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Anatomy Exam 4 > Perineum 1 & 2 > Flashcards

Perineum 1 & 2 Flashcards

1
Q

What is perineum bounded by (3)?

A

1) coccyx
2) ischial tuberosities
3) pubis

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2
Q

A line through which structure divides perineum into 2 triangles?

A

ischial tuberosities

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3
Q

What two triangles can perineum be divided into?

A

1) anal triangle

2) urogenital triangle

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4
Q

Which of the two triangles is anterior and which is posterior?

A

anterior –> urogenital

posterior –> anal

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5
Q

Which triangle includes anal canal and paired ischioanal fossae?

A

anal triangle

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6
Q

Which triangle includes external genitalia?

A

urogenital

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7
Q

The anal canal is the terminal part of large intestines, it runs from ____ ____ to ___

A

pelvic diaphragm to anus

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8
Q

How is the anal canal divided?

A

upper and lower halves

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9
Q

What divides anal canal?

A

pectinate line (based on embryologic development)

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10
Q

Which half is derived from endoderm?

A

upper

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11
Q

What type of epithelium lines the upper half of anal canal?

A

columnar

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12
Q

What marks the anorectal junction?

A

vertical folds = anal columns

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13
Q

Where is the pectinate line in relation to anal columns?

A

inferior

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14
Q

What structure is found in anal columns?

A

semilunar folds (or anal valves)

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15
Q

What type of innervation does the upper anal canal have?

A

autonomic

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16
Q

What arteries supply the upper half of anal canal?

A

1) superior rectal a (from IMA)

2) middle rectal a (from internal iliac a)

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17
Q

Where do blood drain in the upper half of anal canal?

A

superior rectal vein (then into IMV)

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18
Q

Where do lymphatics travel to in the upper half of anal canal?

A

superiorly to inferior mesenteric nodes

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19
Q

What germline is the lower half of anal canal derived from?

A

ectoderm

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20
Q

What type of epithelium does the lower half of anal canal have?

A

stratified squamous

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21
Q

Are anal columns present in the lower half of anal canal?

A

No

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22
Q

What type of innervation does the lower half of anal canal have?

A

somatic

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23
Q

Which nerve innervates lower half of anal canal?

A

inferior rectal branch of pudendal n

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24
Q

What artery supplies the lower half of anal canal?

A

inferior rectal a (from internal pudendal a)

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25
Q

Where do blood drain to in the lower half of anal canal?

A

inferior rectal v (then to internal pudendal v)

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26
Q

Where do lymphatics travel to from the lower half of anal canal?

A

inferiorly to superficial inguinal nodes

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27
Q

True or False. There is an internal and external anal sphincter

A

True

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28
Q

Which anal sphincter is made up of smooth muscle and which is of skeletal muscle?

A

internal –> smooth

external –> skeletal

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29
Q

Which anal sphincter is voluntary and which is involuntary?

A

internal –> involuntary

external –> voluntary

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30
Q

True or False. The internal anal sphincter is the thickening of outer circular muscular coat at proximal anal canal.

A

FALSE. it is the thickening of INNER circular muscular coat

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31
Q

What innervates the external anal sphincter?

A

inferior rectal n.

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32
Q

What is the fat-filled space lateral to anal canal called?

A

ischiorectal (ischioanal) fossa

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33
Q

What are the boundaries to ischiorectal fossa (5)?

A

1) skin
2) levator ani
3) obturator internus
4) sacrotuberous and sacrospinous ligaments
5) deep transverse perineal muscles

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34
Q

What is the significance of the fat-filled ischiorectal fossa?

A

permits distension of anal canal

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35
Q

Where is pudendal canal located?

A

fascial canal on lateral wall of fossa

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36
Q

What is located in pudendal canal?

A

1) pudendal nerve
2) internal pudendal artery
3) internal pudendal vein

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37
Q

What spinal level is pudendal nerve?

A

S2-S4

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38
Q

All contents of pudendal canal enters through…

A

lesser sciatic foramen

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39
Q

Pudendal nerve exits the pelvis via ___ and enters perineum via ___

A

exits –> greater sciatic foramen

eneters –> lesser sciatic foramen

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40
Q

What are the branches of pudendal nerve?

A

1) inferior rectal
2) dorsal nerve of penis or clitoris
3) perineal nerves

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41
Q

Which artery gives rise to internal pudendal artery?

A

internal iliac a

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42
Q

What are the branches of internal pudendal a?

A

1) inferior rectal

2) branches to penis or labia and clitoris

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43
Q

What are hemorrhoids?

A

dilated veins in anal canal

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44
Q

Where are internal hemorrhoids located?

A

upper half of anal canal

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45
Q

Where are external hemorrhoids located?

A

lower half of anal canal

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46
Q

What are the different fascia in urogenital triangle?

A

1) superficial fascia (fatty layer)
2) superficial fascia (membranous layer - Colles fascia)
3) deep fascia (investing fascia)

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47
Q

The fatty layer of superficial fascia is continuous with ____

A

ischiorectal fat

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48
Q

In females, the fatty layer makes up substance of fat in ____ and ____

A

mons pubis and labia majora

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49
Q

The membranous layer in urogenital triangle is called _____ in abdomen

A

Scarpa’s fascia

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50
Q

The fatty layer in urogenital triangle is called ____ in abdomen

A

Camper’s fascia

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51
Q

What forms tubular sheath around penis and clitoris?

