pudendal NAV runs through

piriformus muscle

nerve to obtorator internus

sciatic nerve

ovarian artery & vein

post ganglionic sympathetic from T10-11

ovarian a

uterine a

ovavian a goes through suspensory lig

uterine a goes through mesovarian a

under bulbospongeosus muscle

bulbs are homologus w/ bulb of penus and copus spongiosum

attached to pubic boes anteriorly

ischial spines posteriorly

and to thickening in obtorator fascia called tendinous arch of levator ani

function erection

location superficial pouch

1. What is the innervation to the uterus?

Sympathetics from spinal cord segments T11-L1

Parasympathetics from spinal cord segments S2-4

1. If you needed to remove the uterus, which blood vessels would you need to ligate or tie off?

1. If you needed to remove an ovary, which blood vessels would you need to ligate?

In this case you would ligate the ovarian artery before it reaches the ovary. Remember that the ovarian artery is a branch off the abdominal aorta not the internal iliac reflecting its embryological origin around T10-11 and its subsequent migration down to the pelvis.

You would also need to ligate the portion of the uterine artery that supplies the ovary.

The ovarian vein must also be ligated.

1. Where is the pain from the uterus felt?

Visceral afferents from the body and fundus of the uterus travel with the sympathetics – ie pain refers to dermatomes T11-L1, whereas pain from the cervix travels with the parasympathetics and therefore refers to S2-4.

1. Where is the pain from the ovaries felt?

Visceral afferents from the ovary travel with the sympathetics that supply the ovary. These sympathetics are from spinal cord segment T10-11 therefore pain from the ovary will refer to the periumbilical area.

1. If an ovulated egg does not reach the uterine tube, where is it found?

In the peritoneal cavity - typically in the rectouterine pouch.

1. What is the blood supply to the urinary bladder?

The inferior and superior vesical arteries and veins.

1. What is the innervation to the urinary bladder?

The detrusor muscle, which is the major part of the bladder, receives parasympathetic innervation from the pelvic splanchnics.

1. How do you examine the prostate?

By doing a digital rectal exam. It is found anterior to the rectum.

1. Removal of the prostate gland requires ligation of which vessels?

Prostate receives blood from the inferior vesical artery.

1. What are some of the potential side effects from removing the prostate?

Some men experience impotence and urinary incontinence because the parasympathetics necessary for both erection and urinary continence run on either side of the prostate.

1. What are the components of semen?

Seminal fluid, sperm and prostate secretions.

1. What effect would the removal of the seminal vesicles have on the ejaculate?

It would only contain sperm and prostatic secretions and since most of the volume comes  from the seminal vesicles, the volume would be lower.

1. What two anatomical regions does the greater sciatic foramen connect?

The pelvic cavity and the gluteal region.

1. What passes through greater sciatic foramen?

Sciatic nerve, piriformis muscle, superior and inferior gluteal neurovascular bundles, pudendal neurovascular bundles.

1. What two anatomical regions does the lesser sciatic foramen connect?

The gluteal region and the perineum.

1. What passes through lesser sciatic foramen?

The pudendal neurovascular bundle, nerve to the obturator internus and the obturator internus tendon.

1)    Which two areas does the greater sciatic foramen connect?

Gluteal region and pelvis

1)    Which two areas does the lesser sciatic foramen connect?

Gluteal region &perineum

1)    What are the boundaries of the perineum?

Inferior surface of pelvic diaphragm (superiorly) to skin (inferiorly).  Obturator internus laterally.

1)    What are the boundaries of the superficial pouch?

Perineal membrane superiorly to deep perineal fascia inferiorly

1)    What is the clinical significance of the perineal body in the female?

It helps preserve the muscles of the perineum post partum.

1)    What is an episiotomy?

An incision in the urogenital diaphragm during childbirth used to prevent tearing of the perineum

1)    What is extravasation of urine in the male?

Injury to the penile urethra allowing urine to “spill out” into the scrotum and anterior abdominal wall.

1)    Into how many parts is the perineum divided?

Two triangles…anal and urogenital

contains root of scrotum, penis, vulva

closed by perinial membrane