Complete Supply of Abdomen & Pelvis.

ABDOMEN
& PELVIS Nerve Supply Blood Supply Venous Drainage Lymphatic Drainage

Anterolater Skin & muscles of anterolateral Cutaneous Arteries ( Deep & 1. Venous drainage Lymphatic drainage of
al abdominal wall are supplied by: superficial ): passes above mainly anterolateral abdominal
abdominal  Thoracoabdominal (T7-T11): 1.Musculophrenic Artery: into axillary vein via wall follows the following
wall - Continuation of lower (7th – Origin: pattern.
Internal thoracic artery lateral thoracic vein.
11th ) intercostal nerves.  Superficial Lymphatic
Distribution: 2. Venous drainage
- Supply: Muscles of vessels:
(a) Superficial & deep abdominal passes below mainly
anterolateral abdominal wall - Superior to
wall of hypochondriac region. into femoral vein via
& overlying skin. (b) Anterolateral diaphragm. transumbilical
 Lateral cutaneous (thoracic) superficial epigastric
& great saphenous plane: Drains into
cutaneous branches ( 7th – 9th): 2.Superior epigastric artery: vein. axillary lymph
- Supply : Skin of right & left Origin:
hypochondriac regions. nodes, however a
Internal thoracic artery
 Subcostal (anterior ramus of T12): Distribution: few drain into
- Supply: Muscles of (a) Rectus abdominis muscle parasternal lymph
anterolateral abdominal wall (b) Superficial & deep abdominal nodes
& overlying skin, superior to wall of epigastric & upper
- Inferior to
iliac crest & inferior to umbilical regions.
transumbilical
umbilicus.
3.10th & 11th posterior plane: Drain into
 Iliohypogastric & Ilioinguinal
intercostals arteries: superficial inguinal
nerves: Origin:
( terminal branches of anterior ramus lymph nodes.
Aorta
of spinal nerve L1) Distribution:
- Ilihypogastric: Supply: Skin  Deep Lymphatic vessels:
(a).Superficial & Deep abdominal wall
overlying iliac crest , upper - Drain into –
of lateral region.
inguinal & hypogastric regions, external iliac
internal oblique & transverses 4.Subcostal Artery:
abdominis muscles. Origin: Common iliac
- Ilioinguinal : Supply: Skin of Aorta Right & left
lower inguinal region , mons Distribution: lumbar (caval & aortic)
(a).Superficial & deep abdominal wall lymph nodes.
pubis, anterior scrotum or
 labium majus & adjacent of lateral region.
medial thigh, inferior most
internal oblique & transverses 5.Inferior epigastric artery:
abdominis. Origin:
External Iliac artery
Muscles of 1. External oblique:
Distribution:
Anterolater Thoracoabdominal & subcostal
(a).Rectus Abdominis muscle
al nerve. (b).Deep abdominal wall of pubic &
abdominal 2. Internal oblique: inferior umbilical regions.
wall Thoracoabdominal & first
lumbar nerve 6.Deep circumflex iliac artery:
3. Tranversus abdominis: Origin:
Thoracoabdominal & first External Iliac artery
lumbar nerve. Distribution:
4. Rectus abdominis: (a).Iliacus muscle
Thoracoabdominal nerves. (b).Deep abdominal wall of inguinal
region
(c).Iliac fossa

7.Superficial circumflex iliac

artery:
Origin:
Femoral artery
Distribution:
(a).Superficial abdominal wall of
inguinal region & adjacent anterior
thigh

8.Superficial epigastric artery:

