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Gross III > Part III. Perineum/urogenital triangle/ischioanal fossae pg 79-86 > Flashcards

Part III. Perineum/urogenital triangle/ischioanal fossae pg 79-86 Flashcards

1
Q

Perineum refers to what?

A

External surface and a shallow body compartment that is separated from the pelvic cavity by pelvic diaphragm

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2
Q

What is the anterior osseofibrous border of the perineum?

A

Pubic symphysis

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3
Q

What is the anteriorlateral osseofibrous border of the perineum?

A

Ischiopubic rami

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4
Q

What is the lateral osseofibrous border of the perineum?

A

Ischial tuberosity

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5
Q

What is the posterolateral osseofibrous border of the perineum?

A

Sacrotuberous ligament

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6
Q

What is the posterior osseofibrous border of the perineum?

A

Inferior sacrum and coccyx

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7
Q

An Imaginary transverse line connecting ischial tuberosities subdivides perineum into:

A

Anal triangle and urogenital triangle

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8
Q

What is contained in the anal triangle?

A

Anus bounded by two ischioanal fossae

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9
Q

What closes anterior opening in pelvic diaphragm?

A

Perineal membrane

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10
Q

What is the Attachment point for erectile bodies associated with external genitalia?

A

Perineal membrane

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11
Q

The urethra (both sexes) and vagina (females) perforate what structure in the urogenital triangle?

A

Perineal membrane

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12
Q

Where is the perineal body located?

A

Midpoint of transverse line, posterior to vestibule of vagina or bulb of penis and anterior to anus and anal canal

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13
Q

What muscles attach to the perineal body?

A
  • Superficial transverse perineal muscle
  • deep transverse perineal muscle
  • External anal sphincter
  • bulbospongiosus m.
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14
Q

What muscles span along the posterior aspect of perineal membrane to support and anchor perineal body in providing support to the pelvic floor?

A

Superficial transverse perineal m.

Deep transverse perineal m.

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15
Q

What innervates Superficial Transverse Perineal M and Deep Transverse Perineal M?

A

Deep perineal nerve (a branch of pudendal nerve)

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16
Q

Damage to the perineal body in females may result in what?

A

Prolapse of vagina

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17
Q

What procedure reduces attenuation of perineal body during childbirth?

A

Episiotomy

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18
Q

What structure in the male urogenital triangle is located in superficial perineal pouch, attached to perineal membrane?

A

Root of penis

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19
Q

The root of the penis consists of what?

A
  • crura

- bulb of penis

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20
Q

The bilateral slender masses of erectile tissue?

A

Crura of penis

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21
Q

Where is the crura of the penis attached?

A

To internal part of each ischial ramus (anterior to ischial tuberosity

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22
Q

The crura of the penis is continuous with what structure in the body of the penis?

A

Corpora cavernosa

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23
Q

The crura of the penis is surrounded by what muscle?

A

Ischiocavernosus m.

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24
Q

What occurs when ischiocavernosus muscle contracts?

A

forces blood from crus into corpus cavernosum of penis and compresses Deep Dorsal vein of penis which increases turgidity of penis

I.e erection

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25
Q

The body of the penis is the free, pendulous elongated part of the penis that is suspended from pubis by what?

A

Suspensory ligament of the penis

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26
Q

What are the 3 cylindrical bodies of erectile tissue bound to deep fascia?

A
  • two corpora cavernosa

- corpus spongiosum

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27
Q

Which is dorsally located, corpora cavernosa or corpus spongiosum?

A

Corpora cavernosa is located dorsally in the penis

Corpus spongiosum is located ventrally in penis

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28
Q

What is the thick fibrous structure surrounding the corpora cavernosa?

A

Tunica albuginea

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29
Q

________ expands distally to form the glans penis, while _____ does not extend into glans penis?

A
  • corpus spongiosum

- corpora cavernosum

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30
Q

The bulb of the penis is continuous with what?

A

Corpus spongiosum in the body of the penis

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31
Q

What surrounds the spongy urethra?

A

Corpus spongiosum

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32
Q

The spongy urethra opens from the distal end of the glans (Continuous with corpus spongiosum) where?

A

External urethral orifice

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33
Q

The expanded distal end of the corpus spongiosum?

A

Glans of penis forms the head of the penis

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34
Q

What is the expanded rim beyond end of corpora cavernosa?

A

Corona of glans

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35
Q

What is the constriction between corona of glans and body of penis?

