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

Male and Female Pelvis and Perineum Flashcards

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
Q

inferior UG diaphragm fascia

A

from colles fascia

aka perineal membrane

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26
Q

deep perineal space

A

space between perineal membrane and superior perineal fascia

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27
Q

superficial perineal space in male

A

penis
bulbospongiosus
ischiocavernosus
scrotum

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28
Q

penis

A

male copulatory organ

  • superficial fascia with overlying skin
  • 3 bodies
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29
Q

corpus spongiosum

A

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)

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30
Q

corpus cavernosa

A

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

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31
Q

tunica albuginea

A

thick CT around erectile tissue

spongiosum has thinner tunica albuginea
-prevents urethral collapse during erection

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32
Q

cavernosa in midline?

A

form vascular sinuses

-to equalize pressure on each side

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33
Q

support of penis

A

suspensory ligament - from deep fascia
-arises from pubic symphysis**

-deep to fundiform ligament (from superficial fascia)

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34
Q

suspensory ligament

A

inserts into deep fascia of penis

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35
Q

bulbospongiosus

A

surrounds bulb of penis

-compresses urethra

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36
Q

ischiocavernosus

A

erector of penis

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37
Q

fascia of penis

A

deep penile fascia - bucks
-forms suspensory ligament of penis

superficial penile fascia - colles
-dartos around scrotum

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38
Q

penis skin

A

hairless, thin skin

skin attached directly to erectile tissue at glans penis - prepuce (foreskin)

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39
Q

scrotum

A

skin and superficial fascia

split by midline septum - from dartos fascia

contains testes and ducts

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40
Q

scrotum vasculature

A

anterior scrotal branches from external pudendal artery

posterior scrotal branches from internal pudendal artery

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41
Q

innervation of scrotum

A

anterior scrotal branches from ilioinguinal nerves

posterior scrotal branches from perineal branch of pudendal nerve

42
Q

mons pubis

A

subQ fat over pubic symphysis in females

not as distinct in male

43
Q

labia majora

A

form boundaries of pudendal cleft
-UG vestibule

anterior and posterior commissures

homolog of scrotum in male

44
Q

labia minora

A

homolog of urethral folds in male
join anteriorly around clitoris

prepuce of clitoris
frenulum - where the two sides meet (A and P)

45
Q

UG triangle of female

A

same basic structure as male

sphincter urethrae muscle
compresser urethrae muscle

deep transverse perineal muscle - posterior to urethra

46
Q

superficial transverse perineal muscle

A

posterior edge of UG diaphragm

-insert at central tendon

47
Q

central tendon

A

aka perineal body

48
Q

UG triangle in female

A

split by urethra and vagina

two vestibular bulbs (like bulbs of penis)
-are erectile

49
Q

female corpus cavernosum

A

lead to body of clitoris

from ischiopubic rami to pubic arch

from crura of clitoris

50
Q

bulbospongiosus in female

A

wrap around labia minora

51
Q

fascia in female

A

superficial - interrupted by pudendal cleft

fascia continues into labia majora

deep - homolog to bucks in male
-suspensory ligament of clitoris

52
Q

suspensory ligament of clitoris

A

from deep perineal fascia

53
Q

vasculature of female UG triangle

A

internal pudendal artery

branches:
perineal artery
-transverse perineal artery - muscles
-supplies central tendon

posterior labial artery
-superficial perineal space

54
Q

venous drainage of UG triangle

A

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
Q

testes

A

left usually lower
-surrounded by several tunics from spermatic cord

tunica vaginalis - processus vaginalis (embryologic)
-partial cover

56
Q

tunica albuginea

A

dense CT overs and divides testis to lobules

-each contains seminiferous tubules and rete testis

57
Q

rete testis

A

at mediastinum of teste

-lead to epididymis (head)

58
Q

epididymis

A

form as efferent ductules of rete testis pierce tunica albuginae

single epididymal duct thickens walls and forms vas deferens

59
Q

vas deferens

A

passes into pelvis with spermatic cord via inguinal canal

60
Q

inguinal ligament

A

from edge of external oblique

-superficial ring - split in external oblique aponeurosis

61
Q

external spermatic fascia

A

fascia of external abdominal oblique m.

