male and female pelvis and perineum (ketchum) Flashcards by Andrea Parsons

what are the three portions of the external anal sphincter

subcutaneous
sparse circular fibers

superficial
			tendon of perineum to coccyx
			attaches to:
				central tendon (male)
				perineal body (female)
			corrugator cutis ani
			fibers penetrate superficial portion

deep
encircles anal canal
major portion of anal sphincter

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what is in the ischioanal fossa

adipose tissue (ischioanal fat)
			continuation of Camper’s fascia
		internal pudendal vessels
		inferior rectal vessels
		internal pudendal nerves

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what are the branches of the internal pudendal artery

inferior rectal (1st branch after entering canal)

perineal–> branches into transverse perineal and posterior scrotal or labial arteries

deep and dorsal arteries of penis
which end in the perineal space

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where does the internal pudendal artery leave the pelvis and where does it reenter and then travel in

leaves through greater sciatic foramen

then it goes in the lesser sciatic foramen between sacrotuberous and sacrospinous ligaments

and travels in the pudendal canal (which is formed from obturator internus fascia)

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what are the major brancehs of the pudendal nerve

inferior rectal

perineal

dorsal nerve of penis

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what does the posterior femoral cutaneous contribute to perineum

it sends cutaneous innervation to the lateral aspects of the anal and UG diaphragms and down medial thigh

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what are the VOLUNTARY muscles that span the UG triangle

sphincter urethrae m.
surrounds membranous urethrae

compressor urethae
extends laterally from sphincter

deep transverse perineal m.
post. to sphincter urethrae m.

superficial transverse perineal mm.
at post. edge of UG diaphragm
originate from ischiopubic rami
insert at central tendon

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what are the fascial sheaths of the UG triangle and what spaces do these fascial layers create

superior fascia of UG diaphragm (from transversalis fascia)

inferior fascia of ug diaphragm (aka perineal membrane)

creates superficial perineal space

and deep perineal space (which is the space b/w the perineal membrane and the superficial fascia)

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what are the fascial layers of the urogenital diaphragm

superficial perineal fascia (Colle’s)
-continuation of membranous layer of superficial fascia from anterior abdominal wall
forms superficial penile fascia and is called Darto’s fascia on the scrotum

deep perineal fascia (Buck’s fascia) surrounds the cavernous bodies

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what is the corpus spongiosum

what does it contain

this is the erectile tissue along the midline that is adherent to the inferior fascia of the UG diaphragm

contains the urethra

enlarged at the proximal end to form bulb
enlarged at distal end to form the glans penis
limited erectile function

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what is the corpora cavernosa

what do they contain

twin erectile bodies form the crura of the penis
anchored at ischiopubic rami and adjacent UG diaphragm

they converge at the inferior margin of pubic symphysis

contain deep artery of penis

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what is the facia that surrounds the erectile tissue

tunica albuginae

along the midline this CT fuses to form the septum of the penis

it is also fenestrated to allow equal filling of the cavernosae

NOTE–> the spongiosum has a separate tunic albuginea that is much thinner which prevents urethral collapse during an erection

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what is the fundiform ligament

thickening of Scarpa’s fascia of the lower abdomen

arises from the lower end of scarpa’s fascia in the area of linea alba and inserts into the superfiicial (Colle’s) of the penis

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what is the suspensory ligament of the penis

a triangular band of CT that arises from the pubic symphysis

inserts into deep fascia of the penis

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what are the muscles surrounding and supporting the penis and another that is part of the urogenital diaphragm 3

bulbospongiosus
surrounds bulb of penis
compresses urethra

ischiocavernosus
erector of penis

superficial transverse perineal muscle (posterior edge of the UG diaphragm)

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what is the vascular and innercation of the scrotum

vascular

anterior scrotal branches (from external pudendal which branches form external iliac)
posterior scrotal branches (from internal pudednal)

innervation
anterior scrotal branches from ilioinguinal nerve

posterior scrotal branches from pudendal nerve

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what is the mons pubis

subcutaneous fat pad overlying pubis symphysis

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in the female what muscles (4) attach to the central tendon (perineal body)

superficial and deep transverse perineal muscle
bulbospongiosus
external anal sphincter

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what is the homolog of the corpus spongiosum in the female

vestibular bulbs
lie along the baes of the labia majora
cover the greater vestibular glands (bartholen’s glands)

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what is the homolog of the corpora cavernosae in males that is in females

corpora cavernosa (forms clitoris)

this is 1 inch of erectile tissue buried in a prepuce that is attached to the pubic symphysis by the suspensory ligament of the clitoris

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what are the muscles of the female erectile tissue

bulbospongiosus - wraps around the labia minus

ischiocavernossus - from the ischiopubic rami to the pubic arch forming the crura of the clitoris

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in what part of the external genitalia in the female is the round ligament of the uterus found

labia majora –> homolog of the scrotal folds in the male

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what is the homolog of the urethral folds in the female

the labia minora

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what is different in the female UG diaphragm versus the male

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compressor urethrae muscle is more pronounced

and there is a presence of the urethrovaginalis muscle

is there dartos fascia in the female?

