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ARTERIAL SUPPLY OF ABDOMEN & PELVIS

Anterolateral

Cutaneous Arteries ( Deep & superficial ):

 

Abdominal

1.Musculophrenic Artery:

Wall

Origin:

 

Internal thoracic artery Distribution:

(a)

Superficial & deep abdominal wall of hypochondriac region.

(b)

Anterolateral diaphragm.

2.Superior epigastric artery:

Origin:

 

Internal thoracic artery

Distribution:

 

(a)

Rectus abdominis muscle

(b)

Superficial & deep abdominal wall of epigastric & upper

umbilical regions.

 

3.10

th

& 11

th

posterior intercostals arteries:

Origin:

 

Aorta

Distribution:

 

(a).Superficial & Deep abdominal wall of lateral region.

4.Subcostal Artery:

Origin:

 

Aorta

Distribution:

 

(a).Superficial & deep abdominal wall of lateral region.

5.Inferior epigastric artery:

Origin:

 

External Iliac artery

 

Distribution:

 

(a).Rectus Abdominis muscle (b).Deep abdominal wall of pubic & inferior umbilical regions.

6.Deep circumflex iliac artery:

Origin:

 

External Iliac artery Distribution:

 

(a).Iliacus muscle (b).Deep abdominal wall of inguinal region (c).Iliac fossa

 

Shared by: Ussama maqbool(N61)

 

7.Superficial circumflex iliac artery:

 

Origin:

Femoral artery Distribution:

(a).Superficial abdominal wall of inguinal region & adjacent anterior thigh

8.Superficial epigastric artery:

Origin:

Femoral artery Distribution:

(a).Superficial abdominal wall of pubic & inferior umbilical regions.

Penis

(1).Internal pudendal artery gives off 3 branches which supply the penis:

(i) Deep artery of penis

(ii) Dorsal artery of Penis

(iii) Artery of the bulb of penis.

(2).Femoral artery gives off the superficial external pudendal artery which

supplies the skin & fasciae of penis.

Scrotum

1. Posterior scrotal branches of the perineal artery, a branch of internal

 

pudendal artery

2. Anterior scrotal branches of deep external pudendal artery, a branch of

 

femoral artery

3. Cremestaric artery ,a branch of inferior epigastric artery

Testis

Testicular artery ( branch of abdominal aorta)

Epididymis

Testicular artery

Esophagus

1. Left gastric artery (branch of celiac trunk)

2. Left inferior phrenic artery

Stomach

Along lesser curvature by :

1. Left gastric artery(br. of celiac trunk)

2. Right gastric artery ( br. of proper hepatic artery)

Along greater curvature by:

1. Right gastro-omental artery(right gastroepiploic artery), branch of

 

gastroduodenal artery.

2. Left gastro-omental artery(left gastroepiploic artery), branch of splenic

 

artery.

Fundus:

-

5-7 short gastric arteries (branches of splenic artery)

Duodenum

Upto the opening of bile duct:

-

Superior pancreaticoduodenal artery ( br.of gastroduodenal artery)

Below the opening of bile duct:

-

Inferior pancreaticoduodenal artery (br.of superior mesenteric artery).

 

Shared by: Ussama maqbool(N61)

Jejunum &

Superior mesenteric artery (Lowest part of ileum is also supplied by Ileocolic artery)

 

Ileum

Cecum

Anterior & posterior rectal arteries from the ileocolic artery ( Branch of superior mesenteric artery)

Appendix

Appendicular artery , branch of ileocolic artery

Ascending

1.

Ileocolic artery

colon

2.

