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Hypogastric Nerve
The hypogastric nerve is the nerve that transitions between the superior hypogastric plexus and the inferior hypogastric plexus. The hypogastric nerve enters the sympathetic chain at T12- L3. Structure The hypogastric nerve begins where the superior hypogastric plexus splits into a right and left plexus. Each of these divisions is considered a hypogastric nerve. The hypogastric nerve continues inferiorly on its corresponding side of the body, where it descends into the pelvis to form the inferior hypogastric plexus. Contents of the right and left hypogastric nerves include preganglionic and postganglionic sympathetic fibers from vertebral levels of T10 to L2, passing through the spinal nerve roots of T12- L3. The hypogastric nerve provides sympathetic innervation.Le, Bhushhan, Hoffman. First Aid for the USMLE Step1. p.613. 2019. It is responsible for the emission of semen into the posterior urethra. Emission is the first phase of male ejaculation (followed by the second phase, ...
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Superior Hypogastric Plexus
The superior hypogastric plexus (in older texts, hypogastric plexus or presacral nerve) is a plexus of nerves situated on the vertebral bodies anterior to the bifurcation of the abdominal aorta. Structure From the plexus, sympathetic fibers are carried into the pelvis as two main trunks- the right and left hypogastric nerves- each lying medial to the internal iliac artery and its branches. The right and left hypogastric nerves continues as Inferior hypogastric plexus; these hypogastric nerves send sympathetic fibers to the ovarian and ureteric plexuses, which originate within the renal and abdominal aortic sympathetic plexuses. The superior hypogastric plexus receives contributions from the two lower lumbar splanchnic nerves (L3-L4), which are branches of the chain ganglia. They also contain parasympathetic fibers which arise from pelvic splanchnic nerve (S2-S4) and ascend from Inferior hypogastric plexus; it is more usual for these parasympathetic fibers to ascend to the left-hand ...
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Ejaculation
Ejaculation is the discharge of semen (the ''ejaculate''; normally containing sperm) from the male reproductory tract as a result of an orgasm. It is the final stage and natural objective of male sexual stimulation, and an essential component of natural conception. In rare cases, ejaculation occurs because of prostatic disease. Ejaculation may also occur spontaneously during sleep (a nocturnal emission or "wet dream"). ''Anejaculation'' is the condition of being unable to ejaculate. Ejaculation is usually very pleasurable for men; '' dysejaculation'' is an ejaculation that is painful or uncomfortable. Retrograde ejaculation is the condition where semen travels backwards into the bladder rather than out the urethra. Phases Stimulation A usual precursor to ejaculation is the sexual arousal of the male, leading to the erection of the penis, though not every arousal nor erection leads to ejaculation. Penile sexual stimulation during masturbation or vaginal, anal, oral, or ...
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Superior Hypogastric Plexus
The superior hypogastric plexus (in older texts, hypogastric plexus or presacral nerve) is a plexus of nerves situated on the vertebral bodies anterior to the bifurcation of the abdominal aorta. Structure From the plexus, sympathetic fibers are carried into the pelvis as two main trunks- the right and left hypogastric nerves- each lying medial to the internal iliac artery and its branches. The right and left hypogastric nerves continues as Inferior hypogastric plexus; these hypogastric nerves send sympathetic fibers to the ovarian and ureteric plexuses, which originate within the renal and abdominal aortic sympathetic plexuses. The superior hypogastric plexus receives contributions from the two lower lumbar splanchnic nerves (L3-L4), which are branches of the chain ganglia. They also contain parasympathetic fibers which arise from pelvic splanchnic nerve (S2-S4) and ascend from Inferior hypogastric plexus; it is more usual for these parasympathetic fibers to ascend to the left-hand ...
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Common Iliac Vein
In human anatomy, the common iliac veins are formed by the external iliac veins and internal iliac veins. The left and right common iliac veins come together in the abdomen at the level of the fifth lumbar vertebra, forming the inferior vena cava. They drain blood from the pelvis and lower limbs. Both common iliac veins are accompanied along their course by common iliac arteries. Structure The external iliac vein and internal iliac vein unite in front of the sacroiliac joint to form the common iliac veins. Both common iliac veins ascend to form the inferior vena cava behind the right common iliac artery at the level of the fifth lumbar vertebra. The vena cava is to the right of the midline and therefore the left common iliac vein is longer than the right. The left common iliac vein occasionally travels upwards to the left of the aorta to the level of the kidney, where it receives the left renal vein and crosses in front of the aorta to join the inferior vena cava. The r ...
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Common Iliac Artery
The common iliac artery is a large artery of the abdomen paired on each side. It originates from the aortic bifurcation at the level of the 4th lumbar vertebra. It ends in front of the sacroiliac joint, one on either side, and each bifurcates into the external and internal iliac arteries. Structure The common iliac artery are about 4 cm long in adults and more than a centimeter in diameter. It begins as a branch of the aorta. This is at the level of the 4th lumbar vertebra. It runs inferolaterally, along the medial border of the psoas muscles. It bifurcates into the external iliac artery and the internal iliac artery at the pelvic brim, in front of the sacroiliac joints. The common iliac artery, and all of its branches, exist as paired structures (that is to say, there is one on the left side and one on the right). The distribution of the common iliac artery is basically the pelvis and lower limb (as the femoral artery) on the corresponding side. Relations Both common il ...
