Viscera
|
| Organ/Part of Organ |
Location/Description |
Notes |
| kidney (N334, N342, TG5-30A, TG5-30B, TG5-30C, TG5-31B, TG5-31C, TG5-42) |
excretory organ of the urinary tract located on the posterior abdominal wall |
retroperitoneal; right kidney is lower than the left - its superior pole reaches the 12th rib; superior pole of the left kidney reaches as high as the 11th rib; kidneys develop from the intermediate mesoderm in the embryo |
| calyx, minor (TG5-32B) |
portion of the urinary collecting system within the kidney that drains one renal papilla |
one renal papilla projects into the lumen of one minor calyx; several minor calyces unite to form a major calyx (Greek, calyx = cup) |
| calyx, major (TG5-32B) |
portion of the urinary collecting system within the kidney that drains several minor calyces |
major calyx collects urine from several renal papillae; all major calyces unite to form the renal pelvis (Greek, calyx = cup) |
| pararenal fat (TG5-31B) |
extraperitoneal fat surrounding the kidney |
pararenal fat is located external to the renal fascia |
| perirenal fat (TG5-31B) |
extraperitoneal fat surrounding the kidney |
perirenal fat is located within the renal fascia; it is also located within the renal sinus surrounding the calyces and blood vessels |
| renal columns (TG5-32B) |
columns of tissue that are histologically identical to tissue found in the renal cortex, but which are located in the medulla between the renal pyramids |
interlobar arteries pass from the renal sinus to the renal cortex within the renal columns |
| renal cortex (TG5-32B) |
outer layer of kidney |
renal cortex contains the majority of the glomeruli |
| renal fascia (TG5-31B) |
a fascial pouch derived from extraperitoneal connective tissue that contains the kidneys, the suprarenal glands, the renal vessels and perirenal fat |
renal fascia of the right and left sides is joined across the midline in close relationship to the renal aa. and vv.; renal fascia encapsulates the inferior vena cava and aorta at the level of origin of the renal vessels; do not confuse renal fascia with the renal capsule - the renal capsule is histologically part of the kidney and there is no fat between it and the kidney |
| renal hilum (TG5-32B) |
opening on medial margin of the kidney leading into the renal sinus |
the renal vessels enter/leave the kidney at the hilum; the renal pelvis leaves the kidney at the hilum |
| renal medulla (TG5-32B) |
inner layer of the kidney |
renal medulla contains most of the tubules of the kidney organized as renal pyramids; renal columns consist of cortex-like tissue arranged between the pyramids in the renal medulla |
| renal papilla (TG5-32B) |
tip of renal pyramid projecting into a minor calyx |
several minor calyces combine to form a major calyx; all of the major calyces in the kidney unite to form the renal pelvis (Latin, papilla = a nipple) |
| renal pelvis (TG5-32B) |
large collecting duct for urine that is formed by the union of the major calyces |
renal pelvis is the dilated origin of the ureter; it is located at the renal hilum and is surrounded by the renal sinus |
| renal pyramid (TG5-32B) |
cone-shaped arrangement of tubules in the renal medulla |
tip of the renal pyramid (papilla) projects into a minor calyx |
| renal sinus (TG5-32B) |
hollowed out area on the medial margin of the kidney |
renal sinus opens at the renal hilum; it contains the renal aa. and vv., major calyces and renal pelvis, perirenal fat |
| ureter (TG5-32B, TG5-30B) |
muscular tube that serves as the duct of the kidney to carry urine to the bladder |
ureter is continuous proximally with the renal pelvis; it passes over the pelvic brim medial to the testicular/ovarian vessels; it passes obliquely through the posterior wall of the urinary bladder and drains at the posterolateral angle of the vesical trigone (Latin, ureter/oureter = urinary canal) |
| suprarenal gland (N347, TG5-31C) |
endocrine gland located superomedial to the kidney; right suprarenal gland is somewhat triangular in shape, left suprarenal gland is semilunar in shape |
suprarenal cortex manufactures corticosteroids; suprarenal medulla manufactures epinephrine and norepinephrine; suprarenal medulla receives preganglionic sympathetic innervation from the greater thoracic splanchnic n.; also known as: adrenal gland |
| ductus deferens (N361, TG6-31,
N384, TG6-10, N387, TG6-31) |
duct of the testis |
ductus deferens is continuous with the tail of the epididymis; it passes through the superficial inguinal ring, inguinal canal and deep inguinal ring to reach the posteroinferior surface of the bladder where it joins with the duct of the seminal vesicle to form the ejaculatory duct (Latin, ductus = to lead + deferens = to carry away) |
| ampulla of the ductus deferens (N384, TG6-10) |
dilated part of the ductus deferens located posterior to the bladder |
ampulla of the ductus deferens joins with the duct of the seminal vesical to form the ejaculatory duct (Latin, ampulla = a flask or the dilated part of a duct or channel; ductus = to lead + deferens = to carry away) |
| bladder, urinary (TG6-08, TG6-08) |
