4-Pelvic Arteries, Veins And Nerves

Front 1

From where do the arteries of the pelvis arise?

Back 1

most from the internal iliac, several directly off the abdominal aorta

Front 2

At what level does the aorta bifurcate? What else is located at this level?

Back 2

L3-4
iliac crest, where a spinal tap can be done

Front 3

What are 3 branches off the abdominal aorta that supply the pelvis?

Back 3

superior rectal artery, median sacral artery, ovarian & testicular arteries

Front 4

Which main branch of the abdominal aorta does the superior rectal artery branch from?

Back 4

IMA

Front 5

The left testicular or ovarian vein returns blood to the _____ and the right testicular vein returns blood to the _____.

Back 5

L renal vein
IVC

Front 6

What is a varicocele? One what side is it more likely? Why?

Back 6

abnormal pooling of venous blood in and around the L testicle is more frequent b/c the L renal vein is higher pressure than the IVC

Front 7

Name the branches that stem from the posterior division of the internal iliac arteries.

Back 7

superior gluteal, iliolumbar, lateral sacral

Front 8

Where is the superior gluteal artery located w/ respect to the piriformis muscle?

Back 8

exits superior to piriformis

Front 9

What does the iliolumbar artery supply?

Back 9

iliacus, psoas, & quadratus lumborum muscles

Front 10

What does the lateral sacral artery supply?

Back 10

pelvic diaphragm & sacral spinal cord

Front 11

Name the two terminal branches of the internal iliac arteries.

Back 11

inferior gluteal and internal pudendal arteries

Front 12

Which muscles are located superior and inferior to the inferior gluteal artery?

Back 12

inferior gluteal A is inferior to piriformis but superior to ischiococcygeus

Front 13

Where does the internal pudendal artery exit?

Back 13

around the ischial spine along the pudendal canal

Front 14

Name the 7 branches that can stem from the anterior division of the internal iliac.

Back 14

obturator, umbilical, superior vesicular, uterine, vaginal, inferior vesicular, middle rectal

Front 15

20% of the time the internal iliac can have a middle division. What branches would stem from it?

Back 15

middle rectal, inferior gluteal, internal pudendal

Front 16

Name the 3 arteries that supply the rectum and anal canal.

Back 16

superior rectal, middle rectal, inferior rectal

Front 17

What branch does the superior rectal artery branch from?

Back 17

IMA

Front 18

What branch does the middle rectal artery branch from?

Back 18

anterior division of internal iliac

Front 19

What branch does the inferior rectal artery branch from?

Back 19

internal pudendal artery

Front 20

Name the rectal vein(s) that return blood to the portal system.

Back 20

superior rectal veins

Front 21

Name the rectal vein(s) that return blood to systemic or IVC system.

Back 21

middle and inferior rectal

Front 22

What is the plexus located above the pectinate line? below?

Back 22

internal rectal plexus
external rectal

Front 23

Why are external hemorrhoids usually painful, but internal ones are not?

Back 23

external area has somatic innervation

Front 24

Name the collateral arteries that branch directly from the aorta.

Back 24

ovarian, lumbar and vertebral, middle sacral arteries

Front 25

What does the ovarian artery anaastomose with?

Back 25

uterine artery (a branch from the internal iliac)

Front 26

What artery forms the superior hemorrhoidal arteries?

Back 26

IMA

Front 27

What do the superior hemorrhoidal arteries anastomose with?

Back 27

middle and inferior hemorrhoidal arteries

Front 28

What do middle and inferior hemorrhoidal arteries branch from?

Back 28

hypogastric and internal pudendal arteries

Front 29

Name 2 branches from the external iliac artery.

Back 29

deep iliac circumflex
inferior epigastric

Front 30

What does the deep iliac circumflex artery anastomose with?

Back 30

iliolumbar and superior gluteal (branches of the posterior division of the internal iliac)

Front 31

What does the inferior epigastric artery give off in 27% of cases? What does this anastomose with?

Back 31

obturator artery
external iliac and medial femoral circumflex

Front 32

Name 2 branches of the femoral artery.

Back 32

midial and lateral femoral circumflex

Front 33

What does the medial femoral circumflex artery anastomose with?

Back 33

obturator and inferior gluteal arteries

Front 34

What does the lateral femoral circumflex artery anastomose with?

Back 34

superior gluteal and iliolumbar arteries

Front 35

What spinal levels combine to form the lumbosacral trunk?

Back 35

L4-5

Front 36

What artery leaves the pelvis by passing between the lumbosacral trunk and S1 ventral ramus?

Back 36

superior gluteal artery

Front 37

What artery passes out of the pelvis between the S2&3 ventral rami?

Back 37

inferior gluteal artery

Front 38

What artery exits the pelvis with the sciatic nerve?

Back 38

internal pudendal artery

Front 39

What spinal levels does the sciatic nerve originate from? What does it supply?

Back 39

L4-S3
flexors of knee and all muscle of leg and foot

Front 40

What spinal levels does the superior gluteal nerve originate from? What does it supply?

Back 40

L4-S1
gluteus medius and minimus

Front 41

What spinal levels does the inferior gluteal nerve originate from? What does it supply?

Back 41

L5-S2
gluteus maximus

Front 42

What spinal levels does the pudendal nerve originate from? What does it supply?

Back 42

S2,3,4
external urethral and anal sphincters, motor and sensory to external genitalia

Front 43

At what level do the preganglionic sympathetic fibers stop exiting from the spinal cord?

Back 43

L1

Front 44

Where does the smpathetic chain continue down to? What do they join together at?

Back 44

tip of coccyx
ganglion impar (coccygeal ganglion)

Front 45

What type of innervation is needed at every spinal level? As a result, what must continue to leave at each spinal level?

Back 45

sympathetic (vasomotor, pilomotor, and sudomotor)
postganglionic sympathetic axons

Front 46

What are the pelvic parasympathetic fibers called? What spinal levels do they stem from?

Back 46

pelvic splanchnic nerves
S2,3,4

Front 47

What are the mixed autonomic nerve plexuses in the pelvis called?

Back 47

hypogastric plexuses

Front 48

What plexus wraps around the inferior part of the aorta?

Back 48

superior hypogastric plexus

Front 49

What type of innervation PSNS or SNS is the inferior hypogastric plexus?

Back 49

mixed

Front 50

Name the plexuses that stem from the inferior hypogastric plexus.

Back 50

vesicle and rectal plexuses
prostatic plexus in males
uterovaginal plexus in females

Front 51

What supports the middle third of the vagina?

Back 51

levator ani muscles

Front 52

What supports the lower portion of the vagina?

Back 52

cardinal ligaments

Front 53

The pain fibers from the cerivx accompany what nerves?

Back 53

parasympathetic fibers of S2,3,4

Front 54

What nerve supplies the majority of both motor and sensory fibers to the muscles and skin of the vulva?

Back 54

pudendal nerve

Front 55

What is the importance of the pelvic diaphragm?

Back 55

supports both abdominal and pelvic viscera and facilitates distribution of intraabdominal pressure

Front 56

What is one of the major functions of the urogenital diaphragm?

Back 56

support urethra and maintain urethrovesical junction

Front 57

How can the ureter be distinguished from pelvic vessels during surgery?

Back 57

ID peristalsis after touching it, or ID Aberbach's nerve plexuses