Lecture 25 (8-7-14)

Question 1

What is the Pelvic arterial supply?

Answer 1

• Internal illiac (from common illiac)
• Gonadal a (from aorta)
• Median Sacral a (from aorta)
• Superior rectal a (from inferior mesenteric)

Question 2

What are the branches of the posterior division of the internal iliac artery including what they do.

Answer 2

ALL SOMATIC BRANCHES!! (POST DIV)

• Illiolumbar branches ascend
  
  • lumbar a
  • iliiac branch
• Lateral sacral aa
  
  • ​lots of branches that go out the sacral foramina
• Superior Gluteal A
  
  • ​leaves between LS trunk and S1
  • (Posterior and superior both starts with con.)

Question 3

What are the branches of the anterior division of internal iliac?

Answer 3

ANTERIOR IS BOTH Visceral and somatic

• Umbilical a (v) –>superior vesical (V)
• Obturator (s) (supply medial compart thigh)
• Uterine/ aterty to vas deferns (v)
• Inferior vesical/ vaginal (v) (bladder, seminal vesical, prostate)
• Internal Pudendal (s) (perineum)
• Middle Rectal (v)
• Inferior Gludeal a (s?)
  
  • ​(Inf and Ant both start with vowles!)

Question 4

What does the internal pudendal artery do?

Answer 4

Supply perineum

Question 5

What is the venous drainage of the rectum?

Answer 5

BOTH portal and **systemic **

1. Superior Rectal vv. --> inferior mesenteric–> portal vein
2. Middle rectal vv–> interinal illiac v. –> IVC
3. Inferior rectal vv–> internal pudendal v–> internal illiac v–> IVC

Question 6

What are the nerves in the lumbosacral plexus and what spinal cord segmends are they?

Answer 6

1. Superior Gluteal n (L4-S1)
2. Inferior Gluteal (L5-S2)
3. Nerve to Piriformis (S1-S2)
4. Sciatic (L4-S3)
   
   • Tibial part (L4-S3)
   • Fibular part (L4-S2)
5. N. to Quadratis femoris (L4-S1)
6. N. to Obturator Internus (L5-S2)
7. Posterior Femoral Cutaneous (S2-S3)

Question 7

Identify these nerves

Answer 7

1. Superior Gluteal n (L4-S1)
2. Inferior Gluteal (L5-S2)
3. Nerve to Piriformis (S1-S2)
4. Sciatic (L4-S3)
   
   • Tibial part (L4-S3)
   • Fibular part (L4-S2)
5. N. to Quadratis femoris (L4-S1)
6. N. to Obturator Internus (L5-S2)
7. Posterior Femoral Cutaneous (S2-S3)

Question 8

What are the roots of pelvic splanchnics and what do they do?

Answer 8

S2-S4

parasympathetics to pelvis

Question 9

What is the innervation of the levator ani muscle?

Answer 9

• Levator ani muscles (puboreectalis, puboccoygeus and iliococcygeus)–> nerve to levator ani (s4)
• Coccygeus muscle –> S4, S5

(super gluteal nerve??)

Question 10

1. What spinal cord segments is the pudendal nerve?
2. What is the path of pundendal nerve what does it innervate?
   3.

Answer 10

1. “S2,3,4 keeps your ass off the floor”
2. our greater sciatic foramen–> back in lesser sciatic foramen–> give branches to perineal structures.

Question 11

Ischiovernosus muscle

Answer 11

1. ischial tuberosity–> ??
2. muscular (deep) br of perineal n–> f/ pudendal nerve (s2-S4) {same as bulbospongiosus}
3. compresses veins to keep erection

Question 12

Bulbospongiosus m

Answer 12

1. Perineral body–> clitoral prepuce
2. Muscular branch of perineal n–> from pudendal n (S2-S4) {same as ischiocavernosus
3. helps erection clitoris and bulb of vestibule

Question 13

Superficial Transverse Perineal muscle

Answer 13

1. iscial tuberosity–>
2. Deep branch of perineal nerve–> pudendal nerve (S2-S4)
3. Supports pelvic floor

Question 14

Deep Transverse Perineal

Answer 14

1. 2. Deep br of perineal n–> pudendal nerve (S2-S4
2. supports floor
3. (same as superficial)

Question 15

Sphincter Urethae Muscle.

Answer 15

• Deep branch of the perineal nerve, branch of pudendal nerve (S2-S4)
• Compresses urethrae to maintain urinary continence.

Question 16

Urethrovaginal Muscle

Answer 16

• Deep branch of the perineal nerve, branch of pudendal nerve (S2-S4)
• Compresses urethrae to maintain urinary continence.

Question 17

Compressor Urethrae Muscle

Answer 17

• Deep branch of the perineal nerve, branch of pudendal nerve (S2-S4)
• Compresses urethrae to maintain urinary continence.

Question 18

What is the autonomic Nervous system in the pelvis?

Answer 18

Sympathetics:

Lumbar and sacral splanchnics

Parasympathetics

S2-4 and Pelvic splanchincs

Question 19

What are the Autonomic Nerves in the Pelvic Viscera?

Answer 19

Sympathetics L1-S2 spinal levels f/ sympathetic chain

• Hypogastric nn
• Lumbar splanchnic nn
• Sacral Splanchnic nn

Parasympathetics:

• Pelvic splanchnic from S2-S4

Question 20

What is the function of sympathetics in the abdomen and pelvis?

Answer 20

• Inhibit peristalsis
• Vasoconstriction
• Contract internal urethral sphincter
• Increase sphincter tone
• Release adrenalin into blood stream

-Ejaculation

Question 21

What is the function of parasympathetics in the abdomen and pelvis?

Answer 21

1. peristaliss
2. vasodialation
3. decrease sphinctor tone
4. increase digestive secreations
5. contract detrusor muscle
6. erection

Question 22

How do general visceral afferents travel back? where are they coming from and going to?

Answer 22

organ–> spinal cord with autonomic fibers supply specific organ

from thoracic and abdominal organs with SYMPATHETICS

_from PELVIC ORGANS with PARASYMATHTICS _