Presacral Space
Nerve Injury
Retropubic Space
Course of the Ureter
Potpourri
100
This presacral space structure is the site of attachment for the mesh in an abdominal sacrocolpopexy
What is anterior longitudinal ligament?
100
Injury to these two nerves may occur during lateral extension of a Pfannenstiel incision or during placement of accessory laparoscopy ports
What are the ilioinguinal and iliohypogastric nerves?
100
main obturator artery is most commonly a branch of this artery
What is internal iliac artery?
100
The ureter descends through the pelvic sidewall retroperitoneum adherent to this structure
What is the peritoneum or broad ligament (medial leaf)?
100
These are the boundaries of the femoral triangle
What are the inguinal ligament, sartorius muscle, and adductor longus muscle?
200
This is the terminal branch of the aorta prior to its bifurcation into the common iliac arteries.
What is the middle sacral artery?
200
This branch of the sacral plexus provides sensory and motor innervation to the perineum
What is the pudendal nerve?
200
This structure can be palpated at the dorsal margin of the superior pubic ramus; it allows passage of the obturator nerve and vessels into the medial thigh
What is the obturator canal?
200
Upon its entry into the pelvis, the ureter can be found crossing over the bifurcation of this structure
What is the common iliac artery?
200
During a laparoscopic procedure, these vessels can be identified just medial to the entry point of the round ligament into the deep inguinal ligament
What are the inferior epigastric vessels?
300
This nerve plexus is contained within the loose connective tissue of the presacral space just below the aortic bifurcation
What is superior hypogastric plexus- also known as the presacral nerve?
300
Transection of this nerve during a pelvic lymph node dissection or a paravaginal defect repair will result in inability to adduct the thigh
What is the obturator nerve?
300
This connective tissue structure represents the lateral point of attachment for the anterior vaginal wall. It attaches to the ischial spines proximally and to the inner and inferior surface of the pubic bones distally
What is the arcus tendineus fascia pelvis (ATFP)?
300
The ureter, a muscular tube comprised of a mucosal lining, a muscular layer, and an outer adventitia measures approximately this length
What is 25-30 centimeters?
300
These two ligaments convert the sciatic notches of the ischium into the greater and lesser sciatic foramen
What are the sacrospinous and sacrotuberous ligaments?
400
These two structures define right and left boundaries of the presacral space
What is the ureter or internal iliac vessels on the right and the sigmoid colon on the left?
400
This is the largest nerve in the body and can be subject to stretch injury when patients are positioned in high lithotomy
What is the sciatic nerve?
400
This venous plexus is found along the side of the bladder and drains into the internal iliac vein
What is the vesical (paravesical) venous plexus or plexus of Santorini?
400
These two locations represent the most common ureteral injury sites during hysterectomies
What is the pelvic brim (during clamping of the ovarian vessels) and the cardinal ligament (clamping of the uterine vessels?
400
These are the boundaries of Hasselbach’s triangle
What are the inguinal ligament, lateral border of the rectus muscle, and inferior epigastric vessels?
500
This vascular structure is the closest major vessel to the midsacral promontory
What is the left common iliac vein?
500
Injury to this nerve by self-retaining retractors or hyperflexion of the thighs may result in a patient’s inability to flex the thigh and extend the knee, and absent patellar reflex
What is the femoral nerve?
500
This muscle exits the pelvis through the lesser sciatic foramen, attaches to the greater trochanter of the femur, and functions as a lateral hip rotator
What is the obturator internus muscle?
500
The ureter is closest to the uterosacral ligament at this point.
What is the cervical portion of the uterosacral ligament?
500
These 3 structures are always traversed by the trans-obturator trocar
What are the obturator internus muscle, obturator membrane, obturator externus muscle, adductor magnus?