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GIGU - Week 4 (QUARANTINE) > 26- Male & Female Perineum > Flashcards

26- Male & Female Perineum Flashcards

1
Q

This is a 3-dimensional space in the inferior region of the trunk. It contains the external genitalia and the anal canal.

A

Perineum

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2
Q

Viewed from below, the perineum is a diamond-shaped area located between the thighs and bordered by what structures?

A 
Anterior = Pubic Symphysis 
Posterior = Coccyx 
Anterolateral = Ischiopubic Rami 
Posterolateral = Sacrotuberous Ligaments
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3
Q

The perineum is a 3D space with the superior boundary being the _______ _______, which is the muscular floor of the pelvic cavity. The inferior boundary is the _______ associated with the external genitalia and anal canal.

A

Pelvic Diaphragm

Skin

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4
Q

There is an imaginary line connecting the _______ _______ divides the diamond-shaped perineum into two triangles.

A

Ischial Tuberosities

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5
Q

This triangle of the perineum is delineated by the pubic symphysis, ischiopubic rami, and the imaginary line.

A

Urogenital Triangle

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6
Q

What is contained in the Urogenital Triangle?

A

Urethra

External Genitalia

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7
Q

This triangle of the perineum is delineated by the coccyx, sacrotuberous ligaments, and the imaginary line.

A

Anal Triangle

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8
Q

What is contained in the Anal Triangle?

A

Anal Canal

Anus

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9
Q

This structure is continuous with the rectum and is approximately 1-1.5 inches long.

A

Anal Canal

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10
Q

The upper (proximal) half of the anal canal contains longitudinal folds known as _______ _______. The superior ends of these indicate the location of the _______ _______, which is where the rectum joins the anal canal.

A

Anal Columns

Anorectal Line

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11
Q

The inferior ends of anal columns are joined by folds known as _______ _______. The small recesses superior to these are the _______ _______.

A

Anal Valves

Anal Sinuses

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12
Q

Contained within anal sinuses are glands that secrete mucous, which aids in ________.

A

Defecation

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13
Q

At the junction of the anal columns with the anal valves is the ________ ________.

A

Pectinate Line

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14
Q

Superior to the pectinate line, the anal canal is supplied by _______ _______ _______, while inferior to this line the anal canal is supplied by ________ ________ _______ derived from the _______ _______ _______.

A

Visceral Afferent Fibers (GVA)
Somatic Afferent Fibers (GSA)
Inferior Rectal Nerves (S4)

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15
Q

The internal rectal venous plexus is located in the wall of the proximal half of the anal canal. This venous plexus drains into the…

A

Hepatic Portal System

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16
Q

The external rectal venous plexus is located in the wall of the distal half of the anal canal. This venous plexus drains into the…

A

Internal Pudendal Veins (tributaries to the Caval System)

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17
Q

Within the wall of the anal canal are two sets of sphincters. The (INTERNAL/EXTERNAL) anal sphincter is circular smooth muscle surrounding the proximal 2/3s of the canal.

A

Internal

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18
Q

The internal anal sphincter is innervated by the…

A

Pelvic Splanchnic Ns. (S2-S4)

***This is Parasympathetic (GVE)

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19
Q

The (INTERNAL/EXTERNAL) anal sphincter is skeletal muscle surrounding the distal 2/3s of the canal.

A

External

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20
Q

The external anal sphincter is innervated by the…

A

Inferior Rectal N. (S4)

***This is Somatic Efferent (GSE) and a branch of the Pudendal N.

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21
Q

The external anal sphincter is attached to the ________ ________ posteriorly and the ________ ________ anteriorly.

A

Anococcyxgeal Ligament

Perineal Body

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22
Q

The anal canal is oriented in a posteroinferior direction, due in part to the anterior pull of the ________ ________.

A

Puborectalis Muscle

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23
Q

The anal canal terminates at an external opening known as the _______.

A

Anus

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24
Q

________ ________ are fat-filled, wedge-shaped spaces on either side of the anal canal.

A

Ischiorectal (Ischioanal) Fossae

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25
Q

The Ischiorectal Fossae boundaries include…

A

Lateral Wall = Obturator Internus and Ischium

Superomedial Wall = Levator Ani and Anal Canal

Base = Skin of perineum

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26
Q

What are the contents of the Ischiorectal Fossae?

