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Structure and Function Test 1 > Perineum > Flashcards

Perineum Flashcards

1
Q

Diamond shaped region between the thighs containing the external genitalia, anal canal, and the neurovascular structures that supply them

A

Perineum

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2
Q

The perineum is bordered anteriorly by the

A

Pubic symphysis

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3
Q

The perineum is bordered anterolaterally by the

A

Ischiopubic rami

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4
Q

The perineum is bordered posterolaterally by the

A

Sacrotuberous ligaments

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5
Q

The perineum is bordered posteriorly by the

A

Coccyx

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6
Q

By extending a line from ischial tuberosity to ischial tuberosity, the perineum is divided into which two triangles?

A
  1. ) Urogenital (anterior)

2. ) Anal (posterior)

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7
Q

Contains the anal canal in the midline with the ischioanal fossae on either side

A

Anal triangle

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8
Q

Approximately 4cm in length extending between the anorectal junction (perineal flexure) and its opening

A

Anal canal

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9
Q

The mucosa of the proximal 2/3 of the canal is thrown into folds by underlying branches of the suerior rectal blood vessels. These folds are called called

A

Anal columns

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10
Q

The base of the anal column marks the transition between the

A

Hindgut (endoderm) portion and the proctodeum (ectoderm) derived distal 1/3

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11
Q

Marks the transition between the hindgut (endoderm) portion and the proctodeum (ectoderm) derived distal 1/3

A

Base of the anal canal

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12
Q

This area of transition is called the

A

Pectinate line

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13
Q

Fecal continence is controlled by which two muscular sphincters?

A
  1. ) Internal anal sphincter

2. ) External anal sphincter

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14
Q

Involuntary smooth muscle under autonomic controll

A

Internal anal sphincter

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15
Q

Voluntary skeletal muscle under somatic motor control

A

External anal sphincter

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16
Q

What is the embyonic derivation above the pectinate line

A

Hindgut (endoderm)

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17
Q

What is the motor innervation above the pectinate mind?

A

Autonomic

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18
Q

What is the sensory innervation of the anal canal above the pectinate line?

A

Visceral afferent and pressure

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19
Q

What is the arterial supply to the anal column above the pectinate line?

A

Superior rectal artery

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20
Q

What is the venous return from the anal canal above the pectinate line?

A

Superior rectal vein to hepatic portal venous system

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21
Q

What is the lymphatic drainage from the anal canal above the pectinate line?

A

Internal iliac nodes

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22
Q

Hemorrhoids of the anal canal ABOVE the pectinate line are

A

Internal and covered with mucosa

-Painless

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23
Q

Hemorrhoids BELOW the pectinate line are

A

External and covered by skin

-painful

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24
Q

Fat-filled triangular shaped spaces that allow for the distension and contraction of the anal canal during defecation

A

Ischioanal fossae

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25
Q

The pelvic diaphragm and its inferior fascia form the MEDIAL wall of the

A

Ischioanal fossae

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26
Q

Form the lateral walls of the ischioanal fossae

A

Obturator internus muscle and its fascia

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27
Q

Formed within the fascia of the obturator internus muscle where it lines the LATERAL wall of the ischioanal fossae

A

Pudendal canal

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28
Q

The contents of the pudendal canal include:

A

Pudendal nerve and internal pudendal artery and vein

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29
Q

The internal pudendal artery and vein are passing through the pudendal canal as they travel to the

A

Urogenital triangle

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30
Q

Inferior rectal branches of the pudendal nerve and internal pudendal artery and vein traverse the ischioanal fossae MEDIALLY to supply the

A

External anal sphincter, anal canal, and inferior aspect of pelvic diaphragm

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31
Q

The peroneal structures in the urogenital triangle are contained within which two pouches?

A
  1. ) Deep perineal pouch

2. ) Superficial perineal pouch

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32
Q

Lies between the superior fascia of the urogenital diaphragm (roof) and the inferior fascia (perineal membrane) of the urogenital diaphragm (floor)

A

Deep perineal pouch

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33
Q

Formed by the deep pouch, its contents, and the fascial layers that enclose it

A

Urogenital diaphragm

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34
Q

What are the muscles of the deep perineal pouch in both males and females?

