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Anatomy Week 11 > Perineum II > Flashcards

Perineum II Flashcards

1
Q

What 3 masses of erectile tissue make up the penis?

A
  • R and L corpoa cavernosa (dorsally)

- corpus spongiosum (ventrally)

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2
Q

What does the corpus spongiosum continue as distally?

A

glans of the penis

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3
Q

Which erectile tissue transmits the urethra?

A

corpus spongiosum

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4
Q

What are the layers of penile tissue?

A
  1. Skin
  2. Superficial Penile Fascia (cont. of Colles’)
  3. Deep Penile Fascia (Buck’s)
  4. Tunica Albuginea (cavernous bodies only)
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5
Q

What tissue layer do the deep arteries of the penis travel within?

A
  • R and L corpora cavernosa
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6
Q

What artery supplies the corpus spongiosum and distal urethra?

A
  • artery to the bulb
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7
Q

Between what layers can the DORSAL arteries of the penis be found?

A

Superfically - Buck’s Fascia
Deep - Tunica albuginea

  • on dorsal side of the penis
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8
Q

What supplies the skin and subcutaneous tissue of the penis?

A

Dorsal arteries of the penis

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9
Q

What arterial supply is responsible for erection?

A

Deep arteries of the penis

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10
Q

Which penile arteries would be affected by a clot in the internal pudendal a.?

A
  • Deep arteries of penis (erection)
  • Dorsal arteries of the penis (skin and fascia_
  • artery to the bulb
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11
Q

What fascial layer separates the superficial and deep veins of the penis, where do these veins drain?

A
  • Buck’s fascia separates them

- Drain to internal pudenal v.

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12
Q

Where are the superficial and deep veins of the penis located?

A
  • on the dorsal surface in the midline
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13
Q

What provides sensory innervation to the penis?

A

Dorsal nerve of the penis

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14
Q

What supporting ligament of the penis is derived from the linea alba?
- Describe its course.

A

Fundiform ligament of the Penis

- loops around the base of the shaft

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15
Q

What supporting ligament of the penis attaches to the symphysis pubis?

A

Suspensory ligament of the Penis

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16
Q

Besides the fundiform and suspensory ligaments, what else provides support for the penis?

A

Root of the penis

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17
Q

What are the contents of the spermatic cord?

A
  1. Vas Deferens
  2. Testicular a.
  3. Pampiniform plexus
  4. Cremaster m.
  5. Genital branch of genitofemoral
  6. Artery to the vas deferens
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18
Q

What are the fascial layers of the spermatic cord?

A

Extenal Spermatic fascia

  1. External spermatic fascia (ext. ab. obl.)
  2. Cremaster and middle fascia (int. ab. obl.)
  3. Internal Spermatic fascia (Transversus)
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19
Q

What is the tunica vaginalis and what is it derived from?

A
  • Remnant of Processus vaginalis
  • covers sides and anterior aspect of the tesiis
  • derived from Peritoneum
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20
Q

What this CT capsule surrounds the seminiferous tubules?

A
  • tunica albuginea
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21
Q

Where is the epididymus located and what are enters into and exits it?

A
  • located on the posterolateral aspect of the testis (has a head, body and tail)
Entering = semiferous tubules
Exiting = Vas Deferens
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22
Q

What supplies blood to the scrotum?

A

Perineal branch of the internal pudendal a.

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23
Q

What provides sensory innervation to the scrotum?

A
  1. Ilioinguinal n.
  2. genital branch of genitofemoral
  3. posterior n. of scrotum (from perineal)
  4. posterior cutaneous n. of the thigh
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24
Q

What vessels in the scrotum can become dialated and painful, what is this called, what is the cause?

A
  • Pampinaform vessels
  • Variocele

Cause:

  • Defective valves in veins of plexus
  • compression of testicular (gonadal) vein in abdomin
  • Could be caused by Nutcracker syndrome (LEFT SIDE ONLY)
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25
Q

What is the rounded hair bearing elevation of skin anterior to the pubis?

A

mons pubis

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26
Q

What extends posteriorly from the mons pubis and units at the midline?

A

Labia Majora

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27
Q

What do the labia minora form anteriorly by uniting?

A
  • Prepuce

- Frenulum

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28
Q

What do the labia minora form posteriorly by uniting?

A
  • fourchette
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29
Q

What is the vestibule of the vagina?

A

-Smooth area bounded by the labia minor

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30
Q

What glands are found in the vestibule of the vagina, what do they do?

