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GIGU > Male and Female Perineum > Flashcards

Male and Female Perineum Flashcards

1
Q

What is the inferior region of the trunk that contains the external genitalia and anal canal?

A

perineum

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2
Q

Describe the shape of the perineum viewed from below?

A

diamond-shaped area between thighs

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3
Q

What is the lateral boundary of the peritoneum?

A

ischiopubic rami

sacrotuberous ligaments

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4
Q

What is the posterior boundary of the peritoneum?

A

coccyx

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5
Q

What is the anterior boundary of the peritoneum?

A

pubic symphysis

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6
Q

What is the superior boundary of the perineum?

A

pelvic diaphragm separates perineum from pelvic cavity

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7
Q

What is the inferior boundary of the perineum?

A

skin of external genitalia and anal canal

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8
Q

What is the perineum subdivided into via line b/t BL ischial tuberosities?

A

Urogenital triangle

Anal triangle

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9
Q

What are the boundaries of the anal triangle of peritoneum?

A

1: imaginary line b/t ischial tuberosities
2: coccyx
3: sacrotuberous ligaments

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10
Q

What are the boundaries of the urogenital triangle of peritoneum?

A

1: imaginary line b/t ischial tuberosities
2: pubic symphysis
3: ischiopubic rami

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11
Q

What are the contents of the anal canal?

A

continuous with rectum via anal columns @ anorectal line

inferior anal columns joined by anal valves (folds)–>pectinate line

just below valves are anal sinuses that contain glands for lubrication

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12
Q

What plexus is located in the wall of the distal half of the anal canal?

A

external rectal venous plexus

–>drains into internal pudendal veins

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13
Q

What sphincter is smooth muscle circulating around proximal 2/3 anal canal?

A

internal anal sphincter

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14
Q

What innervates the internal anal sphincter?

A

pelvic splanchnic N

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15
Q

What is skeletal muscle surrounding distal 2/3 anal canal?

A

external anal sphincter

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16
Q

What innervates the external anal sphincter?

A

inferior rectal nerve (S4)

–>a branch off of pudendal N

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17
Q

What is the external anal sphincter attached to anatomically?

A

anococcygeal ligament posteriorly

perineal body anteriorly

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18
Q

What direction is the anal canal oriented?

A

posterioinferiorly

–>d/t anterio pull of puborectalis M

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19
Q

What direction is the anal canal oriented?

A

posterioinferiorly

–>d/t anterio pull of puborectalis M

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20
Q

What are ischiorectal fossae?

A

wedge-shaped fat deposits on either side of the anal canal

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21
Q

What is the lateral wall of the ischiorectal fossa?

A

obturator internus M and ischium

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22
Q

What is the superomedial wall of ischiorectal fossa?

A

levator ani M and anal canal

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23
Q

What is the base of the ischiorectal fossa?

A

skin of perineum

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24
Q

What is on the medial surface of the obturator internus M?

A

pudendal canals

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25
Q

Why do ischiorectal fossae exist?

A

so the anal canal can distend during defecation

–>no organs can interfere d/t fat filled

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26
Q

What reside in the pudendal canals?

A

pudendal N
internal pudendal A
internal pudendal V

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27
Q

What passes from the pudendal canal, through the ischiorectal fossa to the anal canal?

A 
inferior rectal N
-->off pudendal N
inferior rectal A
-->off internal pudendal A
inferior rectal V
--->off internal pudendal V
28
Q

What is the pectinate line

A

junction of anal columns with anal valves

29
Q

What innervates superior to pectinate line?

A

visceral afferent fibers

30
Q

What innervates inferior to pectinate line?

A

somatic afferent fibers vis Inferior Rectal N

–>branch off pudendal N

31
Q

What is the female homolog to the penis?

A

clitoris

32
Q

Where does lymph from superficial perineal space, distal vagina and anal canal below pectinate line drain into?

A

superficial inguinal nodes

33
Q

Where does lymph from deep perineal space, prox vagina, prox anal canal drain into?

A

internal iliac nodes

34
Q

The pudendal N supplies all structures that receive blood from ______

A

internal pudendal A

35
Q

What are the 4 fibers contained within the pudendal N?

A

1: pregang para for glands and SM
2: somatic motor fibers to skeletal M
3: somatic sensory to glands and SM, perineal skin, distal anal canal and distal vagina
4: postgang symp to glands and SM

36
Q

What are the two major vessels that supply the perineum?

A

internal pudendal A
–> via internal iliac A

external pudendal A
–> via femoral A

37
Q

What A supplies superficial branches to scrotum and penis?

A

external pudendal A

–>via femoral A

38
Q

What A supplies superficial branches to the labia major and clitoris?

