Pelvis and Perineum Flashcards
Bony landmarks of the perineum
Anterior: Pubic symphysis
Posterior: Coccyx
Lateral: Ischial tuberosities
Anatomical borders of the perineum
Anterior: Pubic Symphysis
Posterior: Coccyx
Lateral: Inferior pubic rami, Inferior ischial rami, sacrotuberous ligaments
Roof: Pelvic floor
What are the two triangles of the perineum? Which bony prominence separates the two of them?
- Urogenital
- Anal
Ischial tuberosities
Thin sheet of deep fascia that stretches between right and left pubic arch to the pubic symphysis?
Perineal membrane
Function of the external anal sphincter?
Compress the anus and maintain faecal continence
Function of the superficial transverse perineal?
Support the perineal body
Function of the deep transverse perineal?
Anchor the perineal body, supports pelvis viscera
Function of the external urethral sphincter?
Compress the urethra and maintain urinary continence
Function of the bulbospongiosus (male)?
Relaxes to allow micturition, constricts to stop urine flow. Ejaculation in wave-like contractions.
Function of the bulbospongiosus (female)?
Maintain erection. Expresses the secretions of the greater vestibular glands.
Function of the ischiocavernosum (male)?
Maintain erection of penis by reducing venous return
Function of the ischiocavernosum (female)?
Maintain erection of clitoris by reducing venous return
Perineal muscles innervated by what?
Pudendal nerve S2-4.
Deep perineal pouch contents (female)
Utherovaginal sphincter
External urethral sphincter
Deep perineal pouch contents (male)
Urethra
External urethral sphincter
Deep transverse perineum
Bulbourethral glands
What perforates the perineal membrane?
Urethra
Vagina
Superficial perineal pouch contents (female)
Clitoris, Greater vestibular glands
Ischiocavernosus, Bulbospongiosus, Superficial transverse perineum
Superficial perineal pouch contents (male)
Penis
Ischiocavernosus, Bulbospongiosus, Superficial transverse perineum
Perineal fascia consists of what two layers?
Deep and superficial
What attaches to the perineal body?
Levator ani Bubospongiosus Superficial and deep transverse perineal muscles External urethral sphincter External anal sphincter
Clinical consequence of damage to the perineal body?
Pelvic organ prolapse, urinary/bowel incontinence
Which structures pierce through pelvic diaphragm?
Urethra
Anal canal
Vagina (in women)
Is urogenital triangle the one with the deep and superficial layers?
Yes
What is the narrowest part of the male urethra?
Membranous urethra
What is the widest part of the male urethra and why?
Prostatic urethra. Ejaculatory duct, vas deferens and prostatic secretions all open into this region.
What muscles does the penis consist of?
2 corpus cavernosa, 1 corpus spongisum
Corpus cavernosa is covered by what fascial layer?
Tunica albuginea
The urethra is transmitted through the corpus cavernosa or the corpus spongiosum?
Corpus spongiosum
Erection occurs in the corpus cavernosa or the corpus spongiosum?
Corpus cavernosa
Sensory innervation of penis?
Dorsal nerve of the penis, branch of the pudendal nerve
What is the fascia surrounding the penis?
Buck’s fascia
Where is the internal/vesical urethral sphincter located?
At the vesicourethral junction
Is the internal urethral sphincter voluntary or involuntary? What is its innervation?
Involuntary. Sympathetic innervation from inferior hypogastric plexus.
Is the external urethral sphincter voluntary or involuntary? What is its innervation?
Voluntary. Pudendal nerve.
Where is the external urethral sphincter found in females?
Arise from either side of inferior pubic rami
What causes urinary incontinence (with relation to the pelvic floor)
Aging
Prostate surgery (male)
Childbirth (female)
What are the contents of the vulva?
Mons pubis Clitoris Labia majora Labia minora Vestibular gland Vestibule
Innervation of vulva?
Pudendal nerve
Blood supply of vulva?
Internal pudendal artery
What is the vestibule enclosed in? What terminal aspects does it contain?
Labia minora
Urethra and vagina
What is in the anal triangle?
Anal aperture
External anal sphincter
Ischioanal fossa
Pudendal nerve
What is the equivalent of the corpus cavernosa in the female? On that note, what does the male have that the female does not?
Clitoris
There is no equivalent of the corpus spongiosum.
What is the pudendal canal also known as?
Alcock’s canal
What is in the pudendal canal?
Pudendal nerve
Internal pudendal vessels
nerve to obturator internus
What structures do the pudendal nerve and internal pudendal vessels supply?
Pelvic floor
Perineum
External genitalia (sensory)