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SHB - Exam 2 > Perineum > Flashcards

Perineum Flashcards

1
Q

What muscle’s fascia forms the Alcock’s Canal/Pudendal Canal?

A

fascia of Obterator Interus**

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2
Q

What artery can be accidentally tied off during hernia surgery because it is near the Inferior Epigastric?

A

Abnormal Obturator A.

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3
Q

What is the anchoring point/ collection of tendons of the UG diaphragm called?

A

Perineal Body

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4
Q

What forms the ejaculatory duct?

A

Seminal Vesicle + Vas Deferens

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5
Q

What neuromuscular bundle exits through the lesser sciatic foramen? What was this bundle’s original course?

A

Pudendal N. + Internal Pudendal A. + Nerve to Obturator Internus exits through the Greater Sciatic Foramen, loops around SacroSPINOUS ligament, and comes back out through the LESSER SCIATIC FORAMEN

  • tendon to OBTERATOR INTERNUS also leaves via LESSER SCIATIC FORAMEN
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6
Q

What is a site of possible infection/tumors in females?

A

Rectouterine Pouch (behind the uterus)

POUCH OF DOUGLAS*

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7
Q

What muscle covers the BULB? The crura?

A
  1. Bulbospongiosus

2. Ischiocavernosus

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8
Q

What muscles are the components of the DEEP POUCH

A
  1. Deep Transverse Perineal Muscle

2. Sphincter Urethrae Muscle

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9
Q

What two branches does the PUDENDAL N. spit into?

A

Inferior Rectal N.

&

Perineal N.

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10
Q

Scarpa’s fascia becomes _______ fascia in the Perineum

A

COLLES

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11
Q

The uterus has 2 rotations

What is it called at the junction of uterus & vagina?

What is the bend between body of uterus & cervix proper?

A
  1. Anteverted

2. Anteflexion

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12
Q

What muscles form the pelvic diaphragm?

A

Levator Ani + Coccygeus (Iliococcygeus & Pubococcygeus)

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13
Q

How is the weakness in the anterior portion of the Pelvic diaphragm strengthened?

A

UG DIAPHRAGM

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14
Q

Where do the inferior Rectal N and Inferior Rectal A. originate from?

A

Pudendal N.

&

Internal Pudendal Artery

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15
Q

What is the order of layers of the UG diaphragm looking up through the legs?

A
  1. Inferior Fascia
  2. UG Muscle
  3. Superficial Fascia
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16
Q

What is the Bulb of the penis covered with? (Is this present in the female?)
What travels through this?

A

Bulb covered with CORPUS SPONGIOSUM

  • Urethra Travels through this
  • no Corpus Spongiosum in female
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17
Q

Where are the bulbourethral glands/ GREAT VESTIBULAR Glands located in the female? Where are the Cowper’s glands located in the male?

A
  1. Superficial Pouch

2. DEEP pouch

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18
Q

What is another word for the inferior fascia?

A

Perineal Membrane

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19
Q

What two muscles are found within the UG Diaphragm Proper (Deep pouch)?

A
  1. Sphincter Urethrae

2. Deep Transverse Perineus Muscle

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20
Q

What is the path the Pudendal Nerve travels? What nerve roots contribute to the Pudendal N.?

A

(S2, 3 ,4)

  • Leaves the inside of pelvis via GREATER SCIATIC FORAMEN
  • hooks the Sacrospinous Ligament
  • Re-enters the LESSER SCIATIC FORAMEN

-to access the PERINEUM

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21
Q

What is an ectopic pregnancy? Why does this occur?

A

Implantation in the uterine tube

  • Ovulation occurs EXTRA-PERITONEALLY
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22
Q

What are the three subsets of the BROAD Ligament?

A
  1. Mesovarium (mesentery of ovary)
  2. Mesosalphinx (of uterine tube)
  3. Mesometrium ( of endometrium)
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23
Q

What ligament suspends the ovary laterally to the pelvic wall? What is the blood supply to the ovary? Where does this artery come off of?

A

SUSPENSORY ligament

  • Ovarian Artery (of the AORTA–> Gonadal)
24
Q

What passes under the Uterine Artery?

A

URETER

– must be careful off this during Hysterectomy

25
Q

The inferior vesicle artery of the male is replaced by______ in the female. The uterine Artery is a branch of what?

A

VAGINAL Artery

(textbooks says Uterine A. & Vaginal A can be separate or together)

  • Uterine A. is a branch of Anterior Division of Internal Iliac
26
Q

During a Straddle Injury, trauma can cause blood to pool into what area?

A
  • blood from damage to the spongy urethra (mainly a male thing) can flow up the potential space between:
    1. the rectus sheath and
    2. Scarpa’s fascia
27
Q

Where do the ovaries point? What is the course of the ROUND Ligament?

A

ovaries –> point posteriorly

Round Ligament = inserted on labia major

28
Q

The true pelvis is found above or below the Arcuate Line?

A

Below

29
Q

What are the boundaries of the PERINEUM? (4)

A
  1. Pubic Symphysis
  2. Coccyx
  3. TWO Ischial Tuberosities ( on sides)
30
Q

Who has a shorter urethra and thus a higher risk of bladder infections?

A

FEMALES

31
Q

What forms the body of the clitoris?

Of the penis?

