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Pelvic Neurovasculature Flashcards

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1
Q

The abdominal aorta splits into the ______ _____ aa. at L4?

A
  • common iliac
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2
Q

The common iliac aa splits into the ________ & _______ ______ ____

A
  • external

- internal iliac aa.

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3
Q

The external iliac aa exits the pelvis as the ________ aa

A

femoral

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4
Q

The ______ ______ aa enters the true pelvis & branches into 3 posterior & 7 anterior branches

A

internal iliac

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5
Q

What does the internal iliac artery supply?

A
  • pelvic organs

- gluteal region

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6
Q

This posterior branch of internal iliac, runs btw the iliac crest & L5 to suppy the medial ilium and L5

A

iliolumbar a.

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7
Q

What are the branches of the iliolumbar a?

A

iliac
lumbar
spinal

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8
Q

This posterior branch of internal iliac, enters the ventral sacral foramina and supplies the sacrum and ventral sacral nn.

A

lateral sacral a (# of them)

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9
Q

This is a posterior branch of internal iliac that runs btw L5 and S1 nerves to enter the gluteal region superior to piriformis m.

A

superior gluteal a.

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10
Q

The superior gluteal a. supplies _______ mm with superior gluteal nn.

A

gluteal

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11
Q

The superior gluteal a. exits what foramen?

A

greater sciatic foramen

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12
Q

Exiting the greater sciatic foramen = exiting the _____ ______

A

pelvic cavity

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13
Q

This anterior branch of internal iliac runs btw S2 & S3 (s1 & s2) nerves inferior to piriformis m.

A

inferior gluteal a.

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14
Q

The inferior gluteal a. supplies _______ mm with inferior gluteal nn

A

gluteal

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15
Q

The Superior & Inferior gluteal aa. (travel w/ nnn. of same name) exit the pelvis via the ____ ______ foramen

A

greater sciatic

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16
Q

The _____ ______ a runs with pudenal n and exits the pelvis thru the ______ _____ foramen

A
  • internal pudendal (Ant. branch)

- greater sciatic

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17
Q

The internal pudendal a. enters the gluteal region _________ to prififormis, crosses over ________ ligament and re-enters the pelvis thru _____ _____ foramen

A
  • inferiormedially
  • sacrospinous
  • lesser sciatic
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18
Q

The internal pudendal a. supplies the perineum (___ & _____ ____)

A

UG & anal ∆

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19
Q

The ______ _____ contains the internal pudendal a & pudendal n back in pelvis

A

pudendal canal

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20
Q

The pudendal canal is formed by fascia of _______ _____ m.

A

obturator internus

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21
Q

What is the path of the pudendal canal? What does it supply?

A
  • runs anteriorly along ischiopubic ramus (toward UG ∆)

- UG

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22
Q

The _______ a runs toward ant. abd. wall and sends off 3-4 _______ ______ a to the bladder and terminates as medial umbilical ligament

A
  • umbilical a (ant branch)

- superior vesical a

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23
Q

The _______ a runs thru the obturator canal to supply the ______ thigh (aDductor compartment) with obturator n.

A
  • obturator (Ant branch)

