Female Perineum Flashcards
What separates the perineum from the pelvic cavity?
Pelvic diaphragm
What are the two triangles within the perineum?
urogenital triangle and anal triangle
What are the borders of the perineum?
pubic symphysis, ischial tuberosities, and coccyx
Anal triangle contains
anal canal
ischio-anal fossa
pudendal canal
Ischio-anal fossa
wedge shaped space on either side of anal canal (fat, inferior rectal VAN, cutaneous nerves)
Ischo-anal fossa abscesses
Pudendal canal
horizontal passageway within obturator fascia
contains internal pudendal a and v, pudendal n, and nerve to obturator internus
^^^ from lesser sciatic foramen
What is part of the urogenital triangle for females?
urethra
mons pubis
labia majora
labia minora
vestibule of vagina
vestibular glands
bulbs of vestibule
clitoris
superficial perineal mm
deep perineal mm
What is the innervation of the urethra?
Prox: visceral afferents S2-S4
distal: somatic afferents S2-S4
What is the arterial supply for the urethra?
prox: vaginal a
distal: internal pudendal a branches
Venous supply for urethra?
internal iliac vv
Lumbar innervation for perineum?
mons pubs and anterior labia majora
L1- ilioingual n
L1/2- genitofemoral n
Sacral innervation for perineum?
Clitoris: dorsal n of clitoris (S2-S4)
Central perineum: superficial branch of perineal n (S2-S4)
Vaginal orifice/lower vagina: deep branch of perineal n (S2-S4)
Lateral perineum: perineal branch of posterior femoral cutaneous n (S2-S3)
Arterial supply of vulva?
inferior pudendal a branches
- posterior labial a (labia majora and minora
- artery of vestibule (bulb and greater vestibular glands)
Deep a of clitoris (corpus cavernosum)
dorsal a of clitoris (glans clitoris)
external pudendal a branches (mons pubis and anterior labia majora)
Proximal urethra where? distal?
prox: pelvis
distal: perineum
why is there increased UTI risk for female urethra?
4 cm in length
Urethra has what spincter?
external urethral spincter
What are the glands draining directly into the urethra?
urethral glands
What are the glands that drain into the vaginal vestibule. What are they homologus to?
Paraurethral glands
homologus to prostrate glands
Fatty eminence anterior to pubic symphysis
mons pubis
labia majora
folds on either side of pudendal cleft contains sebaceous glands AND hair follicles
join at anterior and posterior commissures
Labia minora
folds of HAIRLESS skin with sebaceous glands
surrounds vestibule fo vagina
anterior: prepuce and frenulum of clitoris
connected posteriorly by transverse fold (frenulum of labia minora)
Vestibule of vagina
space central to labia majora
external urethral orifice surrounded by paraurethral duct openings
Vaginal orifice
Vestibular gland duct openings
Greater vestibular glands
enter at 5 and 7 o clock position
covered by bulbospongious m
secrete mucus during sexual arousal
homologues to bulbo-urethral glands in males
Bulbs of vestibule
erectile tissue superior to but not within labia majora
homologues to bulb/corpus spongiosum of penis
Clitoris
erectile tissue at anterior labia majora
glans (dorsal n of clitoris)
body (covered by prepuce and contains corpus cavernosa)
crura (attach to inferior pubic rami)
Superficial perineal mm
Ischiocavernosus m
Bulbospongiosus m
Superficial transverse perinal m
Ischocavernosus m
compress crura of clitoris and assist erectionBu
Bulbospongiosus m
compresses bulb of vaginal bestibule
assists clitorial erection
support pelvic floor
Superficial transverse perinal m
attach to perinal body and assist with support of pelvic floor
Deep perineal mm
deep transverse perineal m
external urethral spincter
Deep transverse perinal m
attaches to perineal body and assists with support of pelvic floor
innervated by deep branch of perineal n
External urethral spincter
voluntary spincter maintains urinary continence
innervated by dorsal n of clitoris
Perineal pouches
Vertical subdivisions of urogenital triangle
separated by perineal membrane
superficial (inferior to membrane)
deep (superior to membrane)
Fascia of perineum
superficial and deep
perineal membrane separates
deep and superficial perineal pouches
Lymphatics for perineum
most drainage to superficial inguinal nodes
EXCEPT
1. glans clitoris to deep inguinal nodes
2. urethra and anal canal above pectinate line to internal iliac nodes
Superficial perineal fascia
continues anteriorly as membranous layer of abdominal wall subcutaneous tissue
ends posteriorly at perineal body
ends laterally at fascia lata
Deep perinal fascia
covers superficial perineal mm.
