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Block 4 Anatomy > Perineum > Flashcards

Perineum Flashcards

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1
Q

What are the Anterior, Anterolateral, Lateral and Posterolateral boundaries of the Perineum?

A

Anterior‐Symphysis Pubis
Anterolateral—Ischiopubic ramus
Lateral—Ischial Tuberosity
Posterolateral—Sacrotuberous Ligament and Gluteus Maximus

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2
Q

What are the Posterior, Floor and Roof of the perineum?

A

Posterior—Coccyx
Floor—Skin and Fascia
Roof—Pelvic Diaphragm (Levator Ani Portion)

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3
Q

The anterior urogenital triangle and the posterior anal triangle are divided by a line between which two bony structures

A

the Two Ischial tberosities

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4
Q

List the contents of the anal triangle

A
  1. lower part of the anal canal
  2. anus
  3. pudendal canal
  4. two deep wedges called the ischioanal fossae
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5
Q

What is the function of the ichioanal fossae?

A

Allow for the expansion of the anal canal during defecation

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6
Q

boundaries of the ischianal fossae?
Base
Superior medial wall
Lateral Wall

A

Base: overlying skin and connective tissue
Superior medial wall: inferior surface of the levator ani and the external anal sphincter
Lateral Wall: Obturator internus muscle

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7
Q

What fascia forms the pudendal canal that transmists the branches of the internal pudendal vessels and pudendal nerve into the perineum

A

The splitting of the obturator internus Fascia

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8
Q

What is the ischioanal Fossae bounded posteriorly by?

A

Gluteus maximus muscle

sacrotuberous ligament

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9
Q

Between which two boney structures does the sacrotuberous ligament attach

A

Sacrum

Ischial Tuberosity

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10
Q

What is the path of the inferior rectal vessels and nerves to reach the anal canal

A

They traverse lateral to medial through the center of each fossa to reach the anal canal

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11
Q

The external anal sphincter attaches posteriorly to the ________ and passes around the anus and anal canal to attach to the ______ _____ anteriorly.

A

Coccyx

Perineal Body Anteriorly

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12
Q

What Vessels and nerves supply this Skeletal muscle sphincter?

A

Inferior rectal vessels and nerves

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13
Q

How does the pudendal Canal reach the anal triangle?

A

Travels along the medial surface of the obturator internus muscle that connects and transmits structures passing across the dorsal surface of the ischial spine and sacrospinous ligament through the lesser sciatic foramen into the anal canal

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14
Q

The Pudendal Nerve (S__-S__) is derived from the sacral plexus and provides the primary motor and sensory innervation for the urogenital and anal triangles of the perineum.

A

S2-S4

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15
Q

The the pudendal nerve crosses the ischial spine, it divides into what 3 branches ?

A

Perineal nerve
dorsal nerve of the penis/clitoris
inferior rectal nerves

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16
Q

Which nerve is the most medial of the three and crosses through the ischioanal fossa

A

inferior rectal nerves

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17
Q

The perineal nerve enters the perineal space of the UG triangle by passing superficial to which diaphragm

A

UG diaphragm

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18
Q

Once in the superficial perineal space the perineal nerve becomes what and innervates what?

A 
Posterior labial(scrotal) nerves 
-- provide sensory innervation to the posterior aspect of the labia or the scrotum
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19
Q

The dorsal nerve of he penis/clitoris is the most ____ of the three pudendal nerves and is embedded in the ________ fascia.

A

lateral

obturator

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20
Q

The dorsal nerve of he penis/clitoris enter the ____ ______ space by piercing that posterior border of the ________ diaphragm

A

Deep perineal space

urogenital diaphragm

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21
Q

The internal pudendal artery and vein enter the pudendal canal and anal triangle by crossing the ______ spine

A

ischial spine

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22
Q

The superficial (inferior) boundary of the superficial perineal space in both the male and female is the membranous layer of the superficial fascia known as ______ fascia

A

Colles’ Fascia

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23
Q

Colles Fascia is a continuation of what deep membranous layer of the superficial layer fascia of the lower abdominal wall?

A

Scarpa’s Fascia

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24
Q

The in Males the Colles fascia is continuous with the _____ fascia of the scrotum and the ____ penile fascia

A

Dartos fascia

Superficial Penile fascia

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25
Q

What layer continues into the perineum providing the fatty content of the labia majora ?

A

Caper’s Layers (fatty layer)

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26
Q

The deep (superior) boundary of the superficial space of both sexes is the ________ membrane.

