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Anatomy 314 - Urogen > Lecture 10: Pelvic diaphragm and perineum > Flashcards

Lecture 10: Pelvic diaphragm and perineum Flashcards

1
Q

Pelvic cavity

A
  • Pelvis cavity is a space surrounded by the pelvic girdle.
  • Area of transition between the trunk & lower limbs.
  • Bony components of pelvic girdle: ➢Right and left hip (innominate/pelvic)
    bones and sacrum.
  • Pelvic cavity subdivided by pelvic brim (pelvic inlet) into:
  • Greater (false) pelvis (contains the inferior abdominal viscera).
  • Lesser (true) pelvis includes pelvic cavity.
  • Pelvic cavity walls: antero-inferior, posterior, 2 lateral, floor.
  • Pelvic outlet – includes inferior pelvic aperture.
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2
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A
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3
Q

Lateral pelvic walls are covered by

A

obturator internus muscles:
➢Obturator fascia thickened to form tendinous arch.

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4
Q

Posterolateral wall contains

A

piriformis muscle.

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5
Q

Pelvic floor is formed by:

A

➢ Pelvic diaphragm muscles (coccygeus and levator ani).

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6
Q

Pelvic floor location

A

in the pelvic outlet.

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7
Q

Pelvic floor is attached to the

A

tendinous arch

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8
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9
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10
Q

Pelvic Floor: Pelvic diaphragm
Formed by pelvic diaphragm muscles:

A

Coccygeus and levator ani muscles.

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11
Q

Pelvic Floor: Pelvic diaphragm
Formed by pelvic diaphragm muscles:
Separates

A

pelvic cavity from perineum.

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12
Q

Coccygeus: Origin

A

from lateral aspect of inferior sacrum & coccyx

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13
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Coccygeus: distal

A

attaches to sacrospinous ligament

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14
Q

Levator ani:

A

attached anteriorly to pubic bones, ischial spines posteriorly & tendinous arch laterally.
➢Like a hammock between the bones of the pelvis.
➢Anterior gap between medial borders:
- urogenital hiatus.
- passage for urethra (& vagina in females).

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15
Q

Levator ani is composed of 3 muscles:

A

Puborectalis
Pubococcygeus
Iliococcygeus

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16
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17
Q

Puborectalis:

A

runs from posterior pubis and forms a sling around rectum.
➢Forms boundary of urogenital hiatus.

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18
Q

Pubococcygeus:

A

runs from posterior pubis & tendinous arch to coccyx, join in the midline to form anococcygeal ligament (extends from anus to coccyx).
➢Lateral to puborectalis.
➢Gives off muscular slips to midline structures: puboprostaticus (males), pubovaginalis (females), puboanalis.

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19
Q

Iliococcygeus:

A

runs from tendinous arch & ischial spine to anococcygeal ligament.
➢Most posterolateral of the three muscles.

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20
Q

Levator ani functions

A

supports pelvic viscera:
➢Maintains closure of rectum and vagina.
➢Puborectalis: maintains the perineal flexure (angle) – keeps rectum closed (continence).
➢supports posterior pelvic floor.

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21
Q

Pelvic diaphragm

A
22
Q

Perineum is the

A

Diamond-shaped region between the thighs, inferior to the pelvic floor

23
Q

Perineum is bounded by

A

pelvic outlet and separated from pelvic cavity by pelvic diaphragm.

24
Q

Perineum contains:

A

anal canal, urethra, vagina (females) & external genitalia.

25
Q

Perineum borders:

A

➢Anterior – pubic symphysis.
➢Anterolateral – inferior pubic rami and ischial rami.
➢Lateral – ischial tuberosities.
➢Posterolateral – sacrotuberous ligaments.
➢Posterior – sacrum and coccyx.

26
Q

Perineum divided into 2 triangles

A

by a line drawn between ischial tuberosities:
➢Urogenital triangle: contains urethra & external genitalia.
➢Anal triangle: contains anus & external anal sphincter.

27
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28
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29
Q

Urogenital triangle:
Perineal membrane

A
  • Urogenital hiatus – is the U shaped defect in anterior part of levator ani muscles.
  • “Filled in” by the perineal membrane:
    ➢Thick fibrous sheet.
    ➢Free posterior border, anchored in posterior midline to perineal body, attached laterally to pubic arch.
30
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31
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32
Q

Urogenital triangle: Perineal body

A

irregular mass containing collagen and elastic fibers, skeletal and smooth muscle.

33
Q

Perineal body lies

A

deep to skin, posterior to vaginal vestibule/ bulb of penis, anterior to anus and anal canal.

34
Q

Anterior part of perineal body

A

blends with perineal membrane, superior part with rectovesical (males) or rectovaginal septum (females).

35
Q

Perineal body is a site of convergence of muscles:

A

➢Bulbospongiosus.
➢External anal sphincter.
➢Superficial and deep transverse perineal.
➢Smooth & voluntary slips from external urethral sphincter, levator ani.

36
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A
37
Q

Urogenital triangle: Perineal pouches

A
  • Perineal membrane divides urogenital triangle into two pouches/spaces:
  • Deep perineal pouch is superior to perineal membrane.
    ➢Contains skeletal muscle (external urethral sphincter, deep transverse perineal) & neurovascular tissues.
    ➢Pierced by urethra in male, urethra & vagina in female.
  • Superficial perineal pouch is below (superficial to) perineal membrane.
    • Contains the external genitalia & associated skeletal muscles (Superficial transverse perineal, bulbospongiosus, ischiocavernosus).
38
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39
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40
Q

Superficial perineal space: Contents Male

A
  • Bulb and crura of penis.
  • Proximal spongy urethra.
  • Superficial transverse perineal muscles.
  • Bulbospongiosus muscles.
  • Ischiocavernosus muscles.
  • Deep perineal vessels & dorsal nerve of penis.
41
Q
A
42
Q

Superficial perineal space: Contents Female

A
  • Clitoris and bulbs of the vestibule.
  • Greater vestibular glands.
  • Superficial transverse perineal muscles.
  • Bulbospongiosus muscles.
  • Ischiocavernosus muscles.
  • Deep perineal vessels & dorsal nerve of clitoris.
43
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A
44
Q

Perineal muscles:
Function

A
  • Perineal muscles: assists in urination in both sexes.
  • Ejaculation in males.
  • Strengthen pelvic floor/perineal body.
  • Assists & maintains erection of penis (males) and clitoris (females).
  • Bulbospongiosus compresses bulb of penis to expel last drops of urine/semen.
  • More well developed in males.
45
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A
46
Q

Nerve supply of perineal muscles

A
  • Muscles of perineum: bulbospongiosus, ischiocavernosus, superficial and deep transverse perineal:
    ➢deep branch of perineal nerve, branch of pudendal nerve (S2, S3, S4).
  • External urethral sphincter:
    ➢dorsal nerve of penis or clitoris (terminal branch of pudendal nerve, S2, S3, S4).
  • External anal sphincter by inferior rectal nerve (branch of pudendal nerve, S2, S3, S4).
47
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48
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A
49
Q

Urogenital diaphragm consists of

A

The deep perineal muscles:
* Paired deep transverse perineal.
* External urethral sphincter.

AND
Fascial coverings:
* The inferior fascia –perineal membrane.
* Superior fascia (continuous with pelvic fascia).

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51
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Anatomy 314 - Urogen (10 decks)

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