Perineum Flashcards
1
Q
Region of the trunk inferior to the pelvic diaphragm and between the thighs
A
Perineum
2
Q
Forms the margins of the perineum
A
Pelvic outlet
3
Q
Creat the diamond-shaped space of the pelvic outlet
A
Pubic symphysis, inferior pubic rami, ischial rami/tuberosities, sacrotberous ligaments, coccyx
4
Q
Forms the roof of the perineum
A
Pelvic diaphragm
5
Q
2 triangles of the perineum
A
Urogenital, anal
6
Q
Line of division b/t the 2 triangles of the perineum
A
B/t the anterior portions of the ischial tuberosities
7
Q
Central tendon of the perineum (fibromuscular mass)
A
Perineal body
8
Q
Triangular, durable sheet of fascia spanning the ishiopubic rami
A
Perineal membrane
9
Q
Thicken of the anterior margin of the perineal membrane
A
Transverse perineal ligament
10
Q
Deep dorsal vein of the penis/clitoris passes thru what
A
A gap b/t the transverse perineal ligament and the pubic symphysis
11
Q
Found in the middle of the anal triangle
A
Anal canal and anus
12
Q
Skeletal muscle that surrounds the anal canal/anus
A
External anal sphincter
13
Q
3 parts of the external anal sphincter
A
Deep part, superficial part, subcutaneous part
14
Q
Forms a ring around the anal canal, merging with the fibers of the puborectalis
A
Deep part of the external anal sphincter
15
Q
Surrounds the anal canal and attaches superiorly to the perineal body and posteriorly to the coccyx
A
Superficial part of the external anal sphincter
16
Q
Attaches the superficial part to the coccyx
A
Anococcygeal ligament
17
Q
Open, wedge-shaped spaces lateral to the anal canal, that are continuous with each other posteriorly and inconsistently anteriorly
A
Ischioanal fossae
18
Q
What passes thru the ischioanal fossae
A
Inferior rectal nerve and vessels
19
Q
Boundaries of the ichioanal fossae
A
Obturator internus (and fascia) anteriorly, inferior surface of the levator ani muscle superomedially, skin of the perineum inferiorly
20
Q
Pass thru the pudendal canal
A
Internal pudendal artery and pudendal nerve
21
Q
Positioning of the ischioanal fossae
A
projects anteriorly into the urogenital triangle,
superior to the deep perineal pouch as the anterior recesses of the ischioanal fossa.
22
Q
first branch of the internal pudendal artery within the pudendal canal
A
Inferior rectal artery
23
Q
Path of the inferior rectal artery
A
courses medially through the fat in the ischioanal fossa to anastomose with middle and superior
rectal arteries from internal iliac and inferior mesenteric arteries
24
Q
branches from the pudendal nerve near the initial portion of the pudendal canal
A
Inferior rectal nerve
25
Path of the inferior rectal nerve
courses medially with the inferior rectal artery towards the anus
26
Divisions of the urogenital triangle
Superficial perineal space and deep perineal space (pouch) via the perineal membrane
27
Primary arterial and nerve supply to the urogenital triangle
Internal pudendal artery and pudendal nerve
28
Components of penis
Roots, body, glans
29
Makes up the root of the penis
2 crura and the bulb
30
The crus is anchored to what?
Ischiopubic ramus
31
The bulb is anchored to what?
Perineal membrane
32
the free, middle portion of the penis that lies inferior to the symphysis pubis and anterior to the scrotum when flaccid
The body of the penis
33
Expanded, distal end of the penis
Glans
34
Prominent margin of the glans that projects backwards over the body of
the penis
Corona
35
The constriction between the body of the penis and the glans
Neck of the glans
36
Paired erectile tissue that forms the crura of the penis
Corpora cavernosa
37
Surrounds the corpora cavernosa and forms the septum of the body of the penis
Tunica albuginea
38
Single erectile mass surrounded by a tunica albuginea
Corpus spongiosum
39
What does the corpus spongiosum connect?