hollow muscular organ posterior to the pubic symphysis and body of the pubis that acts as a reservoir for urine |
urinary bladder is held in place by the pubovesical/puboprostatic ligaments; ureters enter the posterolateral surface of the bladder at the posterior two angles of the vesical trigone |
| clitoris (N377, TG6-25) |
combination of 3 erectile bodies: glans clitoris and 2 corpora cavernosa clitoris |
clitoris is covered by smooth skin |
| corona of the glans (N382) |
margin of the glans projecting beyond the ends of the corpora cavernosa |
overhangs the neck of the glans that separates the body from the glans of the penis |
| fossa navicularis (TG6-09B) |
dilation of the spongy/penile urethra in the glans penis |
the largest diameter of the penile urethra occurs here |
| ejaculatory duct (N384, TG6-10) |
duct formed by the union of the duct of the seminal vesicle and the ampulla of the ductus deferens |
ejaculatory duct passes through the prostate gland to empty onto the seminal colliculus along the urethral crest in the prostatic urethra |
| external urethral meatus (orifice) (N377, TG6-25) |
slitlike opening of the spongy urethra near the tip of the glans |
|
| frenulum (N377, TG6-25)
|
a more posterior or deeper part of the labia minora passing posterior to the clitoris |
(Latin, frenulum = bridle, a narrow reflection of membrane from the lower surface of the glands with the prepuce) |
| glans penis/clitoridis (N377, TG6-25, N382) |
expanded distal end of the corpus spongiosum which caps the ends of the corpora cavernosa |
the fossa navicularis is an expanded portion of the penile urethra that occurs in the glans (Latin, glans = acorn) |
| interureteric ridge (N366, TG6-10) |
mucosal fold on the inner posterior wall of the bladder connecting the paired ureteric orifices |
interureteric ridge is the superior boundary of the vesical trigone |
| labia majora (N377, TG6-25) |
fat-filled elevations of hair-covered skin lying on either side of the vestibule of the vagina |
labia majora are joined across the midline by the anterior and posterior labial commissures; they blend into each other anteriorly to form the mons pubis (Latin, labia = lips) |
| labia minora (N377, TG6-25) |
paired folds of hairless skin located medial to the labia majora and extending posteroinferiorly from the clitoris |
the anterior end of each labium minus divides: the anterior division of each labium forms the prepuce of the clitoris and the posterior division of each labium forms the frenulum of the clitoris (Latin, labia = lips) |
| mons pubis (N377, TG6-25) |
rounded, fatty prominence anterior to the pubic symphysis |
(Latin, mons = mountain) |
| prepuce (N377, TG6-25) |
fold of smooth skin extending over the glans penis/clitoris |
the anterior divisions of the labia minora combine to form the prepuce of the clitoris (Latin, praeputium = foreskin) |
| prostate (N384, TG6-10) |
exocrine gland located inferior to the urinary bladder and superior to the perineal membrane |
multiple small ducts drain into the prostatic urethra as it passes through the prostate; subject to benign and malignant enlargement, which may compromise micturition due to projection of the uvula into the bladder (Greek, prostate = one stand before, this gland stands before the bladder) |
| prostatic utricle (N384, TG6-10) |
a small blind diverticulum in the posterior wall of the prostatic urethra on the summit of the seminal colliculus |
prostatic utricle is a remnant of the fused lower ends of the paramesonephric ducts - the fused paramesonephric ducts form the uterine canal in the female (Latin, utriculus = little leather bag) |
| seminal colliculus (N384, TG6-10) |
elevation on the posterior wall of the prostatic urethra |
the seminal colliculus is a mound in the posterior wall of the prostatic urethra; on its summit is found the opening of the prostatic utricle (Latin, colliculus = mound) |
| seminal vesicle (N384, TG6-10) |
blind sac located on the posterior surface of the bladder lateral to the ampulla of the ductus deferens |
seminal vesicle produces seminal fluid; its duct joins with the ampulla of the ductus deferens to form the ejaculatory duct |
| seminiferous tubules (N390, TG5-10, TG6-31, TG6-32) |
convoluted tubules of the testis in which sperm are produced |
drain via efferent ductules into the head of the epididymis |
| urachus (N363, TG6-07) |
joins the apex of the fetal bladder to the umbilicus |
after birth, the urachus becomes a remnant called the median umbilical ligament (Greek, urachus/ourachos = the urinary canal of a fetus) |
| ureteric orifices (N366, TG6-10) |
openings of the ureters in the bladder wall |
|
| urethra (NN366, N378, N385, N388, TG6-09A, TG6-09B, TG6-10) |
duct that drains the urinary bladder |
urethra has three parts in the male: prostatic, membranous & penile/spongy; female urethra is much shorter than the male urethra, consisting of the membranous part only |
| urethra, membranous (N385, N388, TG6-09A, TG6-09B) |
part of the urethra that passes through the sphincter urethrae muscle and perineal membrane |