A

Neck of glans

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36
Q

What is the double layer of skin extending from neck to cover glans of penis?

A

Prepuce (foreskin)

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37
Q

What is the ventral median fold of skin from prepuce to glans?

A

Frenulum of prepuce

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38
Q

Thin layer of adipose-free fascial connective tissue adjacent to skin of the penis?

A

Superficial penile fascia

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39
Q

What contains superficial neurovasculature supplying penile skin?

A

Superficial penile fascia

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40
Q

What connective tissue surrounds corpora cavernosa and corpus spongiosum?

A

Deep penile fascia

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41
Q

The deep dorsal neurovasculature of the penis is found where and what does it supply?

A

Enclosed in deep penile (bucks) fascia, then penetrates tunica albuginea and supplies erectile tissue

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42
Q

Where does the suspensory ligament of the penis extend from?

A

From anterior surface of the pubic symphysis to the root of the penis, effectively anchoring erectile bodies of the penis to the pupil symphysis

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43
Q

Internal Pudendal A supplies most penile tissue via the following branches:

A
  • dorsal artery of the penis

- deep artery of the penis

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44
Q

What artery is located between deep penile fascia and tunica albuginea?

A

Dorsal artery of penis

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45
Q

What artery supplies fascial CT and majority of penile skin?

A

Dorsal artery of penis

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46
Q

What artery passes through center of corpora cavernosa and is responsible for erection of penis?

A

Deep artery of the penis

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47
Q

What artery supplies bulb, corpus spongiosum and spongy urethra?

A

Artery of bulb

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48
Q

What supplies blood to the proximal penile skin?

A

Deep and superficial external pudendal arteries that branch from femoral artery

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49
Q

What vein is located in deep (bucks) penile fascia and drains erectile tissue?

A

Deep Dorsal V of penis -> prostatic venous plexus -> Internal Iliac V

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50
Q

What is located in superficial (dartos) fascia and drains skin of the penis?

A

Superficial Dorsal V of penis -> Superficial External Pudendal V -> External Iliac V

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51
Q

Most lymphatic efferents of the penis drain to where?

A

superficial inguinal lymph nodes

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52
Q

What provides sensory innervation of skin and glans penis?

A

Dorsal N of the penis

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53
Q

Dorsal N of penis is a terminal branch of what?

A

Pudendal N

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54
Q

What nerve parallels Dorsal A and Deep Dorsal V of penis?

A

Dorsal N of penis

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55
Q

What nerve is composed of parasympathetic fibers branching from prostatic plexus of nerves and innervates Deep A of penis and responsible for erection?

A

Cavernous nerve

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56
Q

female external genitalia is called

A

Vulva or Pudendum

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57
Q

What is the function of the Vulva/Pudendum?

A
  • Sensory and erectile tissue for sexual arousal and intercourse
  • Directs flow of urine
  • Prevents entry of foreign material into urogenital tract
58
Q

What is the mons pubis?

A

Rounded, fatty prominence covered with coarse pubic hairs (after puberty)

59
Q

The mons pubis is located anterior to what?

A

pubic symphysis, superior pubic rami and pubic tubercles

60
Q

The prominent folds of skin on either side of pudendal cleft?

A

Labia majora

61
Q

The labia majora are connected by anterior and posterior ___________.

A

labial commissures

62
Q

What female structure is homologous to the two halves of scrotal sac in males?

A

Labia majora

63
Q

Where does the Round L of uterus terminate?

A

Labia majora

64
Q

What is the function of the labia majora?

A

Provide protection for clitoris and urethral/vaginal orifices

65
Q

Folds of fat-free, hairless skin enclosed in pudendal cleft by labia majora

A

Labia minora

66
Q

The labia minora is connected posteriorly in young women and virgins by what?

A

frenulum of labia minora

67
Q

What female structure is homologous to skin that covers body of penis in males?

A

Labia minora

68
Q

Erectile organ located where labia minora meet anteriorly

69
Q

What forms the prepuce of clitoris?

A

Anterior part of labia minora

70
Q

The root of the clitoris is continuous with what?

A

Corpus Cavernosum in body of clitoris

71
Q

The root of the clitoris is comprised of 2 crura located along internal surface of ischial rami. Each crus is surrounded by what?

A

Ischiocavernosus M

72
Q

Bulbospongiosus M originates at perineal body and inserts where?

