in the male supplies the seminal vesicle, prostate, fundus of the bladder,
distal ureter, and the vas deferens. In the female, the vaginal artery supplies
the vagina, urinary bladder, and pelvic portion of the urethra. The obtura-
tor artery (answer a)gives off muscular and nutrient branches within the
pelvis and then leaves the pelvis via the obturator canal to supply the thigh.
The internal pudendal artery (answer b)crosses the piriformis muscle,
exits the pelvic cavity via the greater sciatic foramen, and enters the
ischiorectal fossa via the lesser sciatic foramen. It supplies the external gen-
italia (penis and clitoris). The middle rectal artery (answer c)supplies the
inferior rectum and forms important anastomoses with other rectal arteries.
The umbilical artery (answer d)gives off the superior vesical artery in both
sexes. Its distal portion degenerates to form the medial umbilical ligament.
429.The answer is a.(Moore and Dalley, pp 423, 425.)The visceral affer-
ent fibers that mediate sensation from the fundus and body of the uterus,
as well as from the oviducts, tend to travel along the sympathetic nerve
pathways (via the hypogastric nerve and lumbar splanchnics) to reach the
upper lumbar levels (L1–L2) of the spinal cord. Thus, uterine pain will be
referred to (appear as if originating from) the upper lumbar dermatomes
and produce backache. The visceral afferent fibers that mediate sensation
from the cervical neck of the uterus travel along the parasympathetic path-
ways [via the pelvic splanchnic nerves (nervi erigentes);(answer c)] to the
midsacral levels (S2–S4) of the spinal cord. In this instance, pain originat-
ing from the cervix will be referred to the midsacral dermatomes and pro-
duce pain that appears to arise from the perineum, gluteal region, and legs.
Neither the lumbosacral trunk to L4–L5 (answer b)northe pudendal
nerve (answer d)should be involved.
430.The answer is d.(Moore and Dalley, pp 387, 414.)The ureter, lying
just medial to the internal iliac artery in the deep pelvis, passes from pos-
terior to anterior immediately inferior to the lateral cervical ligament. This
ligament sits at the base of the broad ligament and contains the uterine
artery and vein to which the ureters pass inferior approximately midway
along their course between internal iliac artery and uterus. The ureter con-
tinues inferior to the anterior portion of the lateral cervical ligament (where
it can sometimes be palpated through the walls of the vagina at the lateral for-
nices) to gain access to the base of the urinary bladder. The close association
Pelvis Answers 551