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Fall-Anatomy Year 1 > Perineum Male and Female > Flashcards

Perineum Male and Female Flashcards

1
Q

perineum boundaries

general

A

pubic symphisis
R and L IT’s
coccyx

diamond shape
divide in half for urogenital triangle and anal triangle

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2
Q

anal canal

A

pectinate line where endo and exoderm meet
-above line = endoderm feel stretch, pressure
-below line = exoderm, feel pain

anorectal juction in ampulla

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3
Q

anal sphincters

A

internal = involuntary
external = voluntary

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4
Q

external sphincter divisions

A

subcutaneous
superficial
deep (continuos w/ levator ani)

inn: inferior rectal N

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5
Q

levator ani

A

muscle that holds pelvic bowl contents in place

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6
Q

ishioanal fossa

A

fat filled triangle for packing levator ani in place

bound by levator ani (medial) + obturator internus (lateral) + skin (inferior)

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7
Q

pudendal canal

aka Alcock’s

A

contains pudendal nerve + internal pudendal artery + internal pudendal vein

aka nerve of shame

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8
Q

scrotum

A

testes
epididymsis
part of spermatic cord

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9
Q

penis -root

A

physically attached to body

has bulb w/ R and L crus on either side, all erectile tissue

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10
Q

penis - body

A

continuation from root
1. corpus spongiosum- from bulb, has urethra, expands to glans
2. corpora cavernosa- from R and L crura, bounded by deep penile fascia

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11
Q

internal urethral sphincter

A

distal side of bladder/proximal side of prostate aka b/t bladder and prostate

prevents retrograde ejaculation aka no semen in the bladder

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12
Q

anal canal arteries

A

collateral circulation from hindgut and internal iliac arteries

middle and inferior rectal a.s (from internal iliac) anastomose w/ superior rectal from IMA

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13
Q

anal canal veins

A

inferior mesenteric vein and superior rectal > hepatic portal

middle rectal and inferior rectal > IVC

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14
Q

prostatic plexus

A

parasympathetic nerves S2-4
somatic also

surrounds prostate
responsible for erection

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15
Q

superficial perineal pouch

both

A
  1. bulbospongiosus (covers bulb)
    -tightens to keep blood in erect
    -cleans urethra before and during ejaculation
    -can weakly contract vagina
  2. ischiocavernosus (covers crura)
    -keep blood in during erection
  3. perineal body - CT that holds entire perineum together
    -shorter b/t vagina and anus for females
  4. superficial transverse perineals- keep pelvic floor taught

all innervated by nerineal nerve from pudendal

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16
Q

perineal nerve

both

A

from pudendal

motor to:
bulbospongiosus
ischiocavernosus
levator ani
superficial and deep transverse perineal
external urethral sphincter

sensory to:
posterior skin of scrotum OR
skin of labia majora/minora

17
Q

deep pouch

male

A
  1. membranous/intermediate urethra
    (shortest of the 3 parts)
  2. external urethral sphincter/sphincter urethrae @ below prostate
  3. bulbourethral/cowpers glands- cleans urethra of residues, duct to penile urethra
18
Q

deep pouch innervation

both

A

dorsal nerve of penis or clitoris

sensory:
skin of penis or clitoris
responsible for sensory orgasm

sensory is the main type for females

19
Q

deep pouch blood supply

A

from internal pudendal artery

  1. dorsal a. of penis to corpus spongiosum
  2. deep a. of penis to corpora cavernosa

need both for full erection but mainly deep A

same for female just clitoris

20
Q

erection steps

A
  1. parasympathetic stimulation by cavernous nerves (S2-4) shuts down anastomoses
  2. smooth muscle in coiled arteries relaxes > helicine arteries straighten = cavernous sinuses fill w/ blood
  3. bulbospongiosus and ischiocavernosus contract = block off deep dorsal vein so sinuses can’t drain, somatic
21
Q