A

Colles fascia (membranous layer)

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52
Q

What layer envelopes muscles of perineum?

A

deep fascia

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53
Q

The deep fascia is fused to _____ of penis or clitoris

A

suspensory ligament

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54
Q

The deep fascia in urogenital triangle is continuous with what layer in abdomen?

A

fascia of external oblique and rectus sheath

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55
Q

What holds penile corpora together?

A

deep penile fascia (Buck’s fascia)

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56
Q

Deep penile fascia is continuous of what?

A

deep fascia of urogenital triangle

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57
Q

Potential space between membranous/Colles fascia and perineal membrane

A

male superficial perineal pouch

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58
Q

Thin inferior fascia of urogenital diaphragm

A

perineal membrane

59
Q

What are the contents of male superficial perineal pouch (5)?

A

1) root of penis (bulb and crura)
2) ischiocavernosus m
3) bulbospongiosus m
4) superficial transverse perineal m
5) spongy urethra

60
Q

Space between superior fascia of urogenital diaphragm and perineal membrane

A

male deep perineal pouch

61
Q

The male deep perineal pouch is essentially filled by …

A

sphincter urethrae and transverse perineal muscles

62
Q

What are the contents of male deep perineal pouch (6)?

A

1) membranous urethra
2) external urethral sphincter
3) bulbourethral (Cowper’s) gland
4) deep transverse perineal m
5) dorsal nerve of penis
6) internal pudendal arterial branches

63
Q

Which perineal pouch is easily ruptured?

A

male deep perineal pouch

64
Q

What are the contents of scrotum?

A

1) testes
2) epididymis
3) spermatic cord

65
Q

Which fascia attaches to and contains dartos muscle?

A

membranous fascia (Colles)

66
Q

What type of muscle is dartos muscle?

A

smooth

67
Q

What is the function of dartos muscle?

A

wrinkling and expanding of skin of scrotum

68
Q

What innervates scrotum?

A

genital branch of genitofemoral

69
Q

What surrounds corpora cavernosa and corpus spongiosum of penis?

A

runica albuginea

70
Q

What is known as erectile bodies?

A

corpora cavernosa and corpus spongiosum

71
Q

What binds erectile bodies together?

A

deep penile fascia (Buck’s fascia)

72
Q

What surrounds penis externally underneath the skin?

A

superificial penile fascia (Colles/membranous)

73
Q

What are the three cylindrical erectile tissue in root of penis?

A

1) bulb - corpora spongiosum

2) right and left crura - corpus cavernosum

74
Q

What is the bulb from root of penis attached to?

A

perineal membrane of urogenital diaphragm

75
Q

What is right and left crura from root of penis attached to?

A

ischiopubic rami

76
Q

True or False. Body of penis is continuation of erectile tissues from the root of penis

A

True

77
Q

What erectile tissue contains urethra?

A

corpus spongiosum

78
Q

What expands at its terminal end to form glans penis?

A

corpus spongiosum

79
Q

What paired muscles are attached to each other at median tendinous raphe?

A

bulbospongiosus muscles

80
Q

What occurs when bulbospongiosus muscles contract?

A

compress bulb

1) aids in emptying spongy urethra of residual urine/semen
2) erection by increasing pressure on erectile tissue in the root and compressing venous return

81
Q

Which paired muscles cover the right and left crus?

A

ischiocavernosus muscles

82
Q

What occurs when ischiocavernosus muscles contract?

A

compress each crus and aids in achieving and maintaining an erection via the compression of the crura and by retarding venous recturn

83
Q

What are the small muscles that arise from ischial tuberosity and inserting into perineal body?

A

superficial transverse perineal muscles

84
Q

Which muscles fix the perineal body?

A

superficial transverse perineal muscles

85
Q

What is the small fibrous mass in center of perineum?

A

perineal body

86
Q

What structures attach to perineal body?

A

1) external anal sphincter
2) bulbospongiosus
3) superficial transverse perineal muscles

87
Q

What innervates perineal muscles and skin?

A

perineal branches of pudendal nerve

88
Q

What are the muscles of perineum?

A

1) ischiocavernosus
2) bulbospongiosus
3) superficial transverse perineal

89
Q

Which part of the urethra is the smallest and narrowest?

A

membranous

90
Q

What innervates external sphincter of urethra?

A

perineal branch of pudendal n

91
Q

True or False. external sphincter of urethra is a voluntary muscle

A

True

92
Q

What are the ducts of the glands extend into superficial perineal pouch to enter spongy urethra?

A

bulbourethral (Cowper’s) glands

93
Q

What produces a few drops of fluid that cleanse the urethera and provide lubricating fluids for sexual activity?

A

bulbourethral glands

94
Q

What muscle is posterior to sphincter urethrae and extends from ischial rami to perineal body?

