Podcast
Questions and Answers
The pelvic splanchnic nerves originate from which sacral spinal cord levels?
The pelvic splanchnic nerves originate from which sacral spinal cord levels?
- S1, S2, S3
- S1, S3, S5
- S3, S4, S5
- S2, S3, S4 (correct)
The superior rectal artery is a direct continuation of which major artery?
The superior rectal artery is a direct continuation of which major artery?
- Internal iliac artery
- Inferior mesenteric artery (correct)
- External iliac artery
- Common iliac artery
At what vertebral level does the ovarian artery typically originate from the abdominal aorta?
At what vertebral level does the ovarian artery typically originate from the abdominal aorta?
- L2 (correct)
- L3
- L4
- L1
The median sacral artery originates from the posterior aspect of the aorta at which vertebral level?
The median sacral artery originates from the posterior aspect of the aorta at which vertebral level?
Which of the following is a parietal branch arising from the posterior division of the internal iliac artery?
Which of the following is a parietal branch arising from the posterior division of the internal iliac artery?
The distal part of the umbilical artery eventually obliterates to form which structure?
The distal part of the umbilical artery eventually obliterates to form which structure?
Which of the following structures is supplied by the inferior vesical artery in males?
Which of the following structures is supplied by the inferior vesical artery in males?
Which artery directly supplies the uterus and uterine tubes in females?
Which artery directly supplies the uterus and uterine tubes in females?
Which of the following muscles is responsible for the lateral rotation of the thigh and receives its nerve supply from S1 and S2 nerve roots?
Which of the following muscles is responsible for the lateral rotation of the thigh and receives its nerve supply from S1 and S2 nerve roots?
The coccygeus muscle originates from the ischial spine and inserts onto which of the following structures?
The coccygeus muscle originates from the ischial spine and inserts onto which of the following structures?
Which nerve(s) provide(s) innervation to the upper surface of the levator ani muscle?
Which nerve(s) provide(s) innervation to the upper surface of the levator ani muscle?
Which of the following is NOT a described action of the pelvic diaphragm?
Which of the following is NOT a described action of the pelvic diaphragm?
The lumbosacral trunk, which contributes to the formation of the sacral plexus, is composed of nerve roots from which levels?
The lumbosacral trunk, which contributes to the formation of the sacral plexus, is composed of nerve roots from which levels?
Which of the following nerves is formed, at least in part, by the sacral plexus?
Which of the following nerves is formed, at least in part, by the sacral plexus?
The pelvic part of the sympathetic chain is typically formed by how many ganglia?
The pelvic part of the sympathetic chain is typically formed by how many ganglia?
What is the name of the structure formed by the fusion of the pelvic sympathetic chains anterior to the coccyx?
What is the name of the structure formed by the fusion of the pelvic sympathetic chains anterior to the coccyx?
Which of the following characteristics is typically observed in a female sacrum compared to a male sacrum?
Which of the following characteristics is typically observed in a female sacrum compared to a male sacrum?
Which of the following structures does NOT contribute to the boundary of the pelvic inlet?
Which of the following structures does NOT contribute to the boundary of the pelvic inlet?
If a patient has damage to the nerve that supplies the obturator internus, what action of the thigh would be most affected?
If a patient has damage to the nerve that supplies the obturator internus, what action of the thigh would be most affected?
Which of the following joints of the bony pelvis is classified as a synovial plane joint?
Which of the following joints of the bony pelvis is classified as a synovial plane joint?
What is the primary difference between the false and true pelvis?
What is the primary difference between the false and true pelvis?
A surgeon is performing a procedure near the pelvic outlet. Which of the following structures marks the posterior border of this outlet?
A surgeon is performing a procedure near the pelvic outlet. Which of the following structures marks the posterior border of this outlet?
During a dissection, a student identifies a muscle originating from the middle three sacral segments. Which muscle is the student most likely observing?
During a dissection, a student identifies a muscle originating from the middle three sacral segments. Which muscle is the student most likely observing?
Which of the following best describes the insertion point of both the Obturator Internus and Piriformis muscles?
Which of the following best describes the insertion point of both the Obturator Internus and Piriformis muscles?
Which of the following muscles inserts, in part, onto the ano-coccygeal body?
Which of the following muscles inserts, in part, onto the ano-coccygeal body?
Damage to the S4 nerve root would most likely affect which specific function of the pelvic diaphragm?
Damage to the S4 nerve root would most likely affect which specific function of the pelvic diaphragm?
If the communicating branches between the pelvic sympathetic chain and sacral nerves were severed, which physiological function would be most directly affected?
If the communicating branches between the pelvic sympathetic chain and sacral nerves were severed, which physiological function would be most directly affected?