female: membranous urethra connects the urinary bladder to the external urethral orifice at the vestibule of the vagina; male: membranous urethra connects the prostatic urethra with the spongy/penile urethra |
| urethra, penile (N388, TG6-09A, TG6-09B) |
part of the urethra contained within the bulb and the corpus spongiosum of the penis |
longest part of male urethra; penile urethra has a dilation in the region of the glans called the navicular fossa; also known as: spongy urethra |
| urethra, prostatic (N388, TG6-09A, TG6-09B) |
part of the male urethra passing through the prostate gland |
prostatic urethra begins at the internal urethral orifice at the anteroinferior angle of the vesical trigone; posterior wall of the urethra has an elevated ridge called the urethral crest with a prominence called the seminal colliculus (veru montanum = spitting mountain); seminal colliculus has a blind diverticulum called the prostatic utricle with orifices of ejaculatory ducts located below it |
| urethra, spongy (N388, TG6-09A, TG6-09B) |
part of the urethra contained within the bulb and the corpus spongiosum of the penis |
longest part of male urethra; spongy urethra has a dilation in the region of the glans called the navicular fossa; also known as: penile urethra |
| ureter |
muscular tube that serves as the duct of the kidney to carry urine to the bladder |
ureter is continuous proximally with the renal pelvis; it passes over the pelvic brim medial to the testicular/ovarian vessels; it passes obliquely through the posterior wall of the urinary bladder and drains at the posterolateral angle of the vesical trigone |
| uvula of the bladder (N366, TG6-10) |
elevation of the inner bladder wall posterosuperior to the internal urethral orifice |
uvula is caused by the middle lobe of the prostate gland; if the prostate becomes enlarged (either benign hypertrophy or malignancy) the uvula can constrict the internal urethral orifice and cause difficulty in voiding the bladder; only found in males |
| vagina (N377, TG6-25) |
part of the female genital canal located between the vestibule and the cervix |
vaginal fornices surround the cervix; the word "vagina" is derived from the Latin word for sheath |
| vesical trigone (N366, TG6-10) |
smooth triangular region located on the inner surface of the posterior wall of the urinary bladder |
vesical trigone is bounded by the openings of the ureters (2) superolaterally, the interureteric ridge between the openings of the ureters and the internal urethral orifice inferiorly (Greek, trigone = triangle) |
| vestibule of the vagina (N377, TG6-25) |
region inferior to the hymen/hymeneal caruncles and between the labia minora |
vestibule of the vagina contains the external urethral orifice, the opening of the vagina and the openings of the greater vestibular glands |
| vulva (N377, TG6-25) |
serves as sensory and erectile tissue for sexual intercourse and arousal, directs the flow of urine, prevents entry of foreign material into the urogenital tract |
clinically called the pudendum |
Muscles
|
| Muscle |
Origin |
Insertion |
Action |
Innervation |
Artery |
Notes |
Image |
| diaphragm (N185, N263, TG5-33) |
xiphoid process, costal margin, fascia over the quadratus lumborum and psoas major mm. (lateral & medial arcuate ligaments), vertebral bodies L1-L3 |
central tendon of the diaphragm |
pushes the abdominal viscera inferiorly, increasing the volume of the thoracic cavity (inspiration) |
phrenic nerve (C3-C5) |
musculophrenic a., superior phrenic a., inferior phrenic a. |
left crus attaches to the L1-L2 vertebral bodies, the right crus attaches to the L1-L3 vertebral bodies |
 |
| iliacus (N263, TG5-33) |
iliac fossa and iliac crest; ala of sacrum |
lesser trochanter of the femur |
flexes the thigh; if the thigh is fixed it flexes the pelvis on the thigh |
femoral nerve |
iliolumbar a. |
inserts in company with the psoas major m. via the iliopsoas tendon |
 |
| psoas major (N263, TG5-33) |
bodies and transverse processes of lumbar vertebrae |
lesser trochanter of femur (with iliacus) via iliopsoas tendon |
flexes the thigh; flexes & laterally bends the lumbar vertebral column |
branches of the ventral primary rami of spinal nerves L2-L4 |
subcostal a., lumbar aa. |
the genitofemoral nerve pierces the anterior surface of the psoas major m. |
 |
| psoas minor (N263, TG5-33) |
bodies of the T12 & L1 vertebrae |
iliopubic eminence at the line of junction of the ilium and the superior pubic ramus |
flexes & laterally bends the lumbar vertebral column |
branches of the ventral primary rami of spinal nerves L1-L2 |
lumbar aa. |
absent in 40% of cases |
 |
| quadratus lumborum (N263, TG5-33) |
posterior part of the iliac crest and the iliolumbar ligament |
transverse processes of lumbar vertebrae 1-4 and the 12th rib |
laterally bends the trunk, fixes the 12th rib |
subcostal nerve and ventral primary rami of spinal nerves L1-L4 |
subcostal a., lumbar aa. |
the lateral arcuate ligament of the diaphragm crosses the anterior surface of the quadratus lumborum m. |
 |
| sphincter urethrae, in female (N361, TG6-08,N366, TG6-10,N385) |
encircles the urethra |
