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Blood Supply+The Innervation Part Included in the Article

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Blood Supply+The Innervation Part Included in the Article Urinary system Blood supply Venous drainage Nerve supply Lymphatic drainage Kidney Right, left renal arteries Right, left renal veins renal plexus derived from Lateral aortic lymph from abdominal aorta (L2 drain into IVC the celiac plexus, and lowest nodes level). splanchnic nerve (T12) Renal artery> 5 segmental (mainly vasomotor in > lobar > interlobar> function) (sympathetic) arcuate> interlobular> glomerular arterioles. Renal pain: renal plexus > lowest splanchnic nerve > T12 > subcostal nerve> flank and anterior abdominal wall. Ureter Abdominal part: renal sympathetic fibers from T11- Lateral aortic, common artery, abdominal aorta, L2 segments of spinal cord. iliac lymph nodes gonadal and common iliac Sensory fibers from the arteries. ureter enter the spinal cord Pelvic part: vesical, through the same segments. middle rectal and uterine arteries. Ureteric pain: sympathetic > T11-L2 > genitofemoral nerve (L1,L2) > groin, anterior aspect of the thigh, scrotum or labium majora Urinary M: superior vesical, Vesical venous plexus > Vesical nerve plexus from Internal and external bladder inferior vesical artery. vesical veins > internal inferior hypogastric plexus. iliac lymph nodes. F: superior vesical, vaginal iliac veins (through Sympathetic: L1,L2 Nick > directly to sacral artery. posterior ligaments) inhibitory to detrusor and stimulant lymph nodes to sphincter vesicae Parasympathetic: pelvic splanchnic nerves (S2-S4) motor to the detrusor muscle, inhibitory to sphincter vesicae Sensory: pelvic splanchnic and sympathetic fibers. Urethra Urethra receives its blood -Urethra receives its nerve M: prostatic and supply from those of supply from those of membranous parts > prostate and penis. prostate and penis. internal and external -Internal urethral sphincter> iliac LN, Autonomic fibers from the spongy part > deep and inferior hypogastric plexus. superficial inguinal LN -External urethral sphincter > Somatic from the perineal branch of pudendal nerve of the sacral plexus. Male genital Blood supply Venous drainage Nerve supply Lymphatic drainage system Scrotum -Internal pudendal artery -Anterior 1/3: ilioinguinal Superficial inguinal (from internal iliac) (L1), genital branch of LN -deep and superficial genitofemoral nerve. external pudendal arteries -Posterior 2/3: scrotal (from femoral artery) branches of Pudendal nerve, - cremastric artery from Posterior cutaneous nerve inferior epigastric artery of the thigh (S3) (from external iliac) Testis and Testicular artery from Pampiniform venous **Refer to the last page Lateral aortic LN epididymis abdominal aorta (L2 level) plexus > testicular vein > right drains into IVC, left into left renal vein. Varicocele: elongated and dilated veins of pampiniform plexus, more common on left side. Vas deferens Artery of vas (branch from Vesical venous plexus Prostatic nerve plexus from inferior vesical artery) inferior hypogastric plexus (Sympathetic) Seminal Inferior vesical artery & Vesical venous plexus Prostatic nerve plexus vesicles middle rectal artery Mainly sympathetic Bulbourethral Artery of bulb of penis Prostatic nerve plexus glands Prostate Inferior vesical artery, Prostatic venous plexus Prostatic nerve plexus from Internal and Middle rectal artery (Present only in front and sides) inferior hypogastric plexus external iliac LN Posterolaterally: to internal iliac vein which communicates with internal vertebral venous plexus through Batson venous plexus. Superiorly: communicate with vesical venous plexus. Penis 1. Dorsal artery of the penis 1.Deep dorsal vein of penis Sensory: dorsal nerve of Superficial inguinal supplies the skin, fascia, and > prostatic venous plexus penis (branch from LN. glans . pudendal nerve) lateral to