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Anatomy Exam 2 > Perineum > Flashcards

Perineum Flashcards

1
Q

Where is the perineum?

A

inferior to the pelvic diaphragm, bounded by the pelvic outlet

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2
Q

What are the 2 triangles of the perineum?

A

urogenital triangle

anal triangle

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3
Q

What is the ischioanal fossae?

A

fat filled space on either side of the anal canal, allow for dilation of the anal canal

lateral wall of each fossae made up of obturator internus and ischial tuberosity

medial wall of each fossae is made of up levator ani and external anal sphincter

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4
Q

anterior recesses

A

the ischioanal fossa project into the UG triangle forming these recesses which facilitate the spread of infection between the UG and anal triangles

they also communicate with each other, facilitating the spread of infection between the left and right sides of the anal triangle

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5
Q

Anal canal

A

begins at anorectal flexure and ends at the anus

  • anal columns: vertical folds in the mucosal lining
  • anal valves: crescent shaped folds that unite the anal columns inferiorly
  • pectinate line: irregular line at level of anal valves, where internal tissue meets external tissue
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6
Q

Where is blood supplied/drained superior to the pectinate line?

A

superior rectal veins (from inferior mesenteric vessels) (portal) and partly middle rectal veins

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7
Q

Where does lymph drain superior to the pectinate line?

A

internal iliac lymph nodes

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8
Q

Anal canal is derived from…superior to the pectinate line and ….inferior to the pectinate line

A

endoderm

ectoderm

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9
Q

What supplies/drains anal canal inferior to the pectinate line?

A

inferior rectal vessels (internal pudendal vessels from internal iliac)

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10
Q

Where does lymph drain inferior to the pectinate line?

A

superficial inguinal lymph nodes

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11
Q

Inferior to the pectinate line, anal canal receives somatic innervation from what nerve?

A

inferior rectal nerve (caval system)

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12
Q

In the case of portal hypertension, the increased blood to the inferior rectal veins can lead to…

A

external hemorrhoids

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13
Q

Internal anal sphincter

A

smooth muscle sphincter

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14
Q

What does sympathetic innervation to the internal anal sphincter do? parasympathetic?

A

contract to prevent defecation via lumbar splanchnic nerves

relax to allow for defecation via pelvic splanchnic nerves

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15
Q

external anal sphincter

A

skeletal muscle

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16
Q

What kind of innervation does the external anal sphincter receive? What does it do?

A

somatic motor innervation via inferior rectal nerves

contract to prevent defecation

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17
Q

What are the layers of the perineal fascia covering the UG triangle?

A

superficial perineal fascia

  • SF fatty layer> continuous with camper fascia of abd wall
  • deep membranous layer aka colles fascia > continuous with scarpa fascia (or dartos in males)

deep perineal fascia

perineal membrane

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18
Q

perineal membrane

A

attachment for erectile tissue and muscles

urethra and vagina pass through it

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19
Q

perineal body

A

thickening of the posterior border of the perineal membrane where muscles and the perineum insert

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20
Q

Weakening of the perineal body can result in…

A

vaginal prolapse

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21
Q

episiotomy

A

controlled cut through perineal body prior to childbirth to prevent ragged tear

22
Q

vulva/pudendum

A

external female genitalia

23
Q

labia majora

A

homologous to scrotum

fat filled folds containing the round ligament of the uterus

24
Q

labia minora

A

thin folds located on either side of the midline, join together superior to the clitoris to form the prepuce

25
Q

vestibule

A

space btwn labia majora, contains opening for the urethra and vagina

26
Q

hymen

A

mucous membrane that spans the vaginal orifice

27
Q

What are the erectile tissues in the female?

A

clitoris, bulb of the vestibule (both paired)

28
Q

clitoris

A

corpora cavernosa, supported by the suspensory ligament of the clitoris, extension of deep fascia

29
Q

bulb of the vestibule

A

paired structure

corresponds to corpus spongiosum

located on either side of the vaginal opening

30
Q

erectile tissue in male

A

corpora cavernosa (paired) dorsal body of penis

corpus spongiosum (unpaired) ventral body of penis, glans and bulb of penis

31
Q

prepuce

A

foreskin

32
Q

Skeletal muscle of the UG triangle

A

ischiocavernosus- paired muscles covering crura, aids in erection

bulbospongiosus- paired, covers bulbs, unite in the midline for males

superficial transverse perineal muscle- attached to the ischial tuberosities laterally and the perineal body medially, help stabilize

33
Q

What are the deep muscles of the UG triangle?

A

deep transverse perineal muscles-attach to perineal body, help stabilize

external urethra sphincter, surrounds urethra

34
Q

What kind of innervation does the external urethral sphincter receive?

A

somatic motor innervation via perineal nerves

contract to prevent urination

35
Q

parts of the urethra in males (SF to deep)

A

prostatic urethra, membraneous urethra, penile spongy urethra

36
Q

greater vestibular (bartholin) gland

A

only in females

just posterior to the bulbs of the vestibule, secrete mucous for lubrication into the vestibule

37
Q

bulbourethral (cowper) gland

A

only in males

just lateral to the external urethral sphincter

secretes pre-ejaculation into the penile urethra which helps with lubrication and neutralize the urethra

38
Q

Spinal level of sacral plexus

A

L4-S4

can be compressed by pelvic tumors or the fetal head during childbirth

39
Q

spinal level of lumbosacral trunk

A

L4-L5

40
Q

What is a major branch of the sacral plexus?

A

pudendal nerve “S2-S4 keep your junk off the floor”

41
Q

branches of pudendal nerve

A

inferior rectal nerves, perineal nerves, dorsal nerve of the penis/clitoris

42
Q

inferior rectal veins

A

innervate the external anal sphincter and skin of anal triangle

43
Q

perineal nerves

A

innervate the muscles and skin of the UG triangle

44
Q

deep nerve of the penis or clitoris

A

innervate the skin, particularly glans

45
Q

pudendal nerve block to..

A

numb the perineum

46
Q

Autonomic controls of sex function

A

point and shot

parasympathetic: via pelvic splanchnic nerves- achieve erection
sympathetic: via lumbar splanchnic nerves-emission and contraction of internal urethra spinchter

47
Q

primary source of blood to perineum?

A

pudendal artery, branch off internal iliac

48
Q

Branches of pudendal artery

A

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

49
Q

where does lymph drain from the deep perineal tissue?

A

deep perineal tissue>

internal iliac lymph nodes

50
Q

where does lymph drain from the superficial perineal tissue?

A

superficial perineal tissue> superficial inguinal nodes

Anatomy Exam 2 (10 decks)

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