encircles urethra and vagina; extends superiorly along the urethra as far as the inferior surface of the bladder |
compresses urethra and vagina |
deep branch of perineal nerve from pudendal nerve |
internal pudendal a. |
skeletal muscle (Greek, sphincter = that which binds tight) |
 |
| sphincter urethrae, in male (N361, TG6-08, N366, TG6-10, N385) |
encircles the urethra |
encircles urethra, reaches lateral surface of prostate and inferior bladder |
compresses urethra |
deep branch of perineal nerve from pudendal nerve |
internal pudendal a. |
skeletal muscle (Greek, sphincter = that which binds tight) |
 |
| coccygeus (TG6-15, TG6-21, TG6-23) |
ischial spine |
side of the coccyx and lower sacrum |
elevates the pelvic floor |
branches of the ventral primary rami of spinal nerves S3-S4 |
inferior gluteal a. |
coccygeus and levator ani combined form the pelvic diaphragm |
 |
| iliococcygeus (TG6-15, TG6-21, TG6-23) |
arcus tendineus levator ani and the ischial spine |
anococcygeal raphe and the coccyx |
elevates the pelvic floor |
branches of the ventral primary rami of spinal nerves S3-S4 |
inferior gluteal a. |
the combination of puborectalis, pubococcygeus and iliococcygeus is called the levator ani m. |
 |
| levator ani (TG6-15, TG6-21, TG6-23) |
posterior surface of the body of the pubis, fascia of the obturator internus m. (arcus tendineus levator ani), ischial spine |
anococcygeal raphe and coccyx |
elevates the pelvic floor |
branches of the ventral primary rami of spinal nerves S3-S4 |
inferior gluteal a. |
the combination of puborectalis, pubococcygeus & iliococcygeus is the levator ani m.; coccygeus and levator ani combined form the pelvic diaphragm (Latin, levator = to lift) |
 |
| obturator internus (TG3-13, TG5-07, TG6-14) |
the internal surface of the obturator membrane and margin of the obturator foramen |
greater trochanter on its medial surface above the trochanteric fossa |
laterally rotates and abducts the thigh |
nerve to the obturator internus m. |
obturator a. |
the obturator internus m. leaves the pelvis by passing through the lesser sciatic foramen; the superior and inferior gemellus mm. insert on the obturator internus tendon |
 |
| piriformis (TG3-12, TG6-21, TG6-23) |
anterior surface of sacrum |
upper border of greater trochanter of femur |
laterally rotates and abducts thigh |
ventral rami of S1-S2 |
|
piriformis leaves the pelvis by passing through the greater sciatic foramen |
 |
| pubococcygeus (TG6-15, TG6-21, TG6-22, TG6-23, (TG6-35, TG6-36) |
posterior aspect of the superior pubic ramis |
coccyx |
elevates the pelvic floor |
branches of the ventral primary rami of spinal nerves S3-S4 |
inferior gluteal a. |
the combination of puborectalis, pubococcygeus and iliococcygeus is called the levator ani m. |
 |
| puborectalis (TG6-15, TG6-21, TG6-22, TG6-23, (TG6-35, TG6-36) |
posterior aspect of the body of the pubis |
unites with the puborectalis m. of other side posterior to the rectum |
draws the distal rectum forward and superiorly; aids in voluntary retention of feces |
branches of the ventral primary rami of spinal nerves S3-S4 |
inferior gluteal a. |
the combination of puborectalis, pubococcygeus and iliococcygeus is called the levator ani m. |
 |
| pubovaginalis |
posterior aspect of the body of the pubis |
fascia of the vagina and perineal body |
draws the vagina forward and superiorly |
branches of the ventral primary rami of spinal nerves S3-S4 |
inferior gluteal a. |
pubovaginalis is part of the levator ani muscle |
 |
Arteries
|
| Artery |
Source |
Branches |
Supply to |
Notes |
| aorta, abdominal (N264, TG5-34)
|
the continuation of the descending thoracic aorta |
inferior phrenic aa. (2), celiac trunk, middle suprarenal aa. (2), lumbar aa. (4 pairs), superior mesenteric a., renal aa. (2), testicular/ovarian aa. (2), inferior mesenteric a., median sacral a., common iliac aa. (2) |
abdominal wall; gastrointestinal tract; body below the level of the respiratory diaphragm |
abdominal aorta passes posterior to the diaphragm (aortic hiatus) at the level of the T12 vertebral body |
| common iliac (TG3-62, TG5-29, TG5-30) |
abdominal aorta |
external iliac a., internal iliac a. |
pelvis, lower limb |
abdominal aorta bifurcates at the level of the L4 vertebral body to form the right and left common iliac aa.; the common iliac artery bifurcates anterior to the sacroiliac articulation into its terminal brs. (external iliac a. and internal iliac a.) |
| inferior phrenic (TG5-32) |
abdominal aorta |
superior suprarenal aa. |
diaphragm, suprarenal gland |
inferior phrenic a. is the first abdominal branch of the aorta; it may arise from the celiac trunk (Latin, phrenic = diaphragm) |
| lumbar (TG5-34) |
abdominal aorta |
anterior br., posterior br., spinal br. |
psoas major m., psoas minor m., quadratus lumborum m., spinal cord and vertebral column, deep back muscles |
the 4 lumbar arteries on each side arise from the posterior surface of the aorta at the level of vertebrae L1-L4; they course posterior to the psoas major m. |
| median sacral TG5-34) |
abdominal aorta |
5th lumbar aa. |
sacrum |
median sacral a. appears to be the continuation of the abdominal aorta in the median plane, although it is much smaller in size |
