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General Anatomy 1 > Perineum > Flashcards

Perineum Flashcards

1
Q

What forms the pelvic diaphragm?

A

Levatores ani and coccygeus muscles with covering fasciae

The pelvic diaphragm separates the pelvic cavity from the perineum.

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2
Q

What is the urogenital hiatus?

A

An incomplete anterior section of the pelvic diaphragm allowing passage for urethra in males and urethra and vagina in females

This hiatus is crucial for the passage of urinary and reproductive tracts.

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3
Q

What are the two main divisions of the pelvic cavity?

A
  • Main Pelvic Cavity
  • Perineum

The perineum is located below the pelvic diaphragm.

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4
Q

Describe the shape and boundaries of the perineum.

A

Diamond-shaped; bounded by symphysis pubis, ischiopubic rami, ischial tuberosities, sacrotuberous ligaments, and coccyx tip

The perineum can be divided into two triangles: urogenital and anal triangles.

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5
Q

What is the lithotomy position?

A

Supine position with hip joints flexed and abducted, feet in stirrups

This position is commonly used for pelvic exams in females.

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6
Q

Where is the perineal body located in males and females?

A

Males: between the bulb of the penis and anus; Females: between the vagina and anus

The perineal body serves as an attachment site for muscles and fascia.

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7
Q

List common perineal issues for males.

A
  • Urethral obstruction
  • Penile urethra rupture
  • Epididymis/testis infections

These conditions can significantly affect male reproductive and urinary health.

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8
Q

List common perineal issues for females.

A
  • Infections
  • Injuries
  • Prolapses in anal canal, urethra, and external genitalia

These issues can lead to various complications in female pelvic health.

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9
Q

What are the boundaries of the anal triangle?

A
  • Ischial tuberosities
  • Sacrotuberous ligaments
  • Coccyx tip

The anal triangle contains the anus as its primary structure.

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10
Q

What is the length of the anal canal?

A

Approximately 1.5 inches (4 cm)

The anal canal connects the rectal ampulla to the anus.

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11
Q

What is the function of the anal sphincters?

A

Control the passage of feces and maintain continence

The anal sphincters include both internal (involuntary) and external (voluntary) components.

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12
Q

Fill in the blank: The internal anal sphincter is formed from _______.

A

smooth muscle thickening

It is involuntary and part of the anal sphincter complex.

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13
Q

What is the role of the puborectalis muscle?

A

Forms a sling around the anorectal junction, maintaining an acute angle

This muscle is vital for fecal continence.

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14
Q

True or False: Internal hemorrhoids are painful.

A

False

They are sensitive only to stretch due to visceral afferent nerves.

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15
Q

What causes external hemorrhoids to be painful?

A

They are sensitive to pain, temperature, touch, and pressure due to inferior rectal nerves

External hemorrhoids occur at the anal margin.

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16
Q

What is an anal fissure?

A

An elongated ulcer caused by fecal mass catching on the mucous membrane

Anal fissures are commonly found posteriorly in the midline.

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17
Q

What is the significance of the pectinate line?

A

Indicates the level where the upper half of the anal canal joins the lower half

It separates areas with different embryological origins and nerve supplies.

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18
Q

List the components of the pudendal nerve.

A
  • Inferior rectal nerve
  • Dorsal nerve (penis/clitoris)
  • Perineal nerve

The pudendal nerve supplies the perineum and external genitalia.

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19
Q

What is the clinical significance of the anorectal ring?

A

Essential for continence; damage can lead to fecal incontinence

The ring consists of the deep part of the external sphincter, internal sphincter, and puborectalis.

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20
Q

What are the contents of the superficial perineal space (pouch)?

A
  • Bulb of penis/bulbs of vestibule
  • Crura of penis/clitoris
  • Superficial transverse perineal muscles
  • Perineal nerves and vessels
  • Greater vestibular glands (females)

This space is located between superficial perineal fascia and the perineal membrane.

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21
Q

Fill in the blank: The superior rectal artery is the arterial supply for the _______ half of the anal canal.

A

upper

The inferior rectal artery supplies the lower half.

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22
Q

What is an imperforate anus?

A

A congenital condition occurring in approximately 1 in 4000 births due to fusion issues of the cloaca with the proctodeum

It may require surgical intervention after birth.

