2nd lq - MUSCLES OF THE PERINEUM AND RELATED STRUCTURES Flashcards

1
Q

PELVIC DIAPHRAGM:

A

o Levator ani muscle
o Coccygeus muscle

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2
Q

superficial =

A

inferior

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3
Q

deep

A

superior

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4
Q

PERINUEM Boundaries:

A

Symphysis pubis
Ischiopubic rami
Ischial tuberosities
Sacrotuberousligaments
Tip of the coccyx

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5
Q

PERINUEM Triangles:

A

Urogenital triangle
Anal triangle

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6
Q

an important point of
stability for perineal
integrity and functions.

A

PERINEAL BODY

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7
Q

ANAL TRIANGLE Boundaries

A

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

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8
Q

CONTENTS OF
ANAL SPHINCTER

A

1.Anus
2.Ischional Fossa

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9
Q

ANAL CANAL measurements :

A

1.5 inches or 4 cm

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10
Q

anal Boundaries anterior in male:

A
  1. Perineal body
  2. Urogenital diaphragm
  3. Membranous part of the urethra
    4.Bulb of the penis
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11
Q

anal Boundaries anterior in female:

A
  1. Perineal body
  2. Urogenital Diaphragm
    3. Lower part of the vagina
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12
Q

Boundaries lateral

A

Fat-filled ischiorectal fossa

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13
Q

Boundaries posterior

A

Anococcygeal body

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14
Q

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

A

UPPER HALF
(with ANAL COLUMNS)

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15
Q

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

A

LOWER HALF
(without ANAL COLUMNS)

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16
Q

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

A

PECTINATE LINE

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17
Q

ANAL SPHINCTERS:

A

INTERNAL SPHINCTER - Involuntary
EXTERNAL SPHINCTER – Voluntary

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18
Q

what’s in ANORECTAL JUNCTION

A

PUBORECTALIS FIBERS

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19
Q

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

A

anorectal ring

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20
Q

What is the Physiology of DEFECATION?

A

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.

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21
Q

Also known as Ischiorectal Fossa

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

ISCHIOANAL FOSSA

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22
Q

ISCHIOANAL FOSSA Contents:

A

1.The pudendal nerve
2.Internal pudendal vessels

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23
Q

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

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

A

PUDENDAL NERVE

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24
Q

PUDENDAL NERVE BRANCHES

A

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

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25
INTERNAL PUDENDAL ARTERY *Branch of the internal iliac artery BRANCHES:
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
26
Boundaries Anterior: PUBIC ARCH Lateral: ISCHIOPUBIC RAMI ISCHIAL TUBEROSITIES
UROGENITAL TRIANGLE
27
UROGENITAL TRIANGLE Layers
1. Skin 2. Superficial perineal fascia 3. Deep perineal fascia 4. Superficial (inferior) perineal space (pouch) 5. Deep (superior) perineal space (pouch)
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FATTY LAYER – superficial
CAMPER’s FASCIA
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30
membranous layer– superficial
SCARPA’s FASCIA
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SUPERFICIAL PERINEALSPACE Zone between the superficial fascia and perineal membrane
1. Posterior Closure 2. Lateral Closure 3. Anterior Closure
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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)
SUPERFICIAL PERINEALSPACE
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
DEEP PERINEAL SPACE AND UROGENITAL DIAPHRAGM
34
Layers of Urogenital Diaphragm
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
35
MALE UROGENITAL TRIANGLE Contents:
1.Penis 2.Scrotum
36
has a fixed root and a body that hangs free 1. Bulb of the penis 2. Right and left crura of the penis
PENIS/PENILE BODY
37
PENIS LYMPH DRAINAGE
penis wall of the scrotum medial group of superficial inguinal lymph nodes
38
nerve supply of anterior scrotum
ilioinguinal nerve genital branch of the genitofemoral nerve
39
nerve supply of posterior scrotum
pudendal and posterior femoral cutaneous nerves
40
Superficial Perineal Space Contents :
*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
41
IMPORTANT MUSCLES
1.Bulbospongiosus muscles 2.Ischiocavernosus muscles 3.Superficial transverse perineal muscles
42
What is the Physiology of PENILE ERECTION and EJACULATION?
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
43
8 in. (20 cm) long * extends from the neck of the bladder to the external meatus on the glans penis
MALE URETHRA
44
parts of MALE URETHRA
1. Postatic urethra 2. Intermediate (membranous) urethra 3.penile (spongy) urethra
45
FEMALE UROGENITAL TRIANGLE CONTENTS:
External Genitalia Orifices of the Urethra and Vagina
46
collective name for the area of the female external genitalia Borders: 1.Mons Pubis 2.Genitocrural fold 3.Perineal body
VULVA
47
Blood Supply of vulva:
external and internal pudendal arteries
48
Lymph drainage of vulva
medial group of superficial inguinal nodes.
49
nerve supply of anterior parts of the vulva
ilioinguinal nerves and the genital branch of the genitofemoral nerves
50
nerve supply of posterior parts of the vulva
Branches of the perineal nerves and the posterior femoral cutaneous nerves
51
* female phallic organ that corresponds to the penis in the male * situated anteriorly, at the apex of the vestibule
CLITORIS
52
parts of CLITORIS
1. CLITORAL ROOT 2. CLITORAL BODY 3. GLANS OF CLITORIS
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Blood Supply of clitoris
internal pudendal artery
54
Lymph drainage of clitoris
internal iliac nodes or to the deep inguinal nodes
55
Nerve Supply of clitoris
Branches of the pudendal nerve carry sensory fibers from the clitoris and provide motor supply to the associated skeletal muscles (ischiocavernosus)
56
paired erectile bodies located on each side of the vestibule, deep to the labia minora * bulbospongiosusmuscle covers each bulb
VESTIBULAR BULB
57
presence of the greater vestibular glands in the female superficial space AND bulbourethral glands perineal space in males.
SUPERFICIAL PERINEAL SPACE
58
SUPERFICIAL PERINEAL SPACE contents
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
59
What is the Physiology of CLITORAL ERECTION OR FEMALE ORGASM?
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.
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
FEMALE URETHRA
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
LESSER VESTIBULAR (PARAURETHRAL) GLANDS
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
VAGINA
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
VAGINA
64
vagina blood supply
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.
Pudendal nerve block
66