S2M3 anatomy

• - iliolumbar
• - lateral sacral
• - superior gluteal

• - umbilical
• - superior vesicle
• - obturator
• - middle rectal
• - internal pudendal
• - inferior gluteal (passes b/t S2 and S3 nerves)
• - inferior vesicle
• - vaginal and uterine (women)
• "Um,So, I I I, U, v u"

obliterated umbilical artery

• - homolog of ductus deferens
• - descending vaginal brannch--> cervix and vagine
• - ascending branch--> uterus

**ligation during hysterectomy poses risk of damage to ureter (as it passes under 2 cm superior to ischial spine)**

• lumbar<---> iliolumbar
• median sacral<---> lateral sacral
• superior rectal(IMA)<---> middle rectal (aIIA)
• inferior gluteal<---> deep artery of thigh

• - fundus of uterus near the round ligament
• - most of the EXTERNAL genitalia
• - labia majora/ scrotum

• - glans penis/ clitoris
• - labia minora
• - distal half of the corpus spongiosum

• - ovary/ testes
• - uterine tubes
• - uterine fundus

• - uterine body
• - cervix
• - bladder

• - prostate
• - rectum (lower part)

- monstly sympathetics

**note- inferior hypogastric plexus is actually mixed**

- parasympathetic to pelivic viscera and descending and sigmmoid colon

• - L4-S4
• - lumbosacral
• - SGn
• - nerve to piriformis
• - IGn
• - nerve to quadratus femoris
• - nerve to obterator internus
• - pudendal
• - sciatic
• - obterator

- obterator nerve

• - sensory to genitalia
• - perineal muscles
• - external urethral and anal sphincters
• **possible damage during prostectomy==> ED**

• - Male- penis, scrotum and perineal area outside of perianal area
• - Female- vagina and perineal area outside of perianal area

• - S5- inner perianal
• - S4- outer perianal and area above perineal body

-S4-scratching perinanal skin can evoke an anal reflex (contraction of external anal sphincter)

• - ovarian ligament
• - round ligament

- space b/t perineal fascia and perineal membrane

- space b/t perineal membrane and inferior fascia of pelvic diaphragm

- space b/t inferior and superior fascia of pelvic diaphragm