A

Sphincter urethra and deep transverse perineal muscle

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35
Q

What are the viscera structures in the MALE deep perineal pouch?

A

Urethra and bulbourethral glands

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36
Q

What are the visceral structures in the FEMALE deep perineal pouch?

A

Urethra and vagina

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37
Q

Extends from deep to superficial between the perineal membrane of the urogenital diaphragm (facial roof) and the superficial perineal fascia (fascial floor)

A

Superficial perineal pouch

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38
Q

Constructing the SUPERFICIAL perineal pouch from deep to superficial, what is the FIRST layer?

A

Erectile bodies

39
Q

Attach to the perineal membrane and ischiopubic rami

A

Erectile bodies

40
Q

Constructing the SUPERFICIAL perineal pouch from deep to superficial, what is the SECOND layer?

A

Deep penile fascia (Buck’s)

41
Q

Covers erectile bodies

A

Deep penile fascia

42
Q

Constructing the SUPERFICIAL perineal pouch from deep to superficial, what is the THIRD layer?

A

Skeletal muscle

43
Q

The skeletal muscle of the third layer covers part of the erectile bodies and attaches to the

A

Central tendon (perineal body)

44
Q

Constructing the SUPERFICIAL perineal pouch from deep to superficial, what is the FOURTH layer?

A

Superficial perineal fascia

45
Q

Constructing the SUPERFICIAL perineal pouch from deep to superficial, what is the FIFTH layer?

46
Q

In the MALE and FEMALE, what are the muscles of the superficial perineal pouch?

A

Bulbospongiosus, ischiocavernosus, and superficial transverse perineal muscles

47
Q

What is the main difference in the viscera of the superficial perineal pouch of the MALE?

A

Bulb of the penis, corpus spongiosum, crura of the penis, and corpa cavernosa

48
Q

What is the main difference of the superficial perineal pouch of the FEMALE?

A

Vagina, vestibular bulb, greater vestibular gland, and crura of clitoris

49
Q

Covers the erectile bodies and skeletal muscle of the superficial perineal pouch

A

Deep Penile Fascia (Buck’s)

50
Q

Forms the floor of the superficial perineal pouch and goes by a number of different names

A

Superficial perineal fascia

51
Q

The part of the superficial perineal fascia that covers the penis

A

Superficial penile fascia

52
Q

The part of the superficial perineal fascia that covers the scrotum

A

Dartos fascia

53
Q

The part fo the superficial perineal fascia that is the region between the external ginitalia and the anal triangle

A

Colle’s fascia

54
Q

The superficial perineal fascia is continuous with the fascia of the anterior abdominal wall called the

A

Scarpa’s fascia

55
Q

What are the 4 types of superficial perineal fascia?

A
  1. ) Scarpa’s
  2. ) Superficial
  3. ) Darto’s
  4. ) Colle’s
56
Q

What are the 2 types of deep penile fascia

A
  1. ) Buck’s (erectile)

2. ) Investing (Muscle)

57
Q

Can lead to extravasation of blood and/or urine

A

Urethral tears

58
Q

A urethral tear as it enters the bulb of the penis that also tears the Buck’s fascia would allow fluid extravasation into the

A

Superficial pouch and the anterior abdominal wall

59
Q

Pyrimidal shaped structure centrally located between the urogenital triangle and the anal triangle

A

Central tendon of the Perineum (Perineal Body)

60
Q

The central tendon of the perineum (perineal body) consists of fibrous tissue and some smooth muscle and serves as an important attachment site for

A

Perineal and pelvic diaphragm muscles

61
Q

We an see the importance of the perineal body as pelvic visceral support because when the perineal body is damaged, we see an increased incidence of

A

Prolapse of the pelvic viscers

62
Q

Procedure where physicians cut the perineal body to prevent uncontrolled tearing during delivery

A

Episiotomy

63
Q

What are the perineal muscles that attach to the central tendon of the perineum (perineal body)?

