Male and Female Perineum

Question 1

• What forms the trigone of the urinary bladder?
• What is the superior limit of the trigone?
• What is the swelling at the posterior wall of the urinary bladder at the internal urethral orifice called?

Answer 1

• Two ureteric orifices and internal urethral orifice
• Interureteric fold-superior limit of the trigone
• Uvula of the urinary bladder

Question 2

• _ muscle is the primary component of the wall of the urinary bladder and is surrounded by _ fascia

Answer 2

• Detrusor
• Vesical fascia (loose CT)

Question 3

• Parts of the urinary bladder and their locations

Answer 3

• Apex-anterior portion
• Body-between apex and fundus
• Fundus-posterior part furthest away from internal uretheral orifice
• Neck-tapers off into urethra

Question 4

• What are the parts of the male urethra?

Answer 4

• Preprostatic urethra (in neck of urinary bladder)
• Prostatic urethra (in prostate gland and communicates with prostatic utricle and ejaculatory duct)
• Membranous urethra (short, through external uretheral sphincter
• Spongy urethra (inside corpus spongiosum)

Question 5

• What are the parts of the prostatic urethra?

Answer 5

• Urethral crest
  
  • Median ridge that swells in center of prostate gland as seminal colliculus and is surrounded on either side by prostatic sinuses)
• Prostatic sinus
  
  • Space on either siode of seminal colliculus and urethral crest
    Accepts secretions from prostatic ductules
• Seminal colliculis
  
  • Rounded mound on urethral crest and has slit openings
    
    • Prostatic utricle (small blind end pouch on seminal colliculus-remnant of uterovaginal canal)
    • Openings for ejaculatory ducts

Question 6

• Where is the spongy urethra located?
• What are the components of the spongy urethra?

Answer 6

• Corpus spongiosum
  
  • Intrabulbar fossa
    
    • Internal expansion of spongy urethra in bulb of penis
    • Receives secretions from bulbourethral glands
  • Navicular fossa
    
    • Internal expansion of spongy urethra in glans penis
  • Urethral glands
    
    • Mucus secreting glands that empty directly into spongy urethra

Question 7

• Rectum
  
  • Transverse rectal folds
  • Anorectal flexure
  • Ampulla

Answer 7

• Transverse rectal folds
  
  • Three, superior middle and inferior of mucosa and submucosa layers
  • Anorectal flexure
    
    • At levator ani muscles
    • Important for fecal continence
  • Ampulla
    
    • Holds fecal mass until defecation

Question 8

• Anal canal
  
  • Anal columns
  • Anal valves
  • Anal sinuses

Answer 8

• Anal columns
  
  • Ridges that run longitudinally
  • Contain terminal branches of superior rectal a. and v.
• Anal valves
  
  • pockets in mucosa that define anal sinuses
  • Exist at inferior ends of anal columns
• Anal sinuses
  
  • Small recesses, when compressed, exude mucus to aid in evacuation of anal canal

Question 9

• Penile raphe
• Scrotal raphe
• Perineal raphe

Answer 9

• Midline skin fold between glans penis and scrotum
• Midline skin fold between penile raphe and perineal raphe
• Midline skin fold between scrotal raphe and anus

Question 10

• Ductus deferens

Answer 10

• Muscular tube
• Conveys sperm
• Continuation of duct of epididymis
• Begins at tail of epididymis
• Travels thru inguinal canal as part of spermatic cord
• Enters pelvis
• Swells to ampulla of ductus deferens and joins with ducts of seminal vesicles to form ejaculatory duct

Question 11

• _ of the ductus deferens is the part closest to the ejaculatory duct

Answer 11

• Ampulla

Question 12

• Deferentectomy/Vasectomy

Answer 12

• Ligation and or excision of ductus deferens thru incision in superior scrotum
• Rendering ejaculation of spermatozoa

Question 13

• Testicular artery branches directly off of _ and supplies testis
• Pampiniform venous plexus drains into _ vein
• _ innervates the cremaster m.
• Lymphatics of the spermatic cord drain into _ lymph nodes
• Artery of ductus deferens comes from _ vessel
• Cremasteric a. comes from _ and supplies cremaster m.
• _ nerve produces anterior scrotal nerve

Answer 13

• abdominal aorta
• testicular
• Genital branch of genitofemoral n.
• Lumbar
• Inferior vesical a.
• Inferior epigastric a.
• Ilioinguinal n.

Question 14

• Layers of the Scrotum (superficial to deep)

Answer 14

• Skin
• Dartos fascia
• Dartos m.

Question 15

• Layers of the spermatic cord (superficial to deep)

Answer 15

• External spermatic fascia (from external oblique aponeurosis)
• Cremasteric fascia (from internal oblique aponeurosis)
• Internal spermatic fascia (from transversalis fascia)

Question 16

Layers of the testis

Answer 16

• Tunica vaginalis
  
  • Parietal layer-adherent to internal spermatic fascia (from parietal peritoneum)
  • Visceral layer-adherent to tunica albuginea (from visceral peritoneum)
    
    • Sinus of epididymis-small recess in visceral tunica vaginalis between epididymis and testis
• Tunica albuginea
  
  • Fibrous coat adherent to testis

Question 17

• Parts of the testis

Answer 17

• Seminiferous tubules
• Straight tubule
• Rete testis
• Septum

Question 18

• _ fascia surrounds the erectile tissue and deep vasculature of the penis (made of deep perineal fascia)

Answer 18

• Deep fascia of penis

Question 19

• Regional organization of the penis

Answer 19

• Root
  
  • Attached
  • Includes:
    
    • Bulb
    • Crura
    • Bulbospongiosus m. and ischiocavernosus m.
• Body
  
  • Free
  • Includes:
    
    • CT
    • Paired corpora cavernosa
    • Corpus spongiosum
    • Spongy urethra
• Glans penis
  
  • Distal expansion
  • Continuous with corpus spongiosum proximally

Question 20

• What makes up the ventral cylinder of penile erectile tissue (central, unpaired from proximal to distal)

Answer 20

• Bulb of penis (erectile tissue at root of penis-continuous with corpus spongiosum)
• Corpus spongiosum (transmits spongy urethra)
• Glans penis
  
  • Corona of glans penis
  • Neck of glans (separation of body and glans penis)

Question 21

• What makes up the dorsal cylinder of penile erectile tissue (paried, from proximal to distal)?

Answer 21

• Crura of penis
• Corpus cavernosum
  
  • House deep a. of penis

Question 22

• Prepuce

Answer 22

• Skin and fascia of the penis that covers glans penis

Question 23

• Prostate gland

Answer 23

• Largest accessory sex gland
• Prostatic fluid (20% seminal)
• Prostatic ducts (convey prostatic fluif from parenchyma of gland to prostatic sinus)

Question 24

• Seminal vesicles

Answer 24

• Paired elongated structure between urinary bladder and rectum
• Secretes fluid that becomes part of ejaculatory sperm

Question 25

* Ejaculatory ducts

Answer 25

* Formed from joining of seminal vesicles and ampulla of vas deferens * Near neck of urinary bladder * Empty into prostatic urethra thru paired opening on seminal colliculus (on either side of prostatic utricle)

Question 26

* Bulbourethral glands

Answer 26

* Pea sized glands * Posterolateral to membranous urethra * Produce mucus substance during sexual arousal * **Duct of bulbourethral glands conveys bulbourethral secretions to intrabulbar fossa of spongy urethra**