Perineum

Question 1

Ischioanal fossae

Answer 1

Fat filled spaces that support the anal canal while permitting its descent and expansion during defecation

Question 2

Perineum can be split into two triangles, name them

Answer 2

anal triangle

Urogenital triangle

Question 3

Ischioanal Fossa communicates with urogenital triangle via the anterior recesses, what is a potential problem with this?

Answer 3

Potential route for the spread of infection

Question 4

What is the tendinous connection between the anus and coccyx?

Answer 4

anococcygeal raphe

Question 5

What is important about the pudendal canal? Where is it located?

Answer 5

• passageway for pudendal n. and internal pudendal a. and v.
• Located between Obturator internus and ischioanal fossa

Question 6

What are the branches off the internal pudendal artery?

Answer 6

*internal pudendal a. comes off internal iliac a.

• inferior rectal
• splits into deep a. of penis (clitoris) and dorsal a. of penis (clitoris)

Question 7

Where can you find the pudendal n. (S2-4)?

Answer 7

• greater sciatic foramen -> ishcial spine and sacrospinous ligament -> lesser sciatic foramen
• Passes through the pudendal canal and branches to innervate perineal structures

Question 8

When is the pudendal and ilioinguinal nerve blocks used

Answer 8

• to help with the pain of childbirth
• Pudendal nerve block: inject near ischial spine -> perineal structures numbed
• Ilioinguinal nerve block: for pain of superior aspect of labia majora

Question 9

The anal canal has different embryological deviation. What line seperates the proximal and distal aspects?

Answer 9

Proximal: endodermally derived

Distal: ectodermally derived

Line: pectinate line

Question 10

The superior portion of the anal canal recieves what innervation, blood supply; and lymph drainage?

Answer 10

Innervation: Autonomic and visceral sensory

Blood supply : Superior rectal a. and v. (Portal)

Lymph: internal iliac nodes

Question 11

The inferior portion of the anal canal has what innervation; what blood supply; and what lymph drainage?

Answer 11

Innervation: somatic motor and sensory innervation

Blood supply:inferior and middle rectal a. and v. (Caval)

Lymph: Superficial inguinal nodes

Question 12

Internal hemorrhoids (“piles”)

Answer 12

• Prolapse of normally distended veins of internal venous plexus
• often compressed by sphincters - impeding blood flow leading to ulceration and strangulation
• Bleeding is bright red
• visceral pain

Question 13

External hemorroids

Answer 13

• Thromboses (blood clots) in veins of external venous plexus
• predisposing conditions include pregnancy; chronic constipation
• any condition that impedes venous blood flow
• somatic pain

Question 14

Internal anal spincter: location, what affect does sympathetics and parasympathetics have on it

Answer 14

• Location: smooth muscle sphincter that surrounds superior 2/3 of anal canal
• contraction: maintained (tonic) via sympathetics
• Inhibited by: parasympathetics

Question 15

External anal sphincter: origin, insertion, innervation, action

Answer 15

O: skin and fascia around arus; coccyx; anococcygeal ligament

I: surrounds lateral aspects of anal canal

N: inferior rectal n.

A: voluntary constriction of anal canal

Question 16

Fetal incontinence is usually an impairment of 2 of what 3 muscles

Answer 16

• internal anal sphincter
• external anal sphincter
• puborectalis

Question 17

What is the hood of the clitoris called

Answer 17

prepuce of clitoris

Question 18

What is the anterior portion of the female external genitalia superficial to pubic bone (grows hair)?

Answer 18

Mons pubis

Question 19

What is the dorsal, ventral aspect of the penis?

Answer 19

dorsal and ventral are in relation to erect penis

Question 20

What is the name of the skin that covers the head of the penis?

Answer 20

prepuce of penis

Question 21

What membrane attaches the roots of external genitalia and associated muscles?