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23
Q

What is the primary cause of anal fistulae?

A

Spread or inadequate treatment of anal abscesses

Fistulae connect the anal canal or rectum with the skin surface near the anus.

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24
Q

What is the significance of the ischioanal fossa?

A

Wedge-shaped space prone to infection and contains fat supporting the anal canal

It communicates posteriorly around the anal canal.

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25
Q

What are the three cylinders of erectile tissue found in the penile body?

A
  • Two corpora cavernosa (dorsal)
  • Corpus spongiosum (ventral)

Enclosed in Buck’s Fascia.

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26
Q

What is the expanded end of the corpus spongiosum called?

A

Glans Penis

Located at the distal extremity of the penis.

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27
Q

What is the function of the frenulum in the male anatomy?

A

Attaches prepuce to glans below urethral orifice

A tissue fold that plays a role in penile function.

28
Q

Which artery supplies the skin and superficial fascia of the penis?

A

External pudendal artery

Arises from the femoral artery.

29
Q

What is the primary venous drainage of the penis?

A

Deep dorsal vein

Drains into the prostatic venous plexus.

30
Q

Where does the lymph from the skin of the penis drain?

A

Medial group of superficial inguinal nodes

Important for understanding lymphatic spread of infections.

31
Q

Name the nerve that provides somatic nerve supply to the penis.

A

Pudendal Nerve

Supplies skeletal muscles and skin.

32
Q

What structures are contained in the scrotum?

A
  • Testes
  • Epididymides
  • Lower ends of spermatic cords

An outpouching of the anterior abdominal wall.

33
Q

What is the blood supply to the scrotum?

A
  • External pudendal branches (femoral artery)
  • Scrotal branches (internal pudendal artery)

These are crucial for temperature regulation.

34
Q

Which nerve supplies the anterior scrotum?

A

Ilioinguinal nerve

Along with the genital branch of the genitofemoral nerve.

35
Q

What are the contents of the superficial perineal space in males?

A
  • Root structures of penis (bulb and crura)
  • Superficial transverse perineal muscles
  • Branches of pudendal nerve and internal pudendal vessels

Important for understanding male pelvic anatomy.

36
Q

What is the function of the bulbospongiosus muscle?

A

Compresses penile urethra, aiding in voiding and erection

Located at the midline, covering the penile bulb.

37
Q

What is the length of the intermediate (membranous) urethra?

A

Approximately 0.5 in. (1.3 cm)

Shortest and least dilatable part of the urethra.

38
Q

What is the function of the bulbourethral glands?

A

Secrete mucus into the urethra in response to erotic stimulation

Embedded in the sphincter urethrae muscle.

39
Q

What is the mechanism of penile erection?

A

Vasodilatation of helicine arteries increases blood flow in erectile tissue

Affects corpora cavernosa and corpus spongiosum.

40
Q

What is the sequence of events during ejaculation?

A
  • Bulbourethral glands secrete fluid
  • Sympathetic nerve discharge stimulates contraction of reproductive structures
  • Seminal fluid is propelled by rhythmic contractions

Preventive mechanisms include contraction of the internal urethral sphincter.

41
Q

What are the three sections of the male urethra?

A
  • Prostatic Urethra
  • Intermediate (Membranous) Urethra
  • Penile (Spongy) Urethra

Each section has distinct anatomical features.

42
Q

What is the collective term for female external genitalia?

A

Vulva

Includes mons pubis, labia majora, labia minora, clitoris, and vestibule.

43
Q

What is the blood supply to the clitoris?

A

Internal pudendal artery

Supplies the clitoral body and glans.

44
Q

What are vestibular bulbs?

A

Paired erectile bodies on each side of the vestibule

Covered by bulbospongiosus muscle.

45
Q

What is the function of the ischiocavernosus muscle in females?

A

Assists in clitoral erection

Covers the clitoral crus.

46
Q

What is the length of the female urethra?

A

Approximately 1.5 in. (3.8 cm)

Connects the bladder neck to the vestibule.

47
Q

What are the vaginal supports in the upper third?

A
  • Levatores ani muscles
  • Transverse cervical ligaments
  • Pubocervical ligaments
  • Sacrocervical ligaments

Important for maintaining pelvic structure.

