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Anatomy Week 11 > Perineum I (lecture) > Flashcards

Perineum I (lecture) Flashcards

1
Q

What structures pass through the anal triangle?

A
  • Anal Canal

- Pudendal N. and Internal Pudendal vessels enter on the lateral wall of this

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2
Q

What are the ischioanal fossae and what is their purpose?

A
  • Fat filled spaces on either side of the anal canal

- Allow for movement of pelvic diaphragm and expansion of the anal canal during defecation

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3
Q

What are the boundaries of the anterior recess of the ischioanal fossae?

A
  • Apex - closed and pointed anteriorly toward the pubis
  • Base - open and continuous posteriorly with the ischioanal fossa
  • Inferior - UG diaphragm
  • Superomedial - Levator ani
  • Lateral - obturator internus
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4
Q

What fills the anterior recess of the ischioanal fossa?

A

Fat

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5
Q

What are the contents of the ischioanal fossa overall?

A
  1. Fat

2. External Anal Sphincter

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6
Q

What are the borders of the more posterior part of the ischioanal fossae?

A
  • Lateral - obturator internus muscle
  • Superiomedial - pelvic Diaphragm
  • Inferior - Skin/Fascia
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7
Q

What are the 3 parts of the external Anal Sphincter muscle?

A
  • Subcutaneous
  • Superficial
  • deep
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8
Q

What are structures are immediately anterior and posterior to the external anal sphincter?

A

Anterior: Perineal Body
Posterior: Anococcygeal body

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9
Q

What is the anococcygeal body?

A
  • Mass of fibrous tissue lying between the anal canal and the coccyx
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10
Q

T or F: the External Anal Sphincter is under autonomic control.

A

False, the external anal sphincter is skeletal muscle, therefore under control of the somatic nervous system.

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11
Q

Which lies medial to the External Anal Sphincter and what type of nerves control this structure?

A
  • Internal Anal Sphincter

- Smooth muscle, so under ANS control

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12
Q

Specifically, what nerves control the EAS?

A
  • Inferior rectal nn. (S2-S4)

Note: this is a branch of the pudendal n.

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13
Q

Specifically, what nerves control the Internal Anal Spinchter?

A
  • lumbar splanchnic nn. (L1/L2) (sympathetic)

- Pelvic Splanchnic nn. (S2-S4) (parasympathetic)

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14
Q

What is the pudendal canal?

A

specialization of fascia of the obturator internus

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15
Q

What are the contents of the pudendal canal?

A
  • Pudendal n.

- internal pudendal vessels (and their branches)

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16
Q

Describe the course of the Pudendal n.

A
  1. Exits the pelvis via greater sciatic foramen
  2. wraps around sacrospinous ligament
  3. enters perineum via lesser sciatic foramen
  4. Travels through ischioanal fossa within the pudendal canal
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17
Q

What is the SOLE MOTOR SUPPLY to the perineum?

A

Pudendal n. (S2-S4)

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18
Q

What is the MAJOR sensory supply to most of the perineal skin?

A

Pudendal n. (S2-S4)

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19
Q

What nerve would you need to probably block when doing a gynecological procedue?

A

Pudendal n. (S2-S4)

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20
Q

What are the 3 main branches of the pudendal n.?

A
  1. Inferior rectal n.
  2. Perineal n.
  3. Dorsal n. or Clitoris/Penis
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21
Q

What is the course of the inferior rectal n.?

A
  • Courses from lateral to medial in the ischioanal fossa to reach the external anal sphincter and anal canal
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22
Q

What are the functions of the inferior rectal n.?

A
  1. Motor innervation to the external anal sphincter

2. Sensory innervation to the lower part of the anal canal and perianal skin

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23
Q

What is the course of the perineal n.?

A
  • Enters the superficial perineal space by passing superficial to the UG diaphragm
24
Q

What is the motor function of the perineal n.?

A
  • Motor innervation to the 5 muscles of the superficial and deep perineal spaces
25
Q

What is the sensory function of the perineal n.?

A
  1. Posterior scrotum/labia
  2. bulb of penis
  3. Urethra
26
Q

What is the course of the dorsal n. of the clitoris/penis?

A
  • courses along the lateral wall of the ischioanal fossa (ob. internus) and enters the DEEP perineal space by PIERCING the posterior border of the UG diaphragm
27
Q

T or F: the Dorsal n. of the Clitoris/Penis only has sensory function.

A

True

28
Q

T or F: the pudendal n. contains all of the sensory fibers for the perineum.

A

FALSE, others like ilioinguinal, genitofemoral, posterior femoral cutaneous, and annococcygeal nn. also give sensory fibers to this area

29
Q

What artery gives rise to the internal pudendal artery?

