Male and Female Perineum Flashcards
What are the anatomic boundaries of the perineum?
LO1
anterior: pubic symphysis
anterolateral: ischipubic ramus
posterolateral: sacrotuberous ligament
posterior: coccyx
superior: pelvic diaphragm
inferior: skin associated with external genitalia and anal canal
Where is the line distinguishing the UG triangle from anal triangle?
LO1
ischial tuberosities
What is contained in the urogenital triangle?
LO1
urethra and external genitalia
What is contained in the anal triangle?
LO1
anal canal and anus
- external anal sphincter
- internal anal sphincter
What is the external anal sphincter attached to?
levator ani, anococcygxgeal ligament, and perineal body (central tendon)
What are the boundaries of the ischiorectal (ischioanal) fossae?
LO2
lateral wall: obturator internus and ischium
superomedial wall: levator ani and anal canal (external anal sphincter)
base: skin of perineum
What does the ischioanal canal contain?
LO2
fat, blood vessels, nerves
What is the pudendal canal?
LO6
fascial lined space
Where is the pudendal canal?
LO6
medial surface of obturator internus
What are the contents of the pudendal canal?
- pudendal N
- internal pudendal A
- internal pudendal V
What supplies the inferior rectum?
-where do they travel
LO8
- inferior rectal A (branch of internal pudendal A)
- inferior rectal V (tributary to internal pudendal V)
- travel through the ischiorectal fossae
What is the inferior rectal N?
LO7
- branch of pudendal N
- travels through ischiorectal fossae
- supplies anal sphincters and skin
Describe the two spaces in the urogenital triangle
LO3
superficial perineal space
deep perineal space: urogenital diaphragm and associated fascia and structures
What structures are in the deep perineal space in males?
LO3
- superior fascia
- inferior fascia or perineal membrane
- deep transverse perineus m
- external urethral sphincter
- membranous urethra
- bulbourethral glands
What structures are in the deep perineal space in females?
LO3
- superior fascia
- inferior fascia or perineal membrane
- deep transverse perineus m
- external urethra sphincter surrounds urethra
- compressor urethrae
- vagina
What structures are in the superficial perineal space in males?
LO3
LO10
- root of penis
- 2 crura
- bulb of penis
- ischiocavernosus m
- bulbospongiosus m - spongy or penile urethra
- superficial transverse perineus m
What are the parts of the body (shaft) of the penis?
LO10
- skin
- subcuteaneous tissue
- corpus spongiosum (contains penile urethra)
- corpus cavernosum (bilateral)
- dorsal a, v, n of penis
What does the vulva consist of?
LO10
- labia majora
- labia minora
- clitoris
What is the vestibule of the vagina?
LO10
- surrounded by labia minora
- contents
1. external urethral orifice
2. vaginal orifice
3. paraurethral glands orifices
4. greater vestibular glands orifices
What are the parts of the clitoris?
LO10
- bilateral crura covered by ischiocavernosus m
- bilateral corpora vacernosus
- body
- glans clitoris (visible externally)
What are the contents of the superficial perineal space of the female?
LO3
- bulbs of the vestibule
- bulbospongiosus m (bulbocavernosus m)
- greater vestibular (Bartholin’s) glands
- superficial transverse perineus m
- clitoris
- ischiocavernosus m
Describe the blood supply of the perineum
LO10
- external pudendal A
- scrotum and penis in males
- labia majora and clitoris in females - internal pudendal A (branch of internal iliac A_
- passes through greater and lesser sciatic foramena to enter pudendal canal
- branches to all perineal structures
What are the pudendal N contents?
LO5
- preganglionic parasympathetic
- somatic motor fibers
- somatic sensory fibers
- postganglionic sympathetic
What is the path of the pudendal N?
-branches and what they innervate
LO4
LO5
S2-S4 –> greater sciatic foramen –> under ischial spine and sacrospinous ligament –> lesser sciatic foramen –> pudendal canal
branches
- inferior rectal nerve (external anal sphincter and anal skin)
- dorsal nerve (penis/clitoris)
- pudendal N (ischiocavernosus, bulbospongliosus, deep transverse perineal, superficial transverse perineal, sphincter urethrae, scrotum/labia majora, and urethra/labia minora)
What are the causes of male impotence?
LO11
- nerve damage to prostatic nerve plexus
- atherosclerosis advrsely affect blood supply to erectile tissues
- type II diabetes
- spinal cord injury
- hormonal disorders
- psychological disorders
Where does lymph go from the distal portions of vagina and anal canal?
Superficial Inguinal lymph nodes
Path of lymph from the proximal vagina, proximal anal canal?
Internal iliac lymph nodes
What is an episiotomy?
Surgical incision btwn vagina and anus to prevent perineal tear during delivery.
4 types
Most common is a medio-lateral incision. Incision made through posterior vaginal wall, bulbospongiosus m, superficial transverse perneus m, skin and associated fascia.
Repair involves 3 layers of sutures in vaginal wall, muscle layer, and subcutaneous fascia and skin.
