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Gross Anatomy > Perineum > Flashcards

Perineum Flashcards

1
Q

What are the defining borders of the perineum?

A

Coccyx, Ischial tuberosities, and the pubis.

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2
Q

A line through the ischial tuberosities dicides the perineum into what two triangles?

A

The anal triangle and the urogenital triangle.

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3
Q

The anal triangle is composed of what parts?

A

It is the posterior triangle and is composed of the anal canal and the paired ischioanal fossae.

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4
Q

The urogenital triangle is composed of what parts?

A

The urogenital triangle is the anterior most triangle and includes different structures in the male and female.

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5
Q

What is the upper half of the anal canal derived from embryologically?

A

hindgut endometrium lined with columnar epithelium

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6
Q

The semilunar folds or anal valves are the inferior aspect of the anal columns and indicates an irregular line known as the…?

A

Pectinate line!

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7
Q

What is the arterial supply of the upper half of the rectal canal?

A

Arteries: Superior rectal (off IMA) and the middle rectal which comes from the internal iliac - anterior division.

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8
Q

What is the nervous supply of the upper half of the anal canal?

A

Autonomic nerves

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9
Q

What is the venous supply to the upper half of the anal canal?

A

Superior rectal which drains into the IMV

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10
Q

What is the lymphatic drainage pattern of the upper half of the anal canal?

A

Drains superiorly to the mesenteric nodes.

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11
Q

What embryologic tissue is the lower 1/2 of the rectal canal derived from?

A

The ectoderm of the proctoderm (future anal pit) this is lined by stratified squamous epithelium. And contains no anal columns.

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12
Q

What is the nervous innervation of the lower half of the anal canal?

A

Somatic via the inferior branch of the pudendal nerve.

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13
Q

What is the arterial supply to the lower half of the rectal canal?

A

Inferior rectal artery which is a branch off the internal pudendal artery.

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14
Q

What is the venous drainage of the lower half of the rectal canal

A

Inferior rectal vein which drains into the internal pudendal vein.

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15
Q

The internal analsphincters are composed of smooth muscle and are innervated by what?

A

These are involuntary muscles

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16
Q

The external anal sphincters are composed of skeletal muscles and are voluntary these are innervated by what?

A

These are innervated by the inferior rectal nerve which is a branch of the pudendal.

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17
Q

What is the ischiorectal fossa?

A

A fat filled space lateral to the anal canal containing many boundaries (skin, levator ani, obturator internus, sacrotuberous, sacrospinous ligaments, deep transverse perineal muscles)

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18
Q

What are the contents of the ischiorectal canal?

A

Fat and connective tissue as well as the pudendal canal.

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19
Q

What are the contents of the pudendal canal?

A

The pudendal nerve (S2-S4) and the internal pudendal artery and vein.
**The nerve to the obturator internus enters the canal breifly but quickly exits.

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20
Q

The pudendal nerve exits via what foramen and enters the perineum via what foramen?

A

Exits via the greater sciatic foramen and enters via the lesser sciatic foramen.

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21
Q

What are the branches of the pudendal nerve?

A

Inferior rectal, dorsal nerve of the penis or clitoris, and the perineal nerves.

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22
Q

What are the branches of the internal pudendal artery?

A

The internal pudendal artery comes off the internal iliac anterior devision and gives rise to branches that go to the penis or labia and clitoris.

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23
Q

The urogenital triangle has a superficial fascial fatty layer. This layer makes up what parts in the male and is analogous to what layer in the abdomen?

A

This layer is continuous with the ischiorectal fat and is synonymous with the campers fascia in the abdomen.

This superficial fatty layer in males dissapears in the scrotum and penis where it is replaced by the dartos muscle.

24
Q

The urogenital triangle has a superficial fascial fatty layer. This layer makes up what parts in the female?

A

In the female this fatty layers makes up the mons pubis and labia majora.

25
Q

In the urogenital triangle the superficial fascia contains a membranous layer known as the colles fascia. In the abdomen this fascial layer is known as what?

A

Scarpas Fascia

26
Q

In the urogenital triangle the superficial fascia contains a membranous layer known as the colles fascia, this fascia provides what for males and females?

A

Forms a tubular sheath around the penis and clitorus and in males it is attached to the scrotums dartos fascia.

27
Q

The deep investing fascia of the urogenital triangle (Buck’s fascia) provides what structures in the men and women?
What is this layer synonymous to in the abdomen?

A

Envelopes the muscles of the perineum and is fused to the suspensory ligament of the clitoris or penis.

In the abdomen this layer is synonymous with the fascia of the external abdominal oblique and rectus sheath.

28
Q

What is the male superficial perineal pouch.

A

The male superficial perineal pouch is a potential space in males found between the membranous/colles fascia and the perineal membrane (thin inferior fascia of the UG diaphragm)

29
Q

What does the male superficial perineal pouch contain?