A
  1. 2 Crus –> Corpus Cavernosum

2. 2 Corpus Cavernosum + 1 Corpus Spongiosum

32
Q

Who has a split BULB? Male or females?

A

FEMALES –> form the vagina

33
Q

What are the 2 superficial terminal branches of the Pudendal Nerve? What are the 3 deep branches?

A
  1. Perineal N. (becomes Posterior Labial/Scrotul N.)
  2. Inferior Rectal
  3. Artery to the Bulb
  4. Deep Artery to Penis/Clitoris
  5. Dorsal Artery to Penis/Clitoris
34
Q

What muscles are found within the superficial pouch? Which sex has the Greater Vestibular Glands in this pouch?

A
  1. IschioCavernosum (covering CRUS)
  2. Bulbospongiosum (covering the Bulb)
  3. Superficial Tranvserse Perineus

+ Crura & Bulb = erectile tissue*

FEMALES!!!!

  • superficial pouch = between Colles’ Fascia & Inferior Fascia of UG
35
Q

What are the layers of the Perineum from the deepest part to the most superficial?

A

MUST IMAGINE MRI view (through legs)

(at the bottom)

  • SKIN
    1. Colles Fascia
    2. Superficial Pouch
  • Crura/Bulb
  • Muscle
    3. Inferior Fascia
    4. Deep Pouch
    5. Superior* Fascia
  • looking through legs –> SEE INFERIOR FASCIA FIRST*
36
Q

What 3 nerves does the Pudendal Nerve split into after entering the Perineum?

A
  1. Perineal
  2. inferior Rectal (deep)
  3. Dorsal N. of Penis/Clitoris
37
Q

Where is the superficial pouch?

A

Between the inferior fascia & Colles’ Fascia

38
Q

What penetrates the SUPERIOR Fascia?

A

Vagina & Uterus

39
Q

What is the origin and support for Levator Ani Muscle?

A

ARCUS TENDINEUS

- thickening across Obturator Internus Muscle

40
Q

What artery enters the Cavernous Bodies of the Penis/Clit?

A

DEEP Artery of the Penis/Clitoris

41
Q

What are the origin of the 3 rectal arteries?

  1. Superior Rectal
  2. middle Rectal
  3. Inferior Rectal
A
  1. Superior Rectal = IMA
  2. Middle Rectal = ANTERIOR INTERNAL ILIAC
  3. Inferior Rectal = Internal Pudendal A.

TEST!!!!

42
Q

What muscles attach at the central tendon?

A
  1. Ischiocavernosus
  2. Bulbospongiosus
  3. Superficial Transverse Perineal
43
Q

What kind of injury leads to one splitting the urethra? Which pat of the urethra is usually injured? What is likely to occur ?

A
  1. STRADDLE INJURY
    - more likely in males (longer urethra)

SPONGY URETHRA can tear

–> blood will move internally through the area between COLLES’ Fascia (Scarpa’s) &

Rectus Sheath

FROM SUPERFICIAL POUCh (continuous w/ Colles’ Fascia & Rectus SHeath)

44
Q

Arteries to GI structures branch _____. arteries to non go branch____

A
  1. Anteriorly

2. Laterally

45
Q

Parasympathetic innervation of the:

  1. Foregut/Hindgut
  2. Hindgut
A
  1. Vagus
  2. Pelvic Splanchnics

increase peristalsis, decrease sphincter

46
Q

Sympathetic innervation of the:

  1. Foregut/Hindgut
  2. Hindgut
A
  1. Greater, lesser, least Splanchnics

2. Lumbar Splanchnics

47
Q

If arteries off of the abdominal aorta are blocked, what are the compensatory anastomoses?

A
  1. Superior Epigastric + Inferior Epigastric
  2. Superior Pancreaticoduodenal + Inferior Epigastric
  3. Middle Colic –> Left Colic
  4. Superior Rectal + Middle/Inferior Rectal
48
Q

What are the 3 sites of anastomoses of portal & systemic system?

A
  1. Left Gastric & Esophageal
  2. Superior Rectal + Inferior & Middle Rectal
  3. Paraumbiilcal + Superficial & Inferior Epigastric
49
Q

Above pectinate line ? Below Pectinate Line

A
  1. Internal hemorrhoids

2. External Hemorrhoids

50
Q

A landmark for the pudendal nerve block would be what part of the lateral wall of the pelvis?

A

Ischial Spine

51
Q

PED &

TIP

A

Peroneal Everts & Dorsiflexes, if injured, FOOT DROP

Tibial Inverts & Plantarflexes, if injured, can’t stand on TIP toes

52
Q

Ear, Tonsils, Bottom to top

  • Describe the Brachial Pouch Derivatives
A 
1 Ear
2 Tonsils
3 Inferior Parathyroid (Bottom)
3 Thymus (to)
4 Superior Parathyroid (Top)
53
Q

Describe the Brachia Arch Derivatives

1
2
3
4
&
6
A

1 = Mastication (5)

2 = Facial expression (7)

3 = Stylopharyngeus (9)

4 - Swallow (cricothyroid m.)

6 = speak (all the laryngeal muscles)

54
Q

Where does the round ligament insert?

A

Labia Majora

55
Q

What is related to the gubernaculum of the testes?

A

Mesovarium

56
Q

Where is erectile tissue found?

A

SUPERFICIAL POUCH –> the bulb

SHB - Exam 2 (21 decks)

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