Perineum, Pouches, Penis, Urethra, Vulva Flashcards
How do you orientate the Pelvis into anatomical position?
The Anterior Superior Iliac Spine and Pubic Tubercle should lie along the same Coronal Plane
What are the 2 parts of the Perineum?
- Urogenital Triangle
2. Anal Triangle
What separates the Perineum into the Urogenital and Anal triangles?
A horizontal line joining the 2 Ischial Tuberosities
What are the layers of the Urogenital Triangle from superficial to deep?
- Skin
- Superficial layer of Superficial Perineal Fascia (Continuous with Camper’s Fascia)
- Colles’ Fascia (Continuous with Scarpa’s Fascia)
- Superficial Perineal Pouch
- Perineal Membrane
- Deep Perineal Pouch
What are the layers of the Urogenital Diaphragm?
Superior/Deep–> Thin layer of Pelvic Fascia
Middle Layer–> Deep Perineal Pouch
Inferior/Superficial–> Perineal Membrane
What is in the Deep Perineal Pouch?
- Muscles
- Pudendal Nerve (S2-4)
- Internal Pudendal Artery
- Bulbourethral Glands (of Cowper) in Males
What muscles are in the Deep Perineal Pouch in Males?
- External Urethral Sphincter
2. Deep Transverse Perinei
What muscles are in the Deep Perineal Pouch in the Female?
- External Urethral Sphincter
- Deep Transverse Perinei
- Sphicter Urethrovaginalis
What is the Perineal Body?
The Central Perineal Tendon–> Fibromuscular node at the junction of urogenital and anal triangles
What muscles are attached to the Perineal Body?
- Levator Ani
- External Anal Sphincter
- Sphincter Urethrae
When can the Perineal body be damaged?
- Childbirth
2. Trauma
What could happen if the Perineal Body is damaged?
Incontinence and Prolapse
What is the part where the scrotum is fused together called?
Raphe
What are the parts of the Penis?
- Corona of Glans
- Neck of Glams
- Prepuce
- Glans Penis
- External Urethral Orifice
- Frenulum of Glans
Which part of the penis is removed in circumcision?
Prepuce
Which part of the Penis joins with the Raphe from the outer skin?
Frenulum of Glans
What is in the Superficial Perineal Pouch in Males?
- Roots of the External Genitalia
- Erectile Tissue
- Muscles of the External Genitalia
What are the Roots of the External Genitalia?
Bulb and Crus
What are the Erectile Tissue and where do they come from?
Corpus Spongiosum–> Bulb
Corpus Cavernosum–> Crus
What are the muscles of the male external genitalia?
- Bulbospongiosus from Bulb
2. Ischiocavernosus from Crus
What are the ligaments supporting the Penis?
- Fundiform ligament of the penis
2. Suspensory ligament of penis
Where is the Fundiform ligament of the Penis attached?
Linea Alba–> hooks down like a sling around the penis and attaches back up to the Pubic Symphysis
Where is the Suspensory Ligament of the Penis attached to?
Pubic Symphysis
What is the Fascia covering the erectile tissue of the penis?
Buck’s Fascia
What is the blood supply to the Penis?
From the Internal Pudendal Artery:
- Artery of Bulb to Corpus Spongiosum
- Deep Penile Artery to Corpora Cavernosa
- Dorsal Penile Artery to Skin and Glans
What is the Venous Drainage of the Penis?
Deep Dorsal Vein to the Prostatic Plexus of Veins to the Internal Pudendal Vein
What is the Lymphatic drainage of the skin of penis and scrotum?
Superficial Inguinal Nodes
What is the Lymphatic Drainage of Glans Penis?
Deep Inguinal Nodes
What is the Lymphatic Drainage to Corpora and Penile Urethra?
Internal Iliac Nodes
What is the Lymphatic Drainage of the Testes?
Para-aortic -Lumbar nodes
What is the nerve supply to the External Genitalia of the Male?
Pudendal Nerve to give Deep Perineal Nerve to the Dorsal Nerve of Penis and Superficial Perineal Nerves to the Posterior Scrotal Nerves
What are the 4 parts of the Urethra in the male?
- Preprostatic part
- Prostatic part
- Membranous Part
- Spongy part
How long is the Urethra in males?
14cm
What are the features of the membranous part of the male urethra?
- 1cm
- Passes through the Deep Perineal Pouch
- External Urethral Sphincter is here
- Cowper’s glands lie to either side
What are the features of the Spongy part of the male urethra?
- 10cm long
- Passes into the bulb of penis, into the corpus spongiosum, through the Navicular Fossa and out the External Urethral Meatus
- Mostly lined with Transitional Epithelium
- Squamous Epithelium just inside external meatus
What are parts of the Female Vulva?
- Mons Pubis
- Prepuce of Clitoris
- Glans Clitoris
- Lateral and Medial folds of Labia Minora
- Labia Majora
- Vestibule
- Hymen
- Frenulum
- Fourchette
- Bartholin’s Glands
What is in the Superficial Perineal Pouch of the Female?
- Ischiocavernosus
- Bulbospongiosus
- Superficial Transverse Perineal Muscle
- Greater Vestibular Gland
- Bulb of Vestibule
- Glans Clitoris
What is the Lymphatic Drainage of the skin of Labia?
Superficial Inguinal Nodes
What is the Lymphatic Drainage of the Clitoris?
- Deep Inguinal Nodes
2. Internal Iliac Nodes
What is the nerve supply to the female reproductive system?
- Dorsal Nerve of Clitoris
- Posterior Labial Nerve
- Perineal Nerve
- Pudendal Nerve
How long is the Urethra in the Female?
Usually 4cm, may extend up to 10cm long in childbirth
What is an Episiotomy?
Making a posterolateral incision in the perineum at the time of childbirth
Why are Episiotomies used?
- Prevent a perineal tear or excess stretching of the muscles
- Protect the Foetus if delivery is slow or if in distress
- Prevent damage if abnormal presentation