A

Perineal Membrane

Inferior fascia of the urogenital diaphragm

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27
Q

The _______ membrane is a strong fascial layer on the inferior surface of the urogenital diaphragm that serves as a platform for what?

A

–Perineal membrane

–platform for the suspension of the external genitalia

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28
Q

The anterior scrotal or labial cutaneous nerves (branches of the __________ nerve) enter the superficial space _________.

A

Branches of the ilioinguinal nerve

anteriorly

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29
Q

The deep perineal space is a muscular layer composed of the urogenital diaphragm that is bounded inferiorly by the ____ membrane and superiorly by the _____ fascia of the UG diaphragm

A

perineal membrean

superior fascia of the UG diaphragm

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30
Q

The prepuce of the penis cover the _____ penis

A

Glans

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31
Q

What is deep to the skin of the Penis?

A

Subcutaneous CT layer

Superficial Penile Fascia = Superficial Perineal Fascia

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32
Q

What structure is located in the Superficial Penile Fascia?

A

Superficial Dorsal Vein

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33
Q

Where does the Superficial Penile Vein drain?

A

Via External Pudendal Veins into Greater Saphenous Vein

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34
Q

What is deep to Superficial Penile Fascia?

A

Deep Penile Fascia

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35
Q

The Deep Penile Fascia functions to encircle the ______ bodies. It then continues into the ______ ________ space as muscular fascia

A

cavernous

superficial perineal

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36
Q

What vessels/structures are deep to Deep Penile Fascia?

A

Deep Dorsal Vein

Dorsal Arteries of the Penis (2
Dorsal Nerves of the Penis (2)
Paired: artery and nerve)

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37
Q

Location of structures above?
Deep Dorsal Vein:
Dorsal artery and nerve:

A

Deep Dorsal Vein: Midline, dorsum of penis

Dorsal artery and nerve: Each dorsum side of midline

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38
Q

The deep Dorsal vein drains deeply into the _______ ________ Plexus by passing the gap between the __________ and the __________.

A

Prostatic Venous Plexus

Symphysis Pubis and UG Diaphragm

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39
Q

What forms the body of the penis?

A

2 Corpora Cavernousa Penis
1 Corpus Spongiosum
(3 Cylinders)

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40
Q

What is the relationship of the Copora cavernousa and the corpus spongiosum?

A 
Corpus Spongiosum (ventral)
2 Corpora Cavernosa Penis (dorsal)
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41
Q

Function of the the Copora cavernousa and the corpus spongiosum?

A

Engorge with blood during erection

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42
Q

What encloses the Copora cavernousa and the corpus spongiosum?

A

Dense, fibrous layer (Tunica Albuginia)

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43
Q

Which of the three cylinders conveys the urethra?

A

Within the center of the Corpus Spongiosum

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44
Q

What is the Glans Penis?

A

Distal end of the Corpus Spongiosum

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45
Q

What is the proximal end of Corpus Spongiosum?

A

Bulb of Penis

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46
Q

The Deep Artery of the penis courses in the center of each _______ ________?

A

Corpus cavernosum

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47
Q

The anterior scrotal nerves enter the scrotum from the anterior abdominal wall via the ______ _______ of the inguinal canal

A

superficial ring

48
Q

The anterior scrotal nerves are breaches of ilioinguinal nerve from the _______ plexus and are sensory to the anterior surface of the scrotum

A

Lumbar

49
Q

Origin and path of Perineal Nerve?

A

Branch of Pudendal Nerve

Courses superficial to the urogenital diaphragm into the superficial perineal space from the anal triangle

50
Q

What occurs to the Perineal Nerve in the Superficial Perineal Space?

A

Branches
Posterior Scrotal Nerves
Muscular Branches to 5 Muscle of UG Triangle
Nerve to Bulb of Penis

51
Q

What separates the scrotum into 2 halves?

A

Scrotal Septum

52
Q

What makes up the root of hte penis

A

The crura of the penis and

the bulb of the penis

53
Q

What is the course of the Corpora Cavernosa?

A

Courses along the Ischiopubic Rami on each side of the UG Triangle

54
Q

The origin of the Corpora Cavernosa is referred to as?

A

Begins as Crura of the Penis

55
Q

Where is the Ischiocavernosus Muscles located?

A

On the surface of each Crus of the Penis

56
Q

What is the origin of the Ischiocavernosus Muscles?

A

Ischium

57
Q

Path and insertion of the Ischiocavernosus Muscles?

