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86 Cards in this Set
- Front
- Back
Which five bones make upt the pelvis?
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Ileum, Ischium, Pubis, Sacrum, and Coccyx
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The most superior point of the iliac crest as palpated posteriorly is located at which vertebral level?
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L4
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What are the four major articulations of the pelvis?
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1. The lumbrosacral joint 2. The sacroiliac joints 3. The sacrococcygeal joints 4. The symphysis pubis
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Which of the articulations of the pelvis are cartilaginous joints?
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The symphysis pubis, the sacrococcygeal joint, and the lumbrosacral joint
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Which three ligaments support the sacroiliac joint?
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1. The anterior sacroiliac ligament 2. The posterior sacroiliac ligament 3. The interosseus ligaments
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List five ways the pelvis differs between women and men
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1. In women, the bones of the pelvis are smaller, lighter, and thinner 2. In women, the sacrum is broader and shorter 3. In women, the suprpubic arch and the greater sciatic notch are wider 4. In women, the pelvic inlet is ovoid, while in men it is heart-shaped 5. In women, the ischial tuberosities are everted, thereby enlarging the pelvic outlet
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Which muscles comprise the urogenital diaphragm?
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1. The deep transverse perineal muscles, running transversely anteriorly and posteriorly 2. The sphincter urethrae muscle (and the sphincter vaginae muscle in women)
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The superior fascia of the urogenital diaphragm is continuous with which fascial layer?
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The obturator internus (pelvic parietal) fascia
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What is the origin of the obturator internus muscle?
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The pelvic surface of the obturator internus fascia and the surrounding parts of the ilium and pubis
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What is the insertion of the obturator internus muscle?
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The greater trochanter of the femur
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What is the innervation of the obturator internus muscle?
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The obturator nerve (from the sacral plexus)
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What is the action of the obturator internus muscle?
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Lateral rotation of the thigh when the hip joint is extended
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What structure covers the obturator internus muscle?
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The obturator internus fascia
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What structure is formed by the obturator internus (pelvic parietal) fascia?
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The pudendal canal, which transmits the pudendal nerve, artery, and vein
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What is the anorectal angle?
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The angle between the rectum and the anal canal; contraction of the puborectalis muscle holds the anorectal junction anteriorly, preventing the passage of feces from the rectum into the anal canal
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What is the origin of the coccygeus muscle?
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The lateral pelvic surface of the ischial spine and the sacrospinous ligament
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What is the insertion of the coccygeus muscle?
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The medial and lateral margin of the coccyx and vertebra S5
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What is the innervation of the coccygeus muscle?
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Branches of the spinal nerves S4 and S5
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What is the action of the coccygeus muscle?
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Assists the levator ani muscle group in supporting the pelvic viscera; supports and pulls the coccyx anteriorly
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The pelvic fascia is consistent with which fascial layer of the abdominal wall?
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The transversalis fascia
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The common iliac artery divides into the external and the internal iliac arteries at which vertebral level?
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L5-S1
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What is the first branch of the internal iliac artery?
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The iliolumbar artery
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How does the internal iliac artery terminate?
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By dividing into the anterior and posterior branches
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What are the three branches from the posterior internal iliac artery?
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1. Iliolumbar artery 2. Lateral sacral artery 3. Superior gluteal artery
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How does the superior gluteal artery leave the pelvis?
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Through the superior part of the greater sciatic foramen (i.e. the part above the piriformis muscle)
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What are the eight branches from the anterior internal iliac artery?
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1. Umbilical artery 2. Superior vesical arteries 3. Uterine artery 4. Vaginal artery (women) or inferior vesical artery (men) 5. Middle rectal artery 6. Obturator artery 7. Internal pudendal artery 8. Inferior gluteal artery
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How does the obturator artery leave the pelvis?
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Through the obturator foramen
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How does the inferior gluteal artery leave the pelvis?
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Through the inferior part of the greater sciatic foramen
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What are the two terminal branches of the internal pudendal artery?
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The deep and dorsal arteries of the penis (men) or the clitor (women)
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Where do the ovarian arteris arise?
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Anteriorly from the abdominal aorta, just inferior to the renal arteries
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Where do the testicular arteris arise?
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Anteriorly from the abdominal aorta, just inferior to the renal arteries
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What is the drainage of the pelvic lymph nodes (i.e. the external iliac and internal iliac nodes)?
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The common iliac nodes
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Which two major nerves are dericed from the sacral plexus?
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The sciatic nerve and the pudendal nerve
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The pudendal nerve follows the course of which artery?
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The internal pudendal artery
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What are the two distal branches of the pudendal nerve?
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1. The perineal branches 2. The dorsl nerve of the penis or clitoris
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The pudendal nerve carries which sensory fibers?
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Those that supply the external genitalia and perianal region
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The pudendal nerve carries which motor fibers?
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Those that supply the external anal sphincter and muscle associated with ejaculation
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Which branch of the pudendal nerve supplies the external anal sphincter?
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The inferior rectal nerve
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Which nerves contribute to the inferior hypogastric plexus?
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1. Parasympathetics, via the pelvic splanchinic nerves (derived from spinal segments S2-S4) 2. Sympathetics from the superior hypogastric plexus and pelvic sympathetic trunk
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Afferent fibers sensing bladder fullness are carried by which nerves?
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The pelvic splanchnic nerves
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Visceral efferents to the detrusor muscle and internal sphincter of the bladder are carried by which nerves?
