Pelvis & Perineum MCQs

The umbilical artery supplies the superior part of the bladder by giving off the superior vesical arteries. In males, this artery supplies the ductus deferens via the artery of the ductus deferens. Distal to those branches, the umbilical artery is not patent, and it becomes the medial umbilical ligament. The middle rectal artery supplies blood to the middle of the rectum, while the obturator artery supplies blood to the medial thigh and hip. The inferior gluteal artery supplies blood to gluteus maximus, and the uterine artery supplies blood to the uterus. Reference - Textbook of Gray's Anatomy for students, 3rd Edition, Pelvis and Perineum, Page number - 237

The sacral splanchnic nerves do not come out of the sacral nerve roots--instead, these nerves come from the sacral sympathetic ganglia. So, anesthesia bathing the sacral nerve roots would not affect the sacral splanchnic nerves, which are coming from the sympathetic trunk. The sacral splanchnic nerves contribute to the inferior hypogastric plexus and provide sympathetic innervation to pelvic organs. Reference- Textbook of Gray's Anatomy for students, 3rd Edition, Pelvis and Perineum, Page number - 266

Bulbourethral glands are not a content of the superficial perineal pouch. They are located in the deep perineal pouch. The superficial perineal pouch is a potential space between the perineal membrane above and the membranous layer of perineal fascia (Colle's fascia) below. Reference- Textbook of Gray's Anatomy for students, 3rd Edition, Pelvis and Perineum, Page number - 222

Answer- A. Bucks fascia Superficial to tunica albuginea there is Buck's facia (deep layer of superficial fascia of penis), a prolongation of colle's fascia (membranous layer of superficial fascia of perineum). If Buck's facia remains intact, hematoma is restricted to penile shaft only causing egg-plant deformity. If Buck's fascia is disrupted, hematoma can extend to scrotum, perineum and suprapubic regions.

The root of the penis consists of two crura and one bulb. It is a content of the superficial perineal pouch. The deep perineal pouch is used to describe the space enclosed between the endopelvic fascia and the perineal membrane. Reference - Textbook of Gray's Anatomy for students, 3rd Edition, Pelvis and Perineum, Page number - 261

Although all the other splanchnic nerves carry sympathetic fibers, the pelvic splanchnic nerves transmit preganglionic parasympathetic fibers from S2, 3, and 4. These fibers are carried to the inferior hypogastric plexus. The parasympathetic fibers from the inferior hypogastric plexus supply the smooth muscle of the pelvic viscera, while the sympathetic fibers from the inferior hypogastric plexus supply vascular smooth muscle of vessels supplying the pelvic viscera. The superior hypogastric plexus is a continuation of the intermesenteric plexus it contributes sympathetic fibers to the inferior hypogastric plexus through hypogastric nerves. Reference - Textbook of Gray's Anatomy for students, 3rd Edition, Pelvis and Perineum, Page number - 224

Pelvic splanchnic nerves come from the anterior branches of S2 through S4. These are parasympathetic nerves, which send parasympathetic neurons to the hypogastric plexus, and therefore the pelvic viscera and distal colon. Hypogastric nerves are from the superior hypogastric plexus. These nerves transmit sympathetic neurons to the hypogastric plexus, and therefore the pelvic viscera. The pudendal nerve is a branch of the sacral plexus. It provides motor innervation to the muscles of the perineum, and it is the primary sensory innervation to the genitalia. Sacral splanchnic nerves are from the second and/or third ganglia of the sacral sympathetic trunk. These provide a secondary way for sympathetic neurons to reach the hypogastric plexus, and therefore the pelvic viscera. Reference - Textbook of Gray's Anatomy for students, 3rd Edition, Pelvis and Perineum, Page number - 221

The sacral plexus includes contributions from L4 through part of S4. It supplies motor innervation to muscles of the pelvic diaphragm, muscles of the urogenital diaphragm, and muscles of the posterior hip, posterior thigh, leg and foot. It supplies sensory innervation to the skin of the perineum, posterior thigh, leg and foot. So, this patient's pain and weakness in the thigh, as well as his inability to empty his rectum, point to damage in the sacral plexus. Reference- Textbook of Gray's Anatomy for students, 3rd Edition, Pelvis and Perineum, Page number - 218