A

deep transverse perineal muscle

95
Q

What innervates skin of penis and glans penis?

A

dorsal nerve of penis

96
Q

Deep arteries of the penis fill which erectile tissue with blood that aids in erection?

A

corpora cavernosa

97
Q

What is the origin of deep arteries of penis?

A

internal pudendal a

98
Q

What opens into cavernous spaces, coiled arteries in flaccid penis?

A

helicine branches

99
Q

What structure in the female body is the terminal part of round ligamen?

A

labia majora

100
Q

Labia major is prominent folds of skin, what is its function?

A

protection

101
Q

What is labia majora filled with?

A

fat and smooth muscle

102
Q

What are lies medial to labia majora and has delicate mucus membrane folds?

A

labia minora

103
Q

Which structure forms the prepuce and frenulum?

A

labia minora

104
Q

What is the space between labia minora?

A

vestibule

105
Q

What are the contents of vestibule?

A

1) external meati of urethra
2) vagina
3) ducts of greater and lesser vestibular glands

106
Q

The clitoris has two parts, what are they?

A

1) root

2) body

107
Q

Which part of the clitoris is the attached portion in superficial perineal pouch?

A

root

108
Q

What does the root of clitoris contain?

A

1) bulb of vestibule

2) R and L crura

109
Q

Bulb of vestibule is homologous to which structure in males?

A

bulb of penis and corpus spongiosum

110
Q

How is bulb of vestibule divided?

A

2 parts: surrounding vaginal and urethral orifice

111
Q

Just like males, right and left crura is ____ in females

A

corpora cavernosa

112
Q

What does right and left crura attach to in females?

A

pubic arch

113
Q

Which part of clitoris is proximally detached?

A

body

114
Q

What does the body of clitoris consist of?

A

corpora cavernosa

115
Q

What muscle covers bulb of vestibule?

A

bulbospongiosus muscles

116
Q

What muscle covers crura of clitoris?

A

ischiocavernosus muscles

117
Q

Which muscle aids in erection of clitoris?

A

ischiocavernosus muscles

118
Q

What glands secrete lubricating mucus during sexual activity in females?

A

greater vestibular glands

119
Q

Where do greater vestibular glands open into?

A

vestibule, posterolateral to vaginal orifice

120
Q

Which structure of the female body corresponds to male’s prostate?

A

lesser vestibular glands

121
Q

Where do lesser vestibular glands open into?

A

vestibule, lateral to urethral orifice

122
Q

Mucus secreted by lesser vestibular glands is for distribution to…

A

labia and vestibule

123
Q

What are the contents of female superficial perineal pouch?

A

1) root of clitoris
2) muscles covering bulb and crura
3) greater vestibular glands
4) lesser vestibular glands
5) superficial transverse perineal muscles
6) perineal body
7) perineal branches of pudendal n

124
Q

What are the contents of female deep perineal pouch?

A

1) part of urethra
2) part of vagina
3) sphincter urethrae
4) deep transverse perineal muscles
5) internal pudendal vessels, arterial branches
6) dorsal nerves of clitoris

125
Q

What is the origin of dorsal nerves of clitoris?

A

pudendal n

126
Q

What structure do dorsal nerves of clitoris supply?

A

clitoris

127
Q

True or False. Internal urethral sphincter is present in both sexes.

A

False. only in males

128
Q

What type of muscle do internal and external urethreal sphincters have?

A

internal –> smooth

external –> skeletal

129
Q

What are the three sexual function of perineal organs in males?

A

1) erection
2) emission
3) ejaculation

130
Q

What type of innervation controls erection?

A

parasympathetic

131
Q

What type of innervation controls emission?

A

sympathetic

132
Q

What type of innervation controls ejaculation?

A

somatic (also autonomic)

133
Q

Where do nerve fibers originate from in parasympathetic innervation of erection?

A

pelvic splanchnic nerves (S2-S4)

134
Q

What do parasympathetic fibers control during erection?

A

dilate helicine arteries, filling cavernous tissues with blood

135
Q

How do bulbospongiosus and ischiocavernosus muscles assist during erection?

A

by compressing venous plexus, impeding venous return

136
Q

Where do nerve fibers originate from in sympathetic innervation of emission?

A

L1-L2

137
Q

What do sympathetic fibers control during emission?

A

1) movement of semen into prostatic urethra
2) peristalsis of ductus deferntes and seminal vesicles
3) prostatic contraction

138
Q

What does prostatic contraction accomplish?

A

adds prostatic fluid

139
Q

What glands are involved in emission?

A

1) seminal vesicles
2) prostate
3) bulbourethral glands

140
Q

What do somatic nerve fibers control during ejaculation?

A

expulsion of secretions and spermatozoa

141
Q

Ejaculation is affected by rhythmic contractions of which muscles?

A

bulbospongiosus and ischiocavernosus muscles

142
Q

What nerve innervate the process of ejaculation?

A

S2-S4 –> pudendal n

143
Q

How do autonomic nerve fibers contribute during ejaculation?

A

sympathetics –> close internal urethral sphincter

parasympathetics –> contract urethral muscle

Anatomy Exam 4 (9 decks)

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