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SMP - SDR > GA Lab 2 - Male Perineum & Pelvis > Flashcards

GA Lab 2 - Male Perineum & Pelvis Flashcards

1
Q

What is the perineal membrane?

A

Thick fibrous sheath that fills the urogenital triangle

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2
Q

Attachments of the perineal membrane?

A

Free posterior border and attached laterally to the pubic arch

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3
Q

Role of perineal membrane?

A

Provides support for the external genitalia, which are attached to its inferior surface

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4
Q

What does the perineal membrane separate?

A

Separates the deep and superficial pouches

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5
Q

What is the root of the penis made up of?

A

Both corporus spongiosum and corpora cavernosa

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6
Q

When does the body of the penis start?

A

Begins when the two proximal free parts of the corpora cavernosa and corpus spogiosum meet = free part of the penis

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7
Q

What does Colle’s fascia attach to? What is it continuous with?

A

Attached:

  1. To posterior end of the perineal membrane (does not extend to anal triangle)
  2. To ischiopubic rami (does not extend into the thigh)

Continuous with fascia on the anterior abdominal wall

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8
Q

What is Darto’s fascia?

A

Superficial fascia of scrotum made of BOTH Scarpa’s and Camper’s fascia

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9
Q

6 layers around testes and what they correspond to in the anterior abdominal wall?

A
  1. Skin
  2. Dartos fascia => BOTH Scarpa’s and Camper’s fascia
  3. External spermatic fascia => external oblique aponeurosis
  4. Cremasteric fascia and muscle => internal oblique muscle
  5. Internal spermatic fascia => transversalis fascia
  6. Obliterated processus vaginalis = visceral and parietal tunica vaginalis => parietal peritoneum
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10
Q

9 contents of spermatic cord?

A
  1. Genital branch of genitofemoral nerve
  2. Deferential artery + vein
  3. Ductus deferens
  4. Pampiniform plexus of testicular veins
  5. Testicular artery from abdominal aorta
  6. Cremasteric artery and vein
  7. Sympathetic efferents and visceral afferents (later ones carrying pain)
  8. Lymphatics
  9. Remnants of the processus vaginalis
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11
Q

What is the spermatic cord enveloped by?

A

External spermatic fascia

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12
Q

What is the scrotal ligament? Embryological derivation? Purpose? Other name?

A

Ligament that secures the testis to the most inferior portion of the scrotum

  • Remnant of gubernaculum in a fetus
  • Tethering it in place and limiting the degree to which the testis can move within the scrotum

= testicular ligament

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13
Q

Does the visceral layer of the tunica vaginalis cover the whole testis?

A

NOPE - not the posterior aspect

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14
Q

Other name for deferential artery?

A

Artery of ductus

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15
Q

Position of ductus deferens in relation to the spermatic cord?

A

Posterior

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16
Q

Is the perineal body more prominent in males or females?

A

Females

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17
Q

What defines the superior margin of the superficial perineal pouch?

A

Perineal membrane

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18
Q

Location of perineal membrane with regards to erectile tissues and their muscles?

A

Superior

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19
Q

What is the deep fascia of the penis called? What does it contain? What does it NOT contain?

A

Buck’s fascia

Contains corpora cavernosa, corpus spongiosum, dorsal arteries, deep dorsal vein, dorsal nerve

Does NOT contain superficial dorsal vein

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20
Q

What is the terminal branch of the anterior trunk of the internal iliac artery?

A

Inferior gluteal artery

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21
Q

Levator ani muscles:

  1. Origin
  2. Insertion
  3. Innervation
  4. Function
A
  1. In a line around the pelvic wall: from the posterior aspect of the pubic bone => tendinous arch of obturator internus muscle (thickening of the obturator internus fascia) => ischial spine
    • Anterior part: superior surface of the perineal membrane
    • Posterior part: meets its partner on the other side at the perineal body, around the anal canal, and along the anococcygeal ligament
  3. Branches direct from the anterior ramus of S4, and by the inferior rectal branch of the pudendal nerve (S2 to S4)
    • Contributes to the formation of the pelvic floor, which supports the pelvic viscera
    • Maintains a 90 degree angle between the rectum and anal canal
    • Reinforces the external anal sphincter
    • In women: functions as a vaginal sphincter (sphincter vaginae) during orgasm
    • In men: principal support for the prostate (levator prostatae)
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22
Q

Describe the pathway of the inferior rectal nerve and its function.