Right colic branches of superior mesenteric arteries

Transverse

Middle colic artery (branch of superior mesenteric artery)

colon

Descending

1. Left colic artery ( br.of inferior mesenteric artery)

colon &

2. Sigmoid arteries (br.of Inferior mesenteric artery)

sigmoid

colon

Spleen

Splenic artery

Pancreas

1. Pancreatic branches of splenic artery

2. Superior pancreaticoduodenal artery

3. Inferior pancreaticoduodenal artery

Liver

Liver receives blood

1. 20-25% through hepatic artery

2. 75-80% through portal vein

Bile duct

1. Cystic artery

2. Right phrenic artery

3. Posterior superior pancreaticoduodenal artery

4. Gastroduodenal artery

Gall bladder & cystic duct

Cystic artery ( arise from right phrenic artery)

Kidneys

Renal artery divides to form various segmental arteries:

1. Superior segmental artery to Superior segment

2. Anterosuperior segmental artery to Anterosuperior segment

3. Anteroinferior segmental artery to antero inferior segment

4. Inferior segmental artery to inferior segment

5. Posterior segmental artery to posterior segment of the kidney

Ureters

1. Upper part Renal artery

2. Middle part- (i) Testicular/ovarian arteries

 

(ii) Abdominal aorta (iii) Common iliac arteries

3. Lower part-

(i) Vesical artery (ii) Middle rectal artery (iii) Uterine vessels

Suprarenal

1. Superior suprarenal arteries (6-8) from inferior phrenic arteries

Gland

2. Middle suprarenal arteries (≤1) from abdominal aorta

3. Inferior suprarenal arteries (≤1 from Renal artery)

Urinary

1. Superior & Inferior vesical arteries (branches of anterior trunk of internal iliac artery)

bladder

 

Shared by: Ussama maqbool(N61)

   

In females from uterine & vaginal arteries instead of inferior vesical.

 
 

2. Obturator & Inferior Gluteal arteries ( additional supply to bladder)

Male urethra

 

1. Urethral artery arises from internal pudendal artery

2. Dorsal penile artery via circumflex branches on each side

Female

 

1. Superior vesical arteries

urethra

2. Vaginal arteries

Rectum

 

1. Superior rectal artery continuation of inferior mesenteric artery

2. Middle rectal arteries arise from anterior division of internal iliac artery

3. Median sacral artery small branch arising from back of aorta

Anal canal

Above pectinate line superior rectal artery

Below pectinate line Inferior rectal artery

Ovaries &

 

1. Ovarian arteries (arise from abdominal aorta)

Uterine

2. Tubal branches of uterine arteries ( Branch of internal iliac arteries)

tubes

 

Uterus

 

1. Uterine arteries

2. Ovarian arteries

Vagina

 

1. Vagina branch of internal iliac artery

2. In addition

- The upper part is supplied by cevicovaginal branch of uterine artery.

- Lower part by middle rectal & internal pudendal arteries.

Branches of these arteries anastomose to form anterior & posterior midline

vessels called the vaginal azygos arteries.

Ductus

Artery to ductus deferens ( arises from one of the terminal branches of

deferens

superior vesical artery but occasionally arises from inferior vesical artery)

Prostate

Supplied by branches from

gland

 

1. Inferior vesical

2. Middle rectal

3. Internal pudendal arteries

- These arteries form a large outer or subcapsular plexus, and a small

 

inner or periurethral plexus. Greater part of gland is supplied by

subcapsular plexus.

 

Reference: K.L.M & B.D chaurasia

VENOUS DRAINAGE OF ABDOMEN & PELVIS

Anterolateral

1.

Venous drainage passes above mainly into axillary veinvia lateral thoracic vein.

 

abdominal wall

2.

Venous drainage passes below mainly into femoral veinvia superficial epigastric & great saphenous vein.

Penis

1.

Superficial dorsal vein:

- Drain prepuce & penile skin

- Open into external pudendal vein

2.

Deep dorsal vein:

 

Shared by: Ussama maqbool(N61)

 

- Drains glans penis & corpora cavernosa penis

 

- Divide into left & right branches which connect with internal pudendal vein & enters the prostatic plexus.

