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Endo Exam 2 > Male and Female Pelvis and Perineum > Flashcards

Male and Female Pelvis and Perineum Flashcards

(102 cards)

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1
Q

perineum division

A

line connecting ischial tuberosities

anal triangle
UG triangle

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2
Q

boundaries of anal triangle

A

anterior - posterior edge of UG diaphragm
posterolateral - ischial tuberosities and sacrotuberous ligament
posterior - coccyx

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3
Q

contents of anal triangle

A

anal canal
ischioanal fossa
vessels and nerves to perineum

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4
Q

external anal sphincter

A

voluntary muscle surrounding anal canal

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5
Q

divisions of anal triangle

A

subQ - circular fibers
superficial - tendon of perineum to coccyx
deep - encircles anal canal

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6
Q

attachment of tendon of perineum to coccyx

A

central tendon male

perineal body female

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7
Q

currugator cutis ani

A

superficial of external anal sphinchter

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8
Q

ischioanal fossa

A

below levator ani muscle
-between superficial anal triangle and pelvic diaphragm

posteriorly - left and right communicate
anterior - separation by anterior recesses

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9
Q

anterior ischioanal fossa

A

adipose tissue
- continuation of campers fascia

internal pudendal nerves
inferior rectal vessels
internal pudendal nerves

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10
Q

internal pudendal artery

A

1 of 2 terminal branches
-of internal iliac artery

leaves pelvis through greater sciatic foramen
-crosses ischial spine between sacrospinous ligament and sacrotuberous ligament

comes back into perineum via lesser sciatic foramen

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11
Q

alcocks canal

A

aka pudendal canal

  • split of obturator fascia
  • contains internal pudendal vessels and pudendal nerve
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12
Q

branches of internal pudendal artery

A

in ischioanal fossa

  • inferior rectal - 1st branch
  • perineal artery - 2nd branch
  • deep and dorsal arteries of penis (clitoris)
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13
Q

inferior rectal artery

A

supplies sphincter, anal canal, skin of anus

first branch of internal pudendal artery

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14
Q

perineal artery

A

2nd branch of internal pudendal artery

arises - posterior edge of UG

  • branches further:
  • transverse perineal arteries
  • posterior scrotal artery - males
  • posteior labial artery - females
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15
Q

perineal artery blood supply to?

A

superficial perineal and deep perineal mm.

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16
Q

posterior scrotal (labial) artery

A

end branch of perineal artery from internal pudendal artery

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17
Q

terminal branch of internal pudendal arteries

A

deep and dorsal arteries of penis (clitoris)

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18
Q

nerves of anal triangle

A

similar to arterial distribution

pudendal nerve - S2-4
-same course as internal pudendal arteries

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19
Q

branches of pudendal nerve

A

inferior rectal nerves
perineal nerve
dorsal nerve of penis

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20
Q

perineal branches of posterior femoral cutaneous nerve

A

innervate lateral aspect of anal and UG regions

-down onto medial thigh

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21
Q

UG triangle borders

A

anterior - pubis
lateral - ischiopubic ramus
posterior - dorsal edge UG diaphragm
superior - pubococcygeus of levator ani (pelvic diaphragm)

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22
Q

male UG triangle

A

pierced by urethra
-sphincter urethrae m. and compressor urethrae m.

posterior edge - deep transverse perineal m. and superficial transverse perineal m.

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23
Q

insertion of superficial perineal m. in male?