| renal (NN 332 ,N335, TG5-34, TG5-32) |
abdominal aorta at the level of the upper border of the L2 vertebra |
inferior suprarenal a., apical segmental a., anterior br: superior anterior segmental a., middle anterior segmental a., inferior segmental a.; posterior br.: posterior segmental a. |
kidney, upper ureter, suprarenal gland |
the right renal a. is longer than the left renal artery; the right renal artery passes posterior to the inferior vena cava |
| suprarenal, inferior (N332, TG5-34, TG5-32) |
renal a. |
numerous unnamed branches |
inferior aspect of the suprarenal gland |
inferior suprarenal a. may anastomose with the superior suprarenal a. |
| suprarenal, middle (N332, TG5-34, TG5-32) |
abdominal aorta |
numerous unnamed branches |
medial side of the suprarenal gland |
middle suprarenal a. anastomoses with the superior suprarenal a. and the inferior suprarenal a. |
| suprarenal, superior (N332, TG5-34, TG5-32) |
inferior phrenic a. |
multiple small aa. |
superior aspect of the suprarenal gland |
superior suprarenal aa. are numerous small vessels that enter the suprarenal gland independently |
| gluteal, inferior (N402, N403, TG6-17A, TG6-17B) |
internal iliac a., anterior division |
unnamed muscular branches |
gluteus maximus m., hip joint |
inferior gluteal a. participates in the formation of the cruciate anastomoses of the hip |
| gluteal, superior (N502, N402, N403, TG3-26, TG3-27, TG6-17A, TG6-17B) |
internal iliac, posterior division |
superficial br., deep br. |
gluteus maximus m., gluteus medius m., gluteus minimus m., hip joint |
superior gluteal a. participates in the formation of the cruciate anastomoses of the hip |
| iliolumbar (N264,
N402,
N403, TG5-34, TG6-17A, TG6-17B) |
internal iliac a., posterior division |
iliac br., lumbar br. |
iliacus m., psoas major m., quadratus lumborum m. |
lumbar br. of the iliolumbar a. sends a small spinal br. into the vertebral canal |
| internal iliac (TG3-18, TG3-20, TG5-30 |
common iliac a. |
anterior division gives rise to the : umbilical a., obturator a., uterine a., vaginal a., inferior vesical a., middle rectal a., internal pudendal a., inferior gluteal a.; posterior division gives rise to the: iliolumbar a., lateral sacral a., superior gluteal a. |
pelvic viscera, gluteal region, hip, medial thigh |
common iliac artery bifurcates anterior to the sacroiliac articulation to form the internal iliac a. and the external iliac a. |
| internal pudendal (N402, N403, N404, N405, TG6-17A, TG6-17B, TG6-29) |
internal iliac a., anterior division |
inferior rectal a., perineal a., artery of the bulb of the clitoris/penis, urethral a., deep clitoral/penile a., dorsal clitoral/penile a. |
anus, muscles of the superficial and deep perineal spaces, clitoris/penis, posterior aspect of the scrotum/labium majus |
internal pudendal a. is the primary blood supply to the perineum (Latin, pudendus = ashamed, the term referred to "the shameful parts") |
| lateral sacral (N264, TG5-34,
N402,
N403, TG6-17A, TG6-17B) |
internal iliac a., posterior division |
spinal brs. |
sacrum, sacral nerve rootlets, meninges, adjacent muscles |
there are usually 2 lateral sacral aa. on each side, a superior one and an inferior one |
| middle rectal (N402, N403, N398, TG6-17A, TG6-17B) |
internal iliac, anterior division |
no named branches |
middle portion of the rectum |
middle rectal a. anastomoses with the inferior rectal a and the superior rectal a. |
| obturator (N402, N487, TG3-54, TG6-17) |
internal iliac a., anterior division |
pubic br., acetabular br., anterior br., posterior br. |
medial thigh and hip |
anterior and posterior brs. pass on the anterior and posterior sides of the adductor brevis m.; aberrant obturator a. arises from the inferior epigastric a. in 30% of cases |
| umbilical (N402,
N403, TG6-17A, TG6-17B) |
internal iliac a., anterior division |
superior vesical aa., a. of the ductus deferens |
superior part of the bladder; ductus deferens |
distal to the branches described at left, the lumen of the umbilical a. becomes obliterated after birth and the remnant of the vessel becomes the medial umbilical ligament |
| uterine (N402, N404, TG6-17) |
internal iliac a., anterior division |
tubal br., vaginal br. |
uterus, uterine tube |
uterine a. anastomoses with the ovarian a. and the vaginal a.; it passes superior to the ureter in the pelvis; remember the saying "water under the bridge" |
| vaginal (N402, N404, TG6-17) |
internal iliac a., anterior division; occasionally it arises from uterine a. |
numerous unnamed branches |
vagina |
anastomoses with the uterine a.; participates in the formation of the azygos arteries along the lateral surface of the vagina |
| vesical, inferior (TG6-17) |
internal iliac a., anterior division or it may arise from the middle rectal a. |
no named branches |
lower part of the urinary bladder, prostate/vagina |
inferior vesical a. anastomoses with the middle rectal a. |
| vesical, superior (TG6-17) |
umbilical a. |
no named branches |
superior aspect of the bladder |
superior vesical aa.arise from the umbilical a. proximal to where its lumen becomes obliterated |
