch of bladder
visceral afferents
150
pain from the top of the bladder with travel with the [...]
sympathetics
151
pain from the bottom of the bladder will travel with the [...]
parasympathetics
152
lymphatics from the prostate go to [...] nodes
internal iliac
153
vascular supply to prostate
inferior vesicle artery
154
cavernous nerves are [parasympathetic/sympathetic] fibers
parasympathetics
155
damage to [...] nerve fibers can cause urinary incontinence
sympathetic
156
ovary/testical drain to what lymph node?
lumbar node
(aka aortic or caval; scrotum has different nodes)
157
scrotum drains to what lymph node?
superficial inguinal
158
what arteries supply the bladder?
super and inferior vesicular
159
what arteries supply the prostate? [2]
inferior vesicle a.
middle rectal a.
160
what arteries supply the rectum? [3]
superior, middle, and inferior rectum
161
what arteries supply the uterus? [2]
uterine a.
branches of ovarian a.
162
what artery supplies the structures of the perineum?
internal pudendal a.
163
parasympathetics are located at what spinal level?
S2-4
164
sympathetics are located at what spinal level?
T12-L2
165
landmark for pudendal nerve block
ischial spine
166
lymphatic drainage from the external genitalia passes to the [...] nodes
superficial and deep inguinal
167
the superior bladder will drain into the [...] nodes
external iliac
168
the inferior bladder will drain into the [...] nodes
internal iliac
169
the ovary and uterine tubes will drain into the [...] nodes
lumbar
(aortic/caval)
170
sensory deficits around the anus and the vestibule of the vagina indicate damage to the [...] nerve
pudendal
171
provides sensation to the skin around anus
inferior rectal nerve
172
sensation to the anterior scrotum is supplied by [2]
ilioinguinal
genitofemoral
173
lymphatic drainage of the testis goes to the [...] nodes
lumbar
(due to descent from posterior abdominal wall during development)