Glans penis> 2. Deep artery of the penis dorsal artery of penis supplies the corpus cavernous 2.superficial dorsal vein of directly to gland of with convoluted helicine penis > superficial exteranl Autonomic Cloquet in the arteries. pudenedal vein (parasympathetic): femoral canal 3. Artery of the bulb cavernous nerves (from supplies the corpus inferior hypogastric plexus spongiosum and glans penis S2-S4) produce vasodilation and erection Female genital Blood supply Venous drainage Nerve supply Lymphatic drainage system Ovary Ovarian arteries from Pampiniform venous Autonomic nerves along Lateral aortic LN abdominal aorta (L2 plexus > ovarian vein > ovarian arteries, derived level). right drains into IVC, from celiac and aortic Through suspensory ligament> left into left renal vein nerve plexuses (sensory mesovarium > hilum at and vasomotor) anterior border Uterine tube Lateral 1/3: ovarian artery Same as blood supply Lateral 1/3: ovarian nerve Medial 2/3: uterine artery plexus Medial 2/3: uterine nerve plexus (Sympathetic and parasympathetic from inferior hypogastric plexus) Vagina Vaginal arteries & uterine Vaginal venous plexus > Above hymen: Autonomic Above hymen: external arteries. vaginal vein > internal fibers from the and internal iliac LN. Anastomose to form iliac vein uterovaginal plexus Below hymen: azygos arteries (2 median derived from the inferior superficial inguinal LN. longitudinal vessels which hypogastric plexus. descend anterior and Below hymen (lower inch): posterior to vagina). Pudendal nerve (somatic) Uterus Uterine artery Uterine venous plexus > uterovaginal nerve plexus Body: external iliac Crossed by ureter at lateral uterine vein > internal derived from the inferior Cervix: external& vaginal fornices (water under iliac vein. hypogastric plexus. internal iliac, sacral LN. the bridge) The plexus communicates Fundus: lateral aortic LN. with vaginal and ovarian Uterotubal junction: venous plexuses along the round ligament of the uterus to superficial inguinal LN. Summary of the “innervation” part of the article sent by Dr Ahmad Salman somatic supply to the testes and scrotum originates from the L1–L2 and S2–S4 nerve roots: ➢ iliohypogastric nerve > skin above the pubis ➢ ilioinguinal nerve > skin of the inner thigh, penile base, and upper scrotum ➢ femoral branch of genitofemoral nerve > small area of skin on the inside of the thigh ➢ genital branch of genitofemoral nerve > cremaster muscle, tunica vaginalis scrotum anterolateral surface > genital branch of genitofemoral nerve anterior surface > ilioinguinal nerve (anterior scrotal nerves) posterior surface > perineal branch of pudendal nerve (posterior scrotal nerves) inferior surface > posterior femoral cutaneous nerve **The testes are embryologically derived from the same level as the kidneys. Therefore, they share a common level of autonomic innervation: sympathetic (90%): T10-L1, parasympathetic: S2-S4 Three groups of autonomic nerves travel with the gonadal vessels and vas deferens to the epididymis and testis: 1) superior spermatic nerves: from renal and intermesenteric plexuses follow the testicular artery to testis association between the intestinal (intermesenteric) and testicular nerves may explain the “kick in the stomach” feeling accompanying testicular injury. 2) Middle spermatic nerves: from superior hypogastric plexus pass to the mid-ureter and travel alongside the vas deferens to the internal ring, where they join the spermatic cord. ureteral proximity may explain pain radiation to the scrotum of an obstructing ureteral stone. 3) Inferior spermatic nerves: from inferior hypogastric plexus (pelvic plexus) join the middle spermatic nerves at the prostate-vesical junction Some afferent and efferent fibers decussate to the contralateral pelvic plexus, which may explain how lesions in one testis affect the function of the other testis. Done by: Leen Hajeer .
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