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MD3002 Week 9 > 3. Urogenital triangle > Flashcards

3. Urogenital triangle Flashcards

1
Q

What features define the pubic outlet?

A

Pubic symphysis and ischiopubic ramus
to Ischial tuberosity
To sacrotuberous ligament and sacrum and coccyx

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2
Q

Division of the perineum?

A

Anterior urogenital triangle

Posterior anal triangle

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3
Q

Which vessels pass through the lesser sciatic foramen to reach the perineum?

A

Pudendal nerve

Internal pudendal vessels

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4
Q

2 divisions of the urogenital triangle?

A

Divided by the Perineal Membrane into a superior, Deep Pouch and an inferior, Superficial Pouch

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5
Q

Attachments of perineal membrane?

A

Spans urogenital triangle br
between the ischiopubic rami
Attached to the perineal body in the midline posteriorly

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6
Q

Male deep pouch of the urogenital triangle, inferior and upper boundaries?

A

Inferior boundary: The thick perineal membrane and its upper boundary
Upper boundary: The thinner fascia covering the superior surface of the external urethral sphincter and the deep transverse perineal muscles. Also contains urethra and bulbo-urethral glands

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7
Q

Contents of deep pouch of urogenital triangle

A

Superior, deep pouch (or urogenital diaphragm)l, made up of:

  • The external urethral sphincter
  • Urethra and vagina passing through
  • Anterior aperture (opening for the passage of nerves and vessels to the penis or clitoris)
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8
Q

Content of the superficial pouch of the urogenital triangle?

A

Superficial pouch contents:

  • Penis and clitoris
  • Labia minora and majora forming the vulva and vaginal vestibule in the female
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9
Q

Genitalia are attached to the _____ membrane and ischiopubic rami. Are bounded inferiorly by ____ fascia.

A

Genitalia are attached to the perineal membrane and ischiopubic rami. Are bounded inferiorly by superficial fascia.

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10
Q

Change of superficial fascia from abdomen to scrotum?

A

Abdomen: Scarpa’s
Scrotum: Colles’, perineal fascia

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11
Q

Contents and position of dartos fascia in scrotum and penis?

A
  1. Dartos muscle(continuation of Camper’s)
  2. Colles’ membraneous perineal fascia (continuation of Scarpa’s)

Merged together and indistinct in the penis

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12
Q

Similarities between the anatomy of clitoris and penis?

A
  1. Both have 2 crura. Attached to ischiopubic rami and become corpora cavernosa that fill with blood during erection
  2. One central bulb.
    Female: Split as the bulb of vestibule
    Male: Becomes the corpus spongiosum that houses the urethra to prevent compression during erection.

Crura and bulb form the root

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13
Q

How many corpora does the penis have?

A

3 corpora: 2 dorsal cavernosa and the ventral spongiosum

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14
Q

Structural features of penile skin?

A

Dark, loose, no far
Superficial dartos fascia surrounds whole penis
The skin “doubles back on itself” yo form the prepuce/foreskin that is continuous with the glans at the corona

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15
Q

Structure of the corpora cavernosa?

A

Divided by a septum that is complete proximally but pectiniform distally (to even out pressures and stay straight)
Each are surrounded by thick tunica albuginea, and deep fascia (Buck’s)

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16
Q

Structure of the corpus spongiosum?

A

Transmits the urethra and forms the glans as a cap over the corpora cavernosa

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17
Q

Muscles and ligaments of the penis

A

Ischiocavernosus muscle:

  • surrounds each crus
  • bulbospongiosus surrounds the bulb
  • The muscles support the penis and contribute to erection,

Bulbospongiosus
-compresses the urethra during ejaculation or to expel urine

The supportive ligaments are: -Fundiform
-Triangular (suspensory) from the linea alba and pubic symphysis

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18
Q

What is the foreskin?

A

Fold of skin, continuous with the glans. With mucous membrane of the urethra

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19
Q

Sebaceous glands form… in the penis

A

smegma

20
Q

Where is the frenulum?

A

Ventrally between the foreskin and the glans

Increased sensation at either side

21
Q

The skin and glans show a…

A

Ventral, midline raphe

22
Q

4 parts of urethta?

A

Preprostatic
Prostatic
Membraneous
Spongy (containing bulbar and penile)

23
Q

Features of the membranous part of urethra?

A
  • 1-1.5 cm and narrowest part except for external orifice
  • tube of fibro-elastic and smooth muscle, within the striated external sphincter (slow twitch) and pubo-urethral or puboprostatic part of levator ani to resist surges of raised intra-abdominal pressure
24
Q

Shape and relations of external sphincter?