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Parasympathetics
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Which nerves supply motor innercation to the smooth muscle of the prostate, the seminal vesicle, the ejaculatory ducts, and the ductus deferns?
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Sympathetics
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Which autonomic nerves coordinate erection?
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Parasympathetics
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Which autonomic nerves coordinate ejaculation?
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Sympathetics
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How does the ductus deferens travel relative to the ureter
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The ductus deferens travels anterior to the ureter (as the ureter enters the bladder) to join with the duct of the seminal vesicle
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Where do the ejaculatory ducts open into the urethra?
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At the sminal colliculus, lateral and inferior to the porstatic utricle (a remant of the mullerian duct)
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Where do the bulbourethral glands (of Cowper) open into the urethra?
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At the spongy urethra
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Where do the prostatic ducts open into the urethra?
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At the prostatic sinuses (grooves alongside the urethral crest)
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What is the normal position of the uterus?
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Anteflexed and anteverted
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What is the vesicouterine pouch?
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The intraperitoneal space between the bladder and the uterus
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What is the Pouch of Douglas (rectouterine pouch)?
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The intraperitoneal space between the uterus and the rectum
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What are the five parts of the fallopian tube?
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1. Infundibulum 2. Ampulla 3. Isthmus 4. Intramural region 5. Fimbriae
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Which ligament runs antero-inferiorly from the uterus within the broad ligament?
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The round ligament of the uterus
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Where do the ends of the round ligament of the uterus attach?
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One end attaches to the anterolateral fundic region of the uterus; the other attaches in the labium majus
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Which veins drain the rectum?
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The inferior and middle rectal veins (part of the systemic venous system) and the superior rectal vain (part of the portal venous system)
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What is the dentate (pectinate) line?
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The division between the superior and inferior anal canal
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Where is the dentate line located?
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Approximately two thirds of the way down the anal canal
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What are the three main components of the anal triangle?
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1. Anal canal 2. External anal sphincter 3. Ischioanal fossae
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Describe the location and shape of the ischioanal fossae
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The ischioanal fossae are wedge-shaped areas located on each side of the anus
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What are the three major borders of the ischioanal fossae?
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The base of the wedge is formed by the skin overlying the anal triangle on each side of the anus. The lateral walls are formed by the obturator internus muscle and fascia. The medial walls are formed by the levator ani muscle group (i.e. the pelvic diaphragm)
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Which two nerves traverse the ischioanal fossa?
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1. Inferior rectal nerve 2. Perineal branch of the femoral cutaneous nerve
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What are the three major parts of the external anal sphincter?
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Subcutaneous, superficial, and deep
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With which muscle does the deep part of the external anal sphincter blend?
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The puborectalis muscle
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Which nerve innervates the external anal sphincter?
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The inferior rectal nerve
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How does control of the external anal sphincter differ from that of the internal anal sphincter?
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Control of the external anal sphincter is voluntary, whereas control of the internal anal sphincter is involuntary
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Which sphincter must relax for defectation to occur?
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External and internal sphincters
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What structure is at the apex of the urogenital triangle?
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The symphysis pubis, (i.e. imaginary lines connecting the symphysis pubis to each ischial tuberosity form the two sides of the triangle, and an imaginary line between the ischial tuberosities forms the bottom)
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Where are the deep arteries of the penis located?
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Within the corpora cavernosa
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Where is the deep dorsal vein of the penis located?
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Between the tunica albuginea and Buck's (deep) fascia (like the dorsal arteries)
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What are the three anatomic divisions of the male urethra?
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1. Prostatic urethra 2. Membranous urethra 3. Spongy urethra
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What is the innervation of the scrotum?
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The scrotum is innervated by the ilioinguinal, genitofemoral, perineal, and posterior femoral cutaneous nerves
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What is the lymphatic drainage of the scrotum
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Superficial inguinal lymph nodes
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What is the lymphatic drainage of the testis?
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The aortic and retroperitoneal lymph nodes
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Into which vein does the testicular vein drain on the left?
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The left renal vein
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Into which vein does the testicular vein drain on the right?
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Inferior vena cava
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From which artery does the left ovarian/testicular artery arise?
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The aorta
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From which artery does the right ovarian/testicular artery arise?
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The aorta
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Into which vein does the left ovarian/testicular vein drain?
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The left renal vein
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Into which vein does the right ovarian/testicular vein drain?
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Directly into the inferior vena cava
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What are the three branches of the posterior internal iliac artery
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1. Iliolumbar artery 2. Lateral sacral artery 3. Superior gluteal artery
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Which arteries supply the rectum?
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1. The superior rectal artery, the direct continuation of the inferior mesenteric artery 2. The middle rectal artery, a branch of the internal iliac artery 3. The inferior rectal artery, a branch of the internal pudendal artery
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Which veins drain the rectum?
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The inferior, middle, and superior rectal veins
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Which rectal veins are systemic
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The inferior and middle rectal veins
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Which rectal veins are portal
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The superior rectal vein
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What is the origin and path of the pudendal nerve in the pelvis?
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The pudendal nerve, a branch of the sacral plexus, accesses the gluteal region by exiting the pelvis through the greater sciatic foramen; it then reenters the pelvis through the lesser sciatic foramen to travel in the pudendal canal
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Which three nerves arise from the pudendal nerve?
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1. Inferior rectal nerve 2. Perineal nerve 3. Dorsal nerve of the penis (in men) or clitoris (in women)
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