2nd lq - MUSCLES OF THE PERINEUM AND RELATED STRUCTURES

Question 1

PELVIC DIAPHRAGM:

Answer 1

o Levator ani muscle
o Coccygeus muscle

Question 2

superficial =

Answer 2

inferior

Question 3

deep

Answer 3

superior

Question 4

PERINUEM Boundaries:

Answer 4

Symphysis pubis
Ischiopubic rami
Ischial tuberosities
Sacrotuberousligaments
Tip of the coccyx

Question 5

PERINUEM Triangles:

Answer 5

Urogenital triangle
Anal triangle

Question 6

an important point of
stability for perineal
integrity and functions.

Answer 6

PERINEAL BODY

Question 7

ANAL TRIANGLE Boundaries

Answer 7

1.Ischial Tuberosities
2.Sacrotuberous Ligaments
3.Tip of the Coccyx

Question 8

CONTENTS OF
ANAL SPHINCTER

Answer 8

1.Anus
2.Ischional Fossa

Question 9

ANAL CANAL measurements :

Answer 9

1.5 inches or 4 cm

Question 10

anal Boundaries anterior in male:

Answer 10

1. Perineal body
2. Urogenital diaphragm
3. Membranous part of the urethra
   4.Bulb of the penis

Question 11

anal Boundaries anterior in female:

Answer 11

1. Perineal body
2. Urogenital Diaphragm
   3. Lower part of the vagina

Question 12

Boundaries lateral

Answer 12

Fat-filled ischiorectal fossa

Question 13

Boundaries posterior

Answer 13

Anococcygeal body

Question 14

Hindgut entoderm
COLUMNAR EPITHELIUM

Hypogastric Plexuses
(sensitive to stretch only)

Superior Rectal Artery

Superior Rectal Vein

LD: Superior Rectal Node -> Pararectal Node -> Inferior Mesenteric Nodes

Answer 14

UPPER HALF
(with ANAL COLUMNS)

Question 15

Ectoderm of the proctodeum
STRATIFIED SQUAMOUS
EPITHELIUM

Inferior Rectal Nerve
(sensitive to pain, temperature,
touch and pressure)

Inferior Rectal Artery
Inferior Rectal Vein

Ld: Superficial inguinal nodes

Answer 15

LOWER HALF
(without ANAL COLUMNS)

Question 16

indicates the level where
the upper half of the anal
canal joins the lower half

Answer 16

PECTINATE LINE

Question 17

ANAL SPHINCTERS:

Answer 17

INTERNAL SPHINCTER - Involuntary
EXTERNAL SPHINCTER – Voluntary

Question 18

what’s in ANORECTAL JUNCTION

Answer 18

PUBORECTALIS FIBERS

Question 19

consists of the external anal sphincter and the puborectalis muscles and is a good landmark for locating the tumor

Answer 19

anorectal ring

Question 20

What is the Physiology of DEFECATION?

Answer 20

the rectum shortens as it expels material into the anal canal, and peristaltic waves propel the feces out of the rectum. In the anus there are two muscular constrictors, the internal and external sphincters, that allow the feces to be passed or retained.

Question 21

Also known as Ischiorectal Fossa

• Posterior recess -> Gluteus
  maximus muscles
• Anterior recess -> perineal
  membrane and pelvic diaphragm

Answer 21

ISCHIOANAL FOSSA

Question 22

ISCHIOANAL FOSSA Contents:

Answer 22

1.The pudendal nerve
2.Internal pudendal vessels

Question 23

branch of the sacral plexus (S2
to 4 anterior rami)

supply the external anal
sphincter and the muscles and
skin of the perineum

Answer 23

PUDENDAL NERVE

Question 24

PUDENDAL NERVE BRANCHES

Answer 24

1.INFERIOR RECTAL NERVE
2.DORSAL NERVE OF THE
PENIS ( CLITORIS)
3.PERINEAL NERVE

Question 25

INTERNAL PUDENDAL ARTERY *Branch of the internal iliac artery BRANCHES:

Answer 25

1.Inferior rectal artery : supplies the lower half of the anal canal 2. Branches to the penis in the male and to the labia and clitoris in the female

Question 26

Boundaries Anterior: PUBIC ARCH Lateral: ISCHIOPUBIC RAMI ISCHIAL TUBEROSITIES

Answer 26

UROGENITAL TRIANGLE

Question 27

UROGENITAL TRIANGLE Layers

Answer 27

1. Skin 2. Superficial perineal fascia 3. Deep perineal fascia 4. Superficial (inferior) perineal space (pouch) 5. Deep (superior) perineal space (pouch)

Question 28

FATTY LAYER – superficial

Answer 28

CAMPER’s FASCIA

Question 30

membranous layer– superficial

Answer 30

SCARPA’s FASCIA

Question 31

SUPERFICIAL PERINEALSPACE Zone between the superficial fascia and perineal membrane

Answer 31

1. Posterior Closure 2. Lateral Closure 3. Anterior Closure

Question 32

Contents: * Bulb of the penis or bulbs of the vestibule plus the bulbospongiosus muscles * Crura of the penis or clitoris plus the ischiocavernousmuscles * Superficial transverse perineal muscles * Perineal nerves and vessels *Greater vestibular glands (in females)

Answer 32

SUPERFICIAL PERINEALSPACE

Question 33

This diaphragm is a three-layered, flat, triangular, musculofascial structure situated in the anterior part of the perineum and fills in the urogenital hiatus

Answer 33

DEEP PERINEAL SPACE AND UROGENITAL DIAPHRAGM

Question 34

Layers of Urogenital Diaphragm

Answer 34

1. Inferior fascia of the urogenital diaphragm (also termed the perineal membrane) 2. Deep perineal space (pouch), formed by the sphincter urethrae and deep transverse perineal muscles 3. Superior fascia of the urogenital diaphragm