A lesion affecting the lumbosacral trunk would MOST likely result in weakness in what lower limb movement?
A lesion affecting the lumbosacral trunk would MOST likely result in weakness in what lower limb movement?
Which of the following actions would be MOST affected by damage to the nerve innervating the piriformis muscle?
Which of the following actions would be MOST affected by damage to the nerve innervating the piriformis muscle?
Which nerve directly innervates the lower surface of the levator ani muscle?
Which nerve directly innervates the lower surface of the levator ani muscle?
A patient reports a complete loss of sensation from the perineum, as well as difficulty controlling urination and defecation. Which nerve is MOST likely affected?
A patient reports a complete loss of sensation from the perineum, as well as difficulty controlling urination and defecation. Which nerve is MOST likely affected?
What is the most likely consequence of disrupting the ganglion impar?
What is the most likely consequence of disrupting the ganglion impar?
Which of the following accurately describes a key difference between the male and female sacrum?
Which of the following accurately describes a key difference between the male and female sacrum?
A patient presents with difficulty in the lateral rotation of their thigh. If the issue stems from a muscle within the pelvis, which of the following muscles is MOST likely affected?
A patient presents with difficulty in the lateral rotation of their thigh. If the issue stems from a muscle within the pelvis, which of the following muscles is MOST likely affected?
A surgeon is describing the boundaries of the pelvic inlet during a lecture. Which of the following is an accurate and complete description of the pelvic inlet's boundaries?
A surgeon is describing the boundaries of the pelvic inlet during a lecture. Which of the following is an accurate and complete description of the pelvic inlet's boundaries?
Following a traumatic injury, a patient experiences paralysis of muscles responsible for the lateral rotation of the thigh. Imaging reveals damage to a nerve exiting the pelvis through the lesser sciatic foramen. Which muscle is MOST likely affected?
Following a traumatic injury, a patient experiences paralysis of muscles responsible for the lateral rotation of the thigh. Imaging reveals damage to a nerve exiting the pelvis through the lesser sciatic foramen. Which muscle is MOST likely affected?
A 60-year-old male patient experiences pain originating from a ligament attached to the ischial tuberosity and the sacrum. Which of the following ligaments is MOST likely involved?
A 60-year-old male patient experiences pain originating from a ligament attached to the ischial tuberosity and the sacrum. Which of the following ligaments is MOST likely involved?
During a pelvic examination, a physician palpates the ischial spines to assess the pelvic outlet. Which of the following structures also contributes to the boundary of the pelvic outlet?
During a pelvic examination, a physician palpates the ischial spines to assess the pelvic outlet. Which of the following structures also contributes to the boundary of the pelvic outlet?
A patient is diagnosed with a condition affecting the true pelvis. Which of the following best describes the location of the true pelvis?
A patient is diagnosed with a condition affecting the true pelvis. Which of the following best describes the location of the true pelvis?
Which type of joint is the Sacro-iliac joint, and what kind of movement does it allow?
Which type of joint is the Sacro-iliac joint, and what kind of movement does it allow?
A patient presents with damage to the S3 spinal nerve. Which of the following functions would be most directly affected, considering the typical distribution of pelvic splanchnic nerves?
A patient presents with damage to the S3 spinal nerve. Which of the following functions would be most directly affected, considering the typical distribution of pelvic splanchnic nerves?
Following a surgical error during a bowel resection, a patient experiences impaired blood supply to the upper rectum. Which artery was MOST likely compromised during the procedure?
Following a surgical error during a bowel resection, a patient experiences impaired blood supply to the upper rectum. Which artery was MOST likely compromised during the procedure?
A 35-year-old woman undergoing a diagnostic imaging procedure is found to have an anatomical variation where her ovarian artery originates at the L1 vertebral level, instead of the typical L2 level. This variation would mean that:
A 35-year-old woman undergoing a diagnostic imaging procedure is found to have an anatomical variation where her ovarian artery originates at the L1 vertebral level, instead of the typical L2 level. This variation would mean that:
During an autopsy, it is noted that the median sacral artery is significantly larger than normal. This unusual size most likely indicates increased blood flow to which structure?
During an autopsy, it is noted that the median sacral artery is significantly larger than normal. This unusual size most likely indicates increased blood flow to which structure?
A patient undergoing a pelvic lymph node dissection experiences damage to a branch of the internal iliac artery, leading to impaired blood flow to the iliacus muscle. Which artery was MOST likely affected?
A patient undergoing a pelvic lymph node dissection experiences damage to a branch of the internal iliac artery, leading to impaired blood flow to the iliacus muscle. Which artery was MOST likely affected?