Origin:
Femoral artery
Distribution:
(a).Superficial abdominal wall of
pubic & inferior umbilical regions.
Penis Sensory nerve supply : sensory nerve (1).Internal pudendal artery gives 1. Superficial dorsal 1. Deep Inguinal
supply is derived from off 3 branches which supply the vein: lymph nodes –
1. Dorsal nerve of penis penis:
 2. Ilioinguinal nerve
Autonomic : Autonomic nerves are
derived from Pelvic plexus via
prostatic plexus.
- Sympathetic nerves are
vasodilator
- Parasympathetic nerves
(S2,S3,S4) are vasodilator.
 Autonomic fibers are distributed
through pudendal nerve.
Muscles of Penis: supplied by perineal
branch of pudendal nerve.
Scrotum The nerves of scrotum include
 Branches of lumbar plexus to
anterolateral surface.
 Branches of sacral plexus to
posterior & inferior surfaces.
1. Anterolateral surface: Genital
branch of genitofemoral nerve
(L1 & L2).
2. Anterior surface: Anterior
scrotal nerves (branches of
ilioinguinal nerve L1)
3. Posterior surface: Posterior
scrotal nerves (branches of
perineal branch of pudendal
nerve S2,S3,S4)
4. Posteroinferior surface:
Perineal branches of posterior
cutaneous nerve of thigh
S2,S3.
Dartos muscle: Genital branch of
(i) Deep artery of penis - Drain prepuce & glans penis
(ii) Dorsal artery of Penis penile skin 2. Superficial inguinal
(iii) Artery of the bulb of penis. - Open into lymph nodes – rest
of penis
external
(2).Femoral artery gives off the
superficial external pudendal pudendal vein
artery which supplies the skin & 2. Deep dorsal vein:
fasciae of penis. - Drains glans penis
& corpora
cavernosa penis
Divide into left & right
branches which connect
with internal pudendal vein
& enters the prostatic
plexus.
1. Posterior scrotal branches Scrotal veins accompany the Superficial inguinal lymph
of the perineal artery, a arteries nodes
branch of internal
pudendal artery
2. Anterior scrotal branches
of deep external pudendal
artery, a branch of femoral
artery
3. Cremestaric artery ,a
branch of inferior
epigastric artery
 genitofemoral nerve.
Testis The autonomic nerves of testis arise
as testicular plexus of nerves &
contain:
1. Vagal parasympathetic &
visceral afferent fibers.
2. Sympathetic fibers from T7
segment of spinal cord.
Epididymis Testicular plexus of nerves
Esophagus Esophagus is innervated by the
esophageal plexus formed by:
1. Vagal trunks
2. Thoracic sympathetic trunks
via greater splanchnic nerves
& peri-arterial plexus around
left gastric & inferior phrenic
arteries.
Stomach Sympathetic nerve supply : From T6-
T9 segments of spinal cord passes to
celiac plexus through greater
Testicular artery ( branch of
abdominal aorta)
Testicular artery
1. Left gastric artery (branch
of celiac trunk)
2. Left inferior phrenic artery
Along lesser curvature by :
1. Left gastric artery(br. of
celiac trunk)
Veins emerging from the 1. Right & left lumbar
testis & Epididymis form (caval/aortic)
Pampiniform venous plexus, lymph nodes
a network of 8-12 veins lying
anterior to the ductus Preaortic lymph nodes
deferens & surrounding the
testicular artery in the
spermatic cord.
The veins of each
pampiniform plexus
converge superiorly forming
right testicular vein which
enters inferior vena cava &
a left testicular vein which
enters the left renal vein.
Same as testis. 1. Right & left lumbar
(caval/aortic)
lymph nodes
2. Preaortic lymph
nodes
The venous drainage from Left gastric lymph nodes (
the submucosal veins of this Efferent lymphatic vessels
part of esophagus is both to from these nodes drain
- Portal venous mainly to celiac lymph
system through nodes)
left gastric vein
Systemic venous system
through esophageal veins
entering the azygous vein
Veins of stomach parallel the Stomach can be divided
arteries in position & course into 4 lymphatic
-Right & left gastric veins territories:
 splanchnic nerve & is distributed
through the plexus around gastric &
gastro-omental arteries.
Parasympathetic nerve supply: From
- Anterior vagal trunk (derived
mainly from left vagus nerve):
Gives off: Hepatic, duodenal &
anterior gastric branches.
- Posterior vagal trunk ( derived
mainly from right vagus
nerve):
Gives off: a celiac branch ,
posterior gastric branches &
branches to anterior &
posterior surfaces of stomach.
2. Right gastric artery ( br. of
proper hepatic artery)
Along greater curvature by:
1. Right gastro-omental
artery(right gastroepiploic
artery), branch of
gastroduodenal artery.
2. Left gastro-omental
artery(left gastroepiploic
artery), branch of splenic
artery.
Fundus:
- 5-7 short gastric arteries
(branches of splenic
artery)
drain into hepatic portal vein (a) Upper part of left
-Short gastric veins & left 1/3rd –
gastroepiploic (gastro- pancreaticosplenic
omental) veins drain into
nodes
splenic vein which joins
superior mesenteric vein (b) Right 2/3rd – left
(SMV) to form hepatic portal gastric nodes
vein (c) Lower part of left
-Right gastroepiploic (gastro- 1/3rd – Right
omental) vein empties into gastroepiploic
SMV. nodes
Prepyloric vein ascends over
the pylorus to the right Pyloric part – pyloric
gastric vein. lymph nodes

Duodenum Sympathetic nerve supply: T9 & T10 Upto the opening of bile duct: 1. Superior 1. Anterior lymphatic
segments of spinal cord. - Superior pancreaticoduodenal vessels : Drain
Parasympathetic nerve supply: pancreaticoduodenal vein – drains into upward into
Derived from vagus & greater and artery ( br.of portal vein pancreaticoduode
lesser splanchnic nerves by the way of
gastroduodenal artery) 2. Inferior nal lymph nodes &
celiac & superior mesenteric plexuses
& reach the duodenum along its pancreaticoduodenal into pyloric lymph
Below the opening of bile duct: vein – joins the SMV
arteries. Inferior pancreaticoduodenal nodes
artery (br.of superior mesenteric 2. Posterior
artery). lymphatic vessels:
Drain downward
via
pancreaticoduode
nal nodes to the
superior
 mesenteric lymph
nodes

 Efferent lymphatic
vessels of all above lymph
nodes drain into celiac
lymph nodes.
Jejunum & (Reference from Superior mesenteric artery Superior mesenteric vein Lymph passes through 3
Ileum BD Chaurasia) (Lowest part of ileum is also (SMV) groups of lymph nodes:
Nerve supply is derived from supplied by Ileocolic artery) 1. Juxta-intestinal
sympathetic & parasympathetic lymph nodes
nerves 2. Mesenteric lymph
- Sympathetic: T9-T11
nodes
- Parasympathetic: from vagus
nerve 3. Superior central
(Reference from lymph nodes
Keith.L.Moore)
 Efferent lymphatic
- The sympathetic fibers
vessels from the
originate in the T8-T10
mesenteric lymph nodes
segments of spinal cord &
drain into superior
reach the superior mesenteric
mesenteric lymph nodes.
nerve plexus through
sympathetic trunks & thoracic
abdominopelvic
(greater,lesser & least)
splanchnic nerves.
- The parasympathetic fibers
derived from posterior vagal
trunks.
Cecum Sympathetic: originate in lower Anterior & posterior rectal Venous drainage from Lymph passes from
thoracic part of spinal cord. arteries from the ileocolic artery ( cecum flow through a several mesenteric lymph
Parasympathetic: derive from vagus Branch of superior mesenteric tributary of SMV, the nodes to ileocolic lymph
nerve. artery) ileocolic vein. nodes , then to superior
 Branches from sympathetic & mesenteric lymph nodes
parasympathetic nerves form the
superior mesenteric plexus.
Appendix Same as cecum Appendicular artery , branch of SMV (same as cecum) Same as cecum in
ileocolic artery addition to appendicular
nodes
Ascending Sympathetic & parasympathetic 1. Ileocolic artery SMV Lymph passes from :
colon (vagus) nerves from superior 2. Right colic branches of Epicolic &
mesenteric plexus. superior mesenteric paracolic➔Ileocolic &
arteries intermediate right colic
nodes➔superior
mesenteric lymph nodes.
Transverse Superior mesenteric nerve plexus via Middle colic artery (branch of SMV Middle colic lymph
colon peri-arterial plexuses of right & left superior mesenteric artery) nodes➔Superior
colic arteries. mesenteric lymph nodes
These nerves transmit sympathetic,
parasympathetic (vagal) & visceral
afferent nerve fibers.

Descending Sympathetic: From lumbar part of 1. Left colic artery ( br.of From inferior mesenteric 1. Intermediate colic
& sigmoid sympathetic trunk via : inferior mesenteric artery) vein ➔ Splenic vein ➔ lymph nodes
colon - Lumbar splanchnic nerves 2. Sigmoid arteries (br.of hepatic portal vein. 2. Inferior
- Superior mesenteric plexus Inferior mesenteric artery) mesenteric lymph
- Peri-arterial plexus
Parasympathetic: From pelvic nodes
splanchnic nerves via:  Lymph from left colic
- Inferior hypogastric plexus & flexure may also drain to
nerves. superior mesenteric lymph
nodes.
Pancreas Sympathetic: Splanchnic nerves 1. Pancreatic branches of 1. Splenic vein 1. Pancreaticosplenic
through the plexus. splenic artery 2. Superior mesenteric lymph nodes
Parasympathetic: Vagus 2. Superior vein (SMV) 2. Celiac lymph
pancreaticoduodenal 3. Portal vein nodes
artery 3. Superior
3. Inferior mesenteric lymph
pancreaticoduodenal nodes
artery
Liver Nerves of liver derived from Hepatic Liver receives blood Hepatic sinusoids drain into 1. Superficial
 plexus ( derivative of celiac plexus)
Which consists of
- Sympathetic fibers from celiac
plexus
- Parasympathetic fibers from
anterior & posterior vagal
trunks.
Gall Nerves to gall bladder & custic duct
bladder & from:
Cystic duct 1. Celiac plexus – sympathetic &
visceral afferent fibers.
2. Vagus nerve –
parasympathetic fibers
3. Right phrenic nerve – Somatic
afferent fibers.
Bile Duct
Kidneys Renal nerve plexus which consists of
- Sympathetic T10-L1 &
parasympathetic fibers.
1. 20-25% through hepatic
artery
2. 75-80% through portal
vein
Cystic artery ( arise from right
phrenic artery)
1. Cystic artery
2. Right hepatic artery
3. Posterior superior
pancreaticoduodenal
artery
4. Gastroduodenal artery
Renal artery divides to form
various segmental arteries:
1. Superior segmental artery
to Superior segment
2. Anterosuperior segmental
artery to Anterosuperior
segment
3. Anteroinferior segmental
artery to antero inferior
interlobular veins ➔ which lymphatics – caval
join to form sublobular veins , hepatic,
➔ which join to form paracardial &
hepatic veins ➔ which drain
celiac lymph
into inferior vena cava (IVC)
nodes.
2. Deep lymphatics –
inferior vena cava
& hepatic lymph
nodes.
From cystic veins to hepatic 1. Hepatic lymph
portal pancreaticoduodenal nodes ➔ celiac
vein to hepatic portal lymph nodes
vein.vein
2. Cystic lymph
nodes ➔ celiac
lymph nodes
The posterior superior 1. Cystic nodes ➔
pancreaticoduodenal vein celiac lymph nodes
drains the distal part of the 2. Lymph node of
bile duct and empties into omental foramen
the hepatic portal vein or ➔ celiac lymph
one of its tributaries. nodes
Cystic veins 3. Hepatic lymph
nodes ➔ celiac
lymph nodes
Right & Left renal veins Right & left lumbar ( caval
 Interlobular veins ➔ & aortic ) lymph nodes
arcuate veins ➔ interlobar
veins ➔ renal vein ➔ IVC
 segment
4. Inferior segmental artery
to inferior segment
5. Posterior segmental artery
to posterior segment of
the kidney

Ureters 1. Renal plexus 1. Upper part – Renal artery 1. Renal veins 1. Superior part –
2. Abdominal aortic plexus 2. Middle part- (i) 2. Gonadal Lumbar lymph
3. Superior hypogastric plexus Testicular/ovarian arteries (testicular/ovarian) nodes
(ii) veins. 2. Middle part –
Abdominal aorta common iliac
(iii) Common lymph nodes
iliac arteries 3. Inferior part –
3. Lower part- common, external
(i) Vesical artery or internal iliac
(ii) Middle rectal artery lymph nodes.
(iii) Uterine vessels

Suprarenal 1. Celiac plexus 1. Superior suprarenal  Suprarenal veins Lateral aortic ( lumbar)
glands 2. Abdominopelvic (greater, arteries (6-8) from inferior 1. Right suprarenal vein lymph nodes
lesser & least splanchnic phrenic arteries ➔ IVC
nerves) 2. Middle suprarenal arteries 2. Left suprarenal vein
(≤1) from abdominal aorta ➔ joins inferior
3. Inferior suprarenal arteries phrenic vein ➔
(≤1 from Renal artery) drains into Left renal
vein.
Diaphragm Motor nerve supply: Phrenic nerves
(ventral rami C3,C4,C5)
Sensory nerve supply:
- Central part: Phrenic nerve
- Peripheral part: lower 6
thoracic nerves
Muscles of Psoas major : Anterior rami of lumbar
posterior nerves L1, L2, L3.
abdominal Iliacus: Femoral nerve (L2-L4)
wall Quadratus lumborum: Anterior
branches of T12 & L1-L4 nerves.
Urinary Urinary bladder is supplied by vesical 1. Superior & Inferior vesical Vesical venous plexus ➔ 1. External iliac
bladder plexus of nerves which is made up of arteries (branches of which drains into Internal nodes
nerves derived from inferior anterior trunk of internal iliac veins 2. Internal
hypogastric plexus. Vesical plexus iliac artery) iliac/lateral aortic
contains both sympathetic &  In females from uterine nodes
parasympathetic components, each of & vaginal arteries instead
which contains motor(efferent) & of inferior vesical.
sensory(afferent) fibers. 2. Obturator & Inferior
- Parasympathetic efferent Gluteal arteries (
fibers S3,S3,S4 additional supply to
- Sympathetic efferent fibers bladder)
T11-L2.
- Somatic: pudendal nerve
(S2,S3,S4)
- Sensory nerves [For
detail see page#378 BD
Chaurasia]
Male Nerves are derived from prostatic 1. Urethral artery arises from Anterior urethra: 1. Prostatic urethra –
urethra plexus ( one of the pelvic plexus) internal pudendal artery Dorsal vein of penis➔ internal iliac
Parasympathetic nerves are from 2nd 2. Dorsal penile artery via internal pudendal vein ➔ lymph nodes
to 4th sacral segments. circumflex branches on prostatic venous plexus. 2. Membranous
each side Posterior urethra: urethra – internal
Prostatic & vesical venous iliac lymph nodes
plexus ➔ internal iliac veins. 3. Anterior urethra –
deep inguinal
lymph nodes.
Female Vesical plexus & pudendal nerve. 1. Superior vesical arteries Venous plexus around 1. Internal iliac
urethra Explanation: 2. Vaginal arteries urethra ➔ vesical venous lymph nodes
- Parasympathetic preganglionic plexus ➔ internal pudendal 2. External iliac
fibers from 2nd to 4th sacral vein lymph nodes
segments of spinal cord.
Synapse in vesical venous
plexus. Post-ganglionic fibers
 reach smooth muscles.
- Somatic fibers from S2-S4. Do
not synapse in vesical venous
plexus.
- Sensory fibers in pelvic
splanchnic nerves reach to 2nd
to 4th sacral segments of spinal
cord.
- Postganglionic sympathetic
fibers arise from plexus
around vagina arteries.

Rectum Nerve supply to rectum is derived 1. Superior rectal artery – 1. Superior rectal vein – 1. Upper half of
from sympathetic & parasympathetic continuation of inferior tributeries of this rectum : Inferior
systems. mesenteric artery vein arise from mesenteric nodes
- Sympathetic: from lumbar 2. Middle rectal arteries – internal rectal after passing
spinal cord (L1-L2) conveyed arise from anterior division venous plexus. through pararectal
via: of internal iliac artery 2. Middle rectal vein – & sigmoid nodes
 Lumbar splanchnic nerve 3. Median sacral artery – open into internal 2. Lower half of
 Hypogastric/pelvic plexus small branch arising from iliac veins. rectum: Internal
 Peri-arterial plexus (of back of aorta 3. Median sacral vein – iliac nodes
inferior mesenteric & superior joins left common
rectal arteries) iliac vein
- Parasympathetic: from S2-S4
passing via
 Pelvic splanchnic nerves
 Left & right inferior
hypogastric plexus to the
rectal (pelvic) plexus.
Anal canal Above pectinate line: Above pectinate line – superior 1. Internal rectal 1. Above pectinate
- Sympathetic: Inferior rectal artery venous plexus line: Internal iliac
hypogastric plexus Below pectinate line – Inferior 2. External rectal lymph nodes ➔
- Parasympathetic: Pelvic rectal artery venous plexus common iliac &
splanchnic nerve S2,S3. 3. Anal veins lumbar lymph
 Below pectinate line:
- Somatic: inferior rectal nerve
(S2,S3,S4) branch of pudendal
nerve
External anal sphincter:
- Inferior rectal nerve
- Perineal branch of 4th sacral
nerve
Ovaries & 1. Ovarian plexus : Derived from
uterine renal, aortic & hypogastric
tubes plexus. Contains both
sympathetic &
parasympathetic nerve fibers.
- Sympathetic: T10-T11 are
afferent for pain as well as
efferent or vasomotor.
- Parasympathetic: S2,S3,S4 are
vasodilator.
2. Uterine plexus
Uterus Sympathetic & parasympathetic
nerves through Inferior hypogastric &
ovarian plexus.
- Sympathetic nerves are from
T12 & L1.
- Parasympathetic nerves are
S2,S3,S4.
1. Ovarian arteries (arise
from abdominal aorta)
2. Tubal branches of uterine
arteries ( Branch of
internal iliac arteries)
1. Uterine arteries
2. Ovarian arteries
Veins drainig the ovary form
a vine like pampiniform
plexus of veins. The plexus
condenses into a single
ovarian vein near pelvic
inlet.
 Right ovarian vein drains
into inferior vena cava
 Left ovarian vein drains
into left renal vein.
Uterine Tube:
Tubal veins : drain into
pampiniform venous plexus
& uterine venous plexus.
The veins form a plexus.
Plexus drains through
Uterine , ovarian & vaginal
veins into internal iliac veins.
nodes
2. Below pectinate
line : Superficial
inguinal lymph
nodes.
Lateral aortic & para
aortic lymph nodes.
3 lymphatic territories:
1. Upper lymphatics:
Drain into aortic &
superficial inguinal
lymph nodes.
2. Middle
lymphatics: Drain
into external iliac
lymph nodes.
3. Lower lymphatics:
External iliac,
internal iliac &
sacral nodes.
Vagina Lower 1/3rd : Supplied by pudendal
nerve through inferior rectal &
posterior labial branches of perineal
nerve.
Upper 2/3rd : Supplied by
- Sympathetic – L1,L2
- Parasympathetic – S2,S3,S4.
Nerves are derived from inferior
hypogastric & uterovaginal plexus.
Prostate Prostate is supplied by Prostatic
Gland plexus of nerves which is derives from
lower part of inferior hypogastric
plexus.
1. Vagina branch of internal Vaginal venous plexus Upper 1/3rd : External iliac
iliac artery drains into internal iliac nodes
2. In addition veins. Middle 1/3rd : Internal
- The upper part is supplied iliac nodes
by cevicovaginal branch of Lower 1/3rd : Medial
uterine artery. group of superficial
- Lower part by middle inguinal lymph nodes.
rectal & internal pudendal
arteries.
 Branches of these arteries
anastomose to form anterior &
posterior midline vessels called
the vaginal azygos arteries.
Supplied by branches from Veins form a rich plexus 1. Internal iliac
1. Inferior vesical which communicates with lymph nodes.
2. Middle rectal vesical plexus & with 2. External iliac
3. Internal pudendal arteries internal pudendal vein & lymph nodes.
- These arteries form a large drains into vesical & internal 3. Sacral lymph
outer or subcapsular iliac veins. nodes.
plexus, and a small inner
or periurethral plexus.
Greater part of gland is
supplied by subcapsular
plexus.
Reference: K.L.M & B.D chaurasia