Answer 21

Perineal membrane

Question 22

What are corpora cavernosa and corpora spongiosa

Answer 22

spongy erectile tissue in females; females have two of each

Question 23

Clitoris has two lateral attachments that form from the corpora cavernosa, what are they

Answer 23

crura

Question 24

What are corpora cavernosa and corpus spongiosum? What structure lies in the corpus spongiosum?

Answer 24

erectile tissue in men; men have only one corpus spongiosum that encloses urethra

Question 25

What are the two ends of the penis called?

Answer 25

bulb of penis and glans penis

Question 26

Ishciocavernous is found in both males and females. What is the origin, insertion, innervation, and action

Answer 26

O: internal surface of ischiopubic ramus and ischial tuberosity I: crus of penis/clitoris N: pudendal n A: helps maintain erection

Question 27

What is the origin, insertion, innervation, and action of Bulbospongiosus in males?

Answer 27

A: compresses bulb, assists erection and ejactulation O: perineal body, median raphe I: surrounds bulb of penis N: pudendal n

Question 28

O, I, A, N or bulbospongiosus in females

Answer 28

A: assists erection, "sphincter of vagina" O: perineal body I: pubic arch, fascia of corpora cavernosa N: pudendal n

Question 29

action, origin, insertion, and innervation of superficial transverse perineal in males and females

Answer 29

A: supports and flexes perineal body to pelvic floor; supports pelvic floor O: ischiopubic ramus and ischial tuberosity I: perineal body N: pudendal n.

Question 30

External urethral sphincter and Compressor Urethrae : action; origin; insertion; innervation in males and females

Answer 30

Action: compress urethra (helps maintain continence); compress vagina (females) O: ischial tuberosity I: anterior aspect of urethra N: dorsal n. of penis/clitoris (branch of pudendal n)

Question 31

What artery runs in the corpora cavernosa in males

Answer 31

deep artery of the penis

Question 32

What two (paired) arteries stem fro the internal pudendal a and supply the perineum in males and females

Answer 32

dorsal a. of penis/clitoris Deep a. or penis/clitoris

Question 33

Veins of perineum in males

Answer 33

superficiall dorsal v. of penis: drains to thigh Deep dorsal v. of penis: drains to pudendal v.

Question 34

Veins of perineum in females

Answer 34

Parallel arteries! - dorsal v. of clitoris - deep v. of clitoris

Question 35

What nerve innervates the perineum in males and females

Answer 35

Paired! * dorsal nerve of penis/clitoris \* from pudendal n. (male picture showed)

Question 36

NAVAN

Answer 36

mneumonic for nerve, artery, vein, artery, nerve in the male penis

Question 37

What is the deep perineal pouch?

Answer 37

* Location: b/w perineal membrane (pictured as blue line) and pelvic diaphragm * contains external urethral spincter, glands (in males); included anterior recesses of ischioanal fossa

Question 38

Superficial perineal pouch

Answer 38

* Location: b/w perineal membrane (blue line) and deep perineal fascia * contains erectile tissue and associated muscles as well as space between deep and superficial fasciae

Question 39

Scarpa's fascia runs continuously around the external genitalia. Name the parts

Answer 39

* superficial fascia of penis * Dartos fascia: around scrotum * Colles fascia

Question 40

fascia beginning from rectus abdominis and External oblique aponeurosis runs deep around the penis. Name the parts

Answer 40

* buck's fascia * deep perineal fascia

Question 41

In males, the urethra can be broken down into 4 sections: name them

Answer 41

* Intramural urethra (leaving bladder) * Prostatic urethra (in prostate) * Intermediate urethra * Spongy urethra (in penis)

Question 42

Rupture of urethra superior to perineal membrane will cause

Answer 42

bloody urine will enter the deep pouch and abdominopelvic cavity

Question 43

Rupture of urethra inferior to perineal membrane

Answer 43

* break is through corpus spongiosum * bloody urine will enter the perineal cleft