73
Q

What is the function of the bulbospongiosus muscle in females?

A

Covers bulb of vestibule and weakly constricts vagina

74
Q

What is the body of the clitoris composed of?

A

2 corpora cavernosa

75
Q

What is the function of the glans clitoris?

A

functions solely as an organ of sexual arousal

76
Q

Space between labia minora where urethra and vagina open externally

A

Vestibule of Vagina

77
Q

The thin fold of mucous membrane covering vaginal orifice

78
Q

What is the shape of the hymen?

A

Usually crescent shaped posteriorly but may cover vaginal orifice completely

79
Q

What structure must be perforated at puberty to allow menstrual flow and is reduced to remnants after coitus?

80
Q

Paired masses of elongated erectile tissue deep to labia minora?

A

Bulb of Vestibule

81
Q

The bulb of the vestibule is continuous with ______.

A

glans clitoris

82
Q

The bulb of the vestibule is covered by ______.

A

Bulbospongiosus M

83
Q

What female structure is homologous to the bulb of penis and corpus spongiosum in males?

A

Bulb of vestibule

84
Q

Round or oval glands located on each side of vestibule posterolateral to vagina

A

Vestibular glands

85
Q

What female structure is homologous to bulbourethral glands in males?

A

Vestibular glands

86
Q

Where do the ducts of the vestibular gland open?

A

into vestibule near orifice of vagina

87
Q

Vestibular glands are partially surrounded by what muscle?

A

Bulbospongiosus M

88
Q

What is the function of the vestibular glands?

A

Secrete mucous during sexual arousal to moisten labia and vestibule

89
Q

What supplies skin and superficial fascia of the vulva with blood?

A

Deep and superficial External pudendal arteries that branch from femoral nerve

90
Q

What supplies blood to the erectile tissue of the clitoris?

A

Internal Pudendal A (via Deep A of Clitoris)

91
Q

What is the venous drainage of the vulva?

A

Internal Pudendal V -> Internal Iliac V

92
Q

Efferent lymphatic drainage of the vulva is via what?

A

superficial inguinal lymph nodes

93
Q

What supplies somatic innervation of the vulva?

A
  • Ilioinguinal N forming Anterior Labial N
  • Genitofemoral N innervating anterolateral perineum
  • Pudendal N terminating as Posterior Labial N (from Superficial Perineal N)
94
Q

Parasympathetic innervation of the vulva is via what?

A

Cavernous N from uterovaginal nerve plexus

95
Q

What is the effect of parasympathetic innervation to the vulva?

A

Increases vaginal secretion and erection of clitoris

96
Q

The fatty superficial layer of the superficial perineal fascia is continuous with ________ in the abdomen?

A

Camper’s fascia

97
Q

The membranous deep layer of the superficial perineal fascia is called what?

A

Colles’ fascia

98
Q

In females, the fatty superficial layer of the superficial perineal fascia extends where?

A

into labia majora and over mons pubis

99
Q

In males, the fatty superficial layer of the superficial perineal fascia extends where?

A

reduced, replaced by smooth muscle in penis/scrotum

100
Q

Colle’s fascia attaches laterally to _________.

A

Fascia lata of the thigh

101
Q

Colle’s fascia is continuous with ________ in the abdomen and ________ in the penis and scrotum?

A

Scarpa’s fascia in the abdomen

Dartos fascia in the penis and scrotum

102
Q

What fascia invests Ischiocavernosus M, Bulbospongiosus M & Superficial Transverse Perineal M?

A

Deep Perineal (Gallaudet) Fascia

103
Q

The Deep Perineal (Gallaudet) Fascia attaches laterally to what?

A

Ischiopubic rami

104
Q

The Deep Perineal (Gallaudet) Fascia fuses anteriorly with what?

A

Suspensory L of either penis or clitoris

105
Q

The Deep Perineal (Gallaudet) Fascia is continuous with what?

A

deep fascia of anterolateral abdominal wall

106
Q

What is the Superficial Perineal Pouch?

A

Potential space between Colles’ fascia and perineal membrane

107
Q

What is contained in the superficial perineal pouch in males?

A
  • Crura and bulb of penis, Ischiocavernosus M, Bulbospongiosus M
  • Proximal part of spongy urethra
  • Superficial Transverse Perineal M
  • Deep Perineal Branches of Internal Pudendal AV and Pudendal N
108
Q

What is contained in the superficial perineal pouch in females?

