Pelvic wall and cavity 2 of 2 Flashcards Preview

2020 MHS Anatomy unit 2 > Pelvic wall and cavity 2 of 2 > Flashcards

Flashcards in Pelvic wall and cavity 2 of 2 Deck (46)
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describe the somatic pelxuses broadly

  1. fibers
  2. supply

  1. somatic plexuses
    1. from anterior rami of spinal nerves :GSA,GSE, GVE sympathetic  fibers
  2. supply
    1. pelvis wall
    2. lower limb
    3. peineum


describe the plexus at the following level

  1. sacral plexus
    1. L4-S4
    2. located in lesser plevis
  2. coccygeal plexus
    1. S4-Co
    2. located in lesser pelvis
  3. lumbar plexus
    1. L1-L4
    2. located in greater pelvis 
      1. obturator 
        1. passes through lesser pelvis
      2. iliolinguinal and genitofemoral 
        1. innervatire perineum


what part of the somatic plexus lies at L1-L4?

lumbar plexus


what part of the somatic plexus lies at L4-S4?

sacral plexus


what part of the somatic plexus lies at S4-Co

coccygeal plexus


this nerve is L4-S3

sacral plexus

  1. sciatic nerve


This nerve is S2 to S4

sacral plexus

  1. pudendal nerve 
    1. innervates most of the perineum and pelvic diaphragm


thes nerves are L5-S2 (3)

sacral plexus

  1. inferior gluteal nerve
  2. nerve to obterator internus
  3. superior gemellus


what nerves originate from L4-S1?

Sacral plexus

  1. quadratus femoris
  2. inferior gemellus


what ner originates from S1-S3?

sacrala plexus

  1. posterior femoral cutaneous nerve
    1. perineal branch to crotum or labuim majorum


what is the nerve oridinating from S2-S3?

sacral plexus

  1. perforating cutaneous nerve


what nerves originate from S1-S2

sacral plexus

  1. Nerve to piriformis


what nerve originates from S4?

sacral plexus

  1. nerve to levator ani
    1. rectal sphincter


what nerves originatefrom S4-S5?

sacral plexus

  1. nerve to coccygeus


what are the nerves originateing from Co?

coccygeal plexus 

  1. anococcygeal nerves
    1. to anococcygel ligamen
    2. peinanal skin
    3. pelvic diaphragm


What is compressed during childbirth to produce pain in lower limbs?

compression of sacral plexus by fetal ahead during childbirth produces pain in lower limbs

  1. pudendal nerv-innervates most of theperineum and pelvic diaphragm
  2. posterior femoral cutaneous nerve- perineal branch of labium majorum
  3. perforating cutaneous
  4. nerve to piriformis
  5. nerve to leavtor ani-recal sphincter


removal of cancerous lymph nodes or pregnancy causes painful reactions, what are they and what nerve is involved

injury to the obturator nerve - removal of cancerous lymph nodes or pregnancy- causes painful spasms of thigh adductors and sensory deficicts in medial thigh region.


a patient is experiencing numbness to the right limb below the knee behind the thigh and difficulty moving the leg as well. What could be causing the symptoms


sciatic nerve invovlement by a pelvic tumor can affect function of the muscles of the posterior thigh and all muscle below the knee and cause sensory deficits in most of the skin covering those areas


A female patient presents to you with a symptoms of difficulty urinating, pass a bowel movement and sexual dysfunction. what could be happening?

pudendal nerve entrapment syndrom / pudendal neuralgi

  1. nerve compression between sacrotuberous and sacrospinous ligaments (70%), in puudendal canal (20%) or elswhewhere along its course that results in 
    1. pain in the perineum
    2. urincary problems
    3. bowel problems
    4. sexual dysfunction


what forms the inferior hypogastric plexus?

  1. formed by nerve fibers from
    1. hypogastric nerves
    2. pelvic splanchnic nerves
    3. sacral splanchnic nerves
  2. contain
    1. GVA and GVE
      1. both sympathetic and parasympathetic fibers


what forms sub-plexuses around pelvic organs?

inferior hypogastric plexus

  1. supplies pelvic viscera and ciscera of the perineum
  2. contain GVA and GVE of by sympathetic and parasympathetic fibers


Describe the sacral sympathetic trunks

  1. descending pre-ganglionic sympathetic fibers from lumbar level L1-L2


describe the paravertebral ganglia

  • 4 pairs (S1-S4)
  • contain post-ganglionic sympathetic neurons


what tunksare they and what are the main function of sacral sympathetic trunk

  1. main function is sympathetic innervation of pelvic  and perineal walls, lower limbs 
    1. Gray communicas = white arrow
    2. splanchnic nerves +black arrow


what type of fibers innervate the pelvic vessels, hair erector smooth muscle and sweat glands?

sympathetic GVE fiber


describe the sympathetic trunk with respect to the spinal cord and directionality of nerve inferior of L1

Sympathetic GVE fibers innervating vessels (vasomotion), hairerector smooth muscle (pilomotions) and sweat glands (sudomotion) of pelvic wall and part of periunem

  1. preganglionic neurons in spinal cord level L1-L2 enter sympathetic ganglia via white rami communicantes
  2. preganglionic fibers travel down the sympathetic trunk to reach ganglia beyond L2 (NO WHITE RAMUS COMMUNICSNS BELOW L2!!!!)
  3. Synapse on postganglionic sympathetic neurons in lumbar and sacral paravertebral ganglia L4 to Co
  4. postganglionic fibers join L4 to Co spinal nerves via GRAY RAMI COMMUNICANTES


the pelvic visceral plexus: inferior hyposgastric , receives what type of fibers and from where?

  • receives GVE and GVA fibers from
    • superior hypogastric nerves 
    • pelvic splanchnic nerves 
    • sacral splanchnic nerves
  • form sub plexuses around pelvic organs
    • rectal plexus
    • vesical plexus
    • males- in perineum
      • prostatic plexus- cavernous nerve of penis
      • vas deferent plexus
    • females- in perineum
      • uterovaginal plexus- clitoris plexus


explain the nerve fiber types involved in the viscera(organs, glands,vessels) of the pelvis and perineum

inferior hypogastric plexus

  1. supply viscera (organs, glands,vessels) or the pelvis and perineum
    1. GVE:contraction of smooth muscles and glands secretion
      1. sympathetic postganglionic fibers
      2. parasympathetic preganglionic fibers (synapse on ganglia in wall of viscera)
    2. GVA:distention, pain
      1. reflective sensations: GVA fibers accompany parasympathetic fibers to spinal levels S2-S4
      2. pain follows PELVIC PAIN LINE


describe the pelvic pain line

GVA fibers in the pelvis and perineum are part of the inferior hypogastric plexus

  1. reflective sensations :pass along information for distention and pain
    1. GVA fiber accompany parasympathetic fibers to spinal levels S2-S4
  2. pain follows the pelvic line
    1. painsuperior to pelvic pain line 
      1. travels in GVA fibers accompanyingsympathetic fibers to the levels L1-L2
    2. pain inferior to pelvic pain line 
      1. travels in GVA fibers accompanying parasympathetic fibers to spinal levels S2-S4


Pain to the following organs will reffer pain through which direction?

ovaries, uteine tubes, body of uterus/ureters and superior bladder

pain superior to pelvic line 

  1. from viscera above or in contact wit hthe peritoneum
  2. pain referred to dermatomes of lower abdomen and inguinal region L1-L2