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Anatomy > Perineum > Flashcards

Perineum Flashcards

1
Q

What are the boundaries of the perineum

A

inferior to pelvic diaphragm, bound by inferior pelvic aperture

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2
Q

What happens if you draw a line between the ischial tuberosities

A

You divide the perineum into the urogenital triangle, and anal triangle

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3
Q

What are the sischioanal fossae

A

fat filled spaces on either side of the anal canal that allow the anal canal to expand if necessary

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4
Q

What are the lateral walls of the fossae formed by

A

obturator internus and ischial tuberosity

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5
Q

What are the medial walls of the fossae formed by

A

External anal sphincter

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6
Q

What does each fossa project anteriorly into

A

The UG triangle, formin anterior recesses, allowing for easy spread of infection between UG and anal triangle

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7
Q

What is the importance of the ischioanal fossa communicating posteriorly

A

Allows for spread of infection between left and right sides of anal triangle

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8
Q

Where does the anal canal begin

A

At the anorectal flexure (held up by puborectalis)

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9
Q

What allows the anus to close off when not in use

A

anal columns and anal valves

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10
Q

What is the line where external tissue meets internal tissue in the anal canal

A

Pectinate line (inferior to anal valves

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11
Q

What supplies/drains anal canal superior to pectinate line

A

superior rectal vessels (IMA) with aid from middle rectal vessels

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12
Q

Where does lymph superior to pectinate line drain

A

internal iliac nodes

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13
Q

What innervation does superior to pectinate line receive

A 
Parasympathetic and Sympathetic (similar to hindgut)
Visceral sensory (stretch, ischemia)
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14
Q

What supplies/drains inferior to the pectinate line

A

inferior rectal vessels (to pudendal, to internal iliac)

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15
Q

Where does lymph drain inferior to the pectinate line

A

superficial inguinal nodes

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16
Q

What innervation does inferior to pectinate line receive

A

Somatic via inferior rectal nerve (pain, temp, touch)

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17
Q

What anastomoses happens in the anal canal

A

Superior rectal vein (proximal, portal) with Inferior rectal vein (distal, caval)

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18
Q

What are external hemorrhoids indicative of

A

portal hypertension

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19
Q

What is the internal anal sphincter made of

A

smooth muscle

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20
Q

What effect does innervation have on the internal anal sphincter

A

Sympathetic- stimulates contraction, prevents defecation

Parasympathetic- relaxes, allowing defecation

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21
Q

What is the external anal sphincter made of

A

Skeletal muscle, receiving somatic motor innervation

22
Q

What does “potty training” involve

A

learning to control the external anal sphincter

23
Q

What is SF fatty layer of SF perineal fascia continuous with

A

camper fascia

24
Q

What is deep membranous layer of SF perineal fascia continuous with

A

Scarpa fascia (dartos fascia in men, colles fascia in women)

25
Q

What separates superficial and deep muscles on the perineum (UG triangle)

A

Perineal membrane (openings for vagina and urethra)

26
Q

What does the perineal membrane provide

A

attachment for erectile tissue and muscles of UG triangle

27
Q

What is an episiotomy

A

incision made through, or lateral to the perineal body during child birth to minimize tearing

28
Q

What are the external female genitalia

A

Mons pubis, labia majora, labia minora (prepuce), vestibule (hymen)

29
Q

What is the erectile tissue in women

A 
Corpora cavernosa (paired)- crus, body, and glans
Bulbs of the vestibule
30
Q

What muscles cover erectile tissue

A

Crura covered by ischiocavernosus

Bulbs covered by bulbospongiosus

31
Q

What are the erectile tissues in men

A 
Corpora cavernosa (paired)- crura
Corpus spongiosum (unpaired)- glans, bulb
32
Q

What covers the glans of the penis

A

The prepuce (foreskin)

33
Q

What is the purpose of ischiocavernosus

A

aid in erection by compressing veins of corpora cavernosa and maintaining blood

34
Q

What is the purpose of bulbospongiosus

A

aid in erection and expel semen during ejaculation

35
Q

What muscle runs along the inferior border of the UG triangle

A

Superficial Transverse Perineal, helps stabilize perineal body

36
Q

What are the deep perineal muscles

A

Deep transverse perineal (smooth and skeletal in females)

External urethral sphincter (surrounds membranous urethra in men)

37
Q

What innervation does the external urethral sphincter receive

A

Somatic motor- stimulating contraction may help prevent urination

38
Q

What are the levels of urethra in men

A

Prostatic, membranous, penile (spongy)

39
Q

What are the glands of the female UG triangle

A 
Bartholin glands (great vestibular), infection and cysts can occur
open into vestibule, secrete mucus for lubrication
40
Q

What are the glands of the male UG triangle

A

Bulbourethral (cowper) glands

empty into penile urethra

41
Q

What spinal levels contribute to the sacral plexus

A 
Ventral rami of L4-S4
Lumbosacral trunk (L4-L5) and ventral rami of S1-S4 go through piriformis
42
Q

What levels contribute to the Pudendal nerve

A

S2-S4, keep your junk off the floor

43
Q

What is the path of the pudendal nerve

A

Exits pelvic cavity through greater sciatic foramen, inferior to piriformis
Goes around ischial spine
Enters perineum through lesser sciatic foramen
Enters pudendal canal

44
Q

What are the branches of the pudendal nerve after entering pudendal canal

A

Inferior rectal nerves
Perineal nerves
Dorsal nerve of penis or clitoris

45
Q

What is a pudendal nerve block

A

used to anesthetize the perineum by directing the needle towards the ischial spine

46
Q

What does parasympathetic do to sexual function

A

Helps achieve erection by closing off anastomoses to help blood pool in penis

47
Q

How does Sympathetic innervation control sexual function

A

helps achieve emission by peristalsis of ductus deferens, and contracting internal urethral sphincter to prevent sperm back flow into bladder

48
Q

What is the primary source of blood to the perineum

A

Internal pudendal artery

49
Q

What are the branches of the internal pudendal artery

A

inferior rectal artery, perineal arteries, dorsal artery of the penis or clitoris, deep artery of the penis or clitoris

50
Q

What do veins of perineum accompany

A

arteries of the perineum.

Except: superficial and dip dorsal veins of the penis

51
Q

Where does lymph from SF perineum drain

A

superficial inguinal nodes

52
Q

Where does lymph from deep perineum drain

A

internal iliac nodes

Anatomy (10 decks)

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