446.The answer is c.(Moore and Dalley, pp 436, 438.)Vaginal wall, bul-
bospongiosus, and superficial transverse perineal muscles. Both the pubo-
coccygeus and iliococcygeus muscle (answers a and b)are part of the
pelvic diaphragm and are much deeper muscles and thus would notbe cut.
The prepuce and rectus abdominis muscle (answer d)are superior and lat-
eral to the vagina and an episiotomy is performed in a posterior mediolat-
eral direction, notanterior mediolateral direction. Both the sacrospinous
and sacrotuberous ligaments (answer e)are much deeper structures,
which stabilize the pelvis and never cut during an episiotomy.
447.The answer is c. (Moore and Dalley, pp 392–393, 431, 452.)Lymph
drains from the testicles to preaortic nodes, because remember that the
Pelvis Answers 557
Kidneys Aorticorenal plexus, T12 Subcostal and pubic
Renal pelvis least splanchnic regions
Upper ureters nerve, white ramus of
T12, subcostal nerve
Descending colon Aortic plexus, lumbar L1–L2 Lumbar and inguinal
Sigmoid colon splanchnic nerves, regions, anterior
Midureters white rami of L1–L2, mons and labia,
Urinary bladder spinal nerves L1–L2 anterior scrotum,
Oviducts anterior thigh
Uterine body
None No white rami L3–S1 No visceral pain refers
between L3–S1 to dermatomes L3–S1
Cervix Pelvic plexus, pelvic S2–S4 Perineum, thigh,
Pelvic ureters splanchnic nerves, lateral leg and foot
Epididymis spinal nerves S2–S4
Vas deferens
Seminal vesicles
Prostate gland
Rectum
Proximal anal canal
PELVIC VISCERAL AFFERENT INNERVATION
Organ Afferent Pathway Level Referral areas
445.The answer is d.(Moore and Dalley, p 425.)See table below: