Deep Dorsal Vein: It carries most of the blood from the penis / clitoris.

It has two pathways:

Primary Pathway: Passes through the genital hiatus, posterior to the arcuate ligament ------> to prostatic venous plexus (only in male) ------>

to Vesicular venous plexus on the bladder (both sexes) ------> Internal Iliac Vein.

Secondary Pathway: Deep Dorsal Vein ------> Internal Pudendal Vein ------> Internal Iliac

CLINICAL: Prostate Cancer in the male. If the prostatic venous plexus is removed during removal of the prostate, then very little blood will be able to

return from the penis. Result = no erection!

Internal Pudendal Vein: It comes off the Aorta ------> Common Iliac ------> Internal Iliac ------> Anterior Division of Internal Iliac ------> Internal

Pudendal.

Internal pudendal carries the rest of the blood from the genitalia (the part not carried directly by deep dorsal vein)

Has three primary branches:

Deep Dorsal Vein: Secondary drainage of penis / clitoris

Perineal Vein: UG diaphragm and UG viscera

Inferior Rectal: Anal fossa

Pelvic Splanchnic Nerves: Come from the Prostatic Plexus (in the male) and Vesicular Plexus (both sexes) to give autonomic parasympathetic innervation to

the penis / clitoris.

Prostatic Plexus -- ANS plexus from S2, S3, S4.

Vesicular Plexus -- plexus on bladder from ANS S2, S3, S4.

Pudendal Nerve: Somatic innervation. It originates at the sacral plexus (S1-S4). It enters the perineal region through the lesser sciatic foramen. It has three

primary branches.

Inferior Rectal Nerve -- innervates, um, the rectum.

Perineal Nerve -- UG viscera

Deep Dorsal Nerve -- sexual stimulation, man.

Ilioinguinal Nerve: Innervates the anterior labia majora / scrotum.

Originates from the Lumbar Plexus at L1 -- sympathetic innervation. It enters the perineum through the inguinal canal.

BLOCKAGE OF THE PUDENDAL NERVE: The pudendal nerve is the main nerve you need to deaden, to anesthetize the pelvic region... but there are others.

To find the nerve, palpate for the ischial spine, because that is where the nerve exits the pelvis and enters the pudendal canal.

By anesthetizing right there, you can deaden all the branches in one shot: the inferior rectals, perineals, and deep dorsal.