Vascular and Nerve Supply of the Pelvis

Question 1

The abdominal aorta bifurcates at which vertebral location?

Answer 1

L4

Question 2

What does the abdominal aorta bifurcate into?

Answer 2

Left and right common iliac arteries

Question 3

Each common iliac artery bifurcates into which arteries?

Answer 3

External and internal iliac arteries

Question 4

Where does the common iliac artery bifurcate?

Answer 4

Anterior to the sacroiliac joint

Question 5

What are the two branches of the external iliac artery?

Answer 5

Deep circumflex iliac and inferior epigastric artery

Question 6

The external iliac artery continues as what structure below the inguinal ligament?

Answer 6

Femoral artery

Question 7

Which artery is specifically the major source of blood to structures within the pelvis?

Answer 7

Internal iliac artery

Question 8

What crosses the external iliac artery at the pelvic brim?

Answer 8

Ureter

Question 9

What are the branches of the internal iliac artery of the posterior trunk?

Answer 9

Iliolumbar, lateral sacral and superior gluteal arteries

Question 10

What are the branches of the iliolumbar artery?

Answer 10

Iliac branch and lumbar branch

Question 11

What branch of the iliolumbar artery supplies the iliacus muscle and ilium?

Answer 11

Iliac branch

Question 12

Which branch of the iliolumbar artery supplies psoas major and quadratus lumborum muscles?

Answer 12

Lumbar branch

Question 13

Which branch of the internal iliac artery anastomoses with the median sacral artery?

Answer 13

Lateral sacral artery

Question 14

Which branch of the internal iliac artery exits the pelvis through the greater sciatic foramen superior to the piriformis muscle?

Answer 14

Superior gluteal artery

Question 15

The superior gluteal artery usually passes through what structures?

Answer 15

Lumbosacral trunk and 1st sacral nerve

Question 16

Which branch of the internal iliac artery is a part of the anterior trunk and exits the pelvis through the greater sciatic foramen inferior to the piriformis?

Answer 16

Inferior gluteal artery

Question 17

Which branch of the internal iliac artery is a part of the anterior trunk and passes between the 1st and 2nd or 2nd and 3rd sacral nerves?

Answer 17

Inferior gluteal artery

Question 18

Which branch of the internal iliac artery is a part of the anterior trunk and exits the pelvis through the greater sciatic foramen between the piriformis and coccygeus muscles?

Answer 18

Internal pudendal artery

Question 19

Which branch of the internal iliac artery is a part of the anterior trunk and enters the perineum through the lesser sciatic foramen giving off important branches?

Answer 19

Internal pudendal artery

Question 20

Which branch of the internal iliac artery is a part of the anterior trunk and gives off the superior vesical arteries?

Answer 20

Umbilical artery

Question 21

What part of the umbilical artery gives off the superior vesical arteries?

Answer 21

Proximal (patent) portion

Question 22

What do the superior vesical arteries supply?

Answer 22

Superior part of the bladder

Question 23

What gives rise to the artery of the ductus deferens?

Answer 23

One of the superior vesical arteries

Question 24

The distal portion of the umbilical artery is obliterated and gives rise to what structure?

Answer 24

Medial umbilical ligament

Question 25

Which branch of the internal iliac artery is a part of the anterior trunk and exits the pelvis through the obturator foramen?

Answer 25

Obturator artery

Question 26

What does the obturator artery supply?

Answer 26

Muscles of the thigh

Question 27

Which branch of the internal iliac artery is a part of the anterior trunk and supplies the inferior part of the bladder (in both sexes) and the prostate gland and seminal vesicles (in males)?

Answer 27

Inferior vesical artery

Question 28

Which branch of the internal iliac artery is a part of the anterior trunk and supplies the middle portion of the rectum as well as the prostate and vagina?

Answer 28

Middle rectal artery

Question 29

Which branch of the internal iliac artery is a part of the anterior trunk and is homologous to the artery of the ductus deferens in males?

Answer 29

Uterine artery

Question 30

The uterine artery can sometimes form a common trunk with which arteries?

Answer 30

Vaginal or middle rectal arteries

Question 31

Which branch of the internal iliac artery is a part of the anterior trunk and arises from a common trunk with the uterine or directly off the internal iliac artery?

Answer 31

Vaginal artery

Question 32

What is the major supplier of blood to the pelvis?

Answer 32

Internal iliac artery

Question 33

From where does the gonadal (testicular or ovarian) artery arise?

Answer 33

Abdominal aorta

Question 34

From where does the superior rectal artery arise?

Answer 34

Inferior mesenteric artery

Question 35

From where does the median sacral artery arise?

Answer 35

Behind the bifurcation of the abdominal aorta

Question 36

Which two veins make up the common iliac vein?

Answer 36

Internal and external iliac veins

Question 37

What veins unite to form the inferior vena cava?

Answer 37

Right and left common iliac veins

Question 38

In general, tributaries of the internal iliac vein correspond to branches of which artery?

Answer 38

Internal iliac artery

Question 39

Which pelvic structures have SOME portal drainage?

Answer 39

Rectum and anal canal

Question 40

Most pelvic structures have their drainage into which venous system?

Answer 40

Caval system

Question 41

What makes up the sacral plexus?

Answer 41

Lumbosacral trunk and the anterior primary rami of S1-S4

Question 42

What cord levels make up the lumbosacral trunk?

Answer 42

L4, L5

Question 43

What part of L4 makes up the lumbo sacral trunk?