A 
The root of the penis 
Ischiocavernosus muscle
Bulbospongiosus muscle
Superficial transverse perineal muscle
Spongy urethra
30
Q

What is the male deep perineal pouch?

A

This is a space between the superior fascia of urogenital diaphagm and the perineal membrane (inferior fascia of the UG diaphram)

31
Q

What are the contents of the male deep perineal pouch?

A 
Membranous urethra
External urethral sphincter
Bulbourethral gland
Deep transverse perineal muscle
Dorsal nerve of the penis
Internal pudendal arterial branches
32
Q

In the male scrotum, which fascia layer can the dartos muscle be found in?

A

The membranous (colles) fascia layer.

33
Q

What innervates the dartos muscle?

A

The genital branch of the genitofemoral nerve

34
Q

What tissue covers the corpus spongeosum and corpus cavernosa

A

The tunica albuginea

35
Q

What fascia binds the erectile bodies together?

A

The deep penile fasica (bucks fascia)

36
Q

What are the contents of the root of the penis?

A

Three cylindrical erectile tissues including the bulb and the right and left crura.

37
Q

What is the bulb of the penis?

What is it attached to?

A

Contains the corpus spongiosum and is attached to the perineal membrane of the UG diaphram

38
Q

Where do the right and left crura originate from and where do they attach?

A

They originate of the corpus cavernosum and attach to the ischiopubic rami.

39
Q

What are the helicine arteries of the penis?

A

These are coiled arteries seen i the flaccid penis opening into the cavernous spaces.

40
Q

What layer of the vagina forms the prepuce and the frenulum

A

The labula minor is a delicate mucous membranes fold that forms the prepuce and the frenulum.

41
Q

What is the vestibule of the vagina

A

This is the space between the labia minora containing the external meati of the urethra, vagina, and ducts of the greater and lesser vestibular glands.

42
Q

The root of the clitoris is composed of what?

A

It is attached to the portion within the perineal pouch.
Contains 3 masses of erectile tissue that are covered with muscle including the bulb of the vestibule and the right and left crura (attached to the pubic arch)

43
Q

What is the body of the clitoris composed of?

A

Proximal detached portion of the clitoris (glans is the head) consisting of the corpora cavernosa.

44
Q

What are the contents of the female superficial perineal pouch?

A 
Root of the clitorus
Muscles covering the bulb and cura
Greater vestibular glands
Lesser vestibular glands
Superficial transverse perineal muscles
Perineal body
Perineal branches of pudendal nerve
45
Q

What are the muscles that cover the bulb and cura in the female? What is the action of these muscles?

A

The bulbospongiosus muscles cover the bulbe of the vestibule and compress the deep dorsal vein of the clitoris.

The crura are covered by the ischiocavernosus muscles and assist in erection of the clitoris.

46
Q

Which vestibular glands correlate to the male prostate in the female?

A

The lesser vestibular glands that open into the vestibule secreting mucus into the vestibule.

47
Q

What are the contents of the female deep perineal pouch?

A

Part of the urethra
Part of the vagina
Sphincter urethrae
And the deep transverse perineal muscles.
Internal pudendal vessels
Dorsal nerves of the clitoris from the pudendal nerve

48
Q

Internal urethra sphincters are only found in males, what is the mechanism of action for this muscle?

A

The internal sphincter aids in preventing retrograde ejaculation into the bladder and is controlled by sympathetics.

49
Q

The external urethra sphincter is what type of muscle and what does it do?

A

It is a voluntary muscle and permits holding urine past point which bladder would empty.

50
Q

What nervous supply is responsible for erection?

A

Parasympathetics from pelvic splanchnic nerve (S2-S4)

51
Q

How does the penis become erect?

A

Following parasympathetic activation the helicine arteries are dilated filling the cavernous tissue with blood.
The bulbospongiosus and ischiocavernosus muscles help by compressing the venous plexus impeding venous return.

52
Q

What is responsible for the sexual function of emission?

A

Sympathetics (L1-L2) activating ejaculatory glands.

53
Q

What nerves are responsible for ejaculation?

A

Somatic nerves control the rhymic contractions.

Pudendal nerve (S2-S4)

Autonomics also play a role

Sympathetics: Close the internal urethral sphincter.
Parasympathetics: Contract the urethral muscle.

54
Q

What muscles are involved in ejaculation?

A

bulbospongiosus and ischiocavernosus muscles contract rhythmatically under somatic control.

55
Q

The lateral wall of the ischiorerctal fossa is formed by what structure?

A

It is formed by the obturator internus muscle.

56
Q

What structures run through the pudendal (Alcock’s) canal?

A

The pudendal nerve and internal pudendal artery and vein.

57
Q

In females, the bulbous cavernosum (bulbospongiosus) overlies what two structures?

A

The bulbe of the vestibule as well as the greater vestibular gland.

Gross Anatomy (11 decks)

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