A

Fat
Blood Vessels
Nerves

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27
Q

The distention of the anal canal during defecation is made possible because the Ischiorectal Fossae are filled with _______. In other words, there are no vital organs in close proximity to the anal canal to interfere with its distention during defecation.

A

Fat

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28
Q

On the lateral walls of the Ischiorectal Fossae and the medial surface of the Obturator Internus M. are the ________ ________,

A

Pudendal Canals

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29
Q

Contained within the fascial-lined Pudendal Canals are the…

A

Pudendal N.
Internal Pudendal A.
Internal Pudendal V.

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30
Q

Passing from the Pudendal Canal, through the Ischiorectal Fossae, and to the Anal Canal are the…

A

Inferior Rectal N. (branch of Pudendal N.)
Inferior Rectal A. (branch of Internal Pudendal A.)
Inferior Rectal V. (tributary to Internal Pudendal V.)

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31
Q

This nerve supplies the anal sphincters and skin.

A

Inferior Rectal N.

***Specifically External Anal Sphincter

32
Q

The Urogenital Triangle includes two spaces or pouches, which are…

A

Superficial Perineal Space

Deep Perineal Space

33
Q

The Deep Perineal Space (of the Urogenital Triangle) includes what?

A

Urogenital Diaphragm

Fascia

34
Q

This is a continuous sheet of muscle that spans the gap between the Ischiopubic Rami.

A

Urogenital Diaphragm

35
Q

The superior and inferior fascial layers of the Urogenital Diaphragm fuse along the _______ and _______ borders of this diaphragm.

A

Anterior

Posterior

36
Q

The _______ _______ is attached to the midpoint of the posterior border of the Urogenital Diaphragm.

A

Perineal Body

37
Q

In females, the muscular Urogenital Diaphragm is split into two halves by the passage of the ________.

A

Vagina

38
Q

In the Urogenital Diaphragm, there is the first part of the ________ in females and the ________ ________ in males.

A

Urethra

Membranous Urethra

39
Q

In the Urogenital Diaphragm, this is a deep perineal muscle in males that surrounds the membranous urethra that relaxes to allow urination to occur, or when ejaculation of semen occurs.

A

External Urethral Sphincter

40
Q

In the Urogenital Diaphragm, this muscle inserts in the perineal body in both males and females.

A

Deep Transverse Perineus M.

41
Q

In the Urogenital Diaphragm, ________ ________ in males have ducts that empty into the penile urethra. During sexual activity these secrete a clear mucous which lubricates the penile urethra prior to ejaculation of semen.

A

Bulbourethral Glands

42
Q

This is a potential space deep to the perineal skin that covers the external genitalia.

A

Superficial Perineal Space

43
Q

In females, the Superficial Perineal Space is split into two halves by the _________ of the vagina.

A

Vestibule

44
Q

In males, the Superficial Perineal Space contains the root of the penis which includes…

A

Right and Left Crura
Bulb of Penis
Ischiocavernous M.
Bulbospongiosus M.

45
Q

In males, an Ischiocavernous M. (bilateral) surrounds the free surface of each crus. This muscle attaches to the Ischiopubic Ramus and inserts into the _______ _______, which is made of erectile tissue.

A

Corpus Cavernosum

46
Q

In males, the Ischiocavernous M. (bilateral) help to maintain an ________ by compressing the veins which drain the Corpora Cavernosa.

A

Erection

47
Q

The ________ ________ arises from the perineal body and raphe of the penis, then wraps around the bulb and posterior part of the corpus spongiosum (comprised of erectile tissue).

A

Bulbospongiosus M.

48
Q

This muscle aids in compressing (emptying) the urethra of urine or semen.

A

Bulbospongiosus M.

49
Q

In males, the Superficial Perineal Space also contains the body (shaft) of the penis. This consists of…

A 
Skin
Subcutaneous Tissue (No fat) 
Corpus Spongiosum (contains penile urethra)
Corpus Cavernosum (bilateral)
Dorsal A., V., N. of penis
50
Q

In females, the Superficial Perineal Space contains the vulva (external genitalia). The vulva consists of the…

A

Labia Majora
Labia Minora
Clitoris

51
Q

The Labia Majora (bilaterally) unite anteriorly to form the _______ _______.