A

central tendon

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24
Q

superficial UG diaphragm fascia

A

from transversalis fascia

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25
inferior UG diaphragm fascia
from colles fascia aka perineal membrane
26
deep perineal space
space between perineal membrane and superior perineal fascia
27
superficial perineal space in male
penis bulbospongiosus ischiocavernosus scrotum
28
penis
male copulatory organ - superficial fascia with overlying skin - 3 bodies
29
corpus spongiosum
along midline -adherent to inferior fascia of UG diaphragm contains urethra enlarge proximal end - bulb of penis enalrged distal - glans penis -limited erectile function (mostly glans)
30
corpus cavernosa
2x - start lateral and converge toward middle - crura of penis - where they meet anchored at ischiopubic rami -converge at inferior margin of pubic symphysis** each contain deep artery of penis -from internal pudendal artery
31
tunica albuginea
thick CT around erectile tissue spongiosum has thinner tunica albuginea -prevents urethral collapse during erection
32
cavernosa in midline?
form vascular sinuses | -to equalize pressure on each side
33
support of penis
suspensory ligament - from deep fascia -arises from pubic symphysis** -deep to fundiform ligament (from superficial fascia)
34
suspensory ligament
inserts into deep fascia of penis
35
bulbospongiosus
surrounds bulb of penis | -compresses urethra
36
ischiocavernosus
erector of penis
37
fascia of penis
deep penile fascia - bucks -forms suspensory ligament of penis superficial penile fascia - colles -dartos around scrotum
38
penis skin
hairless, thin skin skin attached directly to erectile tissue at glans penis - prepuce (foreskin)
39
scrotum
skin and superficial fascia split by midline septum - from dartos fascia contains testes and ducts
40
scrotum vasculature
anterior scrotal branches from external pudendal artery posterior scrotal branches from internal pudendal artery
41
innervation of scrotum
anterior scrotal branches from ilioinguinal nerves posterior scrotal branches from perineal branch of pudendal nerve
42
mons pubis
subQ fat over pubic symphysis in females not as distinct in male
43
labia majora
form boundaries of pudendal cleft -UG vestibule anterior and posterior commissures homolog of scrotum in male
44
labia minora
homolog of urethral folds in male join anteriorly around clitoris prepuce of clitoris frenulum - where the two sides meet (A and P)
45
UG triangle of female
same basic structure as male sphincter urethrae muscle compresser urethrae muscle deep transverse perineal muscle - posterior to urethra
46
superficial transverse perineal muscle
posterior edge of UG diaphragm | -insert at central tendon
47
central tendon
aka perineal body
48
UG triangle in female
split by urethra and vagina two vestibular bulbs (like bulbs of penis) -are erectile
49
female corpus cavernosum
lead to body of clitoris from ischiopubic rami to pubic arch from crura of clitoris
50
bulbospongiosus in female
wrap around labia minora
51
fascia in female
superficial - interrupted by pudendal cleft fascia continues into labia majora deep - homolog to bucks in male -suspensory ligament of clitoris
52
suspensory ligament of clitoris
from deep perineal fascia
53
vasculature of female UG triangle
internal pudendal artery branches: perineal artery -transverse perineal artery - muscles -supplies central tendon posterior labial artery -superficial perineal space
54
venous drainage of UG triangle
corresponds closely to arteries most to internal pudendal vein superficial dorsal vein - external pudendal vein -to femoral vein deep dorsal vein - large midline vein to deep fascia -drains to prostatic plexus and pudendal plexus helenic plexus drains into deep dorsal vein via circumflex veins which drain cavernosa
55
testes
left usually lower -surrounded by several tunics from spermatic cord tunica vaginalis - processus vaginalis (embryologic) -partial cover
56
tunica albuginea
dense CT overs and divides testis to lobules | -each contains seminiferous tubules and rete testis
57
rete testis
at mediastinum of teste | -lead to epididymis (head)
58
epididymis
form as efferent ductules of rete testis pierce tunica albuginae single epididymal duct thickens walls and forms vas deferens
59
vas deferens
passes into pelvis with spermatic cord via inguinal canal
60
inguinal ligament
from edge of external oblique | -superficial ring - split in external oblique aponeurosis