emission steps

A
  1. semen delivered to prostatic urethra thru ejaculatory ducts and seminal vesicles, prostatic fluid added

sympathetic response aka L1-2

22
Q

ejaculation steps

A
  1. internal urethral sphincter closes so no retrograde ejaculation sympathetic L1-2
  2. urethral muscle contracts parasymp S2-4
  3. bulbospongiosus muscles contract somatic S2-4
23
Q

remission steps

A
  1. penis return to flacid state from sympathetic resp = constriction of smooth muscle in helicine arteries
  2. bulbospongiosus and ischiocavernosus relax = blood drains back into deep dorsal vein somatic
24
Q

erection process

general

A
  1. erection
  2. emission
  3. ejaculation
  4. remission
25
Q

prostate surgery

clinical correlate

A

damage to prostatic plexus (leads to cavernous nerves of penis aka resp for erection) so impotence

treat w/ prosthesis semirigid or inflatable NOT viagra bc problem is not arterial

26
Q

UG triangle

female

A

aka vulva
prepuce covers clitoris
frenulum
labium majus and minus
vestibule aka vagina

27
Q

clitoris

A

R and L crus/crura w/ erectile tissue > body > glans
bulb of vestibule of erectile tissue to maintain clitoral erection

no corpus spongiosum, bulb instead

28
Q

superficial pouch

female

A

crus
bulb of the vestibule
paraurethral gland/lesser vestibular- prostate in men, no specific known function in female but maybe g spot?

greater vestibular gland- lubricate vaginal opening

29
Q

deep pouch

female

A

urethra
sphincter urethrae/external
vagina
perineal membrane over deep transverse perineal muscle

females have internal sphincter but weaker than male and doesn’t usually work

30
Q

dorsal nerve of clitoris

clinical correlate

A

cut or damanged w/
episiotomy, cancer removal, labioplasty

no orgasms

31
Q

perineal body damage

A

uterine prolapse
childbirth- if baby head/shoulders too big then tear or destroy

why?? bc multiple muscles attachment point

32
Q

uterine prolapse types

A

1st degree- slight descent, uterus just slips down
2nd degree- cervix at entrance of vagina
4th degree- complete prolapse, exit the body, no control over urinary bladder

33
Q

prolapse treatments

A
  1. PT is best to strengthen muscles
  2. gellhorn pessary, only temporary, holds uterus up, can be removed to clean
  3. surgery to hold up uterus if no more kids
34
Q

episiotomy

A

only done if
1. baby’s shoulder is stuck behind pelvic bone (shoulder dystocia)
2. baby has abnormal heart rate in delivery
3. operative vaginal delivery w/ forceps or vacuum

either midline or mediolateral incision

doesn’t actually prevent tearing but does heal cleaner

35
Q

chronic perineal injury

males

A

from bicycle seats, motorcycles, horse back riding, constipation =

urinary incontinence, bowel incontinence, ED

can also be acute from trauma

36
Q

pelvis and perineum SOMATICS

both-sensory

A

-voluntary control SOMATICS
-pudendal nerve S2-4
-external sphincters prevent leakage w/ stress, strain, sleep
-tonically active so inhibition = relax

-sensory from external anal and urethral sphincters, pelvic floor muscles, anal canal, urethra aka will let you know when bladder infection

37
Q

pelvis and perineum SYMPATHETICS

both-sensory

A

involuntary
T11-L2
-contract internal anal sphincter and urethral for males
-contract ductus deferens, seminal vesicles, prostatic muslces during emission and remission
-poorly localized sensory but most sensitive to distension

38
Q

pelvis and perineum PARASYMPATHETICS

both-sensory

A

-involuntary
-S2-4 (same as somatic)
-smooth muscle in organ walls
-begins erection to relax helicine arteries
-contract urethral muscle during ejaculation
-contracts detrusor/bladder and rectal muscles
-conveys normal sensation of bladder and rectal distension

Fall-Anatomy Year 1 (17 decks)

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