A

Mons Pubis

52
Q

The Labia Minora (bilaterally) surround the vestibule of the vagina, which contains the…

A

External Urethral Orifice

Vaginal Orifice

Paraurethral Glands Orifices

Greater Vestibular Glands Orifices

53
Q

This is the female homologue to the penis in the male.

A

Clitoris

54
Q

The Clitoris consists of what parts?

A

Bilateral Crura covered by Ischiocavernous Ms.

Bilateral Corpora Cavernosus

Body

Glans Clitoris (visible externally)

55
Q

In females, each crus is continuous with a _______ _______, which is composed of erectile tissue.

A

Corpus Cavernosum

56
Q

In females, the crus and corpus cavernosum are surrounded by an _________ _________, which contracts during sexual arousal to retard the return of venous blood from the corpus cavernosum.

A

Ischiocavernosus Muscle

57
Q

In females, the two corpora cavernosa unite to form the body of the _______. Continuous with the body, is the ______ ______, which is externally visible.

A

Clitoris

Glans Clitoris

58
Q

In addition to the Vulva, the Superficial Perineal Space in females includes several important structures that are deep to the skin. These structures include…

A

Bulbs of the Vestibule
Greater Vestibular Glands (Bartholin’s Glands)
Superficial Transverse Perineus M.

59
Q

These are located deep to the skin of the Labia Minora, and are composed of erectile tissue.

A

Bulbs of the Vestibule

60
Q

Each bulb (of the vestibule) is covered by a ________ ________, which is attached to the perineal body. During sexual arousal these muscles compress the bulbs of the vestibule, retarding the return of venous blood.

A

Bulbocavernosus M.

61
Q

In females, these glands within the Superficial Perineal Space produce a clear mucous secretion during sexual arousal, which lubricates the vulva.

A

Greater Vestibular Glands (Bartholin’s Glands)

62
Q

This artery supplies the scrotum and penis in males, as well as the labia majora and clitoris in females.

A

External Pudendal A.

63
Q

This artery is a branch of the Internal Iliac A. and passes through the Greater and Lesser Sciatic Foramina to enter the Pudendal Canal. Goes to all perineal structures.

A

Internal Pudendal A.

64
Q

What are the important branches of the Internal Pudendal A.?

A

Inferior Rectal A.
Perineal As.
Dorsal A.
Deep A. of Penis or Clitoris (supplies corpora cavernosa)

65
Q

The artery of the bulb of the penis supplies what?

A

Posterior part of Corpus Spongiosum
Urethra within Corpus Spongiosum
Bulbourethral Glands

66
Q

This artery is a branch of the Femoral A. and sends deep and superficial branches to the scrotum and penis in males, and the labia majora and clitoris in females.

A

External Pudendal A.

67
Q

This nerve sends branches to all structures supplied with blood by the Internal Pudendal A.

A

Pudendal N.

68
Q

What are the contents of the Pudendal N.?

A
    • Preganglionic Parasympathetics (GVE)
    • Somatic Motor Fibers (GVE)
    • Somatic Sensory Fibers (GSA)
    • Postganglionic Sympathetics (GVE)
69
Q

Postganglionic parasympathetic fibers from the rectal plexus innervate the…

A

Internal Anal Sphincter

70
Q

What are causes of male impotence?

A
  1. Nerve damage to prostatic nerve plexus.
  2. Atherosclerosis can adversely affect blood supply to erectile tissues.
  3. Type II diabetes
  4. Spinal cord injury
  5. Hormonal disorders
  6. Psychological disorders
71
Q

The Superficial Perineal Space, distal portions of the Vagina and Anal Canal (below the pectinate line) drain to which lymph nodes?

A

Superficial Inguinal LNs

72
Q

The Deep Perineal Space, proximal Vagina and Anal Canal (above the pectinate line) drain to which lymph nodes?

A

Internal Iliac LNs

73
Q

This is a surgical incision between the vagina and anus to prevent perineal tear during delivery.

A

Episiotomy

74
Q

There are four types of episiotomy, but the most common is a __________ incision. This is an incision made with scissors through the posterior vaginal wall, bulbospongiosus M. superficial transverse perineum M., skin and associated fascia.

A

Medio-lateral

75
Q

How do we repair an episiotomy?

A

3 layers of sutures in vaginal wall, muscle layer and subcutaneous fascia, and skin.

GIGU - Week 4 (QUARANTINE) (8 decks)

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