61
external spermatic fascia
fascia of external abdominal oblique m. | -passes down over spermatic cord and testis
62
lowest fibers of internal abdominal obliques
cremaster muscle with cremasteric fascia incompletely wraps around spermatic cord extends around testes within external spermatic fascia
63
internal spermatic fascia
derived from transversalis fascia
64
passing through deep inguinal ring
vas deferens testicular vesels nerves lymphatics
65
processus vaginalis
peritoneal evagination extending into scrotal sac which forms during development forms independently of testicular descent
66
tunica vaginalis
parietal layer and visceral layer visceral - on testicle from processus vaginalis
67
indirect inguinal hernia
if processus vaginalis does not fuse
68
hydrocele
patent processus vaginalis | -peritoneal fluid accumulates in scrotum
69
layers of scrotum and spermatic cord in to out
``` tunica vaginalis internal spermatic fascia cremasteric fascia cremaster muscle external spermatic fascia dartos fascia skin ```
70
ilioinguinal nerve
enters inguinal canal, runs with spermatic cord L1 to upper medial thigh, upper anterior scrotum, anterior scrotal nerve in male, anterior labial nerve in female
71
genitofemoral nerve
L1 and l2 ``` femoral branch genital branch -passes through inguinal canal -supplies cremaster muscle -cutaneous to scrotum ```
72
testicular artery
from abdominal aorta - descends abdomen and pelvis - enters deep inguinal ring
73
pampiniform plexus
veins to testes
74
vas deferens course
crosses external iliac vessels anteriorly crosses over bladder medial to ureters converges with opposite duct posterior to bladder at ampulla - joins semial vesicle
75
ejaculatory duct
where vas deferens and seminal vesicles join course through prostate to prostatic urethra
76
seminal vesicles
arise from ductus deferens | -60% of seminal fluid
77
course of sperm
``` testis epididymis vas deferens seminal vesicles ejaculatory ducts prostatic urethra ```
78
prostate gland location
anterior - pubis posterior - rectum superior - base of bladder inferior - levator ani muscle
79
urethra through prostate
enlargement known as seminal culliculus | -openings of ejaculatory duct
80
seminal culliculus
will find openings of ejaculatory ducts
81
BPH
mainly central zone of prostate gland hard for urination (voiding)
82
lobes of prostate
anterior median 2x lateral posterior
83
blood to prostate
inferior vesical artery capsular (main portion) and urethral
84
venous drainage of prostate
prostatic plexus and vesicular plexus | -to internal iliac veins
85
ovaries
lie on lateral pelvic wall along posterior surface of broad ligament inferolateral to uterine tube anterior to ureter
86
mesovarium
broad ligament to ovary
87
suspensory ligament of ovary
attached to upper pole of ovary via uterine tube
88
ovarian ligament
lower end of ovary to lateral border of uterus
89
uterine tube
medial to laterally - open ended - infundibulum - fimbriated at distal end - open into peritoneal cavity - ampulla - greatest diameter portion of tube - isthmus - thick walled, constricted lumen - uterine portion - within muscular wall of uterus, very constricted lumen
90
uterus
fundus - above uterine tubes body - uterine cavity (main portion) cervix - uterine os - forms fornix
91
uterus position
anteverted or retroverted anteflexed or retroflexed ante - forward retro - backward version - vagina flexion - cervix
92
vagina
thin walled tube CT and muscle stratified squamous epithelium -opens into urogenital vestibule
93
vaginal exam
``` bladder and urethra uterus, uterine tubes, ovaries small intestine loops rectum colon ```
94
broad ligament
peritoneal reflections from lateral uterus -divides pelvis into anterior and posterior segments divided to mesosalpinx, mesovarium, and mesometrium
95
mesosalpinx
broad ligament near uterine tubes
96
mesovarium
broad ligament to ovary
97
mesometrium
broad ligament to uterus to lateral pelvic wall
98
pouches in female
separated by broad ligament recto-uterine pouch vesico-uterine pouch
99
ovarian artery
from aorta | -travels in suspensory ligament of ovary
100
ovarian branch of uterine artery
passes laterally in broad ligament | -forms anastomose with ovarian artery**
101
venous drain of ovary
follows arterial branches
102
vaginal artery
terminal branch of inferior vesical artery in females

Endo Exam 2 (17 decks)

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