48
Q

What is the clinical significance of the short female urethra?

A

Predisposes to ascending infections, making cystitis more common

Highlights the differences in urinary anatomy between genders.

49
Q

What is the role of the greater vestibular glands?

A

Secretes mucus during intercourse

Homologues of male bulbourethral glands.

50
Q

What is a sign of pregnancy around the 8th-12th week?

A

Bluish discoloration of vulva and vagina due to venous congestion

This is known as Chadwick’s sign, indicating increased blood flow to the pelvic region during early pregnancy.

51
Q

Why are females more prone to cystitis?

A

Short urethra predisposes to ascending infections

The anatomical differences in the female urinary tract contribute to a higher incidence of urinary tract infections.

52
Q

What can cause urethral injuries in females?

A

Pelvic fractures may damage urethra

Urethral injuries are rare in females due to the shorter length of the urethra.

53
Q

What makes catheterization easier in females?

A

Shorter, wider, and straighter urethra

This anatomical structure allows for easier passage of the catheter with minimal resistance.

54
Q

What is the purpose of a vaginal examination?

A

Assessing health of vaginal walls, uterus, & surrounding structures

Digital examination helps in evaluating the condition of the reproductive organs.

55
Q

What risk does the perineal body face during childbirth?

A

Laceration, risking pelvic floor weakness

An episiotomy may be performed to prevent severe tearing during delivery.

56
Q

What is an episiotomy?

A

Posterolateral incision to prevent tears affecting anal sphincters

This surgical procedure is done during difficult deliveries to protect the perineum.

57
Q

What does a pudendal nerve block anesthetize?

A

Perineal skin, useful during difficult labor

This block is particularly helpful in the second stage of labor.

58
Q

Where is the needle injected for a transvaginal pudendal nerve block?

A

Toward ischial spine, around pudendal nerve after sacrospinous ligament

This approach targets the pudendal nerve effectively during labor.

59
Q

Where is the needle introduced for a perineal pudendal nerve block?

A

Near ischial tuberosity, into pudendal canal along medial side

This method provides localized anesthesia during childbirth.

60
Q

What forms the external genitalia in embryology?

A

Mesenchyme forms genital tubercle, folds, and swellings

This process is crucial for the development of both male and female genitalia.

61
Q

What happens to the phallus during male genitalia development?

A

Elongates, forming penile urethra as genital folds fuse

This fusion is essential for the proper formation of male external genitalia.

62
Q

What forms the clitoris in female genitalia development?

A

Phallus forms clitoris, genital folds form labia minora

The development of the clitoris and labia minora occurs from the same embryological structures as the male genitalia.

63
Q

What forms the labia majora in female genitalia development?

A

Genital swellings form labia majora

This is part of the external female genitalia development process.

64
Q

Differentiate upper half and lower half of anal canal in terms of:
1. Origin of mesoderm
2. Epithelium
3. Anatomic features
4. Nerve supply and sensitivity
5. Arterial supply
6. Lymph Drainage

And what demarcates the separation of upper and lower anal canal?

A

Pectinate Line: Marks the junction of the upper and lower halves of the anal canal

Upper Half:

Origin: Hindgut mesoderm (entoderm)
Epithelium: Columnar
Anatomic Features: Anal columns and valves
Nerve Supply: Autonomic hypogastric plexuses
Sensitivity: Sensitive to stretch
Arterial Supply: Superior rectal artery (hindgut)
Lymph Drainage: Pararectal nodes → inferior mesenteric nodes
Lower Half:

Origin: Ectoderm of proctodeum
Epithelium: Stratified squamous
Anatomic Features: No anal columns
Nerve Supply: Somatic inferior rectal nerve
Sensitivity: Sensitive to pain, temperature, touch, pressure
Arterial Supply: Inferior rectal artery (internal pudendal)
Lymph Drainage: Medial group of superficial inguinal nodes

65
Q

Differentiate internal and external anal sphincters in terms of (voluntary vs involuntary; what muscle forms)

A

Internal Sphincter:
Type: Involuntary, formed from smooth
External Sphincter:
Type: Voluntary, skeletal muscle enclosing internal sphincter

General Anatomy 1 (9 decks)

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