A

Internal Iliac a.

30
Q

What are the 3 main branches of the internal pudendal a.?

A
  1. Inferior Rectal a.
  2. Perineal a.
  3. Internal Pudendal a.
31
Q

What is the course of the inferior rectal a.?

A

The same as the inferior rectal n.

  • Courses medially in the ischioanal fossa
32
Q

What does the perineal artery supply blood to?

A
  • Perineal muscles and posterior scrotum/labia
33
Q

T or F: the perineal. a. can be found in the deep perineal space?

A

False, the internal pudendal a. can be found here not the perineal.

34
Q

What 2 branches does the internal pudendal a. give off before dividing into its terminal branches?

A
  1. Artery to the urethra

2. artery to the bulb of the penis

35
Q

What are the 2 terminal branches of the internal pudendal a.?

A
  1. Dorsal A. of the Clitoris/Penis

2. Deep A. of the Clitoris/Penis

36
Q

What does the dorsal a. of the clitoris/penis supply?

A
  • Skin and tissues of the penis/Clitoris
37
Q

What does the deep a. of the clitoris/penis do?

A
  • responsible for erection
38
Q

What nerve courses with the deep a. of the penis?

A
  • the deep n. of the penis
39
Q

Suppose the an abscess moved from the external anal sphincter into the ischioanal fossa on the right. Is it possible for this infection to spread to the left ischioanal fossa? If so how?

A

Yes, is would have to move to the other side POSTERIORLY behind the anal canal under the annococcygeal body.

40
Q

Suppose the an abscess moved from the external anal sphincter into the ischioanal fossa on the right. Is it possible for this infection to spread to the UG triangle? If so how?

A

NOT possible, the furthest it can go is the anterior recess of the ischioanal fossa

41
Q

What does scarpa’s fascia continue as in the perineum?

A

Superfical Perineal/Colles’ fascia

42
Q

How far does Colles’ fascia extend in females?

A

the the free posterior margin of the UG diaphragm

43
Q

What does camper’s fascia continue as in females?

A
  • Continues to form the mons pubis

- labia majora

44
Q

What does camper’s fascia continue as in males?

A

NOTHING

45
Q

How far does Colles’ fascia extend in males?

A
  • goes to the dorsal surface of the penis at this point its called SUPERFICIAL PENILE FASCIA
  • Returns on the ventral penis surface to inside margin of scrotum as TUNICA DARTOS
  • Posterior to scrotum attaches to posterior margin of UG diaphragm
46
Q

What is special about the dartos fascia?

A

Contains a layer of smooth muscle that is innervated by sympathetic nerve fibers
- assists cremaster in raising and lowers the testis

47
Q

What Fibers control the dartos fascia?

A

sympathetic n. fibers of the LUMBAR splanchic

48
Q

What travels through the space that exists between the fusion of the superior and inferior membranes/fascia of the UG diaphragm and the symphysis pubis?

A

Deep vein of the Clitoris/Penis

49
Q

What do the superior and inferior membranes of the UG diaphragm fuse with posteriorly?

A
  • Colles’ fascia

- perineal body

50
Q

What do the superior and inferior membranes of the UG diaphragm fuse with laterally?

A

ischiopubic rami

51
Q

What is formed by the lateral fusion of the superior and inferior membranes of the UG diaphragm?

A

Deep perineal space/pouch

52
Q

T or F: the urethra and vaginal canal pass through the deep space.

A

True

53
Q

What are the superior, inferior, lateral, anterior, and posterior boundaries of the superficial pouch?

A
  • Superior: Perineal Membrane
  • Inferior: Colles’ Fascia
  • Lateral: Fusion of perineal (inferior) membrane and Colles to pubic arch (ishiopubic rami)
  • Anterior: space between scarpa’s and abs
  • Posterior: Fusion of perineal (infeior membrane) with Colles’ fascia at posterior margin of UG diaphragm
54
Q

T or F: the superficial pouch is larger in females.

A

False, its larger in males because it surrounds the scrotum and penis

55
Q

T or F: infection could easily spread between the superior and inferior compartments of of the UG diaphragm because there is communication between the superficial and deep compartement.

A

False, there is no communication between superficial and deep compartments

56
Q

Does the superficial compartment communicate with any part of the anal triangle? If so what part?

A

The superificial compartment does not communicate with the anal triangle

57
Q

What does the deep pouch consist of?

A
  • consits of the UG diaphragm which is bounded by perineal membrane and superior fascia of the UG diaphragm

Anatomy Week 11 (3 decks)

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