the bulb and glans
40
The portion of the urethra within the penis
Spongy urethra
41
Dilated urethra within the glans
navicular fossa
42
Pea-sized accessory glands embedded in the fibers of the urethral sphincter muscle
Bulbourethral glands (Cowper's glands)
43
Free fold of skin that overlaps the glans
Prepuce (foreskin), continuous with the skin of the glans
44
Fold of skin connecting the deep surface of the prepuce with the glans, immediately ventral to the external urethral orifice
Frenulum of the prepuce
45
Inability to retract the prepuce from the glans penis due to a constriction in the preputial orifice
Phimosis
46
Superficial penile fascia
Dartos (Colles') fascia, continuous with Sacrpa's fascia
47
Investing penile fascia that is continuous with the deep perineal fascia and aponeurosis of the external abdominal oblique
Deep penile fascia (Buck's fascia)
48
Triangular shaped ligament that attaches to the pubic symphsis and to the deep penile fascia at the proximal end of the body of the penis
Suspensory ligament of penis
49
Structure that arises from superfiscial fascia in the area of the linea alba, splits to encircle the body of the penis near the pubic symphysis
Fundiform ligament of penis
50
Symmetrical, bilateral pair of thin skeletal muscles that covers the bulb of the penis
Bulbospongiosus (attaches posteriorly at the perineal body)
51
Skeletal muscle that covers the crura of the penis
Ischiocavernosus (arises from the medial aspect of ischial tuberosity and ischiopubic rami)
52
Small skeletal muscles of the superficial perineal pouch that runs along the posterior border of the urogenital triangle
Superficial transverse perineal meuscles that attach to the ischial tuberosity and insert into the perineal body
53
Divides the 2 chambers of the scrotum
Scrotal septum
54
Primary layers of the scrotum
Skin and dartos fascia
55
Term for all external female genitalia
Vulva
56
Fatty subcutaneous tissue that forms a rounded eminence anterior to the pubic symphysis
Mons pubis
57
Encapsulated fatty tissue fills bilateral, longitudinal ridges of skin
Labia Majora
58
Passes thru the superficial inguinal ring ending the labium majus
Round ligament of the uterus
59
Inner surfaces of the labia majora
Lateral boundary of the pudendal cleft
60
Two labia majora converge anteriorly at the midline as what?
Anterior labial commisure
61
Posterior midline of the pudendal cleft
Posterior labial commissure
62
Internal folds of skin
Labia minora
63
What do the labia minora bind?
Vestibule of the vagina
64
Unites the labia minora posteriorly
Frenulum of the labia
65
Lateral portions of the labia minora meet at the midline anterior to the clitoris to form what?
Prepuce of the clitoris
66
Medial portions of the labia minora meet posterior to the blans of the clitoris to form what?
Frenulum of the clitoris
67
What forms the clitoris?
Paired masses of eretile tissue called corpora cavernosa clitoridis
68
Cavernous bodies that attach to the ischiopubic rami and perineal membrane
Crura of the clitoris
69
Meeting of the corpora cavernosa clitoridis
Body of the clitoris
70
End of the clitoris
Glans of clitoris beneath the prepuce of the clitoris
71
Attaches the clitoral bod yto the pubic symphysis
Suspensory ligament of the clitoris
72
Space between the labia minora
Vestibule of the vagina
73
Opening into the anterior part of the vestibule of the vagina
External urethral orifice
74
Median slit located posterior to the urethral orifice
Orifice of the vagina
75
Thin fold of mucous membrane that partially closes the vaginal orifice
Hymen
76
Rounded elevations around the margins of the vaginal orfice that represent remnents of the hymen
Hymeneal caruncles
77
3cm elongated masses of erectile tissue, situated deep to the bulbospongiosus muscle in the labia majora
Vestibular bulb
78
Glands located on the lateral aspect of the vaginal orifice
Greater vestibular glands (Bartholin glands)
79
Minute channels on either side of the uretral orifice
Paraurethral glands (Skene's)
80
Skeletal muscles that cover the vestibular bulb and greater vestibular glands
Bulbospongiosus (inserts posteriorly into the perineal body and anteriorly into the clitoris)
81
Layers of superficial perineal fascia in a female
Fatty superficial layer, deep membranous layer (Colles') that is continuous with the Scarpa's fascia
82
Fascia continuous with the aponeurosis of the external abdominal oblique muscle
Deep perineal fascia (Gallaudet's fascia)Splits to invest the superficial perineal muscles and in continuous with deep penile fascia
83
Limits the superficial perineal space (superficially and deeply)
(superficially, inferiorly) Superficial fascia (Colles') and (deeply, spueriorly) perineal membrane
84
8 things in male superficial perineal space
Bulb of penis, crura of penis, bulbospongiosus, ischiocavernosus, spongy urethra, superficial transverse perineal muscle, branches of internal pudendal vessels, pudendal nerve
85
9 things is female superficial perineal space
Bulb of vestibule, crura of clitoris, greater vestibular glands, bulbospongiosus, ischiocavernosus, superficial transverse perineal muscle, branches of internal pudendal vessels, pudendal nerve
86
What is the deep perineal space bounded by?
