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Flashcards in Pelvis Neurovasculature Deck (35):
1

What are the divisions of the internal iliac artery?

Anterior and posterior

2

Briefly describe the course of the superior gluteal arteries

Run posteriorly between lumbosacral trunk and S1, then exit pelvis via greater sciatic foramen superior to piriformis muscle

3

Give the rule of pelvic venous drainage and two exceptions to that rule

Rule - Internal Iliacs to Common Iliacs to IVC. Exception 1 - Lateral sacral veins to Internal vertebral venous plexuses. Exception 2 - Superior rectal veins to portal system.

4

Four main types of pelvic lymph nodes

External iliac, internal iliac, sacral, common iliac

5

What do each of the four types of pelvic lymph nodes drain?

Sacral - Posteroinferior pelvic viscera, External Iliac - Pelvic viscera, inguinal nodes, Internal Iliac - Inferior pelvic viscera, deep perineum, gluteal region, Common iliac - Inferior structures drain up to them and they drain to lumbar (caval/aortic) nodes

6

What cutaneous nerve innervates the largest skin area of any in the body?

The posterior femoral cutaneous nerve (S1-S3)

7

Innervation of quadratus femoris and inferior gamellus

L4-S1 via sacral plexus

8

Innervation of obturator internus and superior gamellus

L5-S2 via sacral plexus

9

Innervation of piriformis muscle

S1-S2 via sacral plexus

10

Where does the obturator nerve originate and where does it go?

Originates in lumbar plexus (L2-L4) and goes to medial thigh

11

Where does the obturator nerve pass through the pelvis?

On the pelvic sidewall and out the obturator foramen

12

4 main types of pelvic autonomic nerves

Sacral sympathetic trunks, periarterial plexuses, hypogastric plexuses, pelvic splanchnic nerves

13

Where do the sacral sympathetic trunks run relative to the pelvic foramina?

Medial to the foramina

14

How many ganglia do the sacral sympathetic trunks usually have?

4

15

Ganglion impar

A structure formed by the convergence of 2 ganglia of the pelvic sympathetic trunk

16

Periarterial nervous plexuses of the pelvis run with which arteries?

Superior rectal, ovarian, internal iliac

17

What is the function of periarterial nervous plexuses of the pelvis?

Vasomotion of the arteries

18

What do pelvic splanchnic nerves carry (include fiber type, system, post/presynaptic, and origin)?

Presynaptic parasympathetic GVA fibers from S2, S3 and S4

19

Where are the superior hypogastric plexuses and what are they formed from?

Just inferior to bifurcation of the aorta, formed as continuation of intermesenteric and inferior mesenteric plexuses

20

What fibers are carried by the superior hypogastric plexus?

GVA Postsynaptic sympathetic nerve fibers

21

What plexuses are supplied by the superior hypogastric plexuses?

Ureteric and testicular plexuses

22

Are the superior hypogastric and inferior hypogastric plexuses connected and if so by what?

Yes, by the right and left hypogastric nerves

23

Generally speaking, the inferior hypogastric plexuses provide what type of innervation to where?

Autonomic innervation to the pelvic viscera

24

Nerves of the inferior hypogastric plexuses spread and join with what?

Pelvic splanchnic nerves

25

Generally speaking, where are sympathetic and parasympathetic fibers relayed through the pelvic plexuses?

Sympathetic fibers via the hypogastric plexuses, parasympathetic fibers via the pelvic splanchnic nerves

26

List the purely sympathetic components of the pelvis

1) Aortic/intermesenteric plexuses, 2) Sacral splanchnic nerves, 3) Ganglion impar, 4) Internal Iliac periarterial plexuses, 5) Sacral/lumbar sympathetic trunks, 6) Left/Right hypogastric nerves, 7) Superior hypogastric plexus, 8) Inferior mesenteric/superior rectal periarterial plexuses

27

List the purely parasympathetic components of the pelvis

Pelvic splanchnic nerves

28

List the mixed autonomic components of the pelvis

Inferior hypogastric plexuses, ovarian periarterial plexuses

29

List the somatic components of the pelvis

Pudendal nerve, sciatic nerve

30

What do sympathetic fibers of the pelvis do?

Produce vasomotion, contraction of internal genital organs during orgasm, inhibit rectal peristalsis

31

What do parasympathetic fibers of the pelvis do?

Stimulate bladder and rectal emptying, extend to the erectile bodies of external genitalia to produce erection

32

What do visceral afferent fibers of the pelvis convey and to where do they convey it?

Unconscious reflex sensation to spinal sensory ganglia of S2-S4

33

Where is the pelvic pain line?

Inferior limit of the peritoneum

34

What do visceral afferent fibers follow superior to the pelvic pain line?

Sympathetic fibers

35

What do visceral afferent fibers follow inferior to the pelvic pain line?

Parasympathetic fibers

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