Question 35

MALE UROGENITAL TRIANGLE Contents:

Answer 35

1.Penis 2.Scrotum

Question 36

has a fixed root and a body that hangs free 1. Bulb of the penis 2. Right and left crura of the penis

Answer 36

PENIS/PENILE BODY

Question 37

PENIS LYMPH DRAINAGE

Answer 37

penis wall of the scrotum medial group of superficial inguinal lymph nodes

Question 38

nerve supply of anterior scrotum

Answer 38

ilioinguinal nerve genital branch of the genitofemoral nerve

Question 39

nerve supply of posterior scrotum

Answer 39

pudendal and posterior femoral cutaneous nerves

Question 40

Superficial Perineal Space Contents :

Answer 40

*Structures forming the root of the penis (bulb and crura) *Muscles that cover the root structures (bulbospongiosus and ischiocavernosus) *Superficial transverse perineal muscles *Branches of the pudendal nerve and internal pudendal vessels

Question 41

IMPORTANT MUSCLES

Answer 41

1.Bulbospongiosus muscles 2.Ischiocavernosus muscles 3.Superficial transverse perineal muscles

Question 42

What is the Physiology of PENILE ERECTION and EJACULATION?

Answer 42

Engorgement of the corpus spongiosum constricts and pressurizes the urethral lumen to allow for forceful ejaculation. The bulbospongiosus muscle surrounds the bulb of the penis and, like the ischiocavernosus muscle, forces additional blood into the penis during the rigid erection phase

Question 43

8 in. (20 cm) long * extends from the neck of the bladder to the external meatus on the glans penis

Answer 43

MALE URETHRA

Question 44

parts of MALE URETHRA

Answer 44

1. Postatic urethra 2. Intermediate (membranous) urethra 3.penile (spongy) urethra

Question 45

FEMALE UROGENITAL TRIANGLE CONTENTS:

Answer 45

External Genitalia Orifices of the Urethra and Vagina

Question 46

collective name for the area of the female external genitalia Borders: 1.Mons Pubis 2.Genitocrural fold 3.Perineal body

Answer 46

VULVA

Question 47

Blood Supply of vulva:

Answer 47

external and internal pudendal arteries

Question 48

Lymph drainage of vulva

Answer 48

medial group of superficial inguinal nodes.

Question 49

nerve supply of anterior parts of the vulva

Answer 49

ilioinguinal nerves and the genital branch of the genitofemoral nerves

Question 50

nerve supply of posterior parts of the vulva

Answer 50

Branches of the perineal nerves and the posterior femoral cutaneous nerves

Question 51

* female phallic organ that corresponds to the penis in the male * situated anteriorly, at the apex of the vestibule

Answer 51

CLITORIS

Question 52

parts of CLITORIS

Answer 52

1. CLITORAL ROOT 2. CLITORAL BODY 3. GLANS OF CLITORIS

Question 53

Blood Supply of clitoris

Answer 53

internal pudendal artery

Question 54

Lymph drainage of clitoris

Answer 54

internal iliac nodes or to the deep inguinal nodes

Question 55

Nerve Supply of clitoris

Answer 55

Branches of the pudendal nerve carry sensory fibers from the clitoris and provide motor supply to the associated skeletal muscles (ischiocavernosus)

Question 56

paired erectile bodies located on each side of the vestibule, deep to the labia minora * bulbospongiosusmuscle covers each bulb

Answer 56

VESTIBULAR BULB

Question 57

presence of the greater vestibular glands in the female superficial space AND bulbourethral glands perineal space in males.

Answer 57

SUPERFICIAL PERINEAL SPACE

Question 58

SUPERFICIAL PERINEAL SPACE contents

Answer 58

1. Bulbs of the vestibule plus the bulbospongiosus muscles 2. Crura of the clitoris plus the ischiocavernosus muscles 3. Superficial transverse perineal muscles 4. Perineal nerves and vessels 5. Greater vestibular glands

Question 59

What is the Physiology of CLITORAL ERECTION OR FEMALE ORGASM?

Answer 59

The clitoris is the homologue of the male's glans and corpora cavernosa, and erection is reached in three phases: latent, turgid, and rigid. The vestibular bulbs cause "vaginal" orgasmic contractions, through the rhythmic contraction of the bulbocavernosus muscles.

Question 60

1.5 in. (3.8 cm) long * extends from the neck of the bladder (internal urethral orifice) to the vestibule (external urethral orifice) where it opens about 1 in. (2.5 cm) behind the clitoris

Answer 60

FEMALE URETHRA

Question 61

lie on each side of the vestibule. They open into the vestibule by small ducts on either side of the external urethral orifice * correspond to the prostate in the male

Answer 61

LESSER VESTIBULAR (PARAURETHRAL) GLANDS

Question 62

* female genital canal, the excretory duct for the menstrual flow from the uterus, and part of the birth canaL * Extends upward and backward between the vulva and the uterus

Answer 62

VAGINA

Question 63

measures about 3 in. (8 cm) long. * HYMEN: thin mucosal fold * upper half: lies above the pelvic floor within the true pelvis * Lower half: perineum between the urethra anteriorly and the anal canal posteriorly

Answer 63

VAGINA

Question 64

vagina blood supply

Question 65

an injection in your pelvic region that can provide temporary pain relief. Healthcare providers use them for chronic pelvic pain and as regional anesthesia for certain procedures. The results can vary from person to person. Some people experience pain relief, while others don't.

Answer 65

Pudendal nerve block