- medial

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24
Q

The obturator n travels medial to ______ m from the lumbar plexus

A

psoas

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25
The obturator a. anastomoses with what vessels?
inferior epigastric vessels | - variable, may be arterial, venous or both)
26
What is meant by corona mortis "crown of death"?
- obturator a. anastomoses w/ inferior epigastric - damage to them opens internal & ext. iliac systems (close to bifurcation) - can cause death in min.
27
The _______ a is found in females and anastomoses w/ ovarian a. from aorta
uterine a. (Ant. branch)
28
The uterine a. supplies the ______, _____, & ______ _______ canal
- uterus - cervix - superior vaginal canal
29
The ureter runs immediately below (inferior) which artery?
-uterine a (water under bridge)
30
The ______ a in females supplies the inferior vagina, adj bladder and rectum
vaginal (Ant branch)
31
In males the _____ ______ a supplies the posterior inferior bladder, ureter, seminal vesicle and prostate
inferior vesical (Ant branch)
32
The ureter runs above which arteries?
vaginal (females), inferior vesical (males)
33
This anterior branch of internal iliac a supplies the rectum
middle rectal a
34
The middle rectal a anastomoses w/ _____ ______ a from IMA & _______ ______ a from internal pudendal a.
- superior rectal | - inferior rectal
35
The ureter runs between which 2 arteries in females?
- uterine a | - vaginal a
36
What happens during an hysterectomy?
- uterus is removed and uterine a. is tied off
37
What can happen during a hysterectomy?
- ureter running btw uterine and vaginal a can be cut accidentally, causing serious complications - no evacuation from that side of kidney (kidney stones)
38
What is the major vein of venous drainage of the pelvis?
internal iliac vv. ( pelvic venous plexus) (all aa accompanied by vv. of same name)
39
Most venous drainage ultimately returns to the ____
IVC
40
What venous system is involved in hypertension and anastomoses?
portal venous
41
The ____ venous plexus is a portal caval anastomosis
rectal
42
What is a venous network that surrounds the bladder, prostate or uterus & rectum?
pelvic venous plexus
43
The pelvic venous plexuses intercommunicate ______ to forming named vv.
prior
44
What are the clinical significance of the intercommunication of the pelvic venous plexus?
- transportation of tumor cells or venous hypertension (free access thru venous plexus)
45
Venous plexuses are _______
valveless
46
The sacral plexus is ______ innervation
somatic (S2-4)
47
What are the nerves of the sacral plexus (L4-S4)?
- sciatic & gluteal nn | - pudendal
48
What type of innervation are the autonomic plexuses?
Autonomic - sympathetic - parasympathetic
49
___ - ____ forms the lumbosacral trunk & crosses over sacral ala to descend into pelvic cavity to form sciatic nerve
L4-5
50
___ emerges above piriformis m.
S1
51
____ & ____ emerge thru piriformis m.
S2 & S3
52
___ - ___ contribute to the pudendal n.
S2-4
53
___ - ___ form sciatic & gluteal nn.
L4 - S3
54
___ - ____ form obturator n that travels from lumbar plexus down into pelvic cavity
L2-4
55
Which levels of the spinal cord form the sacral plexus?
L4-S4
56
What three trunks form the sacral plexus?
- lumbosacral - sympathetic - sciatic
57
The ______ plexus is composed of the anterior rami of lumbar spinal nerves, revealed by the removal of the psoas m.
lumbar
58
The sympathetic fibers of the autonomic plexus of the pelvis originate at ____ - ____ ( ) prevertebral plexus and exit at ___ - ____ as ______ ______ nn
- T10-L2(3) - S2-4 - sacral splanchnic nn.
59
Sympathetic fibers are lateral to the vertebral column and become ____ when the enter into the pelvic cavity
medial (anterior to vertebral bodies)
60
The preganglionic parasympathetic fibers exit at ___ - ____ as _____ _____ nn
- S2-4 | - pelvic splanchnic nn.
61
The superior hypogastric plexus contains mostly ____ fibers that cover the bifurcation of the _____ & ______ sacrum
- sympathetic - aorta - upper
62
The superior hypogastric plexus condenses to form 2 _____ nn
hypogastric
63
pelvic parasympathetics _____ to supply the hindgut and splenic flexure
ascend
64
The hypogastric n to inferior plexus contains mostly _____ fibers that diverge & curve outward ______ to _____
- sympathetic (has some psymp too) - bilateral - rectum
65
The hypogastric nere expands to form the _____ ____ plexus
inferior hypogastric pelxus
66
The hypogastric n join pelvic splanchnic & sacral splanchnic to form the _______ _______ _____
-inferior hypogastric plexus
67
_____ _____ _____ exit chain carrying sympathetic fibers
gray rami communicans
68
The inferior hypogastric plexus contains ____ & _____ fibers
- sympathetic | - p symp
69
The inferior hypogastric plexus is found covering pelvic viscera ______
bilaterally
70
What is the main autonomic plexus of the pelvis?
inferior hypogastric plexus
71
The lumbar plexus is from anterior rami ____ - ___
L1-4
72
The sacral plexus is from anterior rami ____ - ____
L4-S4
73
S2-4 pelvic splanchinic nerves (psymp) continue to inferior hypogastric plexus then ascend on _____ ______ _____
superior hypogastric plexus
74
In the thorax, sympathetic chains are ______ to vertebrae then move ______ as they descend
- lateral | - medial
75
The pelvic sympathetic chain fibers are _____ to sacral foramen and converge & terminate ______ to coccyx as ______ _____
- medial - anterior - ganglion impar
76
______ _____ nn are tiny sympathetic fibers off sympathetic chain
sacral splanchnic nn.
77
_____ _____ nn are tiny p-symp fibers off S2-4
pelvic splanchnic nn
78
Sacral and pelvic splanchnic nn enter the ____ ______ plexus and travel on arterial brs. to _____ _____
- inferior hypogastric plexus | - pelvic organs
79
The splanchnic nn. are closely related to _____ _____ & _____
- lateral rectum | - uterus
80
The splanchnic nn are easily injured during ____ surgery or radical _______ and results in impaired _____ control or ______ function
- rectal - hysterectomy - bladder - sexual
81
The abdominopelvic lymphatic vessels and nodes lie along ____, _____ & _____ _____
- aorta - IVC - iliac vessels
82
Lymphatic drainage generally moves ______ to _____ then _____ thru vessels, nodes, and cisterna
- superficial to deep | - superiorly
83
What is the drainage below umbilicus?
-superficial below umbilicus, inferiorly to inguinal then deep then superiorly *exception*
84
What is the drainage above umbilicus?
superficial to deep then superior
85
Each organ has its ____ lymphatic drainage
own
86
Large cisterna chyli are found btw _____ @ SM area
kidneys
87
The ______ _____ duct drains __ head & neck; __ UL and __ upper thorax
- right lymphatic | - R
88
The _____ duct drains __ head & neck; __ UL; remainder of thorax; _____, _____, LLs
- thoracic (left jugular lymphatic duct) - L - abdomen - pelvis

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