A

Extend short distance onto the shaft of Penis

Insert into each Corpus Cavernosum

58
Q

What is the function of the Ischiocavernosus Muscles?

A

Assists in maintaining erection

59
Q

Proximally, what happens to the Corpus Spongiosum?

A

In the midline, it enlarges to form the Bulb of the Penis

60
Q

What nerve originates from the Ilioinguinal Nerve (Lumbar Plexus) to enter the scrotum via inguinal canal on the Spermatic Cord to supply the scrotum?

A

Anterior Scrotal Nerves

61
Q

Which branch of Pudendal Nerve courses superficial to the urogenital diaphragm into the superficial perineal space from the anal triangle

A

Perineal Nerve

62
Q

What occurs to the Perineal Nerve in the Superficial Perineal Space?

A

Branches into:
Posterior Scrotal Nerves
Muscular Branches to 5 Muscle of UG Triangle
Nerve to Bulb of Penis

63
Q

Which part of the Penis courses along the Ischiopubic Rami on each side of the UG Triangle

A

Corpora Cavernosa as the Crura of the Penis

64
Q

What are the attachments of Crura of the Penis?

A

Attaches to the Ischiopubic Rami

lateral aspects of the Urogenital Triangle

65
Q

What muscles is located on the surface of each Crus of the Penis

A

Ischiocavernosus Muscles

66
Q

What is the 3rd Pair of Muscles in the superficial perineal space that attaches to Perineal body at the midline and attaches laterally to the Ischial Tuberosities

A

Superficial Transverse Perineus Muscle

67
Q

All muscles in the superficial Space – bulbouspongiosus, ichiocavernosus, and superficial transverse perineus are all innervated by what nerve?

A

Muscular branches of the perineal nerve

68
Q

What is the central tendinous point? Where is it located?

A

(a.k.a.- Perineal Body)
At the midpoint of the perineum between the anus and the scrotal sac
It’s a dense, fibromuscular tissue mass where the muscular fibers of the external anal sphincter, superficial and deep transverse perineus, and bulbospongiosus muscles interdigitate

69
Q

What is the Location of perineal membrane. Between in the male?

A

Between the Ischiopubic Rami and the bulb of the penis

70
Q

What does the Perineal Membrane form?

A

Covers the inferior surface of the Urogenital Diaphragm

Forms the deep boundary of the Superficial Perineal Space

71
Q

What forms the deep perineal space?

A

Muscular Urogenital Diaphragm

72
Q

What makes up the Muscular Urogenital Diaphragm?

A

Anteriorly: Sphincter Urethrae Muscle
Posteriorly: Deep Transvers Perineus Muscle

73
Q

What Nerve innervates the UG diaphragm?

A

Muscular Branch of the Perineal Nerve

74
Q

What occurs at the point where the urethra penetrates the diaphragm?

A

A circular investment of fibers forms a sphincter around the urethra

75
Q

Where is the Prostate Gland located?

A

Superior to the UG Diaphragm

( right above where the sphincter forms around the urethra

76
Q

What does the Perineal Membrane form anteriorly to separate a small space from it and the symphysis pubis from ?

A

Transverse Perineal Ligament

77
Q

What passes anterior to the Transverse Perineal Ligament?

A

Deep Dorsal Vein of the Penis

78
Q

Where does the Deep Dorsal Vein of the Penis terminate?

A

In the Prostatic Venous Plexus (in the pelvis)

79
Q

What is embedded in the sphincter urethrae muscle on either side of the membranous urethra?

A

Two bulbourethreal glands

80
Q

What is the path of the ducts from the bulbourethral glands?

A

Penetrate the perineal membrane and empty into the urethra as it passes through the bulb of the penis in the superficial perineal space

81
Q

Both the Internal Pudendal Vessels and the Dorsal Nerve of the Penis travel together along what path?

A

Courses through the lateral aspects of the urogenital diaphragm along the ischiopubic ramus

82
Q

Which branch of the Pudendal Nerve enters the deep perineal space from the ischioanal fossa by penetrating the posterior free margin of the urogenital diaphragm?

A

Dorsal nerve of the penis

83
Q

In the UG diaphgram, the internal pudendal artery gives rise to two branches, the artery to the ______ and the _______ artery.

