Flashcards in Lecture 22 - Blood Vessels, nerves and Lymph of Pelvis Deck (31):
Where are the pelvic parasympathetics from?
bracnhes from the side wall of the pelvis are from what artery?
internal iliac - will usually travel in with a NV bundle
the ovarian artery is a branch of what
The superior rectal artery is continuation of what
inferior mesenteric artery
What do the parietal branches of internal iliac supply?
wall of the pelvis and sends some vessels into the gluteal region (not worrying about these as much)
The internal iliac artery is very...
variable! - look at the structure and work back
the superior vesical artery is reinforced by what in males?
what else does this supply
inferior vesicle branch
also supplies the vas, prostate, seminal vescicles
What is within the lateral cervical ligament?
uterine artery in females
comesin at level of cervix - crosses ureter
What happens to the uterine artery at the cervix?
splits - sends branch down to anastomose with the vaginal artery
sends branch up to meet the ovarian artery
vaginal artery is the female equivalent of what
inferior mesenteric artery is reinforced by..
middle rectal artery - coming off internal iliac in both sexes
The inferior rectal artery is a branch of the
pudendal vessels - goes to anal canal
obturator nerve is a branch of the
lumbar plexus - goes through obturator canal
obturator nerve will supply the parietal perineum, therefore pain will be referred to..
medial thigh above the knee
the sacral plexus is formed..
on piriformis with contribution from lumbo-sacral truck formed by L4 remnants
The two really important nerves from the sacral plexus are...
pudendal nerve - nerve of perineum
What is the course of the pudendal nerve?
(S2-4) pelvis - through greater sciatic foramen - winds around ishial spine in gluteal region - back through the lesser sciatic foramen (now beneath the pelvic floor) - now into perineum
True or false
The pudendal nerve penetrates the pelvic floor
false - goes in from behind
once inside the perineum the pudendal nerve slips into the
The first thing that the pudendal nerve does is
send branches to the anal canal - inferior rectal nerves
once beyond the anal triangle what branches are given off?
perineal nerves to sctrutures in the midline.
ends up at the apex of the triangle at the dorsal nerve of clitorus/penis
The pelvic sympathetic fibres reach the pelvis via...
superior hypogastric plexus which lies inferior to the bifurcation of aorta
superior hypogastric plexus (sympathetics) divides into a
Right and Left hypogastic nerves which descend laterally to rectum to join pelvic splanchnic nerves
the combination of pelvic splanchnic nerves and hypogastric nerves creates...
Right and Left inferior hypogastric plexus (an autonomic plexus of para/sympathetic nerves
The pelvic pain line (plane of least dimensions) - divides ...
the referral of pain
structures above the pelvic pain line will convey their pain
accompanying the sympathetic motor fibres - will go up to ant. abdo wall
Everything that has peritoneum draped over the top or related to the broad lig relates pain to the
ant. abdo wall T1-L2
structures below the pelvic pain line will convey their pain...
accompanying the parasympathetics - referred to the peri-anal region, buttocks
What are the componenets of the micturition reflex
1. Stretch receptors in bladder wall
2. Visceral afferents accompany pelvic parasymapthetics
3. Spinal cord segments S2-4
4. Visceral efferents (pelvic parasympathetics)
5. Detrusor muscle of bladder
How is micturtion started?
voluntarily relaxing the external urethral sphincter