LEC34: Pelvis, Perineum, and Female Reproductive Anatomy Flashcards
openings in male pelvic diaphragm
urethral hiatus, anorectal hiatus
openings in female pelvic diaphragm
urethra, vagina, rectum
muscles of pelvic diaphragm
puborectalis, pubococcygeus, iliococcygeus, coccygeus (ischiococcygeus)
extremity muscles
muscles that move the lower extremity, but origins are outside pelvic diaphragm
obturator internus, piriformis
levator anai
muscles that elevate the anus; cover pelvic opening
puborectalis, pubococcygeus, iliococcygeus
clinical significance of women having wider gap between levator anai muscles
after birth, area becomes loose, more likely to have organs prolapse through this area
kegel
exercises women can do to tighten pelvic floor muscles
what does pelvic diaphragm support
organs: rectum, bladder, uterus
where is external anal sphincter
below pelvic diaphragm
muscles of anal sphincter
1) levator ani portion of pelvic diaphragm (SKELETAL)
2) external anal sphincter (SKELETAL)
3) internal anal sphincter (SMOOTH)
what innervates anal sphincter area
inferior rectal nerve, branch of pudendal n.
S2, 3, 4
what is the shape of the anal canal / why does this matter
banana shape- flexure from sigmoid colon > rectum
anything inserted into canal must be flexible, not too big for that area (i.e. re: abuse)
2 triangles inferior to pelvic bones
anal triangle of perineum, urogenital triangle of perineum
boundaries of anal triangle of perineum
point of coccyx, front of pubis, ischeal tuberosities (on side)
what structure is wider in females
urogenital triangle of perineum - can widen during childbirth
perineum meaning
“area around the newborn”
same name for men and women
what surrounds anal triangle
ischiorectal fossa, pocket filled with fat - can compress when vagina or anus expands, and is expendable
urogenital diaphragm (UGD)
aka deep perineal pouch
forms a shelf superficial to the pelvic diaphragm, has 2 layers of fascia
layers of fascia around UGD
superior and inferior (perineal) fascia layers
what does UGD’s fascia membrane contain
contains muscles of urogenital diaphragm in a pouch called deep perineal pouch
what is within deep perineal pouch
deep transverse perineal muscle
sphincter urethrae m (males)
sphincter urethrea m + spincter urethrovaginalis (females)
structures within male urogenital diaphragm/deep pouch
urethral sphincter, bulbourethral gland, deep transverse perineal muscle
what does bulbourethral gland contribute to
fluid of the ejaculate
shape of female bladder
flat top, except when very expanded, because uterus sits directly on top
urethra length in women vs. men
short in women, long in men
is cistitis more common in women or men
women because their urethra is so short, can get bacteria up tube very easily
cell type of bladder, importance
transitional epithelium
allows for massive distortion of shape of whole organ
why does bladder sometimes appear to be an abdominal organ, and is it?
transitional epithelium of bladder means bladder can change shape, go over pelvic brim, appear to go into abdominal area, although in reality it’s in peritoneum so isn’t an abdominal organ
can you work out your bladder muscles
no!
can train yourself to not react when full, but not skeletal, so not excercisable
can you work out pelvic floor muscles?
yes!
are skeletal muscles, so can work them out
sections of male urethra
1) preprostatic part
2) prostatic part- through the prostate
3) membranous part- through peritoneal membrane
4) spongy part- through penis
where do prostate fluids drain
prostatic sinuses, where prostatic utricle, opening of ejaculatory ducts are
sympathetic innervation of pelvic area
superior hypogastric plexus
comes from above
parasympathetic innervation of pelvic area
pelvics
go into inferior hypogastric plexus
> smooth muscle of pelvis, i.e. bladder, to propel things down the ureter
what controls erectile tissue
blood flow
controlled by autonomics of pelvic splanchnic nerves
prostatic plexus
cluster of nerves from inferior hypogastric plexus nerves; run on both sides of diaphragm, cluster around prostate
makes surgery difficult
glans
where fluid exits seminal vesicle