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Local Anesthesia
Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dental procedures with reduced pain and distress. In many situations, such as cesarean section, it is safer and therefore superior to general anesthesia. The following terms are often used interchangeably: * ''Local anesthesia'', in a strict sense, is anesthesia of a small part of the body such as a tooth or an area of skin. * ''Regional anesthesia'' is aimed at anesthetizing a larger part of the body such as a leg or arm. * ''Conduction anesthesia'' encompasses a great variety of local and regional anesthetic techniques. Medical A local anesthetic is a drug that causes reversible local anesthesia and a loss of nociception. When it is used on specific nerve pathways (nerve block), effects such as ...
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Pelvic Splanchnic Nerves
Pelvic splanchnic nerves or nervi erigentes are splanchnic nerves that arise from sacral spinal nerves S2, S3, S4 to provide parasympathetic innervation to the organs of the pelvic cavity. Structure The pelvic splanchnic nerves arise from the anterior rami of the sacral spinal nerves S2, S3, and S4, and enter the sacral plexus. They travel to their side's corresponding inferior hypogastric plexus, located bilaterally on the walls of the rectum. They contain both preganglionic parasympathetic fibers as well as visceral afferent fibers. Visceral afferent fibers go to spinal cord following pathway of pelvic splanchnic nerve fibers. The parasympathetic nervous system is referred to as the ''craniosacral outflow''; the pelvic splanchnic nerves are the ''sacral'' component. They are in the same region as the sacral splanchnic nerves, which arise from the sympathetic trunk and provide sympathetic efferent fibers. Function The pelvic splanchnic nerves contribute to the inner ...
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Parasympathetic Nervous System
The parasympathetic nervous system (PSNS) is one of the three divisions of the autonomic nervous system, the others being the sympathetic nervous system and the enteric nervous system. The enteric nervous system is sometimes considered part of the autonomic nervous system, and sometimes considered an independent system. The autonomic nervous system is responsible for regulating the body's unconscious actions. The parasympathetic system is responsible for stimulation of "rest-and-digest" or "feed and breed" activities that occur when the body is at rest, especially after eating, including sexual arousal, salivation, lacrimation (tears), urination, digestion, and defecation. Its action is described as being complementary to that of the sympathetic nervous system, which is responsible for stimulating activities associated with the fight-or-flight response. Nerve fibres of the parasympathetic nervous system arise from the central nervous system. Specific nerves include several ...
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Erection
An erection (clinically: penile erection or penile tumescence) is a physiological phenomenon in which the penis becomes firm, engorged, and enlarged. Penile erection is the result of a complex interaction of psychological, neural, vascular, and endocrine factors, and is often associated with sexual arousal or sexual attraction, although erections can also be spontaneous. The shape, angle, and direction of an erection varies considerably between humans. Physiologically, an erection is required for a male to effect vaginal penetration or sexual intercourse and is triggered by the parasympathetic division of the autonomic nervous system, causing the levels of nitric oxide (a vasodilator) to rise in the trabecular arteries and smooth muscle of the penis. The arteries dilate causing the corpora cavernosa of the penis (and to a lesser extent the corpus spongiosum) to fill with blood; simultaneously the ischiocavernosus and bulbospongiosus muscles compress the veins of the ...
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Urethra
The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra connects to the urinary meatus above the vagina, whereas in marsupials, the female's urethra empties into the urogenital sinus. Females use their urethra only for urinating, but males use their urethra for both urination and ejaculation. The external urethral sphincter is a striated muscle that allows voluntary control over urination. The internal sphincter, formed by the involuntary smooth muscles lining the bladder neck and urethra, receives its nerve supply by the sympathetic division of the autonomic nervous system. The internal sphincter is present both in males and females. Structure The urethra is a fibrous and muscular tube which connects the urinary bladder to the external urethral meatus. Its length differs between the sexes, ...
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Inferior Hypogastric Plexus
The inferior hypogastric plexus (pelvic plexus in some texts) is a network () of nerves that supplies the organs of the pelvic cavity. The inferior hypogastric plexus gives rise to the prostatic plexus in males and the uterovaginal plexus in females. The inferior hypogastric plexus is a paired structure, meaning there is one on the left and the right side of the body. These are located on either side of the rectum in males, and at the sides of the rectum and vagina in females. For this reason, injury to this structure can arise as a complication of pelvic surgeries and may cause urinary dysfunction and urinary incontinence. Testing of bladder function is used in that case to show a poorly compliant bladder, with bladder neck incompetence, and fixed external sphincter tone. Structure The plexus is formed from: * a continuation of the superior hypogastric plexus on either side, at the Sacrum Promontory in the interiliac triangle. At this location, the presacral nerve sits in the mi ...
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Semen
Semen, also known as seminal fluid, is an organic bodily fluid created to contain spermatozoa. It is secreted by the gonads (sexual glands) and other sexual organs of male or hermaphroditic animals and can fertilize the female ovum. Semen is produced and originates from the seminal vesicle, which is located in the pelvis. The process that results in the discharge of semen from the urethral orifice is called ejaculation. In humans, seminal fluid contains several components besides spermatozoa: proteolytic and other enzymes as well as fructose are elements of seminal fluid which promote the survival of spermatozoa, and provide a medium through which they can move or "swim". The fluid is designed to be discharged deep into the vagina, so the spermatozoa can pass into the uterus and form a zygote with an egg. Semen is also a form of genetic material. In animals, semen has been collected for cryoconservation. Cryoconservation of animal genetic resources is a practice that call ...
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