A newborn infant presents with an anomaly where the medial umbilical ligaments are absent. This condition indicates a failure of obliteration of which arteries?
A newborn infant presents with an anomaly where the medial umbilical ligaments are absent. This condition indicates a failure of obliteration of which arteries?
A male patient undergoing a prostatectomy experiences damage to an artery, leading to reduced blood supply to the seminal vesicle. Which artery was MOST likely affected during the procedure?
A male patient undergoing a prostatectomy experiences damage to an artery, leading to reduced blood supply to the seminal vesicle. Which artery was MOST likely affected during the procedure?
A 45-year-old female patient undergoes a hysterectomy, and during the procedure, a surgeon must carefully ligate an artery that supplies the uterus and uterine tubes. Which of the following arteries is the MOST appropriate target for ligation?
A 45-year-old female patient undergoes a hysterectomy, and during the procedure, a surgeon must carefully ligate an artery that supplies the uterus and uterine tubes. Which of the following arteries is the MOST appropriate target for ligation?
Flashcards
Pelvic splanchnic nerves
Pelvic splanchnic nerves
Originate from S2, S3, and S4 spinal nerves.
Pelvic splanchnic nerve distribution
Pelvic splanchnic nerve distribution
Supplies the hindgut and pelvic organs.
Ovarian artery origin
Ovarian artery origin
Originates from the abdominal aorta at the L2 level.
Ovarian artery end
Ovarian artery end
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Superior rectal artery origin
Superior rectal artery origin
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Superior rectal artery end
Superior rectal artery end
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Median sacral artery origin
Median sacral artery origin
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Median sacral artery end
Median sacral artery end
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Coccygeus Muscle
Coccygeus Muscle
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Action of Pelvic Diaphragm
Action of Pelvic Diaphragm
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Sacral Plexus Formation
Sacral Plexus Formation
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Sacral Plexus Branches
Sacral Plexus Branches
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Pelvic Sympathetic Chain
Pelvic Sympathetic Chain
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Branches of Sympathetic Chain
Branches of Sympathetic Chain
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Sacro-iliac joint type
Sacro-iliac joint type
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Obturator Internus Action
Obturator Internus Action
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Levator prostate/sphincter vaginae
Levator prostate/sphincter vaginae
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Secondary cartilaginous joints of pelvis
Secondary cartilaginous joints of pelvis
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Sacro-tuberous ligament function
Sacro-tuberous ligament function
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Sacro-spinous ligament function
Sacro-spinous ligament function
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Female sacrum characteristics
Female sacrum characteristics
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Boundaries of pelvic inlet
Boundaries of pelvic inlet
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Origin of Obturator Internus
Origin of Obturator Internus
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Action of Obturator Internus
Action of Obturator Internus
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Sacro-tuberous ligament
Sacro-tuberous ligament
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Sacro-spinous ligament
Sacro-spinous ligament
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False pelvis
False pelvis
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True pelvis
True pelvis
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Boundaries of pelvic outlet
Boundaries of pelvic outlet
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Obturator Internus nerve supply
Obturator Internus nerve supply
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Origin of piriformis
Origin of piriformis
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Coccygeus Origin & Insertion
Coccygeus Origin & Insertion
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Puborectalis Muscle
Puborectalis Muscle
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Iliococcygeus Origin & Insertion
Iliococcygeus Origin & Insertion
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Pelvic Diaphragm Actions
Pelvic Diaphragm Actions
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Sacral Plexus Formation/Termination
Sacral Plexus Formation/Termination
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Pelvic Sympathetic Chain Branches
Pelvic Sympathetic Chain Branches
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Pelvic part of sympathetic chain Course and End
Pelvic part of sympathetic chain Course and End
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Internal iliac artery origin
Internal iliac artery origin
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Internal iliac artery function
Internal iliac artery function
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Posterior division branches of internal iliac artery
Posterior division branches of internal iliac artery
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Anterior division branches of internal iliac artery
Anterior division branches of internal iliac artery
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Iliolumbar artery supply
Iliolumbar artery supply
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Lateral sacral artery supply
Lateral sacral artery supply
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Superior gluteal artery supply
Superior gluteal artery supply
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Umbilical artery branches
Umbilical artery branches
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Study Notes
- ANATOMIST Pelvic Wall, with a male and female gender symbol connected by a heart shape
Bony Pelvis
- Sacro-iliac joint is synovial plane
- Remaining pelvic joints are 2ry cartilaginous
- Symphysis pubis, lumbo-sacral, and sacro-coccygeal are examples of cartilaginous joints.