Answer 43

Lower half

Question 44

What part of S4 makes up the sacral plexus?

Answer 44

Upper half

Question 45

The sacral plexus lies primarily on the anterior surface of which muscle?

Answer 45

Piriformis

Question 46

The anterior primary rami of S1-S4 enter the pelvis through what structures?

Answer 46

Anterior sacral foramina

Question 47

What are the branches of the sacral plexus that supply the buttock and lower limb?

Answer 47

Superior and inferior gluteal nerves, sciatic nerve, nerve to obturator internus muscle, nerve to quadratus femoris muscle, and posterior cutaneous nerve of thigh

Question 48

What are the cord levels of the superior gluteal nerve?

Answer 48

L4-S1

Question 49

What branch of the sacral plexus is the only nerve to exit SUPERIOR to the piriformis?

Answer 49

Superior gluteal nerve

Question 50

What does the superior gluteal nerve supply?

Answer 50

Gluteus medius, gluteus minimus, and tensor fasciae latae muscles

Question 51

What are the functions of the anterior gluteal muscles (medius, minimus, and tensor fasciae latae)?

Answer 51

Abductors, prevent pelvis from slumping to unsupported side during gait

Question 52

What is the term for the type of gait that occurs when the anterior gluteal muscles are dysfunctional?

Answer 52

Trendelenburg's Gait

Question 53

What are the cord levels for the inferior gluteal nerve?

Answer 53

L5-S2

Question 54

What does the inferior gluteal nerve supply?

Answer 54

Gluteus maximus

Question 55

What are the cord levels of the sciatic nerve?

Answer 55

L4-S3

Question 56

What is the largest nerve in the body?

Answer 56

Sciatic nerve

Question 57

What is the condition where the sciatic nerve is compromised?

Answer 57

Sciatica

Question 58

What are the cord levels of the nerve to obturator internus muscle?

Answer 58

L5-S2

Question 59

What does the nerve to obturator internus supply?

Answer 59

Obturator internus and superior gemellus muscles

Question 60

What are the functions of the gluteus maximus muscle?

Answer 60

Trunk control and standing form a seated position

Question 61

What are the cord levels for nerve to quadratus femoris muscle?

Answer 61

L5-S1

Question 62

What does the nerve to quadratus femoris supply?

Answer 62

Quadratus femoris and inferior gemellus muscles

Question 63

What are the cord levels for the posterior cutaneous nerve of thigh?

Answer 63

S1-S3

Question 64

What does the posterior cutaneous nerve of the thigh supply?

Answer 64

Sensory to part of the gluteal region and perineum

Question 65

What are the branches of the sacral plexus that supply the pelvis?

Answer 65

Nerve to piriformis muscle, nerves to levator ani and coccygeus muscles, nerve to external anal sphincter muscle, and pudendal nerve

Question 66

What are the cord levels for the nerve to piriformis muscle?

Answer 66

S1, S2

Question 67

Impingement of the nerve to piriformis muscle can lead to what condition?

Answer 67

Sciatica ("Piriformis Syndrome")

Question 68

What are the cord levels for nerves to levator ani and coccygeus muscles?

Answer 68

S3, S4

Question 69

What issues can arise from damage to the nerves to levator ani and coccygeus muscles?

Answer 69

Urinary and fecal continence and parturition issues

Question 70

What are the cord levels for nerve to external anal sphincter muscle?

Answer 70

S4

Question 71

What are the cord levels of the pudendal nerve?

Answer 71

S2-S4

Question 72

The pudendal nerve gives off important branches to what structure?

Answer 72

Perineum

Question 73

Impingement of the pudendal nerve can lead to what issue?

Answer 73

Erectile dysfunction

Question 74

What forms the coccygeal plexus?

Answer 74

Ventral primary rami of S4, S5 and the coccygeal nerve

Question 75

What does the coccygeal plexus supply?

Answer 75

Sacrococcygeal joint, the coccyx, and the overlying skin

Question 76

What are the two ways in which sympathetic fibers reach the pelvis?

Answer 76

Downward continuation of both the sympathetic trunk and the aortic plexus (as the superior hypogastric plexus)

Question 77

What forms as the left and right sympathetic trunks join together in front of the coccyx?

Answer 77

Ganglion impar

Question 78

What mostly makes up the superior hypogastric plexus?

Answer 78

Sympathetic fibers from the lumbar splanchnic nerve and visceral afferent fibers

Question 79

What long, narrow nerve plexuses connect the superior hypogastric plexus to the inferior hypogastric plexus?

Answer 79

Left and right hypogastric nerves

Question 80

What plexuses are formed by the union of the hypogastric, pelvic splanchnic, and sacral splanchnic nerves?

Answer 80

Left and right inferior hypogastric plexuses

Question 81

What makes up the left and right inferior hypogastric plexuses?

Answer 81

Sympathetic fibers, parasympathetic fibers, and visceral afferent fibers

Question 82

The inferior hypogastric plexuses give rise to what structures that supply pelvic viscera?

Answer 82

Subsidiary plexuses

Question 83

What are the preganglionic sympathetic nerves which arise from the sympathetic trunk and synapse in the inferior hypogastric plexus?

Answer 83

Sacral splanchnic nerves

Question 84

What are the parasympathetic nerves which arise from the sacral segments of the spinal cord (S2-S4) and contribute to form the inferior hypogastric plexuses and supply pelvic viscera?

Answer 84

Pelvic splanchnic nerves