A

external pudendal A

—> via femoral A

39
Q

What composes the urogenital triangle?

A

deep and superficial perineal spaces

40
Q

What is contained in the deep perineal space of urogenital triangle?

A

Urogenital Diaphragm

  • -> urethra (1st part in females, membranous in males)
  • ->deep perineal muscles
  • ->bulbourethral glands in males
41
Q

What are the fxn of bulbourethral glands in males?

A

ducts empty into penile urethra, secrete clear mucous during sexual activity to lubricate prior to ejaculation

42
Q

Where does the deep transverse perineus muscle insert?

A

perineal body in m and f

43
Q

What is the fxn of external urethral sphincter in males?

A

surrounds membranous urethra, relaxes to allow urination or ejaculation

44
Q

What is the urogenital diaphragm?

A

continuous sheet of muscle that spans gap b/t ischiopubic rami

–>superior and inferior fascial layers fuse A to P

–>perineal body attaches to midpoint of its posterior border

45
Q

Why is the urogenital diaphragm split in females?

A

split in half by passage of vagina

46
Q

What attaches to the posterior urogenital diaphragm?

A

perineal body

–>runs along imaginary line separating anal and urogenital triangles

47
Q

Where is the superficial perineal space?

A

potential space deep to skin, covers external genitalia

48
Q

Why is the perineal space split in 2 in females?

A

d/t vestibule of vagina

49
Q

What is in the superficial perineal space of males?

A

1: root of penis
2: body or shaft of penis
3: superficial transverse perineus muscle (part of perineal body)

50
Q

What is in the superficial perineal space of females?

A

1: labia majora
2: labia minora
3: clitoris
4: bulbs of vestibule
5: greater vestibular glands (bartholin’s glands)
6: superficial transverse perineus M

51
Q

What is included in the root of the penis?

A
  • R and L crura–>converge to make corpus cavernosum
  • bulb of penis
  • ischiocavernosus M surround free surface of each crus
  • bulbospongiosus M wraps around bulb and posterior corpus spongiosum
52
Q

What is the fxn, O/I of ischiocavernosus M?

A

surrounds free surface of each crus, attaches to ischiopubic ramus and inserts into corpus cavernosum (erectile tissue)

–>maintain erection by compressing veins in corpora cavernosa

53
Q

What is the fxn, O/I of bulbospongiosus M?

A

from perineal body and raphe of penis, wraps around bulb and posterior part of corpus spongiosum (erectile tissue)

–> aids in emptying the urethra or urine or semen

54
Q

What comprises the body/shaft of penis?

A

skin, subq tissue, erectile tissue (corpus spongiosum and 2 corpora cavernosa)

–>corpora cavernosa is the same as corpus cavernosum

55
Q

Where is the superficial transverse perineus M in males and females?

A

posterior border of urogenital diaphragm

56
Q

Labia majora unite anteriorly to form ___

A

mons pubis

57
Q

Labia minora surround ______

A

vestibule of the vagina

58
Q

What comprises the vestibule of the vagina?

A

external urethral orifice
vaginal orifice
openings of: paraurethral glands and greater vestibular glands

59
Q

What is the clitoris comprised of?

A

2 crura
2 corpora cavernosa
one body
glans clitoris (what is externally visible)

60
Q

Describe the anatomy of the clitoris

A

each crus continuous with corpus cavernosum (corpora cavernosa) which is composed of erectile tissue

–>surrounded by ischiocavernosus M (same fxn as males, to maintain “erection” and prevent return of blood)

both corpora cavernosa unite to form body of clitoris which is continuous with glans clitoris

61
Q

What are the bulbs of the vaginal vestibule?

A

deep to skin of labia minora

–>erectile tissue that is covered by bulbocavernosus M attached to perineal body

–>compresses bulbs during sexual activity to retard return of venous blood flow

62
Q

What are the greater vestibular glands or Bartholin’s glands?

A

produce clear mucous to lubricate vulva during sexual arousal

63
Q

Is there fat under the skin of the penis?

A

NO

64
Q

What are causes of male impotence?

A
  • nerve damage to prostatic nerve plexus
  • atherosclerosis
  • Type 2 DM
  • spinal cord injury
  • hormonal disorders
  • psych disorders
65
Q

Define episiotomy

A

surgical incision between vagina and anus to prevent perineal tear during delivery

66
Q

What is the most common type of episiotomy?

A

mediolateral incision through posterior vaginal wall, bulbospongiosus M, superficial transverse perineus M, skin and fascia

67
Q

How many layers of sutures are required to repair an episiotomy?

A

3

vaginal wall, muscle, subQ

GIGU (37 decks)

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