Nerves
|
| Nerve |
Source |
Branches |
Motor |
Sensory |
Notes |
| aorticorenal ganglion (N318, TG8-16, TG5-39) |
preganglionic sympathetic via the lesser thoracic splanchnic n. |
brs. to the renal plexus |
vascular smooth muscle of the brs. of the renal aa. |
pain from the kidney, suprarenal gland, upper ureter |
a sympathetic ganglion; located above or near the origin of the renal a. from the abdominal aorta (Greek, ganglion = a knot or swelling) |
| celiac ganglion (N318, N319, N320, TG8-16, TG5-39) |
preganglionic sympathetic axons arrive via the greater thoracic splanchnic n. |
postganglionic sympathetic axons distribute via the celiac plexus along brs. of the celiac trunk |
vascular smooth muscle of the brs. of the celiac trunk |
pain from the stomach, liver & biliary system, spleen, upper half of the duodenum & pancreas |
a sympathetic ganglion; usually 2 celiac ganglia are located on the abdominal aorta at the origin of the celiac trunk; brs. of the vagal trunks pass through the celiac ganglion without synapsing (Greek, celiac = belly + ganglion = a knot or swelling) |
| collateral ganglia |
splanchnic nn. (thoracic, lumbar) |
plexuses to abdominal & pelvic viscera |
smooth muscle in blood vessels supplying the abdominopelvic viscera |
pain from the abdominopelvic viscera |
sympathetic ganglia; also known as: preaortic ganglia which include: celiac, aorticorenal, superior & inferior mesenteric; brs. of the vagal trunks pass through but do not synapse in collateral ganglia |
| ganglia, preaortic (TG8-03) |
splanchnic nn. |
plexuses to abdominal and pelvic viscera |
vascular smooth muscle of vessels that supply abdominopelvic viscera |
pain from abdominopelvic viscera |
also known as: collateral ganglia which include the celiac ganglion, aorticorenal ganglion, superior mesenteric ganglion and inferior mesenteric ganglion; preganglionic parasympathetic axons of vagal trunk origin pass through the preaortic ganglia but do not synapse there |
| ganglia, sympathetic chain |
preganglionic sympathetic fibers arrive via white rami communicantes of ventral primary rami of spinal nerves T1-L2 |
postganglionic sympathetic fibers depart via gray rami communicantes to all spinal nn.; internal & external carotid nn.; cervical cardiac brs.; thoracic direct visceral brs.; greater, lesser & least thoracic splanchnic nn.; lumbar splanchnic nn.; sacral splanchnic nn. |
dilator pupillae, vascular smooth muscle, arrector pili muscles, sweat glands, suprarenal medulla, heart, lungs and gut |
pain from viscera |
located lateral to the vertebral bodies in the neck, thorax & abdominopelvic cavity; the ganglia plus their interconnecting fibers are also known as the sympathetic trunk; preganglionic cell bodies are located in the intermediolateral gray matter of spinal cord levels T1-L2 |
| greater thoracic splanchnic n. (N318, N320, N323, N344, TG8-16, TG5-39) |
neurons in the intermediolateral cell column of spinal cord levels T5-T9; the greater thoracic splanchnic nerve appears to arise by multiple contributions from the sympathetic trunk |
no named branches |
celiac ganglion; preganglionic fibers supply the adrenal medulla which releases epinephrine and norepinephrine into the blood |
pain from the abdominal viscera |
greater thoracic splanchnic n. passes through the crus of the respiratory diaphragm; postganglionic processes from the celiac ganglion spread down the aorta and distribute with its branches; they innervate the smooth muscle of these vessels and vascular smooth muscle in the organs supplied (Greek, splanchna = viscera) |
| hypogastric n. (TG6-19, TG6-19) |
superior hypogastric plexus |
inferior hypogastric plexus |
supplies vascular smooth muscle of the pelvic viscera |
pain from the pelvic viscera |
paired; hypogastric n. lies inferior to the common iliac vessels; it contains postganglionic sympathetic axons |
| hypogastric plexus, inferior (TG5-40, TG5-41) |
hypogastric nn. and sacral splanchnic nn. (postganglionic sympathetic axons); pelvic splanchnic nn. (preganglionic parasympathetic axons from the ventral primary rami of spinal nerves S2-S4) |
contributes branches to: uterine/vaginal plexus, vesical plexus, prostatic plexus |
sympathetic: supplies vascular smooth muscle of vessels supplying the pelvic viscera; parasympathetic: supplies smooth muscle of the pelvic viscera |
pain from the pelvic viscera; general visceral afferent from the pelvic viscera |
inferior hypogastric plexus lies between the pelvic viscera and the pelvic wall (Latin, plexus = a braid) |
| hypogastric plexus, superior (N318, TG5-40, TG5-41, TG5-39) |
intermesenteric plexus and lumbar splanchnic nn. (postganglionic sympathetic axons) |
hypogastric nn. (right and left) |
vascular smooth muscle of the pelvic viscera (sympathetic) |
pain from the pelvic viscera; general visceral afferent from the pelvic viscera |
superior hypogastric plexus is the continuation of the intermesenteric plexus; it crosses the pelvic brim (Latin, plexus = a braid) |
| intermesenteric plexus (N318, TG5-40, TG5-41, TG8-16, TG5-39) |
lumbar splanchnic nn. 1 and 2 |
