MODULE 3:

OBJECTIVES:

3.1 Know the origins of the nerves supplying the pelvis and perineum.

3.2 Follow the flow of blood into and out of the structures of the pelvis and perineum.Identify the lymphatic drainage of structures in the pelvis and perineum. Identify the sites of aggregations of lymph nodes receiving lymphatic drainage from various areas of the pelvis and perineum (whether or not they are seen on the images).

READINGS:

Pages: 486-502, 513-519 See Green Highlighted sections for clinical correlation.

SECTRA TABLE WORK:

  1. Select Completed pelvis

  2. Add Sciatic and Lumbar nerves

  3. Add Lumbosacral trunk

  4. Add Sacral nerves

    5. HTML

    HTML

    The Coccygeal plexus is too small to be seen in our cadaver.

    Review TABLE 5.4 in Gray's Anatomy pages 489-490 to define the functions of the sacro-coccygeal plexes.

  5. Add Obturator nerve and rotate the cadaver to see the nerve passing through the obturator canal.

    6. HTML

  6. Add Femoral nerves

    7. Pay particular attention to the obturator, genitofemoral, pudendal, coccygeal and pelvic splanchnic nerves.

    HTML

  7. Add Abdominal aorta

  8. Add Inferior vena cava

  9. Add Right and left common iliac artery

  10. Add Right and left external iliac artery

  11. Add Femoral arteries

  12. Add Right and left internal iliac artery

    13. HTML

    The following are branches of the POSTERIOR TRUNK of internal iliac artery:

  13. Add Superior gluteal artery

  14. Add Iliolumbar artery

  15. Add Lateral sacral artery

    16. HTML

    The following are branches of the ANTERIOR TRUNK of internal iliac artery:

  16. Add Obturator artery

  17. Add Uterine artery

  18. Add Inferior gluteal artery

  19. Add Internal pudendal arteries

    20. The following branches of the anterior trunk are not visable in this cadaver:

  20. Umbilical artery

  21. Superior vesical artery

  22. Middle rectal artery

    23. The Ovarian arteries originate from the aorta.

  23. Select Ovarian arteries

    24. In general the veins of the pelvis and perineum follow the course of the arteries and nerves associated with these vessels.

  24. Add Common iliac vein

  25. Add Right and left external iliac vein

  26. Add Femoral veins

  27. Add Right and left internal iliac vein

  28. Add Remainder of the internal iliac venous plexus

    29. The ovarian veins follow the path of the ovarian arteries, but the left ovarian vein drains into the left renal vein. The right ovarian vein directly drains into the inferior vena cava.

  29. Add Ovarian veins

    30. HTML

  30. Add Inguinal lymphatic nodes

    31. Note that the femoral triangle now displays the "NAVEL" configuration. Moving lateral to medial "Nerve-Artery-Vein-Empty-Lymph"

  31. Add Abdominal lymphatic nodes

    32. Discuss the implications of lymph flow based on the figure above.

Return to Beginning of Module