A

Inverted pear: With its base on the perineal membrane and its apex pushing up into the prostatic urethra

25
Q

Features of spongy (bulbar and penile) urethra?

A

16cm long
Narrowest part of external orifice
Contains: Bulbo-urethral glands + scattered glands esp in navicular fossa (lucuna magna)

26
Q

Where are the 2 right angle bends of the urethra?

A
  1. Between membranous and bulbar urethra
  2. In the spongy urethra as it becomes pendulous

These must be straightened when passing a catheter

27
Q

Difference between spongy urethra and external meatus slit in urethra?

A

Spongy urethra – horizontal slit, but External meatus – vertical slit; the direction change causes spiralling of the stream

28
Q

What makes up the vulva?

A

Labia minora
Labia majora: Meet anteriorly to form the mons pubis while posterior they form the posterior commmissure or fourchette
Vestibule between minora, contains vagina and urethral oppening
Prepuce of clitoris (from minora)

29
Q

What must be done during an episiotomy?

A

Episiotomy must be backwards and angled laterally, usually to the right, to avoid cutting the anal sphincter

(Procedure to open vaginal opening in a controlled nature)

30
Q

Structure of clitoris?

A

The body is essentially just the 2 crura, while the bulb contributes minimally as a little cap over the highly sensitive glans
The bulb of erectile tissue is divided by the vagina and covered by bulbospongiosus that aids the pubovaginalis part of levator ani in its sphincteric affect

31
Q

Glands and bulbs of the vulva?

A

Bulbs of the vestibule and the right greater vestibular gland.
Th greater vestibular or Bartholin’s glands may be the site of painful cysts or abscessformation

32
Q

Epithelium of the urethra?

A 
1. Urothelium until ejaculatory ducts
Then...
2. Pseudo stratified columnar
Then...
3. Stratified squamous in distal urethra
Then...
4. Keratinised at external orifice
33
Q

Navicular fossa promotes defensive ….

A

Lactobacilli

34
Q

The internal pudendal supplies the perineum and in both sexes gives arteries to supply the..

A 
Urethra
Posterior 2/3 of the scrotum or labia (anterior via external pudendal from femoral)
Cavernous tissue of penis or clitoris 
Skin of shaft
Glans of penis or clitoris
35
Q

Layers of the penis

A
  1. Skin
  2. fascia
  3. Superficial dorsal veins (to the external pudendals)
  4. Buck’s fascia
  5. Deep dorsal vein (to prostatic plexus –> Internal iliac vein) , Dorsal penile artery, Dorsal nerve of the penis
  6. 2 x corpus cavernosa (containing deep arteries and veins) and corpus spongiosum (containing the urethra and urethral arteries)
36
Q

Drainage of penis

A

Penile skin and foreskin –> SUPERFICIAL DORSAL VEINS –> External pudendals

Glans and shaft –> DEEP DORSAL VEIN –> Prostatic plexus and then internal iliac

Corpus cavernosa–> DEEP VEINS –> Internal pudendal

Internal pudendal inferior to the levator ani recieves scrotal (labial) and penile tributaries

37
Q

Prostatic and vesical plexuses drain to…

A

Internal iliac vein

38
Q 
Lymph drainage of :
Corpora cavernosa,
Corpus spongiosum,
Bulb of penis and vestibule,
Proximal vagina and 
Urethra is to....
A

The internal iliac nodes

39
Q

Lymph drainage of:
Superficial penis
Scrotum
Labia is to…

A

Superficial inguinal nodes

40
Q

Lymph drainage of Glans of penis and clitoris is to..

A

Deep inguinal (Cloquet) and external iliac nodes

41
Q

Perineal nerves need to provide somatic motor control of which striated muscles?

A 
External urethral sphincter
Anal sphincter
Bulbospongiosus
Ischio-cavernosus
Perinei
42
Q

Sensation innervation is require for which perineal structures?

A

Urethra
Glans of penis
Clitoris

43
Q

Where is somatic, sensation and autonomic sensation derived from in the perineum?

A

S2,3,4- Pudendal nerves (Somatic)
and
Pelvic plexus (ANS)

44
Q

Branches given of by pudendal nerve (S2,3,4)

A

Muscular branches to: Bulbospong, ischiocav and external urethral sphincter

Dorsal nerve of penis:
-Sensory as far as glans

Perineal nerve:
-Gives posterior scrotal (or labial) nerves

45
Q

Parasympathetics pelvic splanchnics are from..

A

S2,3,4

46
Q

Cavernous nerves pass to..

A 
Prostate and urethra
Corpus spongiosum
Erectile tissue of corpora cavernosa 
Penis
Clitoris

MD3002 Week 9 (10 decks)

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