PELVIS FLOOR + VISCERA Flashcards
(32 cards)
Where is pain felt in relation to the pelvic pain line for Sympathetics? How about for Parasympathetics?
SNS felt ABOVE the pelvic pain line;
PSNS felt BELOW the pain line
Preganglionic sympathetics in the pelvis span from ____ to ___ spinal levels. These are responsible for _______ of pelvic arteries that supply __________ organs. These help us sense pain _____ the pelvic pain line.
T10-L2 spinal cord regions;
Vasoconstriction of pelvic arteries;
Peritoneal structures;
ABOVE the pain line.
Preganglionic parasympathetics are found in the ___ to ___ spinal cord levels. The postganglionics function to cause _______ at erectile tissues which are _________ structures. These help us sense pain _____ the pelvic pain line.
S2-S4 spinal levels;
Vasodilation at erectile tissues;
Subperitoneal structures;
BELOW the pelvic pain line.
Describe the significance of the intermesenteric plexus in the pelvic autonomic.
These nerves are located on front of the aorta between SMA and IMA plexus. They communicate between the Superior Hypogastric plexus (below L4 bifurcation), Hypogastric nerves (that run down the pelvic wall) and the Inferior Hypogastric Plexus (at the pelvic floor).
Unlike most other organs, the body and fundus of the uterus is a _______ _______ type of organ. The bladder, cervix and vagina are considered ___________ organs, since they are partly covered by peritoneum.
Secondary Peritoneal;
Subperitoneal organs
Ovarian and Fallopian tube pain can be felt _____ the pelvic pain line at around the ___/___ dermatome. This can be similar to ________ that can be felt in the same region. The uterine body and fundus are felt as _________ pain at the ___ to __ dermatome.
Above the pelvic pain line @ T10/T11 dermatome;
Similar to Appendicitis;
Suprapubic pain @ T11-L1
The Pelvic brim separates the ______ ______ from the abdominal cavity.
True pelvis
The Greater Sciatic foramen connects the true pelvis with the ________ ________. The _______ muscle and ________ nerves pass through it.
Gluteal region;
Piriformis, Sciatic nerves
In response to an increase in abdominal pressure, the pelvic floor ___________ in order to prevent urinary and fecal _________.
Contracts;
Incontinence.
What is the cause of Stress Urinary Incontinence?
A fully detached or stretched fascias support leading to a hyper mobile urethra in which urine escapes with an increase in abdominal pressure. For instance, if a menopausal woman sneezes, she might wet them panties.
Describe cystocele.
Lateral detachment of the fascia white line. This causes the bladder to push posteriorly on the anterior wall of the vagina. If the urethra cannot straighten, the patient cannot urinate.
Define rectocele.
This is a posterior vaginal wall prolapse associated with defects of the pelvic floor too. Older age or a prior hysterectomy are risk factors associated with this condition.
The lymphatics for ovaries are found along the lateral ________ nodes.
Aortic nodes
The lymphatics supplying the scrotum are ________ lymph nodes.
Inguinal lymph nodes
The anatomical position of the uterus is both _______ and ________. This reduces the likelihood of a uterine prolapse and allows room for the uterus to grow during pregnancy.
Anteverted;
Anteflexed
The sympathetic preganglionic fibers for the pelvis originate from _____ to _____ vertebral levels. The SNS postganglionics ________ the smooth muscle sphincters and cause ______ of the vas deferens.
SNS preganglionics: T10 - L2
Contract the SM sphincters;
Peristalsis of vas deferens.
The pelvic parasympathetic preganglionic fibers, that innervate the pelvis, originate in the _________ regions, since the ________ nerve can no longer reach these structures. The PSNS postganglionics are responsible to _________ erectile tissues
Sacral (S2-S4) region;
Vagus nerve limited down to Transverse colon;
Vasodilate erectile tissue
What vessel supplies blood for stimulation of external genitalia? What nerve causes vasodilation of external genitalia in the perineum to maintain an erection?
Internal pudendal artery; Cavernous Nerves (PSNS)
Within the outer ring of the pelvis, the Lumbosacral trunk passes over the pelvic _____, to help form the _______ Nerve (of spinal nerves ____ to _____)
Pelvic brim; Sciatic Nerve (L4-S3)
The _______ iliac artery never enters the pelvis, but becomes the ______ artery once it passes by a certain canal to supply the lower limb.
External iliac artery - never enters pelvis;
Femoral artery within the femoral canal (NAV-L, medial to lateral)
Describe the branches of the anterior division of the Internal Iliac artery and what each supplies.
Internal pudendal artery - runs with the nerve to supply external genitalia;
Obturator artery - runs with the obturator nerve towards the canal;
Umbilical artery - supplies the bladder and became the medial umbilical folds;
Uterine artery - tortuous vessel that is coiled in case it stretches during pregnancy
Describe the branches of the Posterior Division of the Internal Iliac artery and what each supplies.
Iliolumbar artery - routes back up to the lumbar
Lateral Sacral artery - heads medially towards the sacrum
Superior gluteal artery - supplies the gluteus minimus and medius
Which of the following may be responsive to a surgical cut made on the Superior Hypogastric Plexus?
A) Ovarian/ Tubal Pain
B) Uterine Fundic Pain
C) Pericervical Pain
B) Uterine Fundic Pain - the uterus has its afferent sensory fibers ABOVE the pelvic pain line. A surgical cut at this plexus can relieve painful menstruation
Define what causes a Rectovaginal fistula?
The stretching of the rectovaginal space after birth can lead to this defect.