A
  • Greater Vestibular Glands

- responsible for mucous secretion in response to sexual excitation

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31
Q

What are the two parts of the clitoris?

A
  • Body of the Clitoris

- Glans of the Clitoris

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32
Q

How is the clitoris similar to the penis?

A
  • has L and R corpura cavernosa

- does NOT have a corpus spongiosum

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33
Q

What caps the clitoris?

A

The glans of the clitorus

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34
Q

What arteries are responsible for erection of the female clitoris and what do they travel through?

A

Deep arteries of the clitoris

- L and R corpura cavernosa

35
Q

What artery supplies the bulb of the vestibule in females?

A

Artery to the bulb

36
Q

What artery supplies the skin and subcutaneous tissues of the clitoris?

A

dorsal arteries of the clitoris

37
Q

What drains blood from the clitoris to the internal pudendal v.?

A

Superficial and deep veins of the clitoris

38
Q

What is responsible for sensory innervation to the clitoris?

A

Dorsal nerve of the Clitoris

39
Q

What supplies blood to the labia?

A
  • Branches of the internal pudendal a. and external pudendal branches of femoral a.
40
Q

What provides sensory innervation of the labia?

A
  • ilioinguinal n.
  • genital branch of the genitofemoral
  • Posterior labial n. (from perineal n.
  • Posterior cutaneous n. of thigh
41
Q

What are the contents of the superficial space?

A
  1. External Genitalia
  2. Roots of Genitalia
  3. 3 skeletal muscles
  4. Perineal n. a. v.
  5. Perineal Body
  6. Distal Urethra and External Urethral Orifice
  7. Low part of vag. and external vag. orifice
  8. Greater Vestibular Glands
42
Q

T or F: the components of the root of the penis are attached to the perineal membrane.

A

True

43
Q

What are the L and R crura continuous with?

A

Corpora cavernosa

44
Q

What makes up the root of the penis?

A
  • L and R crura

- Bulb of the penis

45
Q

What part of the shaft is the bulb of the penis continuous with?

A
  • The corpus spongiosum
46
Q

What is the attachment point of the crura and bulb of the penis?

A
  • Crura - Pubic arch and perineal membrane

- Bulb of the Penis - perineal membrane

47
Q

What are the 3 muscles of the superficial compartment and what is their innervation?

A
  • ALL innervated by the Perineal branch of the Pudendal N.
  1. Bulbospongiosus
  2. Ischiocavernosus
  3. Superficial Transverse Perineal Muscle
48
Q

What muscle extends from the perineal body and covers the bulb of the penis and posterior portion of the corpus spongiosum?

A

Bulbospongiosus muscle

49
Q

What muscle arises from the isciopubic rami and covers the crus of the penis on each side?

A

Ischiocavernosus muscle

50
Q

What muscle arises from the ischial tuberosity and inserts into the perineal body?

A

Superficial Transverse Perineal Muscle

51
Q

What are the functions of the Bulbospongiosus muscle?

A
  1. Compress penile part of urethra to empty residual fluids
  2. Anterior fibers compress deep dorsal vein and impede venous drainage (help maintain erection)
  3. Reflex contraction responsible for pulsatile release of semen
52
Q

What are the functions of the ischiocavernosus muscles?

A
  • to compress the crus of the penis forcing blood into the body of the penis
53
Q

What is the function of the superficial Transverse Perineal Muscle?

A
  • To keep the perineal body centered

- NOT ASSOCIATED WITH THE ROOT OF THE PENIS

54
Q

What structure in the female is analogous the the bulb of the penis?

A
  • The bulb of the vestibule

* Note that its divided into halves due to the vaginal canal

55
Q

T or F: the crura give rise to the glans of the clitoris

A

False, the bulb of the vestibule does

56
Q

Where are the Greater Vestibular Glands (Bartholin’s) located and what is their function?

A
  • Posterior to each bulb

- lubricate the vulva during sexual excitation

57
Q

What is the male homologue of the Bartholin’s glands and where can they be found?

A
  • Cowper’s glands

- located in the DEEP layer

58
Q

What are the 3 muscles of the superficial compartment in the female and what is their innervation?

A
  • ALL innervated by the perineal branch of the pudendal n.
  1. Bulbospongiosum
  2. ischiocavernosus
  3. Superficial Transverse Perineal Muscle
59
Q

Describe the distribution and function of the bulbospongiosum in the female.