Scrotum

Scrotal veins accompany the arteries

Testis

Veins emerging from the testis & Epididymis form Pampiniform venous plexus, a network of 8-12 veins lying anterior to the ductus deferens & surrounding the testicular artery in the spermatic cord. The veins of each pampiniform plexus converge superiorly forming right testicular vein which enters inferior vena cava& a left testicular vein which enters the left renal vein.

Epididymis

Same as testis.

Esophagus

The venous drainage from the submucosal veins of this part of esophagus is both to

- Portal venous system through left gastric vein

- Systemic venous system through esophageal veins entering the

azygous vein

Stomach

Veins of stomach parallel the arteries in position & course

- Right & left gastric veins drain into hepatic portal vein

- Short gastric veins & left gastroepiploic (gastro-omental) veins

drain into splenic vein which joins superior mesenteric vein (SMV)

to form hepatic portal vein

- Right gastroepiploic (gastro-omental) vein empties into SMV.

- Prepyloric vein ascends over the pylorus to the right gastric vein.

Duodenum

1. Superior pancreaticoduodenal vein drains into portal vein

2. Inferior pancreaticoduodenal vein joins the SMV

Jejunum &

Superior mesenteric vein (SMV)

Ileum

Cecum

Venous drainage from cecum flow through a tributary of SMV, the ileocolic

vein.

Appendix

SMV (same as cecum)

Ascending

SMV

colon

Transverse

SMV

colon

Descending &

From inferior mesenteric veinSplenic vein hepatic portal vein.

sigmoid colon

Spleen

Splenic vein

Pancreas

1. Splenic vein

2. Superior mesenteric vein (SMV)

3. Portal vein

Liver

Hepatic sinusoids drain into interlobular veinswhich join to form sublobular veinswhich join to form hepatic veinswhich drain into inferior vena cava (IVC)

Bile duct

From posterior superior pancreaticoduodenal vein to hepatic portal vein.

Gall bladder & cystic duct

From cystic veins to hepatic portal vein

Kidneys

Right & Left renal veins

 

Shared by: Ussama maqbool(N61)

 

Interlobular veins arcuate veins interlobar veins renal vein IVC

 

Ureters

 

1. Renal veins

2. Gonadal (testicular/ovarian) veins.

Suprarenal

Suprarenal veins

glands

 

1. Right suprarenal veinIVC

2. Left suprarenal veinjoins inferior phrenic vein drains into Left renal vein.

Urinary

Vesical venous plexus which drains into Internal iliac veins

bladder

Male urethra

Anterior urethra:

Dorsal vein of penisinternal pudendal vein prostatic venous plexus. Posterior urethra:

Prostatic & vesical venous plexusinternal iliac veins.

Female urethra

Venous plexus around urethra vesical venous plexus internal pudendal

vein

Rectum

 

1. Superior rectal vein tributeries of this vein arise from internal rectal

venous plexus.

2. Middle rectal vein open into internal iliac veins.

3. Median sacral vein joins left common iliac vein

Anal canal

 

1. Internal rectal venous plexus

2. External rectal venous plexus

3. Anal veins

Ovaries

Veins drainig the ovary form a vine like pampiniform plexus of veins. The

plexus condenses into a single ovarian vein near pelvic inlet.

Right ovarian vein drains into inferior vena cava

Left ovarian vein drains into left renal vein.

Uterine tubes

Tubal veins : drain into pampiniform venous plexus & uterine venous plexus.

Uterus

The veins form a plexus. Plexus drains through Uterine , ovarian & vaginal

veins into internal iliac veins.

Vagina

Vaginal venous plexus drains into internal iliac veins.

Ductus

Vesical venous plexus which opens into internal iliac veins.

deferens

Prostate gland

Veins form a rich plexus which communicates with vesical plexus & with

internal pudendal vein & drains into vesical & internal iliac veins.

