Pelvic Vessels, Nerves, and Lymphatics

Question 1

What are the 3 major branches that come off the Abdominal Aorta that are relevant for the pelvis?

Answer 1

Common Iliac A.

Ovarian Aa.

Median (Middle) Sacral A.

Question 2

The Common Iliac A. bifurcates into the external iliac A. and Internal Iliac A. at what level?

A. L3-L4

B. L4-L5

C. L5-S1

D. S1-S2

Answer 2

L5-S1

Question 3

There are posterior and anterior divisions of the Internal Iliac A.. The Posterior Division consists of 3 arteries, while the Anterior Division has a lot more. What 3 arteries are part of the Internal Iliac A. posterior division?

Answer 3

Lateral Sacral A.

Iliolumbar A.

Superior Gluteal A.

Question 4

What structures do the Lateral Sacral Aa. supply? (5)

Answer 4

Erector Spinae

Meniges

Piriformis M.

Scaral spinal roots

Skin on dorsal sacrum

Lateral Sacral Aa. Erects Minimal Performance with Sacral Roots and Skin

Question 5

What structures are supplied by the Iliolumbar A. ? (4)

Answer 5

Cauda Equina

Psoas Major

Iliacus

Quadratus Lumborum

Iliolumbar A. has a high CeP IQ

Question 6

What structures are supplied by the Superior Gluteal A.? (3)

Answer 6

Piriformis

Gluteal Muscles

Tensor Fascia Lata

Question 7

What branches off the Posterior divisions of the internal iliac supply the piriformis?

A. Iliolumbar A. and Lateral Sacral Aa.

B. Lateral Sacral Aa. and Superior Gluteal A.

C. Superior Gluteal A. and Iliolumbar A.

D. All of posterior division branches supply the piriformis

Answer 7

Lateral Sacral Aa. and Superior Gluteal A.

Question 8

What branch of the internal iliac posterior division enters through the anterior sacral foramina and exits through the posterior sacral foramina?

A. Lateral Sacral Aa.

B. Superior Gluteal A.

C. Iliolumbar A.

Answer 8

Lateral Sacral Aa.

Question 9

What branch of the internal iliac posterior division is found between the obturator N. and lumbrosacral trunk posterior to the psoas major muscle?

A. Lateral Sacral Aa.

B. Superior Gluteal A.

C. Iliolumbar A.

Answer 9

Iliolumbar A.

Question 10

What branch of the internal iliac posterior division iis the terminal branch and goes through the greater sciatic foramen superior to the piriformis M.?

A. Lateral Sacral Aa.

B. Superior Gluteal A.

C. Iliolumbar A.

Answer 10

Superior Gluteal A.

Question 11

Which of the following arteries off the anterior division of the internal iliac supplies the bladder? (Select all that apply)

A. Umbilial A. and Superior Vesicular A.

B. Obturator A.

C. Inferior Vesicular A.

D. Middle REctal A.

E. Uterine A.

Answer 11

Umbilial A. and Superior Vesicular A.

Inferior Vesicular A.

NOTE: The Umbilical A. gets obliterated at birth

Question 12

Which of the following arteries off the anterior division of the iliac artey is only found in males?

A. Uterine A.

B. Superior Vesicle A.

C. Inferior Vesicle A.

D. Obterator A.

Answer 12

Inferior Vesicle A.

NOTE: Uterine A. is only found in females

Question 13

Select all of the following branches of the anterior division that supply the vagina.

A. Vaginal A.

B. Internal Pudendal A.

C. Inferior Vesicle A.

D. Umbilical A. and Superior Vesicle A.

E. Middle Rectal A.

F. Uterine A.

G. Inferior Gluteal A.

Answer 13

Vaginal A.

Internal Pudendal A.

Middle Rectal A.

Uterine A.

Question 14

Select all of the branches of the anterior division that supply the prostate, seminal vesicle, and vas deferns.

A. Inferior Vesicle A.

B. Middle Rectal A.

C. Obterator A.

D. Internal Pudendal A.

E. Uterine A.

Answer 14

Inferior Vesicle A.

Middle Rectal A.

Question 15

T/F: THe pelvic veins correspond to the branches of the internal iliac A.

Answer 15

True

Question 16

Which of the following branches of the anterior division exits via the greater sciatic foramen and then loops around the ischial spine to enter the lesser sciatic foramen to enter the perineum?

A. Uterine A.

B. Middle REctal A.

C. Inferior REctal A.

D. Internal Pudendal A.

Answer 16

Internal Pudendal A.

Question 17

What level does the internal iliac v. merge with the external iliac v. to form the common iliac vein–> IVC?

A. L3/L4

B. L4/L5

C. L5/S1

D. S1/S2

Answer 17

L4/L5

Question 18

The pelvic venous plexus is associated with the pelvic viscera are drained by 3 veins. What are those three draining veins?

Answer 18

Internal Iliac V

Inferior Mesenteric V.

Lateral Sacral Vv

Question 19

What pelvic vein anastomosis with the internal vertebral plexus that provides a collateral pathway to the IVC or SVC?

A. Lateral Sacral Vv.

B. Internal Iliac V.

C. Superior Rectal V.

D. Superior Gluteal Vv.

E. Testicular V.

Answer 19

Lateral Sacral Vv.