Perineal membrane (inferior), inferior fascia of the pelvic diaphragm (superior), Obturator fascia (lateral)
87
8 things in male deep perineal space
Anterior recess of ischioanal fossa, deep transverse perineal muscle, external urethral sphincter, membranous urethra, bulbourethral glands, internal pudendal vessels, branches of pudendal nerve
88
9 things in female deep perineal space
Anterior recess of ischioanal fossa, deep transverse perineal muscle, external urethral sphincter, compressor urethrae, urethrovaginal sphincter, transverse vaginal muscles, proximal portion of urethra, internal pudendal vessels, branches of pudendal nerve
89
Where do most superficial structures in the superficial perineal pouch of the perineum drain their lymph to?
Superficial inguinal lymph nodes
90
Where do gential glans drain to?
Deep inguinal nodes
91
Where do deep perinal space and superior part of the anal canal above the pectinate line drain to?
Internal iliac nodes
92
Path of the internal pudendal artery
With pudendal nerve, exits pelvic cavity thru greater sciatic foramen, thru gluteal region, enters perineum thru the lesser sciatic foramen, runs thru the pudendal canal, deep into the superficial perineal space to supply the perineum
93
Path of the perineal artery
From the internal pudendal artery, superficial within the superficial perineal space, b/t the bulbospongiosus and ischocavernosus (female) and on the surface of ischocavernosus (males)
94
Path of the transverse perineal artery
Arises from perineal artery to course along the superficial transverse perineal muscle
95
Path of the posterior scrotal/labial artery
Arises from perineal artery to supply skin and fascia
96
Path of the artery of the bulb of the genitals
Arises from the internal pudendal artery, courses medially and pierces the perineal membrane before entering the bulb
97
Path of the urethral artery
Arises from the internal pudendal artery, pierces the perineal membrane and then enters the corpus spongiosum to run alongside the urethra to the glans penis
98
Path of the deep artery of the penis/clitoris
Aka cavernosal artery, one of the terminal branches of the internal pudendal artery, pierces the perineal membrane, enters the crus, and runs thru the center of the corpus cavernosum
99
2 terminal branches of the internal pudendal artery
Dorsal artery and deep artery of the penis/clitoris
100
3 arteries that pierce the perineal membrane
Urethral artery, deep artery, dorsal artery
101
External pudendal artery branches
Superficial and deep external pudendal arteries
102
Gives rise to the external pudendal arteries
Femoral artery
103
Supplies the skin of the penis/vulve and the anterior aspect of the scrotum/labia majora
superficial external pudendal artery
104
Supplies the skin of the scrotum/labia majora
deep external pudendal artery
105
Path of the deep dorsal vein
Unpairs from the midline of the dorsal aspect of the penis/clitoris, deep into the deep fascia b/t the right and left dorsal arteries, thru the suspensory ligament, terminates in the prostatic venous plexus (male) vesical venous plexus (female)
106
Drains most structures in the perineum
Internal pudendal vein and drains into the internal iliac veins
107
Innervation of the penis
Dorsal nerve of penis (off of pudendal), S2-S4
108
Carries parasympathetic to penis
Cavernous nerves (from inferior hypogastric plexus)
109
Innervates bulbospongiosus and ischiocavernosus
Deep branch of perineal nerve
110
Innervates anterior aspect of vulva
anterior labial nerves from Ilioinguinal and Genitofemoral nerves
111
Innervates the posterior aspect of vulva
posterior labial nerves from perineal branch of posterior cutaneous nerve of the thigh and perineal nerve (from pudendal nerve)
112
Innervates the deep perineal muscles and clitoris
Dorsal nerve of the clitoris