 

Reference: K.L.M & B.D chaurasia

NERVE SUPPLY OF ABDOMEN & PELVIS

Anterolateral

Skin & muscles of anterolateral abdominal wall are supplied by:

 

abdominal

Thoracoabdominal (T7-T11):

wall

 

-

Continuation of lower (7 th 11 th ) intercostal nerves.

Supply: Muscles of anterolateral abdominal wall & overlying skin. Lateral cutaneous (thoracic) cutaneous branches ( 7 th 9 th ):

-

 

-

Supply : Skin of right & left hypochondriac regions.

Subcostal (anterior ramus of T12):

 

-

Supply: Muscles of anterolateral abdominal wall & overlying skin,

 

Shared by: Ussama maqbool(N61)

 

superior to iliac crest & inferior to umbilicus. Iliohypogastric & Ilioinguinal nerves:

 

( terminal branches of anterior ramus of spinal nerve L1)

 

- Ilihypogastric:Supply: Skin overlying iliac crest , upper inguinal & hypogastric regions, internal oblique & transverses abdominis muscles.

- Ilioinguinal : Supply: Skin of lower inguinal region , mons pubis, anterior scrotum or labium majus& adjacent medial thigh, inferior most internal oblique & transverses abdominis.

Muscles of

 

1. External oblique: Thoracoabdominal& subcostal nerve.

Anterolateral

2. Internal oblique: Thoracoabdominal& first lumbar nerve

abdominal

3. Tranversusabdominis: Thoracoabdominal& first lumbar nerve.

wall

4. Rectus abdominis:Thoracoabdominal nerves.

Penis

Sensory nerve supply : sensory nerve supply is derived from

 

1. Dorsal nerve of penis

2. Ilioinguinal nerve

Autonomic : Autonomic nerves are derived from Pelvic plexusvia prostatic

plexus.

 
 

- Sympathetic nerves are vasodilator

- Parasympathetic nerves (S2,S3,S4) are vasodilator.

Autonomic fibers are distributed through pudendal nerve.

Muscles of Penis: supplied by perineal branch of pudendal nerve.

Scrotum

The nerves of scrotum include

Branches of lumbar plexus to anterolateral surface.

Branches of sacral plexus to posterior & inferior surfaces.

 

1. Anterolateral surface: Genital branch of genitofemoral nerve (L1 & L2).

2. Anterior surface: Anterior scrotal nerves (branches of ilioinguinal nerve

 

L1)

 

3. Posterior surface: Posterior scrotal nerves (branches of perineal branch

 

of pudendal nerve S2,S3,S4)

 

4. Posteroinferior surface: Perineal branches of posterior cutaneous nerve

 

of thigh S2,S3.

Dartos muscle: Genital branch of genitofemoral nerve.

Testis

The autonomic nerves of testis arise as testicular plexus of nerves& contain:

 

1. Vagal parasympathetic & visceral afferent fibers.

2. Sympathetic fibers from T7 segment of spinal cord.

Epididymis

Testicular plexus of nerves

Esophagus

Esophagus is innervated by the esophageal plexus formed by:

 

1. Vagal trunks

2. Thoracic sympathetic trunks via greater splanchnic nerves &peri-arterial plexus around left gastric & inferior phrenic arteries.

Stomach

Sympathetic nerve supply : From T6-T9 segments of spinal cord passes to celiac plexus through greater splanchnic nerve & is distributed through the plexus around gastric & gastro-omental arteries. Parasympathetic nerve supply: From

 

-

Anterior vagal trunk (derived mainly from left vagus nerve):

 

Gives off: Hepatic, duodenal & anterior gastric branches.

 

Shared by: Ussama maqbool(N61)

   

-

Posterior vagal trunk ( derived mainly from right vagus nerve):

 
 

Gives off: a celiac branch , posterior gastric branches & branches to anterior & posterior surfaces of stomach.

Duodenum

Sympathetic nerve supply:T9 & T10 segments of spinal cord. Parasympathetic nerve supply: Derived from vagus & greater and lesser splanchnic nerves by the way of celiac & superior mesenteric plexuses & reach the duodenum along its arteries.