-passes down over spermatic cord and testis

62
Q

lowest fibers of internal abdominal obliques

A

cremaster muscle

with cremasteric fascia

incompletely wraps around spermatic cord

extends around testes within external spermatic fascia

63
Q

internal spermatic fascia

A

derived from transversalis fascia

64
Q

passing through deep inguinal ring

A

vas deferens
testicular vesels
nerves
lymphatics

65
Q

processus vaginalis

A

peritoneal evagination extending into scrotal sac which forms during development

forms independently of testicular descent

66
Q

tunica vaginalis

A

parietal layer and visceral layer

visceral - on testicle

from processus vaginalis

67
Q

indirect inguinal hernia

A

if processus vaginalis does not fuse

68
Q

hydrocele

A

patent processus vaginalis

-peritoneal fluid accumulates in scrotum

69
Q

layers of scrotum and spermatic cord

in to out

A 
tunica vaginalis
internal spermatic fascia
cremasteric fascia
cremaster muscle
external spermatic fascia
dartos fascia
skin
70
Q

ilioinguinal nerve

A

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
Q

genitofemoral nerve

A

L1 and l2

femoral branch
genital branch
-passes through inguinal canal
-supplies cremaster muscle
-cutaneous to scrotum
72
Q

testicular artery

A

from abdominal aorta

  • descends abdomen and pelvis
  • enters deep inguinal ring
73
Q

pampiniform plexus

A

veins to testes

74
Q

vas deferens course

A

crosses external iliac vessels anteriorly
crosses over bladder medial to ureters
converges with opposite duct posterior to bladder

at ampulla - joins semial vesicle

75
Q

ejaculatory duct

A

where vas deferens and seminal vesicles join

course through prostate to prostatic urethra

76
Q

seminal vesicles

A

arise from ductus deferens

-60% of seminal fluid

77
Q

course of sperm

A 
testis
epididymis
vas deferens
seminal vesicles
ejaculatory ducts
prostatic urethra
78
Q

prostate gland location

A

anterior - pubis
posterior - rectum
superior - base of bladder
inferior - levator ani muscle

79
Q

urethra through prostate

A

enlargement known as seminal culliculus

-openings of ejaculatory duct

80
Q

seminal culliculus

A

will find openings of ejaculatory ducts

81
Q

BPH

A

mainly central zone of prostate gland

hard for urination (voiding)

82
Q

lobes of prostate

A

anterior
median
2x lateral
posterior

83
Q

blood to prostate

A

inferior vesical artery

capsular (main portion) and urethral

84
Q

venous drainage of prostate

A

prostatic plexus and vesicular plexus

-to internal iliac veins

85
Q

ovaries

A

lie on lateral pelvic wall

along posterior surface of broad ligament

inferolateral to uterine tube
anterior to ureter

86
Q

mesovarium

A

broad ligament to ovary

87
Q

suspensory ligament of ovary

A

attached to upper pole of ovary via uterine tube

88
Q

ovarian ligament

A

lower end of ovary to lateral border of uterus

89
Q

uterine tube

A

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
Q

uterus

A

fundus - above uterine tubes
body - uterine cavity (main portion)
cervix - uterine os - forms fornix

91
Q

uterus position

A

anteverted or retroverted
anteflexed or retroflexed

ante - forward
retro - backward
version - vagina
flexion - cervix

92
Q

vagina

A

thin walled tube
CT and muscle
stratified squamous epithelium
-opens into urogenital vestibule

93
Q

vaginal exam

A 
bladder and urethra
uterus, uterine tubes, ovaries
small intestine loops
rectum
colon
94
Q

broad ligament

A

peritoneal reflections from lateral uterus
-divides pelvis into anterior and posterior segments

divided to mesosalpinx, mesovarium, and mesometrium

95
Q

mesosalpinx

A

broad ligament near uterine tubes

96
Q

mesovarium

A

broad ligament to ovary

97
Q

mesometrium

A

broad ligament to uterus to lateral pelvic wall

98
Q

pouches in female

A

separated by broad ligament

recto-uterine pouch
vesico-uterine pouch

99
Q

ovarian artery

A

from aorta

-travels in suspensory ligament of ovary

100
Q

ovarian branch of uterine artery

A

passes laterally in broad ligament

-forms anastomose with ovarian artery**

101
Q

venous drain of ovary

A

follows arterial branches

102
Q

vaginal artery

A

terminal branch of inferior vesical artery

in females

Endo Exam 2 (17 decks)

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