Perineum Flashcards

1
Q

What are the boundaries of the perineum?

A
  • Anterior: Pubic symphysis
  • Lateral: Ischial tuberosities
  • Posterior: Coccyx
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2
Q

What are the components of levator ani?

A
  • Puborectalis
  • Pubococcygeus (poboanalis, puboprostaticus/vaginalis)
  • Iliococcygeus
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3
Q

What are the origins and insertions of puborectalis?

A

Origins: Posterior surface of pubis

Insertions: Posterior surface of pubis (forms sling around anal canal)

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4
Q

What are the origins and insertions of pubococcygeus?

A

Origins: Posterior surface of pubis

Insertions: Anococcygeal raphé

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5
Q

What are the origins and insertions of iliococcygeus?

A
  • Origins: Whitle line on obturator internus
  • Insertions: Anococcygeal raphé
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6
Q

What is the innervation and function of the levator ani?

A

Innervation:

  • Anterior rami of S4
  • Pudendal nerve

Function:

  • Forms pelvic floor
  • Supports pelvic viscera
  • Reinforces external anal sphincter
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7
Q

What are the structures associated with the perineum?

A
  • Perineal membrane
  • Perineal body
  • Perineal pouches (superficial/deep)
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8
Q

What is the transverse perineal line?

A

Imaginary line between ischial tuberosites dividing perineum into urogenital and anal triangles.

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9
Q

What are the attachments of the perineal membrane?

A
  • Anterior: Missing
  • Lateral: Ischiopubic rami
  • Posterior: Perineal body and Colles’ fascia
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10
Q

What are the structures piercing the perineal membrane?

A
  • Urethra
  • Vagina (females)
  • Nerves and vessels
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11
Q

What attaches to the perineal body?

A
  • Superficial/deep transverse perineal muscles
  • External anal sphincter
  • Bulbospongiosus
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12
Q

What are the contents of the deep perineal pouch?

A
  • Membranous urethra
  • External urethral sphincter
  • Bulbourethral glands
  • Deep transverse perineal muscles
  • Anterior aspects of ischioanal fossa
  • Nerves and vessels of the penis/cloitoris
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13
Q

What are the contents of the superficial perineal pouch?

A
  • Male external genitalia (testes, spermatic cord, penis)
  • Clitoris
  • Ischiocavernosus
  • Bulbospongiosus
  • Superficial transverse perineal muscle
  • Greater vestibular (Bartholin’s) glands (females)
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14
Q

What are the boundaries of the anal triangle?

A
  • Base: Transverse perineal line
  • Lateral: Sacrotuberous ligaments
  • Apex: Coccyx
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15
Q

What are the contents of the anal triangle?

A
  • Anal canal
  • Ischio-anal fossa
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16
Q

What is the structure of the anal canal?

A
  • Upper 2/3 is mucosa
  • Lower 1/3 is skin
  • Boundary between mucosa and skin is the pectinate line
17
Q

What are the differences between the mucosal and skin parts of the anal canal?

A
  • Blood supply: Mucosal part supplied by the superior rectal artery while skin part supplied by the inferior rectal artery
  • Innervation: Mucosal part is autonomic while skin part is somatic
  • Lymphatic drainage: Mucosal part into the internal iliac nodes while skin part into superficial inguinal nodes
  • Embryological origin: Mucosal part from the endoderm while skin part from the ectoderm
18
Q

What are the parts of the external anal sphincter?

A
  • Deep: Fused posteriorly to puborectalis
  • Superifical: Attached anteriorly to the perineal body
  • Subcutaneus: Directly beneath the skin in the perineum
19
Q

What is the structure of the penis?

A
  1. Root
  2. Body
  3. Glans
20
Q

What are the structures supporting the roots of the penis?

A
  1. Crura: Attachments root to the ischiopubic rami.
  2. Suspensory ligament: Attachment of the root to the pubic symphysis.
  3. Fundiform ligament: Attachment of the root to the linea alba.
21
Q

What attaches the foreskin to the glans?

A

Frenulum

22
Q

What is the structure of the male urethra?

A
  1. Prostatic urethra: Part running through the prostate.
  2. Membranous urethra: Part running through the deep perineal pouch and the perineal membrane. It is the most rigid part and is surrounded by the external urethral sphincter.
  3. Penile urethra: Part running in the corpus spongiosum to the external urethral meatus.
23
Q

What is the sensory supply to the scrotum?

A

Anterior 1/3: Ilioinguinal nerve

Posterior 2/3: Pudendal nerve

24
Q

What are the origins of the pudendal nerve?

A

Anterior rami of S2-4

25
Q

What is the path of the pudendal nerve?

A
  • It exits the pelvic cavity through the greater sciatic foraman.
  • Curves around the sacrospinous ligament.
  • Re-enters the pelvic cavity through the lesser sciatic foraman.
26
Q

What are the branches of the pudendal nerve?

A
  • Inferior rectal nerve
  • Perineal nerve
  • Dorsal nerve of the penis
27
Q

What are the structures supplied by the inferior rectal nerve?

A
  • External anal sphincter
  • Perianal skin
  • Levator ani
28
Q

What are the structures supplied by the doral nerve of the penis?

A
  • Skin of penis
  • Glans
29
Q

What are the parts of the perineal nerve?

A
  • Scrotal/labial branches
  • Muscular branches
  • Nerve to bulb
30
Q

What structures are supplid by the scrotal/labial branch of perineal nerve?

A
  • Scrotum
  • Anus
31
Q

What structures are supplid by the muscular branch of perineal nerve?

A
  • Transverse perineal muscle
  • Ischiocavernosus
  • Bulbospongiosus
  • External urethral sphincter
  • External anal sphincter
  • Levator ani
32
Q

What structures are supplid by the nerve to bulb (perineal nerve)?

A

Bulb of corpus spongiosum