where does the superficial dorsal vein of the urogenital area (Clitoris or penis) drain to

external pudendal vein to femoral vein

where does the deep dorsal vein of the penis/clitoris drain

prostatic plexus and pudendal plexus

which testis is lower

the left

what does the tunica vaginalis form from

processus vaginalis partially covers the testes (almost entirely)

what is the tunica albuginae

the innermost layer of the testes ``` dense CT divides the organ into lobules each lobule contains: -convoluted seminiferous tubules -straight seminiferous tubules -rete testis ```

what are the coverings of the testes starting at skin

skin with dartos fascia and muscle dartos continuous with campers and scarpa's fascia external spermatic fascia cremaster muscle cremasteric fascia internal spermatic fascia tunica vaginalis tunia albuginae

what are the parts of the epididymis

head body tail

where does the ductus deferens travel as it leaves the testes

passes through inguinal canal to enter pelvis passes anteriorly to the external iliac vessels crosses the bladder medial to the ureters

what makes the ejaculatory duct

fusion of the ductus deferens and the seminal glands

how does a congenital hydrocele occur

processus vaginalis remains patent and peritoneal fluid can accumulate in the scrotum

what nerves are contributing to the inguinal canal and spermatic cord

``` ilioinguinal nerve (enters inguinal canal) distributes to .... upper anterior scrotum and gives off anterior scrotal/labial nerve ``` genitofemoral nerve --> genital branch passes through inguinal canal and supplies the cremastor muscle

from what does the prostate gland arise

outgrowths of prostatic urethra

what is the arterial supply to the testis and epididymis

testicular artery and vein (pampiniform plexus)

what is the arterial/vascular supply to the ductus deferens

deferential a and v.

what is the vascular supply of the prostate

inferior vesical artery - -> capsular arteries (main portion of gland) - -> urethral artery ``` Veinous drainage (to internal iliac) prostatic plexus (anterior and lateral portions) vescial plexus (to base of bladder) ```

from what do the seminal vesciles arise

ductus deferens

what is the genearl morphology from testis to urethra

``` testis epididymis ductus deferens seminal vesicles ejaculatory ducts prostatic urethra ```

what are the relationships of the prostate gland (anterior, posterior, superior and inferior)

``` relationships anteriorly - pubis posteriorly - rectum superiorly – base of bladder inferiorly - levator ani m. ```

what are the anatomical lobes of the prostate

anterior – isthmus (anterior to prostatic urethra) median – area between ejac. ducts and urethra lateral – bulging posterolateral portions posterior – posteromedian tissue joining lateral lobes

what are the zones that clinicians use to describe the prostate

3 or 4 identified zones peripheral zone (PZ)--> (most common site for carcinomas) transition zone (TZ)--> most common site for BPH central zone (CZ)--> surrounds ejaculatory ducts)

what are the 3 mesenteries that suspend the ovary

mesovarium from broad ligament to ovary suspensory ligament attached to upper pole of ovary via uterine tube ovarian ligament) from lower end of ovary to lateral border of uterus

what are the 4 parts of the uterine tubes

infundibulum fimbriated distal end ampulla greatest portion of tube isthmus thick walled, constricted lumen uterine portion within muscular wall of uterus very constricted lumen

what are the 3 parts of the uterus

fundus- portion of the body that projects above the uterine tubes body - includes uterine cavity cervix - muscular tubular caudal portion projecting into vagina -os

what are 4 positions that the uterus can be in

anteverted - tilted forward on vagina anteflexed – fundus points forward (relative to cervix) retroverted - tilted back toward rectum retroflexed – fundus points backward

by palpating in the vagina, what can be examined

``` bladder & urethra uterus, uterine tubes & ovaries small intestine loops rectum colon in rectouterine pouch ```

what is the vagina lined with

thin walled tube of CT and muscle lined with stratified squamous epithelium

what are the three parts of the broad ligament

mesovarium- supports ovary mesosalpinx- adjacent to uterine tubes mesometrium- from uterus to lateral pelvic wall

what are the female peritoneal pouches

recto-uterine | vesico-uterine

what does the broad ligament do for the pelvis

divides female pelvis into anterior and posterior segments

what is the arterial supply to the ovary

from the ovarian artery (which is a branch of the aortal) this artery travels in the suspensory ligament of the ovary this anastomoses with uterine artery that sends a branch to the ovary

what is the arterial supply to the uterus

from uterine artery (a branch off the anterior division of the internal iliac) courses through the broad ligament to the uterus gives off two branches - cervical branch - vaginal branches -- (main supply to vagina) gives off two branches towards fundus of uterus -tubal a and ovarian branch of uterine artery

what is the arterial supply of the vagina

vaginal branches of the uterine artery vaginal artery --> usually a terminal branch of inferior vesicle internal pudendal artery - lower portion

what is the venous drainage of the vagina

via vaginal venous plexus most drains superiorly lower portion drains to pudendal vv.

male and female pelvis and perineum (ketchum) Flashcards

(58 cards)