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Lymph Nodes and Innervation of Pelvic Wall and FloorVersión en línea
Fill in the information regarding lymph node and innervation of pelvic wall and floor
Lumbar
(
Para
-
Aortic
/
Caval
)
Lymph
Nodes
=
,
,
,
,
External
Illiac
Lymph
Node
=
,
Internal
Illiac
Lymph
Node
=
,
,
,
,
,
Superficial
Inguinal
Lymph
Node
=
(
)
,
,
,
,
,
Deep
Inguinal
Lymph
Node
=
,
,
Sacral
Lymph
=
,
,
,
,
Rectu
m
What
is
the
major
nerve
of
the
perineum
?
.
Pudendal
Nerve
branches
into
.
and
n
.
Inferior
Rectal
innervates
Perineal
n
innervates
triangle
.
All
of
these
three
are
(
)
.
Sympathetic
Innervation
:
Pelvic
Viscera
:
and
.
(
lumbar
.
)
;
sacral
.
Perineum
:
run
with
nerve
(
to
vsaculature
glands
,
and
erectile
tissues
)
Parasympathetic
nerves
:
Pelvic
Viscera
:
nn
.
(
-
)
Perineum
=
nn
.
(
-
)
-
distribute
via
vasculature
to
erectile
tissue
,
gland
s
How
is
pelvic
viscera
pain
relayed
to
the
spinal
cord
?
1
.
=
Parasympathetic
2
.
=
Sympathetic
=
Dividing
Line
Above
pelvic
pain
line
=
Below
pelvic
pain
line
=
Options
for
anesthesia
during
childbirth
:
A
.
block
at
-
in
(
subdural
)
space
B
.
epidural
at
-
in
sacral
canal
C
.
nerve
block
in
canal
(
)
Parasympathetic
=
=
Excitement
and
Plateau
=
Sympathetic
=
=
Orgasm
and
Resolution
=
&
Splanchnics
nn
.
Somatic
=
N
.
What
is
happening
in
erectile
tissue
during
"
point
"
phase
?
-
(
trabecular
)
smooth
mm
.
-
Dilation
of
and
.
-
>
-
Sinusoids
fill
with
and
-
of
veins
(
lack
of
return
-
>
mainly
males
)
-
(
ischiocavernosus
m
.
)
-
Engorgemen
t
"
Shoot
"
=
(
orgasm
phase
)
-
Somatic
Motor
(
efferents
)
-
-
>
pudendal
nerves
-
-
rhythmic
mm
.
-
-
relaxation
of
-
Autonomic
motor
-
-
>
.
-
-
Female
:
of
,
-
-
Male
:
contraction
along
course
from
to
orifice
-
-
-
-
=
fluid
from
to
-
-
-
-
Ejaculation
=
of
from
to
exterior
Clinical
Correlate
=
Ejaculation
retrograde
passage
of
semen
into
bladder
due
to
disruption
of
closure
during
pharmacological
-
ex
.
-
,
psychotropic
medications
anatomical
-
congenital
-
valves
-
acquired
-
neck
or
prostate
resection
neurogenic
-
ex
.
spinal
cord
injury
,
MS
,
diabetic
,
autonomic
neuropathy
Pelvic
innervation
:
Defecation
-
At
rest
/
filling
phase
:
sympathetic
(
.
)
(
Sphincter
)
and
somatic
(
of
-
)
keep
(
sphincter
and
)
anus
tightly
closed
-
Rectum
full
phase
:
sensory
signals
of
fullness
relayed
to
brain
for
the
conscious
decision
:
release
or
continue
to
hold
?
-
At
fecal
evacuation
phase
:
release
is
conscious
(
voluntary
signal
to
relax
sphincter
and
(
somatic
motor
)
(
and
-
)
and
active
parasympathetic
inhibition
of
the
sphincter
(
-
)
Lower
Vagina
-
(
Portion
Sinus
)
Greater
Vestibular
Glands
-
,
Gland
s
Bony
Pelvis
Function
Transmits
weight
from
to
for
activities
such
as
,
,
&
Provides
attachment
for
,
musculature
,
&
Support
&
Structures
Pelvic
Inlet
Sacral
Promontory
Ala
of
Sacrum
Arcuate
Line
of
Ilium
Pectinate
Line
of
Pubis
Pubic
Crest
Pubic
Symphsis
Pelvic
Outlet
Coccyx
Sacrotuberous
Ligament
Ischial
Tuberosities
Ischiopubic
ramus
Pubic
Symphsis
Pernieum
Function
Role
in
&
Function
Supports
Passageway
for
structures
Protection
&
compartmentalization
Contribution
to
pelvic
stability
Structures
Urogenital
Triangle
Perineal
Membrane
splits
into
and
Superficial
Female
-
termination
of
round
ligament
of
uterus
,
protects
urethral
&
vaginal
orifices
-
surrounds
vestibule
-
Erectile
Tissue
-
glans
,
body
,
crura
Vestibule
External
Urethral
Orifice
Vaginal
Orifice
Males
Penis
,
,
,
(
bulb
&
crura
)
,
prepuce
Testis
In
scrotum
w
/
Dartos
Fascia
Epidymis
Short
term
storage
and
maturation
of
sperm
Connects
to
ductus
deferens
Spermatic
cord
-
easy
way
to
remember
is
one
vein
,
nerve
,
and
artery
,
and
one
other
tube
(
remember
there
are
4
!
