Male and Female Perineum Flashcards
What is the compostition of the scrotum
skin and superficial perinal fascia (colles fascia)
What is colles fascia a continuation of
superficial abdominal fascia into the urogenital area of perineum
What is present in fascia of the scrotum
its superficial perinal fascia and it contains the dartos muscle
When does the dartos muscle contract
In the influence of cold
Where is the root of the penis located
superficial perineal pouch
What is the penis composed of and what seperates them?
3 bodies of erectile tissue
2 Coprora cavernosa (with incomplete septum between) Corpus spongiosum (tranversed by spongy urethra)
What is erectile tissue
Meshwork of interlacing and intercommunnicating vascular spaces
What happens to the corpus cavernosa posteriorly
They seperate and expand as crura
Where do the crura attach
Ischiopubic rami
What is the distal expansion of the corpus spongiosum
Glans Penis
How and where do the corpus cavernosum end
blunt terminations behind the glans penis
What happens to the corpus spongiosum posteriorly
enlarges as the bulb of the penis
What surrounds the erectile bodies of the penis individually
Tunica albuginea
What surrounds All the covernous bodies of the penis
Deep fascia of the penis (bucks fascia)
Where does the suspensory ligament of the penis attach
Deep fascia at the junction of the fixed and mobile parts
and the inferior part of the pubic arch
what surrounds the deep fascia around the penis
superficial perineal fascia and skin
What happens to the skin of the penis distally and what is it called?
prolonged and double layered as the prepuce (foreskin)
What does the prepuce cover in males
Glans penis
What is makes up most of the labia majora
fat and connective tissue
What is the mons pubis
rounded fatty eminence formed from the blending together of the labia majora anteriorly
What enters the labia majora anteriorly and what is it attached to
round ligaments
attach to skin
What are the labia majora homologous to in the male
Scrotum
What forms the prepuce of the clitoris
The superior portion of the anterior division of the labia minora
What forms the frenulum of the clitoris
the inferior portion of the anterior division of the labia minora
What are the labia minora homologous to in the male
ventral aspect of the penis
what is the name for the cleft between the labia minora
vestibule
what 4 things open into the vestibule of the vagina
Urethra
Vagina
paraurethral glands
greater vestibular glands
What are the paraurethral glands homologous to on the male
prostate
called skenes glands
What are the greater vestibular glands homologous to on the male
Bulbourethral glands
Where are the openings to the greater vestibular glands located
posterolateral to the vaginal orifice
What surrounds the vaginal orifice
incomplete fold called hymen
Where is the external urethral orifice on females
one inch posterior to clitoris and immediately anterior to vagina
What is located on the sides of the urethral opening in females
openings of the paraurethral glands
Where is the clitoris located
between the anterior ends of the labia minora
What are the parts of the clitoris
mobile body and a root
where is the root of the clitoris located
in superficial perineal pouch
What composes the body of the clitoris
2 corpora cavernosa and athin band of erectile tissue (the commisure of the bulbs)
What is corresponding structure on females to the corpus spongiosum of males
commissure of the bulbs
What is the distal expansion of the commisure of the bulbs
glans clitoris
What is the posterior expansion of the erectile tissue in females analagous to the corpus spongiosum of males
Vestibular bulbs
What is the posterior expansion of the corpora cavernosa in females
Crura
What is located at the junction of the clitoris’ fixed and mobile parts
suspensory ligament
What forms the roof and floor of the superficial perineal pouch
Floor (inferior boundary) superficial perineal fascia (coles fascia)
Roof (superior boundary): perineal membrane (in triangular form)
What gap does the perineal membrane fill
teh interval between ishciopubic rami
What is the superficial perineal fascia a continuation of
the superficial membranous fascia of the abdominal wall (scarpas fascia) inferiorly over the inguinal ligament
Where does the superficial perineal fascia attach in females (3)
inferolaterally: to fascia lata of the thigh
laterally: to ischiopubic rami
posteriorly: to the free margin of the perineal membrane
Where does the superficial perineal fascia continue and attach in males (what does it also form)
continues anteriorly over shaft of penis and in the scrotal wall (forming dartos muscle fibers)
What does the compartment created by the superficial perineal fascia open into in males
scrotum
subcutaneous space of penis
lower abdominal wall
What are the contents of the superficial perineal pouch
Crura Bulb of penis Vestibular bulbs Superficial transverse perineal muscles Greater vestibular glands Perineal body
Where or the crura of the penis and clitoris attached
Ischiopubic rami
What covers the crura
ischiocavernosus muscle
where does the ischiovavernosus muscle originate and insert
originates: Ischial tuberosity and ischiopubic ramus
Inserts: into sides of crus
What does contraction of the ischiocavernosus muscles do
moves blood distally into corpora cavernosa of penis or clitoris
and interferes with venous return ( maintaining erection)
What is contained in the superior part of the bulb of the penis
Urethra
What covers the bulb of the penis
bulbospongiosus muscle
Where does the bulbospongiosus muscle originate and insert
Originates:
median raphe superficial to bulb
perineal body
Inserts:
into perineal membrane
corpus spongiosum
deep fascia on the dorsum of the penis
What are the vestibular bulbs and where do they attach
elongated masses of erectile tissue
attached to perineal membrane on sides of vagina
What unites anterior to the urethra in a female
tapered ends of the vestibular bulbs (commisure of the bulbs)
What is the role of bulbospongiosus muscle
expels semen during ejacuation
expels residual urine during urination