A

Deep and superficial transverse perineal, bulbospongiosus, and external anal sphincter muscles

64
Q

Which muscles of the pelvic diaphragm attach to the central tendon of the perineum (perineal body)?

A

Pubococcygeus and puborectalis

65
Q

The arteries of the perineum are branches of the

A

Internal pudendal artery

66
Q

The internal pudendal artery arises in the pelvis from the

A

Internal Iliac Artery

67
Q

The internal pudendal artery exits the pelvis via the

A

Greater sciatic foramen

68
Q

The internal pudendal artery exits the pelvis via the greater sciatic foramen to enter the

A

Gluteal region

69
Q

The internal pudendal artery then passes from the gluteal region to the ischioanal fossa via the

A

Lesser sciatic foramen

70
Q

In the ischioanal fossa, the internal pudendal artery runs within the pudendal canal to reach the

A

Urogenital triangle

71
Q

Venous drainage of the erectile bodies is via the

A

Deep dorsal vein of the penis and clitoris

72
Q

The deep dorsal vein of the penis and clitoris drain through a gap in the

A

Urogenital hiatus

73
Q

The deep dorsal vein of the penis and clitoris drain through a gap in the urogenital hiatus into the

A

Prostatic venous and vesicle venous plexuses, respectively

74
Q

Which types of innervation does the perineum receive?

A

Somatic, sympathetic, and parasympathetic innervation

75
Q

The perineum receives SOMATIC innervation via the

A

Pudendal nerve (S2, S3, S4)

76
Q

The pudendal nerve follows the same course as the

A

Internal pudendal artery and vein

77
Q

The inferior rectal branch of the pudendal nerve provides MOTOR innervation to the

A

External nal sphincter and pelvic diaphragm

78
Q

The inferior rectal branch of the pudendal nerve provides SENSORY innervation to the

A

Skin of the anal triangle

79
Q

The dorsal nerve of the penis/clitoris provides SENSORY innervation to the

A

Dorsum of the penis/clitoris

80
Q

The perineal branch of the pudendal nerve provides MOTOR innervation to

A

ALL muscles of the ddep and superficial perineal pouches

81
Q

The Perineal branch of the pudendal nerve provides SENSORY innervation to the

A

Deep and superficial pouches and perineal skin

82
Q

In the perineum, SYMPATHETIC innervation is primarily responsible for

A

Vasoconstriction

83
Q

How many pathways of SYMPATHETIC innervation are there in the perineum?

84
Q

In BOTH pathways PREGANGLIONIC SYMPATHETIC NEURONS CELL BODIES ARE LOCATED AT

A

L1 and L2 levels of spinal cord

85
Q

In pathway ONE, axons travel in

A

Lumbar splanchnic nerves to superior hypogastric plexus

86
Q

In pathway ONE, axons travel in lumbar splanchnic nerves to the superior hypogastric plexus and then enter the pelvis via

A

Hypogastric nerves

87
Q

In pathway ONE, PREGANGLIONIC SYMPATHETIC axons synapse on POSTGANGLIONIC cell bodies in the

A

Inferior hypogastric plexus

88
Q

In pathway ONE, postganglionic axons join the

A

Internal pudendal artery (to travel to perineum)

89
Q

In pathway TWO, axons travel down through sympathetic chain and synapse on cell bodies located in

A

Paravertebral ganglia (S2, S3, and S4)

90
Q

In pathway TWO, postganglionic axons join ventral rami of spinal nerves S2, S3, and S4 and travel to the perineum in the

A

Pudendal nerve

91
Q

In the perineum PARASYMPATHETIC innervation is primarily responsible for

A

Dilating arteries of erectile bodies to stimulate erection

92
Q

PREGANGLIONIC PARASYMPATHETIC axons from cell bodies in S2, S3, and S4 reach the inferior hypogastric plexus by travelling on

A

Pelvic splanchnic nerves

93
Q

In the inferior hypogastric plexus, PARASYMPATHETIC axons synapse and then travel in

A

Cavernous nerves

94
Q

Pass through the urogenital diaphragm to reach erectile tissue

A

Cavernousnerves

Structure and Function Test 1 (61 decks)

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