Jejunum &

(Reference from BD Chaurasia) Nerve supply is derived from sympathetic & parasympathetic nerves

Ileum

 

- Sympathetic: T9-T11

- Parasympathetic: from vagus nerve (Reference from Keith.L.Moore)

- The sympathetic fibers originate in the T8-T10 segments of spinal cord

 

& reach the superior mesenteric nerve plexus through sympathetic

trunks & thoracic abdominopelvic (greater,lesser& least) splanchnic

nerves.

 

- The parasympathetic fibers derived from posterior vagal trunks.

Cecum

Sympathetic: originate in lower thoracic part of spinal cord.

Parasympathetic: derive from vagus nerve.

Branches from sympathetic & parasympathetic nerves form the superior

mesenteric plexus.

Appendix

Same as cecum

Ascending

Sympathetic & parasympathetic (vagus) nerves from superior mesenteric

colon

plexus.

 

Transverse

Superior mesenteric nerve plexus via peri-arterial plexuses of right & left colic

colon

arteries.

 

These nerves transmit sympathetic, parasympathetic (vagal) & visceral afferent

nerve fibers.

 

Descending

Sympathetic: From lumbar part of sympathetic trunk via :

&

sigmoid

 

- Lumbar splanchnic nerves

colon

- Superior mesenteric plexus

- Peri-arterial plexus

Parasympathetic: From pelvic splanchnic nerves via:

 

-

Inferior hypogastric plexus & nerves.

Pancreas

Sympathetic: Splanchnic nerves through the plexus.

Parasympathetic: Vagus

Liver

Nerves of liver derived from Hepatic plexus ( derivative of celiac plexus) Which consists of

 

- Sympathetic fibers from celiac plexus

- Parasympathetic fibers from anterior & posterior vagal trunks.

Gall bladder

Nerves to gall bladder &custic duct from:

&

Cystic duct

 

1. Celiac plexus sympathetic & visceral afferent fibers.

 

2. Vagus nerve parasympathetic fibers

3. Right phrenic nerve Somatic afferent fibers.

Kidneys

Renal nerve plexus which consists of

 

-

Sympathetic T10-L1& parasympathetic fibers.

 

Shared by: Ussama maqbool(N61)

Ureters 1. Renal plexus 2. Abdominal aortic plexus 3. Superior hypogastric plexus Suprarenal 1. Celiac
Ureters
1. Renal plexus
2. Abdominal aortic plexus
3. Superior hypogastric plexus
Suprarenal
1. Celiac plexus
glands
2. Abdominopelvic (greater, lesser & least splanchnic nerves)
Diaphragm
Motor nerve supply: Phrenic nerves (ventral rami C3,C4,C5)
Sensory nerve supply:
- Central part: Phrenic nerve
- Peripheral part: lower 6 thoracic nerves
Muscles of
posterior
abdominal
Psoas major : Anterior rami of lumbar nerves L1, L2, L3.
Iliacus: Femoral nerve (L2-L4)
Quadratuslumborum: Anterior branches of T12 & L1-L4 nerves.
wall
Urinary
Urinary bladder is supplied by vesical plexus of nerves which is made up of
bladder
nerves derived from inferior hypogastric plexus. Vesical plexus contains both
sympathetic & parasympathetic components, each of which contains
motor(efferent) & sensory(afferent) fibers.
- Parasympathetic efferent fibers S3,S3,S4
- Sympathetic efferent fibers T11-L2.
- Somatic: pudendal nerve (S2,S3,S4)
- Sensory nerves
[For detail see page#378 BD Chaurasia]
Male urethra
Nerves are derived from prostatic plexus ( one of the pelvic plexus)
Parasympathetic nerves are from 2
nd
to 4
th
sacral segments.
Female
Vesical plexus & pudendal nerve.
urethra
Explanation:
- Parasympathetic preganglionic fibers from 2
nd
to 4
th
sacral segments of
spinal cord. Synapse in vesical venous plexus. Post-ganglionic fibers
reach smooth muscles.
- Somatic fibers from S2-S4. Do not synapse in vesical venous plexus.
- Sensory fibers in pelvic splanchnic nerves reach to 2
nd
to 4
th
sacral
segments of spinal cord.
- Postganglionic sympathetic fibers arise from plexus around vagina
arteries.
Rectum
Nerve supply to rectum is derived from sympathetic & parasympathetic
systems.
- Sympathetic: from lumbar spinal cord (L1-L2) conveyed via:
Lumbar splanchnic nerve
Hypogastric/pelvic plexus
Peri-arterial plexus (of inferior mesenteric & superior rectal arteries)
- Parasympathetic: from S2-S4 passing via
Pelvic splanchnic nerves
Left & right inferior hypogastric plexus to the rectal (pelvic) plexus.
Anal canal
Above pectinate line:
Shared by: Ussama maqbool(N61)
   