!
)
Artery
Nerve
Erectile
Tissues
/
Glands
Female
Clitoris
Composed
of
paired
tissue
Continuation
of
crus
Surrounded
by
-
maintains
erection
Vestibular
bulbs
Made
of
corpora
spongiosum
Surrounded
by
bulbospongiosum
to
expel
glandular
secretions
into
the
vestibule
Greater
&
Lesser
Vestibular
Glands
Greater
(
?
s
)
Lesser
(
)
Mucus
secretion
for
vaginal
/
vulvar
lubrication
Males
Paired
erectile
tissue
Crus
&
Dorsal
Body
-
Surrounded
by
Ischiocavernosus
M
.
-
maintain
erecttion
by
preventing
venous
return
Corpus
spongiosum
Singular
midline
erectile
tissue
Bulb
,
ventral
body
,
glands
spongy
penile
within
Bulb
surrounded
by
bulbospongiosum
Perineal
Musculatures
Perineal
Body
=
fibromuscular
aggregate
tissue
(
stabilizes
region
Superficial
Transverse
Perineal
Muscle
Major
differences
in
erectile
tissue
and
musculature
between
males
and
females
Vestibule
in
female
;
female
does
course
through
Glands
in
superficial
compartment
Deep
glands
(
Male
)
Homologues
to
glands
in
females
Mucus
-
like
secretions
lubricate
urethra&neutralize
acidity
of
urine
Empty
into
spongy
urethra
which
is
superficial
compartment
Perineal
M
.
Neurovascular
supply
Vagina
(
Female
)
Anal
Triangle
Ischioanal
fossa
Horshoe
shaped
region
filling
majority
of
anal
triangle
;
extends
anteriorly
,
deep
to
perineal
membrane
Contains
loose
adipose
tissue
&
neurovascular
supply
to
external
analsphincter
Inferior
Rectal
N
.
and
Artery
Anal
Musculature
M
.
M
.
Ani
M
.
.
M
.
Innervation
&
Vasculature
Main
from
Pudendal
N
.
(
S2
-
S4
)
Sensation
from
skin
around
perineum
&anus
,
external
genitalia
Motor
to
the
perineal
muscles
,
urethra
&
anal
sphincter
Course
Leaves
pelvic
cavity
through
the
greater
sciatic
foramen
Enters
perineum
via
lesser
sciatic
foramen
Branches
Perineal
=
Urogenital
=
Anal
Triangle
Dorsal
nerve
of
penis
/
clitoris
=
Ext
.
Genitalia
Main
artery
to
perineum
=
A
.
Hydrocele
=
Excess
fluid
extends
into
(
)
Cause
:
patent
results
in
persistent
communication
between
;
injury
to
or
inflammation
of
epididymis
Vasectomy
=
definitive
,
procedure
that
involves
disrupting
the
from
the
of
Cremasteric
Reflex
=
stroke
proximal
medial
thigh
to
evoke
contraction
of
cremaster
m
,
absence
of
reflex
can
indicate
Afferent
=
n
Efferent
-
N
.
Greater
Vestibular
(
Bartholin
)
Gland
Cyst
/
Abscess
Cyst
=
presents
typically
as
a
/
;
caused
by
obstructed
duct
?
mucus
accumulation
proximal
to
obstruction
abscess
=
presents
as
large
,
mass
with
swelling
;
caused
by
obstructed
duct
that
becomes
infected
Treatment
:
Warm
compress
,
NSAIDS
,
surgical
drainage
Episiotomy
=
procedure
developed
to
augment
difficult
vaginal
deliveries
while
controlling
for
&
avoiding
potentially
dangerous
perineal
lacerations
during
the
delivery
process
Tear
degrees
:
1st
=
2nd
=
&
.
3rd
=
4th
=
into
Pelvic
Floor
Injury
most
vulnerable
because
of
its
location
(
near
birth
canal
)
and
attachents
(
bone
to
bone
)
Pregnancy
=
occurs
somewhere
other
than
the
uterus
Hysterosalpingogram
=
assess
the
patency
of
the
uterine
tubes
=
?
uterus
?
uterine
?
Benign
Prostatic
Hyperplasia
-
BPH
-
growth
of
the
/
glands
lining
the
urethra
Urethral
(
urogenital
)
folds
-
-
Urogenital
sinus
-
glands
-
gland
s
Urogenital
Sinus
-
glands
-
glan
d
Paramesonephric
Ducts
-
,
,
Mesonephric
Ducts
-
,
,
,
Somatic
Perineum
-
pudendal
nerve
mediates
from
&
around
&
Motor
innervation
to
the
and
.
&
muscles
of
the
perineu
m
|
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