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ANA > Perineum > Flashcards

Perineum Flashcards

1
Q

what is the perineum

A

the region that lies below the levator ani (pelvis diaphragm) and medial to the sacrotuberous ligament

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2
Q

the levator ani forms the ___ of the pelvis and the ___ of the perineum

A

floor of the pelvis and the roof of the perineum

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3
Q

blood supply and innervation of the perineum

A
  • internal pudendal artery

- pudendal nerve

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4
Q

the internal pudendal a. and pudendal n. leave the pelvis via what structure to briefly enter the gluteal region?

A

greater sciatic foramen

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5
Q

the internal pudendal a. and pudendal n. pass through the ______ to the enter the perineum

A

lesser sciatic formen

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6
Q

once the internal pudendal artery and pudendal n. pass through the lesser sciatic foramen, they lie on the ___ wall of the perineum and are covered by ___ ___ forming the ___ ___

A

lateral; deep fascia forming the pudendal canal

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7
Q

greater sciatic foramen location

A
  • in front of hip bone
  • behind sacrotuberous ligament
  • above sacrospinous ligament
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8
Q

lesser sciatic foramen location

A
  • in front of hip bone
  • behind sacrotuberous ligament
  • below sacrospinous ligament
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9
Q

the anatomical perineum is roughly what shape

A

diamond

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10
Q

boundaries of the perineum

A
  • pubic symphysis
  • left and right ischiopubic ramus
  • sacrotuberous ligament
  • left and right ischial tuberosities
  • the coccyx
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11
Q

an imaginary line passing between the ischial tuberosities divides diamond shaped perineum into two triangular regions called

A
  • the urogenital triangle anteriorly

- anal triangle posteriorly

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12
Q

due to the anterior tilt of the pelvis, the urogenital triangle is ____ to the floor while the anal triangle is ___ in orientation

A

horizontal; vertical

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13
Q

2 regions of the urogenital triangle

A
  1. UG diaphragm (deep pouch)

2. superficial pouch

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14
Q

what is the UG diaphragm

A

a diaphragm structure comprised of muscle, connective tissue, and neurovascular branches of the pudendal n.

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15
Q

what is the inferior boundary of the deep pouch (UG diaphragm)

A

perineal membrane; external genitalia hang off here

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16
Q

the superficial is located where

A

below the deep pouch

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17
Q

in the male, the UG diaphragm fills the deficit of the levator ani muscle ____ but does not extend ___

A

anteriorly but does not extend posteriorly

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18
Q

in the male what structure is related to the top of the UG diaphragm

A

prostate

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19
Q

all structures below the perineal membrane are in the ____ pouch of the urogenital triangle (external genitalia and vulva)

A

superficial

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20
Q

the anal canal is or is not in the superficial pouch

A

IS NOT as it is located in the anal triangle of the perineum

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21
Q

what structure is associated with the tip of the UG diaphragm in the female

A

bladder

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22
Q

contents of the UG diaphragm in males

A
  • deep transverse perineal m.
  • membranous urethra
  • external urethral sphincter m.
  • bulbourethral glands (males only)
  • branches of pudendal n/a/v
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23
Q

contents of the UG diaphragm in females

A
  • deep transverse perineal m.
  • membranous urethra
  • external urethral sphincter m.
  • compressor urethra (females only)
  • branches of pudendal n/a/v
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24
Q

muscles of the UG diaphragm are innervated by what nerve

A

pudendal nerve

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25
Q

the region inferior to the perineal membrane is the ____ ____ ____

A

superficial perineal membrane

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26
Q

structures of the superficial pouch

A
  • crura of penis and crura of clitoris
  • bulb of the penis (males)/vestibular bulbs (females)
  • ischiocavernosus muscle
  • bulbospongiosus muscle
  • vestibular gland (female) muscles
  • superficial transverse perineal muscle
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27
Q

what is the perineal body

A

a mass of connective tissue located at the midpoint of the line connecting the ischial tuberosities

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28
Q

the perineal body serves as the attachement point for muscles of the pelvis and the perineum, those muscles are:

A
  • the levator ani
  • deep perineal m.
  • superficial perineal m.
  • bulbospongiosus mm.
  • external anal sphincter
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29
Q

tears of the perineal body may lead to what

A

may compromise structural integrity of the pelvis and perineum and lead to prolapse of organs and urinary incontinence

30
Q

the superficial fascia of the perineum and abdomen are ____ with each other but are given regional names