A

Penetrates through the fascia of the pudendal canal, and courses medially across the ischio-anal fossa

  1. Innervates the external anal sphincter and related regions of the levator ani muscles
  2. Provides general sensory for the skin of the anal triangle
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23
Q

What 3 structures run on the dorsal surface of the penis?

A
  1. 2 dorsal arteries
  2. 1 deep dorsal vein
  3. Dorsal nerve
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24
Q

From what artery does the dorsal artery of the penis originate from?

A

Internal pudendal artery

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25
Q

What is the bulb of the penis?

A

Proximal part of corpus spongiosum

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26
Q

What is the root of the penis made of?

A

Crura + bulb of the penis

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27
Q

What is the navicular fossa?

A

Enlarged distal portion of the spongy urethra at the end of the penis within the glans

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28
Q

What runs within the corpora cavernosa?

A

Deep artery of the penis

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29
Q

What separates the corpora cavernosa and the corporus spongiosum? What does it form?

A

Tunica albuginea of corpora cavernosa

Forms a septum between the 2 corpora cavernosa

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30
Q

Vertebral level of male rectum?

A

S3

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31
Q

Lymphatic drainage of the rectum?

A
  1. Superficial inguinal nodes following inferior rectal artery to internal pudendal artery
  2. Internal iliac nodes following middle rectal artery to internal iliac artery
  3. Inferior mesenteric nodes following superior rectal artery to the IMA
32
Q

Rectum innervation?

A
  • Top half: autonomic afferent nerves

- Bottom half: inferior hypogastric plexuses

33
Q

What is the median umbilical ligament?

A

Remnant of the urachus, which contributes to the formation of the bladder

Connects the umbilicus to the bladder

34
Q

What are the puboprostatic ligaments?

A

Paired fibromuscular bands anchoring the neck of the bladder and urethra to the posterior aspect of the pubic bone

35
Q

What crosses over the ureters in men and women?

A
  1. Men: ductus deferens posterior to the bladder

2. Women: uterine artery lateral to the cervix

36
Q

What is the superior surface of the male bladder covered by?

A

Peritoneum

37
Q

Bladder innervation?

A

Inferior hypogastric plexuses

38
Q

Do the bulbo-urethral glands connect to the membranous urethra?

A

NOPE, to the spongy

39
Q

What is located anterior to the prostate?

A

Pubic symphysis

40
Q

What artery supplies the prostate?

A

Inferior vesicle artery

41
Q

Venous drainage of prostate?

A

Prostatic venous plexus draining to the internal iliac veins

42
Q

Lymph drainage of prostate?

A

Internal iliac nodes

43
Q

Innervation of prostate?

A

Inferior hypogastric plexuses

44
Q

What forms the ejaculatory duct?

A

Ductus deferens joined by ducts of seminal vesicles

45
Q

What do the ducts of the bulbo-urethral glands pass through to reach spongy urethra?

A

Perineal membrane

46
Q

Vertebral level of internal iliac artery?

A

L5/S1

47
Q

What does the iliolumbar artery supply?

A

Posterior abdominal wall

48
Q

What does the lateral sacral artery supply?

A

Sacrum

49
Q

Where do the para-aortic nodes drain to?

A

Thoracic duct

50
Q

What is the sciatic nerve made of?

A

L4-S3

51
Q

Describe the pathway of the sciatic nerve.

A

Exits through greater sciatic foramen inferior to piriformis => divides into 2 major branches: common fibular and tibial nerves

52
Q

What does the sciatic nerve innervate?

A
  1. Muscles in the posterior compartment of the thigh and muscles in leg and foot
  2. Carriers sensory fibers from skin of foot and lateral leg
53
Q

10 branches of sacral plexus?