A
  • Crura of clitoris and Ischiocavernosus M
  • Bulb of vestibule and Bulbospongiosus M
  • Greater vestibular glands
  • Superficial Transverse Perineal M
  • Deep Perineal Branches of Internal Pudendal AV and Pudendal N
109
Q

Where is the deep perineal pouch located?/

A

above perineal membrane and open superiorly to ischioanal fossae

110
Q

What are the contents of the deep perineal pouch in males?

A
  • Membranous urethra and bulbourethral glands
  • External Urethral Sphincter M
  • Deep Transverse Perineal M
111
Q

What are the contents of the deep perineal pouch in females?

A
  • Proximal part of urethra
  • External Urethral Sphincter M
  • Deep Transverse Perineal M
112
Q

The urethral sphincter muscle in males is innervated by what?

A

Dorsal nerve of the penis

Branch of pudendal nerve

113
Q

The urethral sphincter muscle in females is innervated by what?

A

Dorsal nerve of the clitoris

Branch of pudendal nerve

114
Q

Wedge shaped spaces located between skin of anal region and pelvic diaphragm

A

Ischioanal fossae

115
Q

Where does levator ani muscle originate from?

A

Obturator Internus fascia

116
Q

How do the two ischioanal fossae communicate?

A

via a postanal space

117
Q

What is the function of the ischioanal fossae?

A

It is filled with adipose and connective tissue which permits expansion of anal canal during passage of feces

118
Q

What is the lateral boundary of the ischioanal fossa?

A

Ischium and Obturator Internus M (fascia)

119
Q

What is the medial boundary of the ischioanal fossa?

A

Anal canal surrounded by Levator Ani M and External Anal Sphincter

120
Q

What is the posterior boundary of the ischioanal fossa?

A

Sacrotuberous L and Gluteus Maximus M

121
Q

What is the anterior boundary of the ischioanal fossa?

A

Pubic bones inferior to origin of Puborectalis m.

122
Q

The anterior recess of the ischioanal fossa extends forward superior to ________.

A

perineal membrane

123
Q

Where is the Pudendal Canal located?

A

Lateral wall of the ischioanal fossa (on medial aspect of obturator fascia)

124
Q

What does the pudendal canal contain?

A
  • Internal Pudendal AV
  • Pudendal N
  • N to Obturator Internus M
125
Q

The contents of the pudendal canal enter where?

A

at lesser sciatic notch inferior to ischial spine

126
Q

Internal Pudendal A branches to form:

A
  • Inferior Rectal A
  • perineal A
  • Deep A of the penis/clitoris
  • dorsal A of the penis/clitoris
127
Q

What does the inferior rectal artery supply?

A

External Anal Sphincter and perianal skin

128
Q

What does the perineal artery supply?

A

supplies muscles of superficial pouch

129
Q

What supplies the erectile tissue in males?

A

Deep A of Penis and Dorsal A of Penis

130
Q

What supplies the erectile tissue in females?

A

Deep A of Clitoris and Dorsal A of Clitoris

131
Q

The terminal branches of perineal artery in the female?

A

Posterior Labial A and Artery of Bulb of Vestibule

132
Q

The terminal branches of perineal artery in the male?

A

Posterior Scrotal A and Artery of Bulb of Penis

133
Q

Pudendal N branches to form:

A
  • Inferior Rectal N
  • Perineal N
  • Dorsal N of Penis/Clitoris
134
Q

What does the Inferior Rectal N supply innervation to?

A

External Anal Sphincter and perianal skin?

135
Q

What does the perineal N supply?

A

supplies urogenital triangle

136
Q

The perineal nerve branches into what?

A

Superficial perineal nerve (terminates as posterior labial/scrotal a) and deep perineal nerve (terminates as Artery to bulb of the penis/vestibule)

137
Q

What does the superficial perineal nerve supply in males?

A

Cutaneous innervation to scrotum via posterior scrotal nerve

138
Q

What does the superficial perineal nerve supply in fe males?

A

Cutaneous innervation to the labia via posterior labial nerve

139
Q

What does the deep perineal nerve supply?

A
  • Motor to muscles of deep/superficial perineal pouches

- Sensory for inferior part of vagina and its vestibule

140
Q

What does the dorsal nerve of the penis/clitoris supply?

A

Primary sensory nerve of glans (of penis or clitoris)

Gross III (20 decks)

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