renal, testicular (or ovarian) and ureteric brs. |
sympathetic: smooth muscle of vessels supplying the gut distal to the left colic flexure |
pain from the descending colon, sigmoid colon and rectum |
intermesenteric plexus is continuous with the superior mesenteric plexus; it continues inferiorly as the inferior mesenteric plexus and superior hypogastric plexus; intermesenteric plexus does not carry vagal parasympathetic fibers; located anterior to the abdominal aorta between the superior and inferior mesenteric aa. (Latin, plexus = a braid) |
| least thoracic splanchnic n. (N318, N320, N323, N344, TG8-16, TG5-39) |
neurons in the intermediolateral cell column of spinal cord level T12 |
no named branches |
renal plexus |
pain from the kidney and suprarenal gland |
least thoracic splanchnic n.pass through the crus of the diaphragm; it synapses in minute ganglia located in the renal plexus (Greek, splanchna = viscera) |
| lesser thoracic splanchnic n. (N318, N320, N323, N344, TG8-16, TG5-39) |
neurons in the intermediolateral cell column of spinal cord levels T10-T11; the lesser thoracic splanchnic nerve appears to arise by multiple contributions from the sympathetic trunk |
no named branches |
aorticorenal ganglion; |
pain from the kidney and suprarenal gland |
lesser thoracic splanchnic n. passes through the crus of the respiratory diaphragm; postganglionic processes from the ganglion supply vascular smooth muscle of branches of the renal a. and suprarenal aa.; kidney and suprarenal gland (Greek, splanchna = viscera) |
| lumbar splanchnic nn. (N318, TG5-40, TG5-41) |
lumbar sympathetic ganglia L1-L4 |
no named branches |
smooth muscle of vessels that supply the abdominal and pelvic viscera |
pain from abdominal and pelvic viscera |
sympathetic nerves; there are four of these on each side; lumbar splanchnic nn. contribute to preaortic abdominal plexuses (celiac, superior mesenteric, intermesenteric, superior hypogastric) (Greek, splanchna = viscera) |
| pelvic splanchnic n. (TG6-18A, TG6-18B, TG6-19A, TG6-19B) |
ventral primary rami of spinal nerves S2-S4 (cell bodies are located in the lateral horn gray of the sacral spinal cord) |
unnamed branches contribute to the pelvic plexus (inferior hypogastric) plexus |
smooth muscle and glands of the gut distal to the left colic flexure; smooth muscle and glands of all pelvic viscera |
none |
parasympathetic nerves; these contain preganglionic parasympathetic axons (Greek, splanchna = viscera) |
| vagus n. (TG5-40, TG5-41) |
medulla: dorsal motor nucleus (GVE preganglionic parasympathetic); inferior ganglion (GVA); nucleus ambiguus (SVE); superior ganglion (GSA); inferior ganglion(SVA) |
auricular br., pharyngeal br., superior laryngeal, superior and inferior cervical cardiac brs., recurrent laryngeal n., thoracic cardiac brs., brs. to the pulmonary plexus, brs. to the esophageal plexus, anterior and posterior vagal trunks |
SVE: intrinsic muscles of the larynx, pharynx (except stylopharyngeus), and palate (except tensor veli palatini); GVE: smooth muscle of the respiratory tree & gut (proximal to the left colic flexure), heart; secretomotor: mucous glands of the larynx, respiratory tree, pharynx and gut; secretomotor to digestive glands |
GSA: skin of the external auditory meatus; GVA: viscera of head, neck, thorax & abdomen proximal to the left colic flexure; SVA: taste from the epiglottis |
also known as: CN X, 10th cranial nerve; the vagus n. passes through the jugular foramen to exit the posterior cranial fossa; (Latin, vagus = wanderer due to its wide distribution to the body cavities) |
Lymphatics
|
| Structure |
Location |
Afferents from |
Efferents to |
Regions drained |
Notes |
| common iliac nodes (N266, N546, TG5-37) |
along the common iliac vessels; over the sacral promontory |
external iliac nodes, internal iliac nodes |
lumbar (lateral aortic) chain of nodes |
lower limb; pelvic organs, perineum, lower part of the anterior abdominal wall |
common iliac nodes are approximately 6 in number |
| external iliac nodes (N266, N546, TG5-37) |
along the external iliac vessels |
superficial inguinal nodes; deep inguinal nodes; inferior epigastric nodes |
common iliac nodes |
lower limb; external genitalia; lower part of the anterior abdominal wall |
external iliac nodes are 8 to 10 in number |
| internal iliac nodes (N266, N546, TG5-37) |
along the internal iliac vessels |
lymphatic vessels from the pelvic viscera |
common iliac nodes, external iliac nodes |
pelvis, perineum and gluteal region |
internal iliac nodes are 4 to 8 in number |
| lateral aortic nodes (N266, N546, TG5-37) |
along the inferior vena cava and abdominal aorta from the aortic bifurcation to the aortic hiatus of the diaphragm |
common iliac nodes; lymphatic vessels from the posterior abdominal wall and viscera |
efferents form one lumbar trunk on each side |
lower limb; pelvic organs; perineum; anterior and posterior abdominal wall; kidney; suprarenal gland; respiratory diaphragm |
also known as: lumbar nodes; the intestinal trunk drains into to the left lumbar trunk; the lumbar trunks unite to form the thoracic duct/cisterna chyli |