Question 20

What two veins anastomos and provide a channel for metastisis of prostatic or ovarian cancer cells to migrate to the vertebral column or cranial cavity?

A. Interal Iliac V and Lateral Sacral Vv.

B. Superior Rectal V and Internal Venous plexus

C. Lateral Sacral Vv and Internal Venous plexus

D. Internal Venous plexus and Testicular Vv.

Answer 20

Lateral Sacral Vv and Internal Venous plexus

Question 21

What pelvic vein is a tributary of the Inferior Mesenteric V.?

A. Superior REctal V.

B. Middle REctal V.

C. Inferior Rectal V.

D. Lateral Sacral Vv

Answer 21

Superior REctal V.

Question 22

Which of the following nodes recieve lymph from the inguinal nodes and superior parts of the middle to anterior pelvic organs?

A. External Iliac LN

B. Internal Iliac LN

C. Sacral LN

D. Common Iliac LN

Answer 22

External Iliac LN

Question 23

What nodes receive lymoh from pelvic viscera, deep perineum, and the guteal region?

A. External Iliac LN

B. Internal Iliac LN

C. Sacral LN

D. Common Iliac LN

Answer 23

Internal Iliac LN

Question 24

What nodes receive lymph from posterior inferior pelvic viscera?

A. External Iliac LN

B. Internal Iliac LN

C. Sacral LN

D. Common Iliac LN

Answer 24

Sacral LN

Question 25

THe common iliac LN receives lymph from the external and internal iliac LN as well as Sacral LN. But where does the common iliac LN drain to?

Answer 25

Lumbar Nodes

Question 26

The pelvic structures are mainly innnervated by what 3 major nerve sets?

Answer 26

Sacral Spinal Nerves Coccygeal Nerves Pelvic Splanchnic N.

Question 27

The sacral plexus is located on the posterolateral wall of the lesser pelvis, and it gives off branches that all exit through what structure? A. Anterior Sacral Foramina B. Posterior Sacral Foramina C. Greater Sciatic Foramen D. Lesser Sciatic Foramen

Answer 27

Greater Sciatic Foramen

Question 28

What branch of the sacral plexus passes inferior to the piriformis m. to enter the gluteal region to sipply posterior thigh and enterire leg and foot? A. Sciatic N. (L4-S3) B. Pudendal N. (S2-S4) C. Superior Gluteal N. (L4-S1) D. Inferior Gluteal N. (L4-S2)

Answer 28

Sciatic N. (L4-S3)

Question 29

What branch of the sacral plexus passes between the piriformis and coccygeus m. accompanied by the internal pudendal A. A. Sciatic N. (L4-S3) B. Pudendal N. (S2-S4) C. Superior Gluteal N. (L4-S1) D. Inferior Gluteal N. (L4-S2)

Answer 29

Pudendal N. (S2-S4)

Question 30

What branch of the sacral plexus supplies the gluteus medius and minimus after passing the piriformis superiorly? A. Sciatic N. (L4-S3) B. Pudendal N. (S2-S4) C. Superior Gluteal N. (L4-S1) D. Inferior Gluteal N. (L4-S2)

Answer 30

Superior Gluteal N. (L4-S1) NOTE: Inferior gluteal N. passes pinferior to the piriformis tp supply the glut max

Question 31

What nerve can by found on the pelvic surface of the coccugeus muscle?

Answer 31

Coccygeal Plexus (S4-S5)

Question 32

The Inferior hypogastric Plexus supplies sympathetic innervation to pelvic viscera, and gives off branches that form sub-plexuses on viscera. What subplexuses does it form that are relevant for both males and females? Only males? Only females?

Answer 32

Both: lateral rectum and inferolateral urinary bladder Male: Prostate and seminal vesicle Females: Cervix and LAteral Fornix

Question 33

T/F: Pelvic Splanchnic nerves (S2-S4) supply parasympathetic innervation to the pelvic viscera and descending colon, sigmoid colon, rectum and distal anal canal

Answer 33

False; Pelvic Splanchnic nerves (S2-S4) supply parasympathetic innervation to the pelvic viscera and descending colon, sigmoid colon, rectum and **proximal anal anal**

Question 34

What structure is in danger of being damaged during an oophorectomy when the ovarian A. is being ligated? A. Ureter B. Uterine A. C. Urethra D. None of the above

Answer 34

Ureter NOTE: In a hysterectomy where the uterine A. is ligated, the ureter is also in danger

Question 35

During childbirth, the fetal head might compress what nerve of the mother? A. Pelvic Splanchnic N. B. Obturator N. C. Pudendendal N. D. Femoral N. E. Sacral PLexus

Answer 35

Sacral PLexus

Question 36

During removal of a cancerous LN found in the lateral pelvic wall, what nerve could be severed leading to sensory loss on the medial thigh? A. Pelvic Splanchnic N. B. Obturator N. C. Pudendendal N. D. Femoral N. E. Sacral PLexus

Answer 36

Obturator N.

Question 37

T/F: Surgery on the prostate gland can destroy parasympathetic innervation from the S2-S4 pelvic splanchnic nn. thus affecting the patients ability to get an erection in the future

Answer 37

True