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CLINICAL ANATOMY-PELVIS > Perineum > Flashcards

Perineum Flashcards

1
Q

Definition of the perineum

A

Part of the lesser pelvis that contains the external genitalia

Parts: urogenital triangle, anal triangle

shallow, narrow compartment

inferior to the pelvic floor muscles/fascia

supports openings from the pelvic floor

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2
Q

Boundaries of the perineum

A

pubic symphysis
ischiopubic rami
ischial tuberosities
sacrotuberous ligament
coccyx

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3
Q

What does the perineum include?

A

the genitals, external urinary and the anus

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4
Q

urogenital triangle openings

A

openings for urinary and genital systems

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5
Q

anal triangle

A

openings for the anus

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6
Q

Mons pubis def:

A

he mons pubis, also known as the mons Venus or pubic mound, is the rounded mass of fatty tissue that lies over the pubic bones

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7
Q

What are the components of the female vulva?

A

mons pubis
labia minora
labia majora
clitoris
vaginal opening
urethral opening

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8
Q

The function of the perineal body

A

the intersection of many structures/an anchoring structure

-provides attachment to various muscles
-strengthens the pelvic floor

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9
Q

Stress incontinence def and causes;

A

small vol. leakage of urine with coughing, sneezing, exercise

due to lack of endurance in perineal muscles, not power

poor urethral support from pelvic floor muscles; continuous dripping can occur from incomplete closure of urethra due to atrophy or post-surgical changes

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10
Q

Risk factors for urinary incontinence

A

pregnancy and postpartum
vaginal delivery
forceps delivery
increased parity
increased BMI
operative trauma and scarring of the urethra

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11
Q

Where are the internal pudendal artery and vein in relation to the ischial tuberosity?

A

medial

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12
Q

What do the inferior rectal artery and vein supply?

A

the external anal sphincter

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13
Q

Cutaneous innervation of the perineum comes from what 4 nerves:

A

ilioinguinal n.
genitofemoral n.
pudendal n.
posterior femoral cutaneous n.

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14
Q

posterior femoral cutaneous nerve functions:

A

GLUTEAL BRANCHES: function- sensory & postganglionic sympathetic innervation of skin overlying part of the gluteus maximus

PERINEAL BRANCHES: function- sensory & postganglionic sympathetic innervation of skin overlying part of the posterior aspect of the perineum

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15
Q

pudendal nerve (S2-4) - inferior rectal nerve functions

A

sensory & postganglionic sympathetic innervation of the skin overlying the anus; sensory, postganglionic sympathetic & motor (lmn) innervation of the external anal sphincter—> excretion of feces

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16
Q

pudendal nerve (S2-4) - perineal nerve

A

MUSCULAR BRANCHES– sensory, postganglionic sympathetic innervation of the corpus spongiosum or bulb of the vestibule; sensory & postganglionic sympathetic innervation of the spongy urethra; sensory, postganglionic sympathetic & motor (lmn) innervation of the perineal muscles

POSTERIOR LABIAL OR SCROTAL BRANCHES- function- sensory & postganglionic sympathetic innervation of the skin overlying the labia majora & minora, lower vagina & urethra or scrotum

DORSAL NERVE OF THE CLITORIS OR PENIS- sensory & postganglionic sympathetic innervation of the skin overlying penis or clitoris; sensory, postganglionic sympathetic innervation to the corpus cavernosum

17
Q

Ilioinguinal nerve (LUMBAR PLEXUS - L1) function:

A

sensory & postganglionic sympathetic innervation of skin overlying proximal medial thigh, the root of the penis & scrotum or mons pubis & labia majora; sensory, postganglionic sympathetic & motor (lmn) innervation of muscles of the anterior abdominal wall

18
Q

Genitofemoral nerve (L1-L2- lumbar plexus) function:

A

GENITAL BRANCH
function- sensory & postganglionic sympathetic innervation of the skin overlying part of the labia majora or scrotum; sensory, postganglionic sympathetic & motor (lmn) innervation of the cremaster muscle

FEMORAL BRANCH
function- sensory & postganglionic sympathetic innervation of skin overlying the femoral triangle

19
Q

What comprises the female erectile tissue?

A

glans of clitoris

vestibular bulb - covered by bulbospongiosus in the labia majora

crus of clitoris - covered by ischiocavernosus

20
Q

Ischioanal fossa

A

-fat pads and loose connective tissue

found in the anal triangle and fat pads offers support to the rectum, preventing prolapse; outside of the rectum and extends anteriorly to go on the lateral aspect of the vagina

CONTENTS:
-pudendal canal: internal pudendal artery, pudendal nerve
-outside canal: inferior rectal artery, inferior rectal nerve

21
Q

Ischioanal abscess in ischioanal fossa:

A

infection, collection of pus

anal sinus inflammation
anal membrane tear (feces)
anal penetrating wound

there is a meet up between the two ischioanal sinuses posteriorly–> can spread infection

22
Q

Composition of male external genitalia:

A

distal urethra
penis
scrotum

all within the urogenital triangle

23
Q

what is the enlargement of the corpus spongiosum?

A

the bulb of the penis

24
Q

What transitions into the glans of the penis (distal enlargement) if followed distally?

A

corpus spongiosum

25
Q

What flares out into the crus of the penis more proximally?

A

the corpus cavernosum

26
Q

What is the name of the deep fascia of the scrotum?

A

tunica dartos

27
Q

Cremaster attachments, actions, innervation

A

attachment- from the medial edge of the internal oblique to spermatic cord
actions- elevation of testis
innervation- genitofemoral nerve

28
Q

What is the first layer of the fascia that wraps around spermatic cord?

A

external spermatic fascia

29
Q

What coverings cover the testis?

A

tunica vaginalis parietal and visceral layer–> covering of testis

30
Q

What foramen does the internal pudendal artery leave through?

A

the greater sciatic foramen, and then comes in through the lesser sciatic foramen to approach the perineum

31
Q

Pudendal nerve course and branches

A

descends vertically through sciatic foramina (around pelvic floor) –> leave GSF, come back in through LSF

FUNCTIONS:
-micturition (urination)
-defecation (feces)
-parturition (childbirth)
-erection
-ejaculation

32
Q

Pudendal nerve function in erection and ejaculation:

A

ERECTION - POINT - parasympathetic
-smooth muscles of corpora cavernosa relax (para.
axons hitch-hiking on ventral rami S2-4 as they come out of the spinal cord; cavernous nn. extensions of prostatic plexus)

EJACULATION- SHOOT - sympathetic
-contraction of internal genital organs (sympathetic L1-2; lumbar splanchnic to hypogastric plexus

33
Q

What forms where the adjacent anal columns meet?

A

the anal sinuses

34
Q

What is the nonvoluntary, autonomic opening of the anus?

A

The internal anal sphincter

35
Q

What is the voluntary, somatic opening of the anus?

A

external anal sphincter

deep part, superficial part, subcutaneous part

36
Q

What muscle(s) are considered the pelvic diaphragm?

A

the levator ani muscles and coccygeus

37
Q

Where do we transition from rectum to anus?

A

where the levator ani comes around the terminal portion of the digestive system

CLINICAL ANATOMY-PELVIS (5 decks)

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