| lumbar nodes (N266, N546, TG5-37) |
|
|
|
|
also known as: lateral aortic nodes |
| lumbar trunk (N266, N546, TG5-37) |
between the lumbar vertebral bodies and inferior vena cava (right) or aorta (left) at the upper end of the lumbar chain of nodes |
lumbar (lateral aortic) nodes; the intestinal trunk joins the left lumbar trunk |
thoracic duct/cisterna chyli |
left lumbar trunk - left side of the body below the respiratory diaphragm, gut; right lumbar trunk - right side of body below the diaphragm |
lumbar trunks unite to form the lower end of the thoracic duct; an enlargement of the lower end of the thoracic duct (called the cisterna chyli) occurs in about 25% of individuals, and when it is present, the lumbar trunks drain into it |
Clinical Terms
|
| Term |
Definition |
| renal calculus (kidney stone) |
The presence of calculi in the kidney or collecting system. The calculi are usually small
(2-12mm) solid, crystalline, concretions that develop in the kidney and eventually pass
through the genitourinary tract. Stones may be calcium (75-80% of all stones), uric acid,
struvite, or cystine. |
| cystic kidney |
polycystic kidney disease (PKD) is a disorder that is characterized by the growth of numerous cysts in the kidneys. The cysts are filled with fluid. PKD cysts can replace much of the mass of the kidneys, thereby reducing kidney function and leading to kidney failure. When PKD causes kidneys to fail, which usually happens only after many years, the patient requires dialysis or kidney transplantation. About one-half of people with the primary form of PKD progress to kidney failure or end-stage renal disease (ESRD). PKD can cause cysts in the liver and problems in other organs, such as the heart and blood vessels in the brain. These complications help doctors distinguish PKD from the usually harmless "simple" cysts that often form in the kidneys in later years of life. (Greek, cystic/kystis = a bladder or pouch) |
| horseshoe/pelvic kidney |
A congenital abnormality in which the kidneys are united at the inferior poles (shaped like a horseshoe) and migrate up until stopped by the inferior mesenteric artery. |
| abdominal aortic aneurysm (AAA) |
A distended and weakened area in the wall of the abdominal aorta, more common in those who suffer from atherosclerosis. The aneurysm is usually located below the renal arteries and above the aortic bifurcation. Symptoms include sudden, severe abdominal pain with radiation to the back. (Greek, aneurysm = a dilation) |
| IVP (intravenous pyelogram) |
a diagnostic test that follows the time course of excretion of a radiopaque contrast dye through the kidneys, ureters, and bladder after injection into a cutaneous vein. |
| benign prostatic hypertrophy |
it is important to note that hypertrophy is the enlargement of existing cells whereas as
hyperplasia is an increase in the number of normal cells. A benign enlargement of the
prostate gland which begins normally after age 50, probably secondary to the
effects of male hormones. If significant enlargement occurs, it may pinch off the urethra
making urination difficult or impossible. The hyperplasia is typically periurethral. |
| trans-urethral prostatectomy (turp) |
the surgical removal of the prostate gland. Transurethral prostatectomy is performed through the urethral canal of the penis. |
| prostate cancer |
the second most common malignancy in men. A malignant tumor of glandular origin in
the prostate. Over 95% are adenocarcinomas. Most commonly seen in older men,
with the age of 73 being the average age at the time of diagnosis. A family history for
prostate cancer and perhaps a diet that is high in fat are considered to be risk factors
for this malignancy. Early detection is possible through annual digital rectal
examinations and routine PSA testing. The cancer is typically at the periphery of the
prostate (not periurethral like BPH). |
| urinary stress incontinence |
urinary incontinence is the unintentional loss of urine.; urinary stress incontinence happens
when the bladder can't handle the increased compression during exercise, coughing, or
sneezing; this form of incontinence usually occurs in women over 60 and in men who have
had prostate surgery and is the result of relaxation of the pelvic muscles and displacement
of the urethrovesicular junction
|
| iatrogenic injury to ureters |
the ureters may be injured during procedures near the uterine artery; they might be
mistakingly clamped or ligated during a hysterectomy |
| Kegel exercises |
contraction of the pelvic floor muslces (e.g. levator ani), done to strengthen the pelvic floor |
| cystoscopy |
direct visual examination of the urinary tract with a cystoscope |
| urethral catheterization |
the penis is held erect at right angles to the anterior abdominal wall; the lubricated catheter is passed through the narrow external urethral meatus. The penis is then lowered toward the thighs, and the catheter is gently pushed through the sphincter. Passage of the catheter through the prostatic urethra and bladder neck usually does not present any difficulty. |
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