Vasculature/Innervation Pelvis and Perineum
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What are the branches of the posterior division of the internal iliac artery? What do they supply?
- Iliolumbar: Psoas muscle and quadratus lumborum
- Lateral Sacral: Go to anterior sacral foramina
- Superior Gluteal: Gluteus medius, minimus and tensor fascia latae
What are the branches of the anterior division of the internal iliac artery?
- Internal Pudendal
- Inferior gluteal
- Inferior vesical
- Middle rectal
What does the obturator supply?
- Adductor compartment of thigh
- Acetabular branch to femoral head (children)
Where can the obturator artery arise from?
Inferior epigastric or external iliac artery
How does the internal pudendal artery travel?
- Out through grater sciatic foramen
- Passes dorsal to ischial spine
- Enters through elsser sciatic foramen
What does the inferior gluteal artery supply and what is its exit area?
- Supply: Gluteus maximus
- Exit: Between S1/S2 or S2/S3
What are the branches of the umbilic artery?
- Medial umbilical ligament
- Superior vesical branches
- Artery to the ductus deferens
What does the inferior veiscal artery supply? What does it normally arise with?
- Supply: Bladder, prostate, seminal vesicles
- Arise with: Middle rectal artery
What can the uterine artery arise with?
Middle rectal or vaginal
What areas drain into the superficial inguinal nodes?
- Abdominal skin below umbilicus
- External genital structures
- Lower 2/3 of vagina
- Anal canal inferior to pectinate line
What areas drain into the internal iliac nodes?
- Upper 1/3 of vagina
- Pelvic viscera
What areas drain into the para aortic nodes?
Ovaries and testis
What sympathetic and PS components join the superior hypogastric plexus?
- Sympathetic: Lower 2 lumbar splanchnic n
- PS: Pelvic splanchnic nerves
What is the inferior hypogastric plexus made of?
- L/R hypogastric nerves
- PS pelvic splanchnic nerves
What is the inferior hypogastric plexus located on?
Both sides of rectum, urinary bladder and uterine cervix/prostate
What are the component of the pudendal nerve?
- Anterior division of S2, S3, S4
- 4 components: voluntary motor, visceral motor (symp), visceral sensory and somatic sensory
What are the 4 stages of sexual cycle?
What 2 muscles maintain an erection?
Bulbospongiosus and ischiocavernosus
What are the 2 characteristics of the excitement phase of females?
- Vaginal wetness
- Lengthening and expansion of inner 2/3 of vagina
During plateau, what area of the vagina changes in the female?
outer 1/3 of vagina
What are the 2 stages of the male ejaculation?
- Emission: Delivery of semen to membranous urethra
- Ejaculation: Clonic spasms of bulbospongiosus and ischiocavernosus muscles
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