- Sacro-tuberous and sacro-spinus ligaments are present
Differences between male and female sacrum
- Male sacrum promontory: Prominent
- Female sacrum promontory: Less Prominent
- Male Sacrum length: Long
- Female Sacrum length: Short
- Male sacrum width: Narrow
- Female sacrum width: Wide
- Male sacrum articular surface reaches: S3
- Female sacrum articular surface reaches: S2
Pelvic Inlet
- Anteriorly by the upper border of the symphysis pubis
- Posteriorly by the sacral promontory and ala of sacrum
- Laterally by the iliopectineal line
Pelvic Cavity
- False Pelvis: Above the pelvic inlet, contains abdominal organs
- True Pelvis: Below pelvic inlet, contains pelvic organs
Pelvic Outlet
- Anterior border: Lower border of symphysis pubis
- Posterior border: Tip of the соссух
- Lateral border: Pubic arch and sacrotuberous ligament
Muscles of Pelvis
- Muscles lining the pelvis cavity
Obturator Internus Muscle
- Originates from the inner surface of the obturator membrane
- Inserts on the medial border of the greater trochanter
- Nerve supply from the nerve to the obturator internus
- Action: Lateral rotation of the thigh
Piriformis Muscle
- Originates from the middle 3 sacral segments
- Inserts on the upper border of the greater trochanter
- Nerve supply from S1 and S2
- Action: Lateral rotation of thigh
Pelvic Diaphragm
- Coccygeus: Originates from the ischial spine and inserts on the last sacral segment and coccyx, nerve supply comes from S4 and S5
- Levator ani has 3 parts: levator prostate/sphincter vaginae, pubo-rectalis, and ilio-coccygeus
Levator Prostate/Sphincter Vaginae
- Originates from the back of the body of the pubis
- Insertion: perineal body
Pubo-Rectalis
- Originates from the white line
- Insertion: forms a loop around anorectal junction
Ilio-Coccgeus
- Originates from the ischial spine
- Insertion: ano-coccygeal body and coccyx
- Nerve supply to Levator ani, the upper surface comes from S4 and the lower surface is supplied by the inferior rectal nerve of pudendal nerve
Actions of the Pelvic Diaphragm
- Supports viscera during straining
- Acts as a sphincter of the vagina and anorectal junction and coccyx
- Maintains intra-abdominal pressure during expulsive actions
Sacral Plexus
- Formation: Lumbo-sacral trunk "L4,5" and S1,2,3
- Termination: Pudendal and sciatic nerves
- Branches: Piriformis, superior and inferior gluteal, sciatic nerve, nerve to obturator internus, pudendal, pelvic diaphragm, PCN of thigh, and nerve to quadratus femoris
Pelvic part of the sympathetic chain
- Course: Formed of 4 ganglia that enter the pelvis crossing the ala of sacrum
- End: Fuses in front of the coccyx forming the ganglion impar
- Branches: Communicating branches with sacral and coccygeal nerves, to inferior hypogastric plexus and has vascular branches
Pelvic splanchnic nerves
- Origin: S2,3,4
- Distribution: Hindgut and pelvic organs
Arteries of Pelvis
Ovarian Artery
- Originates as a branch from the abdominal aorta at L2
- Terminates uniting with the uterine artery
Superior Rectal Artery
- A continuation of the inferior mesenteric artery
- Supplies the upper part of the rectum
Median Sacral
- Originates from the back of the aorta at the level of L4
- Terminates in front of the coccyx by glomus coccygeus
Internal Iliac Artery
- Originates as a terminal branch of the common iliac at the sacroiliac joint
- Has parietal and visceral branches
Posterior Division
- Are all parietal
- Iliolumbar gives iliac and lumbar branches
- Lateral sacral goes to sacral canal
- Superior gluteal goes to gluteal region
Anterior division
- All branches are visceral except 1, 6, and 7
- Obturator goes to the thigh
- The umbilical artery gives a superior vesical branch to the urinary bladder, and the distal part obliterates to form the medial umbilical ligament
- In females, the vaginal artery supplies the urinary bladder and vagina
- In males, the inferior vesical supplies the urinary bladder, seminal vesicle, and prostate
- In females only, the uterine artery supplies the uterus, uterine tube, and vagina
- The middle rectal supplies the rectum and vagina in females, and the seminal vesicle and prostate in males
- Inferior gluteal
- Internal pudendal
Internal Pudendal Artery
- Origin: Terminal branch of the internal iliac
- Course: Passes from greater sciatic notch to lesser sciatic notch behind ischial spine, then enters pudendal canal and then deep perineal pouch
- Termination: A superficial perineal pouch gives the deep and dorsal artery of the penis/clitoris
- Branches: Inferior rectal, scrotal/labial, artery of bulb, dorsal and deep arteries of penis/clitoris
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