Atlas of Human Anatomy by Netter

FACTS & HINTS

High-Yield Facts

Clinical Points

The obturator nerve and vessels cross the floor of the ovarian fossa; therefore, ovarian disease such as malignancy can present with

referred pain to the medial aspect of the thigh.

After a radical prostatectomy (removal of the prostate gland, seminal vesicles, and periprostatic tissue) for localized prostate cancer, erectile

dysfunction can occur, because of inadvertent damage of the cavernous nerves (nervi erigentes), the parasympathetic fibers from the pelvic

plexus that govern erection.

Clinical Points

Pudendal Nerve Block

Performed to relieve perineal pain during childbirth

Anesthetic agent is injected into tissues around pudendal nerve

Injection is normally done transvaginally

Physician palpates the ischial spine and uses his or her fingers to direct the needle so that the anesthetic is injected in the region of the

ischial spine, where the pudendal nerve wraps around it to enter the lesser sciatic foramen

Pudendal blocks do not relieve the pain of contractions

Mnemonics

Memory Aids

S 2, 3, 4 keeps the

poo off the floor

Defecation is controlled by parasympathetic fibers to the rectum and anal canal from the pelvic splanchnic

nerves via the pelvic plexus. These nerves arise from S2, S3, and S4 spinal cord levels.