A
  • Surrounds Vaginal Orifice and covers vestibular bulbs

Attachments
Anteriorly: corpora cavernosa
Posteriorly: Perineal body

  • Reduces size of the vaginal orifice and compresses the deep dorsal vein allowing for maintenance of erection
60
Q

What is the distribution of the ischiocavernosus muscle and what is its function in the female?

A
  • arises from ischiopubic ramus and covers crus of clitoris

- maintains erection by compressing the crus of the clitoris

61
Q

What could be the result of a weak perineal body in a female?

A

Prolapse

62
Q

Describe the course of the perineal n.

A
  • Through posterior margin of the Colles’ fascia superficial (inferior) to the UG diaphragm on the surface of the perineal membrane
63
Q

What nerve supplies most of the sensory innervation to the scrotum/labia, bulb of penis/vestibule and urethra.

A

Perineal n.

64
Q

What other structure runs its course with the perineal n.?

A

The perineal a.

65
Q

What are the contents of the deep space?

A
  1. External Sphincter Urethrae Muscle
  2. Deep transverse perineal muscle
  3. Urethra - membranous pt.
  4. Dorsal n. of the clitori/penis
  5. 4 Arteries
  6. Vagina
  7. Cowper’s Glands
66
Q

What 4 arteries are found in the deep space?

A
  1. Artery to the Bulb of the Penis
  2. Artery to the Urethra
  3. Deep Artery of the Clitoris/Penis
  4. Dorsal Artery of the Clitoris/Penis
67
Q

What muscle surrounds the urethra in the deep perineal space and what is its job?

A
  • External Urethral Muscle

- Compresses the membranous part of the urethra and relaxes during micturation

68
Q

Would your external sphincter urethrae muscle be affected if the perineal n. was damaged.

A

Yes, perineal n. supplies all 5 muscles in the perineal region

69
Q

What muscles make up the UG diaphragm?

A
  • External Sphincter urethrae muscle

- Deep Transverse Perineal muscle

70
Q

What is the attachment and innervation of the deep transverse perineal muscle?

A
  • attaches to the perineal body and ischial ramus

- innervated by perineal

71
Q

Describe the position and job of the dorsal n. of the clitoris/penis.

A
  • Deep Compartment

- Sensory innevation to glans of clitoris/penis

72
Q

Which artery is responsible for erection?

A

Deep artery of the Penis/Clitoris

73
Q

What nerves are responsible for erection?

A

Both men and women
Parasympathetic nn.
Preganglionic: Pelvic Splanchnics S2-S4
Postganglionic: nn. exiting hypogastric plexus

74
Q

What drives emission?

A

Men only
- Sympathetic Response by Lumar Splanchnics

Note: emission = loading of fluids into urethra

75
Q

What drive ejaculation?

A

Somatic and Sympathetic
Somatic = Bulbospongiosus => Pudendal n.
Sympatheic= L1-L2 splanchnic nn.

76
Q

Where is pain blocked by Regional anesthesia administered at L3/L4?
- Disadvantages?

A
  • Completely numb from the waist down

Disadvantages:
- Legs are paralyzed so mom can’t walk or push out the baby

**Think about what nerves are being blocked

77
Q

Where is a caudal epidural block administered?

  • Advantages?
  • Disadvantages?
A

-Given at S2-S4 region

Advantage:

  • Lower limbs aren’t effected
  • mom can help in pushing

Disadvantage:
- She can still kind of feel the uterine contractions

78
Q

Where is a pudendal nerve block administered?

  • Advantages?
  • Disadvantages?
A
  • Given where the pudendal nerve crosses the lateral aspect of the sacrospinous ligament near the ischial spine
  • Fingers inserted to vagina to palpate the ischial spine, needle is inserted medial to this

Advantages:
Being able to walk and aid in pushing

Disadvantages:
All feeling is not blocked and uterine contractions can still be felt

79
Q

What additional nerve block would need to be performed to block sensation to the rest of the perineum?

A

Ilioinguinal nerve block would be needed because this innervates the superior perineum

80
Q

What structure has different lymphatic draining relative to the rest of the perineum?

A

Testes - drain to the aortic lumbar nodes

81
Q

What do the deep inguinal nodes drain?

A
  • Glans Penis
  • Glans Clit
  • Labia minora
  • Vagina
82
Q

What do the superficial inguinal node drain?

A
  • superficial tissues of the penis
    /clit
  • Scrotum
  • Labia majora
83
Q

GO BACK AND REIVEW SLIDES 18-21 on this lect.

A

GO BACK AND REIVEW SLIDES 18-21 on this lect.

Anatomy Week 11 (3 decks)

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