Flashcards in Lecture 24 DA Deck (39):
What are the two divisions of the external iliac artery?
Posterior branch - to the parietal body wall.
Anterior branch - To the body wall and viscera (to viscera is variable).
What are the arteries of the posterior branch of the external iliac artery (3 of them)?
Iliolumbar, lateral sacral and superior gluteal arteries.
What are the arteries of the antterior branch of the external iliac artery (3 of them)?
Obturator, inferior gluteal and internal pudendal arteries.
What is a feature of the uterine and vaginal artery in regards to pregnancy?
The two anastamose, and are convoluted and tortuous so that when the uterus expands when pregnant, the two can expand with it.
Facial arteries are similar.
What is meant by end organs? Where can they be found?
Means arteries will end there, and dnt anastamose. Occurs in the extremities.
Why shouldn't vasoconstrictors be injected into end organs?
It can cause avascularity and possibly gangrene due to the lack of anastamoses.
Do veins within the pelvic cavity have valves?
Where do the vesical, prostatic and uterovaginal veins drain?
To the internal iliac vein.
Where does the prostate venous plexus drain to? What is the clinical significance of this?
Normally to tributaries of the IVC. Cancer can spread due to this, forming secondary metastasis in bone, liver, brain and neural tissue.
Where can the prostate drain to aside from tributaries to the IVC?
Retrogradely to the vertebral canal via anterior sacral veins.
What happens to cavernous vessels during erection?
They are constricted during erection, filling them with blood.
What is a possible complication of prostatectomy?
Damage of the erectile nerves is possible, as well as blood vessels.
Where does the superior rectal vein drain to?
To the inferior mesenteric vein, at the common iliac vein bifurcation level.
How does the superior rectal vein communicate with the internal iliac vein below?
Via the inferior and middle rectal veins.
What system is the superior rectal vein part of?
What system are the inferior and middle rectal veins part of?
What happens to the rectal veins during portal hypertension?
They will distend, forming varices, and can distend out of the anal canal, called haemorrhoids.
What is the difference between visceral and somatic haemorrhoids?
Visceral haemorrhoids are found in the upper anal canal, and cause some discomfort.
Somatic haemorrhoids are found much lower down and are extremely painful.
What can be said of the lymph drainage of the pelvis?
Accompanies the veins.
What does the superficial inguinal node drain?
Skin of the perineum.
Where does pelvic vicera lymph drain to?
Deep inguinal node.
Where does the superficial inguinal node drain to?
To the deep inguinal node.
Where does scrotum lymph drain to?
To inguinal nodes.
Where does testes lymph drain to? What is a consequence of this?
To para aortic abdominal wall nodes. Cancer is difficult to observe, but can be palpated by checking the left superior clavicular node, a sentinel node. Swollen if cancer is present.
What are the spinal nerves of the sacral plexus, and what does it supply?
Supplies pelvic muscles and gluteal region.
What are the main branches of the sacral plexus?
Obturator and pudendal nerve.
What does the pudendal nerve supply, and how does it avoid compression?
Supplies the perineum and external genitalia, supplying them from below, to prevent compression from viscera above.
What is a pudendal nerve block procedure?
Done during pregnancy, the needle is inserted into the pudendal canal. The ischial spine is palpated through the vagina. Pudendal vessels are endangered.
What nerves do viscera have?
A single sensory pathway - afferent
Dual motor - sympathetic and parasympathetic
What pathway is the inferior hypogastric nerve composed of?
Mixed (both sympathetic and parasympathetic).
What pathway is the superior hypogastric nerve composed of?
What pathway are the pelvic splachnic nerves composed of?
What do sympathetic nerves do within the pelvis?
Contract the sphincters and arteries.
What happens to the neurovascular supply at the junction between endoderm and ectoderm derived structures? Name a site.
They overlap. The rectum is one site. Epidermis, dermis and skeletal muscle is another. Epithelium, lamina propria and smooth muscle.
What is the rectum supplied by above and below the pectinate line?
Above - from unpaired
Below - from paired
Name three pelvic reflex arcs and the spinal nerves involved.
What is the pelvic pain line?
Passes from the inferior pubic bone to the upper coccyx.
How is pain referred above the pelvic pain line?
Referred to the anterior abdominal wall via sympathetics, as visceral afferents pass with sympathetics.