- Sympathetic: Inferior hypogastric plexus

 

- Parasympathetic: Pelvic splanchnic nerve S2,S3.

Below pectinate line:

Somatic: inferior rectal nerve (S2,S3,S4) branch of pudendal nerve External anal sphincter:

-

-

Inferior rectal nerve

-

Perineal branch of 4 th sacral nerve

Ovaries &

 

1.

Ovarian plexus : Derived from renal, aortic & hypogastric plexus. Contains both sympathetic & parasympathetic nerve fibers.

uterine tubes

-

Sympathetic: T10-T11 are afferent for pain as well as efferent or vasomotor.

-

Parasympathetic: S2,S3,S4 are vasodilator.

2.

Uterine plexus

Uterus

 

Sympathetic & parasympathetic nerves through Inferior hypogastric & ovarian

plexus.

- Sympathetic nerves are from T12 & L1.

- Parasympathetic nerves are S2,S3,S4.

Vagina

 

Lower 1/3

rd

:

Supplied by pudendal nerve through inferior rectal & posterior

labial branches of perineal nerve.

Upper 2/3

rd

:

Supplied by

- Sympathetic L1,L2

- Parasympathetic S2,S3,S4.

Nerves are derived from inferior hypogastric &uterovaginal plexus.

Prostate

 

Prostate is supplied by Prostatic plexus of nerves which is derives from lower

Gland

part of inferior hypogastric plexus.

 

Reference: K.L.M & B.D chaurasia

LYMPHATIC DRAINAGE OF ABDOMEN &

 

PELVIS

Anterolateral

Lymphatic drainage of anterolateral abdominal wall follows the following

 

abdominal

pattern.

wall

Superficial Lymphatic vessels:

- Superior to transumbilical plane: Drains into axillary lymph nodes,

however a few drain into parasternal lymph nodes

- Inferior to transumbilical plane: Drain into superficial inguinal lymph

nodes. Deep Lymphatic vessels:

- Drain into external iliac Common iliac Right & left lumbar (caval& aortic) lymph nodes.

Penis

1. Deep Inguinal lymph nodes glans penis

2. Superficial inguinal lymph nodes rest of penis

Testis

1. Right & left lumbar (caval/aortic) lymph nodes

&Epididymus

2. Preaortic lymph nodes

Scrotum

- Superficial inguinal lymph nodes

Esophagus

Left gastric lymph nodes ( Efferent lymphatic vessels from these nodes drain

 

Shared by: Ussama maqbool(N61)

 

mainly to celiac lymph nodes)

 

Stomach

Stomach can be divided into 4 lymphatic territories:

(a)

Upper part of left 1/3 rd pancreaticosplenic nodes

(b)

Right 2/3 rd left gastric nodes

(c)

Lower part of left 1/3 rd Right gastroepiploic nodes

(d)

Pyloric part pyloric lymph nodes

Duodenum

1.