helps maintain erection by compressing the bulb and moving blood distally into corpus sopongiosum and glans penis
What covers the vestibular bulbs
bulbospongiosus muscle
what is the role of the bulbospongiosus muscle in females
acts as a sphincter of the vaginal orifice and helps maintain erection by compressing vestibular bulb
Where are the greater vestibular glands located and what do they secrete
posterior end of each vestibular bulb
secrete mucus to lubricate external genitals
What forms the perineal body (5)
interdigitation of fibers from bulbospogiosus external anal sphincter transverse perineal muscles in part levator ani
perineal membrane (not muscle fibers but contributes)
What is the result of the musculofascial attachments of the deep perineal pouch
does not communicate with the superficial perineal pouch or pelvic cavity
Where is the deep perineal pouch located
superior to pernineal membrane
inferior to pelvic diaphragm
What do the muscels in the deep perineal pouch do
associate with urethra and vagina and provide some support for pelvic viscera at urogenital haitus
What are the contents of the deep perineal pouch (3)
External urethral sphincter
Bulbourethral glands
Deep transverse perineal muscles
What is the origin and path of the external urethral sphincter
originates from ischiopubic rami
some fibers encircle urethra
in females inferior parts of the muscle blend with anterolateral walls of the vagina
What is the section of urethra encircled by the external urethral sphincter called in males
intermediate (membranous) urethra
What is the role of the external urethral sphincter
voluntary sphincter of the urethra
Where are the bulbourethral glands located
embeded in the muscluature of the deep perineal pouch of males
What do the bulbourethral glands do
secrete clear mucus during sexual excitation
Where are the bulbourethral glands homologous to and where are they located
Greater vestibular glands
in female superficial perineal pouch
Where are the Deep transverse perineal muscles found ( insertion orgin) and what do they do
Found only in males
Originate ischial tuberosities and ischiopubic rami
insert: perineal body
support and stabilize the perineal body
What replaces the deep transverse perineal muscles in females
unnamed smooth muscles with uncertain function
What did the urogenital diaphragm make up
the deep perinieal pouch
What were the previous layers of the trilaminar urogenital diaphragm
perineal membrane (inferior fascia of urogenital diaphragm a flat sheet of muscles ( no longer viewed as flat) a superior layer of fascia (in contact with pelvic diaphragm)
What are the new views on the urogenital diaphragm
muscles not flat (eg external shincter shaped like tube)
definitive superior fascia does not exist
What seperates the superficial and deep perinieal pouches
Perineal membrane
What are the perineal pouch layers from superficial (inferior) to deep (superior) (6)
Skin Superficial perineal fascia (colles) Superficial perineal pouch (crura ,bulbs, muscles) Perineal membrane Deep perineal pouch Pelvic diaphragm (levator ani)`
What provides primary innervation to the perineum
Pudenal nerve (S2-4)
What (nerves) supplies the external anal sphincter and anal canal and where do they arise
inferior rectal nervees (arise in ischioanal fossa from pudendal)
Where does the prineal nerve arise and what does it divide into
arises near posterior border of perineal membrane from pudendal
cutaneosus posterior scrotal (labial) nerves
Deep perineal nerve
What does the deep perineal nerve provide
motor to all perinieal muscles
sensory to erectile tissues of the penile (vestibular) bulb and corpus spongiosum (commissur of the bulbs)
What is the continuation of the pudendal nerve called and where does it lie
dorsal nerve of penis (clit)
on dorsum of penis (clit) deep to deep fascia
What does the dorsal nerve of the penis (clit) supply
sensory to crura
Corpora cavernosa and distal two thirds of penis (clit) skin
what are the anterior scrotal (labial) nerves branches of what does it do
iliinguinal (L1) and genitofemoral (L1,2),
help provide perineum innervation
what helps supply posterior scrotum (labium majus)
perineal branch of posterior femoral cutaneous nerve (S1-3)
Which fibers do not travel with the pudendal nerve, where do they go
parasympathetic autonomic
pass inferior to pubic symphysis and enter peritoneum
What is the major vascular source to the perineum and what is it a branch of
indternal pudendal
internal iliac
what path does the internal pudendal artery follow and where does it give off inferior rectal arteries
same path as pudendal nerve
in ischioanal fossa
Where does the perineal artery arise and what does it give off
posterior border of perineal membrane off of pudendal
posterior scrotal (labial) branches
What does the the artery to the bulb come off of and enter
internal pudendal artery
enters penile or vestibular bulb
What are the termianl branches of the internal pudendal artery
deep artery of the penis (clitoris)
dorsal artery of the penis (clitoris)
where does the deep artery of the penis (clitoris) run
enters curs and continues along corpus cavernosum
where does the dorsal artery of the penis (clitoris) run
medial to dorsal nerve of penis (clit)
what provides aditional arterial supply to the perieum
superficial and deep external pudendal arteries
branches of femoral artery
what drains most of the blood from the corpora cavernosa and glans and wehre does it run
deep dorsal vein of the penis (clitoris)
runs between 2 dorsal arteries of the penis(clitoris) and passes inferior to pubic arch to join prosthatic plexus of veins
What drains the blood from the perineum
branches of internal and external pudendal veins and deep dorsal vein of p/c
Where does the prostatic plexus of veins drain
intenral iliac veins
what lymph drains into the superficial inguinal nodes (3)
perineum (except clit and glans penis)
inferior vagina
inferior anal canal
what lymph drains into the internal iliac nodes (7)
glans penis clitoris proximal parts of cavernous bodies deep Perineal pouch intermediate (mebranous) urethra entire female urethra superior vagina GPS DICE
Where does lymph from the testes drain
para aortic nodes