A

Artery of the bulb

Urethral Artery

84
Q

The Internal pudendal artery after giving rise to the Artery of the bulb and the Urethral Artery continues on and terminates by dividing into the _____ artery of the penis and the ______ artery of the penis

A

Deep artery of the penis

Dorsal artery of the penis

85
Q

The deep arteris course in the center of the _______ _______ and are largely responsible for the erection process

A

Corpora cavernosa

86
Q

The dorsal artery and dorsal nerve of the penis can be identified on the _____ of the penis and supply the superficial and deep aspects of the penile _____.

A

dorsum

body

87
Q

What is the termination of the superficial, membranous fascia from the abdominal wall (Scarpa’s Fascia)?

A 
Terminates by attaching to:
Skin of labia Majora
Inguinal Ligament
Ischiopubic Rami
Urogenital Diaphragm
88
Q

What forms the superficial boundary of the superficial perineal space in the female?

A

Superficial Membranous Fascia (Scarpa’s)

89
Q

Define the Vestibule.

A 
Midline cleft (separation)
Through it the urethra, vagina, and ducts of the Greater Vestibular Gland open to the exterior
90
Q

Lateral boundaries of the vestibule?

A

Bounded by the Labia Majora and Minora

91
Q

Define Labia Majora.

A

Rounded lateral folds of skin that contain large amounts of fat from the Campers fascial layer

92
Q

Innervation to Labia Majora and Minora?

A

Anterior and Posterior Labial Nerves

93
Q

What forms anteriorly, when the Labia Majora blend as a Rounded fatty bulge, above the pubis?

A

Mons Pubis

94
Q

What is the area where the labia meet?

A

Anterior labial commissure

Midline, superior to the clitoris

95
Q

What part of the external female genitalia divides superior to the clitoris to form the Prepuce of the Clitoris Posterior to and inferior of the clitoris to form the Frenulum?

A

Labia Minor

96
Q

What forms most of the body of the clitoris?

A

2 Corpora Cavernosa

97
Q

Function of the 2 corpora cavernosa?

A

Erectile bodies

98
Q

Why is there no corpus spongiosum in the female?

A

Because the course of the urethra is separated from the clitoris

99
Q

What caps the corpora cavernosa?

A

Small glans clitoris

100
Q

What forms the small Glans Clitoridis?

A

Superior ends of the Bulb of the Vestibule

101
Q

What is found on the dorsum of the clitoris? Comparison of structures to the male?

A

Dorsal Nerves and Arteries

Much small than in male

102
Q

Location of the 2 corpora cavernosa?

A

Along the ischiopubic rami, deep into the superficial perineal space

103
Q

Deep into the superficial perineal space, what do the corpora cavernosa form?

A

Crura of the Clitoris

104
Q

What covers each crus of the clitoris?

A

Ischiocavernosus Muscle

105
Q

Where is the bulbospongiosus muscle and what is its function?

A

In a circular ring around the labia majora covering covering the bulb of the vestibule

106
Q

Where does the bulbouspongious muscle originate and insert?

A

Originates: perineal body
Insertion: Perineal membrane
Corpora cavernosa
dorsum of the clitoris

107
Q

What part of the Bulb of the Vestibule forms part of clitoris?

A

A small extension of erectile tissue extends superiorly along the ventral surface of the clitoris

108
Q

What is located at the posterior ends of the Bulb of the Vestibule?

A

Greater Vestibular Glands (lodged in the superficial perineal space)

109
Q

What is the Location of the perineal body in the female?

A

Centrally between the anus and the vagina

110
Q

Describe perineal body in a female

A

Strong CT interdigitation of the bulbospongiosus, external anal sphincter, and superficial and deep transverse perineus muscle

111
Q

Describe the Location of the Perineal Membrane in the female

A

Between the Bulb of the Vestibule and the Ischiopubic rami

Spans across the ischiopubic rami on the inferior surface of the urogenital diaphragm

112
Q

What is the difference in the muscles of the UG diaphragm in a man versus a woman ?

A

Female Sphincter Urethrea is more fragmented and does not complete the muscular sling between the ischiopubic rami because the vagina also passes through the diaphragm

113
Q

What courses in the fibers of the urogenital diaphragm along the Ischiopubic Rami?

A

Dorsal Nerve of Clitoris

Terminal parts of Internal Pudendal Artery

114
Q

What are the branches from the Internal Pudendal Artery?

A

Artery of the bulb of the vestibule
Urethral artery
Deep and dorsal artery of the clitoris

115
Q

Where can the dorsal artery and nerve be found?

A

Dorsum of the clitoris

Block 4 Anatomy (4 decks)

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