Anterior lymphatic vessels : Drain upward into pancreaticoduodenal lymph nodes & into pyloric lymph nodes

2.

Posterior lymphatic vessels: Drain downward via pancreaticoduodenal

nodes to the superior mesenteric lymph nodes Efferent lymphatic vessels of all above lymph nodes drain into celiac lymph nodes.

Jejunum

Lymph passes through 3 groups of lymph nodes:

&Ileum

1. Juxta-intestinal lymph nodes

2. Mesenteric lymph nodes

3. Superior central lymph nodes

Efferent lymphatic vessels from the mesenteric lymph nodes drain into

superior mesenteric lymph nodes.

Cecum

Lymph passes from several mesenteric lymph nodes to ileocolic lymph nodes ,

then to superior mesenteric lymph nodes.

Appendix

Same as cecum in addition to appendicular nodes

Ascending

Lymph passes from :

colon

Epicolic&paracolicIleocolic& intermediate right colic nodessuperior

mesenteric lymph nodes.

Transverse

Middle colic lymph nodesSuperior mesenteric lymph nodes

colon

Descending &

1. Intermediate colic lymph nodes

sigmoid colon

2. Inferior mesenteric lymph nodes

Lymph from left colic flexure may also drain to superior mesenteric lymph

nodes.

Spleen

Pancreaticosplenic lymph nodesceliac lymph nodes

Pancreas

1. Pancreaticosplenic lymph nodes

2. Celiac lymph nodes

3. Superior mesenteric lymph nodes

Liver

1. Superficial lymphatics caval , hepatic, paracardial& celiac lymph

 

nodes.

2. Deep lymphatics inferior vena cava & hepatic lymph nodes.

Bile duct

1. Cystic nodes celiac lymph nodes

2. Lymph node of omental foramen celiac lymph nodes

3. Hepatic lymph nodes celiac lymph nodes

Gall bladder & cystic duct

1. Hepatic lymph nodes celiac lymph nodes

2. Cystic lymph nodes celiac lymph nodes

Kidneys

Right & left lumbar ( caval& aortic ) lymph nodes

Ureters

1. Superior part Lumbar lymph nodes

2. Middle part common iliac lymph nodes

3. Inferior part common, external or internal iliac lymph nodes.

Suprarenal

Lateral aortic ( lumbar) lymph nodes

glands

 

Shared by: Ussama maqbool(N61)

Urinary

1. External iliac nodes

   

bladder

2. Internal iliac/lateral aortic nodes

Male urethra

1. Prostatic urethra internal iliac lymph nodes

2. Membranous urethra internal iliac lymph nodes

3. Anterior urethra deep inguinal lymph nodes.

Female

1. Internal iliac lymph nodes

 

urethra

2. External iliac lymph nodes

Rectum

1. Upper half of rectum : Inferior mesenteric nodes after passing through pararectal & sigmoid nodes

2. Lower half of rectum: Internal iliac nodes

 

Anal canal

1. Above pectinate line: Internal iliac lymph nodes common iliac & lumbar lymph nodes

2. Below pectinate line : Superficial inguinal lymph nodes.

Ovaries &

Lateral aortic &preaortic lymph nodes.

 

uterine tubes

 

Uterus

3 lymphatic territories:

 

1. Upper lymphatics: Drain into aortic & superficial inguinal lymph nodes.

2. Middle lymphatics: Drain into external iliac lymph nodes.

3. Lower lymphatics: External iliac, internal iliac & sacral nodes.

Vagina

Upper 1/3

rd

: External iliac nodes

Middle 1/3

rd

: Internal iliac nodes

Lower 1/3

rd

: Medial group of superficial inguinal lymph nodes.

Prostate gland

1. Internal iliac lymph nodes.

 

2. External iliac lymph nodes.

3. Sacral lymph nodes.

 

Reference: K.L.M & B.D chaurasia

Shared by: Ussama maqbool(N61)