Class 3 Flashcards

1
Q

What is the most inferior portion of the trunk?

A

Perineum

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2
Q

The perineum lies inferior to what?

A

Pelvic diaphragm

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3
Q

Name some structures in the male perineum

A

External genitalia (urethra, scrotum and penis)
Perineal muscles
Anal canal

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4
Q

Name some structures in the female perineum

A

Female external genitalia
Perineal muscles
Anal canal

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5
Q

We can divide the perineum into two triangular areas, with the base of each triangle being a line joining the two ischial tuberosities transversely.

Name the two triangles

A

Urogenital triangle

Anal triangle

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6
Q

A thin sheet of deep fascia stretches between right and left sides of the pubic arch, below the pubis symphysis.

What is the name given to this fascia?

A

Perineal membrane

lies directly inferior to the deep perineal space

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7
Q

Name 4 muscles of the perineum

A

External anal sphincter
Superficial transverse perineal muscle
Bulbospongiosus
Ischiocavernosus

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8
Q

What is the innervation of the external anal sphincter?

A

Branch of pudendal nerve

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9
Q

What are the main actions of the external anal sphincter?

A

Constricts anal canal during peristalsis resisting defication

Supports and fixes perineal body/ pelvic floor

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10
Q

What is the innervation and action of the bulbospongiosus muscle?

A

Branch of pudendal nerve

Supports and fixes perineal body/pelvic floor

Males:

  • compresses bulb of penis to expell last drops of semen/urine
  • assists erection by compressing outflow of blood from penis

Female:

  • assists in erection of clitoris and bulb of vestibule
  • compresses greater vestibular gland
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11
Q

What is the innervation and action of the ischiocavernosus muscle?

A

Branch of pudendal nerve

Maintains erection of penis or clitoris by compressing outflow veins and pushing blood from rest of penis or clitorus into body

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12
Q

What is the innervation and action of the superficial transverse perineal muscle and the deep transverse perineal muscle?

A

Pudendal nerve

Support and fix perineal body to support abdominopelvic viscera and resist increased intra abdominal pressure

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13
Q

What is the innervation and action of the external urethral sphincter?

A

Pudendal nerve

Compress urethra to maintain urinary continence

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14
Q

What is the perineal body?

A

Irregular fibromuscular mass located in the median plane between the anal canal and the perineal membrane

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15
Q

What muscles converge towards the perineal body?

A

Bulbospongiosus

External anal sphincter

Superficial and deep transverse perineal muscles

Smooth and voluntary slips of muscle from the external urethral sphincter, levator ani and muscular coats of the rectum

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16
Q

What is an episiotomy?

A

Surgical incision of the perineum and vaginal wall done during labour or vaginal surgery to avoid excessive tearing of the perineum and perineal muscles

17
Q

What are the superficial and deep perineal pouches?

What are their clinical significance?

A

Fascia- limited, potential spaces traversed by the urethra.

They can become infiltrated by urine following traumatic or surgical injury of the urethra

18
Q

The external urethral sphincter is found in which perineal space?

A

Deep perineal space

19
Q

The internal/ vesical urethral sphincter is found in which perineal space?

A

Subperitoneal space

20
Q

Where does the superficial perineal pouch lie?

A

Antero-inferior to the urogenital membrane and surrounds the external genitalia

21
Q

The deep perineal pouch surrounds what?

A

The deep transverse perineal muscle

22
Q

WHat are the 3 parts of the male urethra?

A

Prostatic
Membranous
Spongy

23
Q

What are the widest and narrowest parts of the male urethra and why?

A

Widest:

  • Prostatic part,
  • Urinary and reproductive tracts meet, lots of secretions

Narrowest:

  • Membranous,
  • Surrounded by circular fibres of external urethral sphincter (very fixed)
24
Q

The ischio-anal (ischio-rectal) fosse lies where?

A

Inferior to the pelvic floor and lateral to the anal canal

25
Q

What is the function of the ischio-anal fossae?

A

Allows the anal canal to expand during defaecation

26
Q

What is the major content of the ischia-anal fosse, and why is this often a site of abscess formation?

A

Loose connective tissue:

-FAT

27
Q

A neurovascular bundle enters the ischio-anal (rectal) fosse through the lesser sciatic foramen.

What structures are present in this bundle?

A

Pudendal canal:

  • Internal Pudendal artery
  • Internal Pudendal Vein
  • Pudendal nerve
28
Q

What does the pudendal canal supply?

A

Supply and drain blood from perineum

Innervates most of perineum

29
Q

Which perineal triangle lies inferior to the pubis symphysis?

A

Urogenital

30
Q

Which perineal triangle lies anteroinferior to the coccyx?

A

Anal triangle