A
  1. Superior gluteal nerve
  2. Inferior gluteal nerve
  3. Nerve to quadratus femoris and inferior gemellus
  4. Posterior femoral cutaneous nerve of the thigh
  5. Perforating cutaneous
  6. Nerve to piriformis
  7. Nerves to levator ani, coccygeus and external anal sphincter
  8. Coccygeal plexus
  9. Pudendal nerve
  10. Sciatic nerve
54
Q

Superior gluteal nerve:

  1. Spinal segment?
  2. Function?
A

L4-S1

Gluteus medius and minimum
Tensor fasciae latae

55
Q

Inferior gluteal nerve

  1. Spinal segment?
  2. Function?
A

L5-S2

Gluteus maximum

56
Q

Nerve to quadratus femoris and inferior gemellus

  1. Spinal segment?
  2. Function?
A

L4-S1

Quadratus femoris and inferior gemellus

57
Q

Posterior femoral cutaneous nerve of the thigh

  1. Spinal segment?
  2. Function?
A

S1 + S3

Skin of the posterior aspect of the thigh

58
Q

Perforating cutaneous

  1. Spinal segment?
  2. Function?
A

S2 + S3

Skin over gluteal fold

59
Q

Nerve to piriformis

  1. Spinal segment?
  2. Function?
A

L5-S2

Piriformis muscle

60
Q

Nerves to levator ani, coccygeus and external anal sphincter

  1. Spinal segment?
  2. Function?
A

S4

Levator ani, coccygeus and external anal sphincter + small patch of skin between anus and coccyx

61
Q

Coccygeal plexus

  1. Spinal segment?
  2. Function?
A

S4-Co

Perianal skin

62
Q

Role of pelvic sympathetic fibers?

A
  1. Vasoconstriction
  2. Cause smooth muscle contractions of internal urethral and anal sphincters
  3. Cause smooth muscle contractions associated with reproductive tracts
  4. Important in moving secretions from epididymis into urethra
63
Q

Role of pelvic parasympathetic fibers?

A
  1. Vasodilation
  2. Stimulate bladder contractions
  3. Stimulate erection
  4. Modulate activity of ENS of colon distal to left colic flexure
64
Q

At what part is the spongy urethra NOT protected by erectile tissue? Consequence?

A

At point where it becomes the membranous urethra

Potential damage site

65
Q

What is the sacrogenital fold?

A

Peritoneal fold that extends backward from the sides of the bladder of the male or uterus of the female on either side of the rectum to the sacrum, forming the lateral boundaries of the rectovesical pouch

66
Q

What is found on each side of the rectum?

A

Pararectal fossa

67
Q

What is found on each side of the bladder?

A

Paravesicular fossa

68
Q

What is the supravesicular fossa?

A

Fossa superior to bladder between that and the pubic symphysis

69
Q

What is the rectal ampulla?

A

Lower expanded portion of the rectum

70
Q

Relationship of ureter with regards to inferior epigastric artery?

A

Passes lateral and then posterior as it bends to course medially

71
Q

2 branches of external iliac artery?

A
  1. Inferior epigastric artery

2. Deep iliac circumflex artery

72
Q

Where does the deep dorsal vein of the penis drain? What does it drain?

A

Prostatic plexus of veins

Drains glans penis and corpora cavernosa

73
Q

What do the superficial veins of the penis drain?

A

Prepuce and skin of penis

74
Q

Does Colle’s fascia extend to anal triangle?

A

NOPE

75
Q

Differences between Colle’s and Darto’s fascias?

A
  1. Colle’s in perineum/Darto’s in scrotum
  2. Colle’s corresponds to a continuation of Scarpa’s fascia ONLY (from anterior abdominal wall)/Darto’s corresponds to both Scarpa’s and Camper’s fused together
Scarpa's = membranous superficial fascia
Camper's = fatty superficial fascia
76
Q

When do the testes descend into scrotum? How?

A

7-month-old fetus via the inguinal canal

3 phases:

  1. Testes attachment to the cranial suspensory ligament is severed + gubernaculum contracts (both hormone induced)
  2. Transabdominal descent brings testes down to inguinal ring located cranially to the scrotum
  3. Transinguinal descent brings testes into scrotum

SMP - SDR (23 decks)

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