A

continuous

31
Q

what is the camper’s fascia

A

superficial fatty layer under skin

32
Q

scarpa’s fascia

A

superficial fascia located in the abdominal (infraumbilical region)

33
Q

dartos fascia

A

located in the region of the scrotum and the penis (superficial fatty fascia is gone here)

34
Q

colles fascia

A

located in the region of the urogenital triangle (superficial fatty fascia is gone here)

35
Q

in general, there is a ____ ____ between the superficial fascia and the deep investing fascia of muscles and structures

A

facial plane

36
Q

in certain places, the superficial fascia fuses with the ___ ___ ___

A

deep investing fascia

37
Q

scarpa’s fascia will fuse to the investing fascia of the ___ ___

A

lower limb (fascia lata)

38
Q

the lateral and posterior edges of colles fascia will fuse to the ___ ___

A

perineal membrane

39
Q

the fusing of the fascia has clinical implications why?

A

it prevents fluid from spreading between the regions

40
Q

when can you have perforation of the spongy urethra?

A

during straddle injury

41
Q

what is the region located posterior to the imaginary line between the ischial tuberosities

A

anal triangle

42
Q

what divides the anal triangle into two fat filled spaces

A

anal canal

43
Q

the fat filled spaces formed by the anal canal are called what

A

ischioanal fossae

44
Q

borders of the ischioanal fossa

A
  1. superior- sloping of the levator ani (pelvic diaphragm)
  2. medial- sloping of the levator ani (pelvic diaphragm)
  3. lateral- obturator internus m.
  4. inferior/posterior- skin around the anus
45
Q

what forms the pudendal canal

A

the obturator fascia

46
Q

what does the pudendal canal contain

A

internal pudendal artery, vein, and pudendal n.

47
Q

what arteries and nerves supply the anal canal

A

inferior rectal arteries and nerves as they emerge from the pudendal canal

48
Q

where does the rectum end

A

at the floor of the pelvic cavity where the puborectalis m. encircles it

49
Q

what is the continuation of the rectum

A

the anal canal that extends inferoposteriorly to terminate at the anus

50
Q

the wall of the anal canal is composed of what

A

external and internal anal sphincters

51
Q

what is the internal anal sphincter

A

thickened continuation of the inner circular layer of smooth muscle from the rectum

52
Q

what is the external anal sphincter

A

composed of skeletal (voluntary) muscle

53
Q

superficial portion of the external anal sphincter is attached anteriorly to what and posteriorly to what

A

attached anteriorly to the perineal body and posteriorly to the coccyx

54
Q

what attaches the superficial portion of the external anal sphincter to the perineal body and coccyx

A

anococcygeal raphe

55
Q

the lining of the anal canal exhibits vertical folds of mucous membrane called

A

anal columns

56
Q

the recesses between the anal columns are called what

A

anal sinuses

57
Q

the anal columns are joined at their inferior ends by horizontal folds called

A

anal valves

58
Q

the anal-valves have a __ __ morphology

A

cup-like

59
Q

the spaces behind the anal valves are called the

A

anal crypts

60
Q

what is the clinical importance of the anal crypts

A

they can serve as a point for infection that may lead to fistula into the ischioanal fossa

61
Q

the lower margins of the anal valves form the tooth-like ___ ___

A

pectinate line (dentate line)

62
Q

what happens below the pectinate line

A

important changes including changes in the epithelial lining, arterial supply, venous drainage, and lymphatic drainage

63
Q

arterial supply above the pectinate line

A

superior rectal a. and middle rectal a.

64
Q

arterial supply below the pectinate line

A

inferior rectal aa.

65
Q

venous drainage above the pectinate line

A

hepatic portal system and caval system

66
Q

venous drainage below the pectinate line

A

caval system via inferior rectal vv.

67
Q

lymphatic drainage above the pectinate line

A

internal iliac lymph nodes (deep)

68
Q

lymphatic drainage below the pectinate line

A

inguinal lymph nodes (superficial)

69
Q

innervation above the pectinate line

A

autonomic fibers (poor localization)

70
Q

innervation below the pectinate line

A

pudendal nerve (precise location)

71
Q

describe the relationship between the anterior recess of the ischioanal fossa and the ischioanal fossa

A

the anterior recess is continuous with the fossa as it passes anterior to the ischial tuberosities

72
Q

the boundaries of the anterior recess of the ischioanal fossa are similar to that of the ischioanal fossa, but what is different?

A

the inferior wall is the UG diaphragm

ANA (17 decks)

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