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Anatomy > Perineum & Surface Anatomy > Flashcards

Perineum & Surface Anatomy Flashcards

1
Q

what shape do the pelvic outlet and perineum make?

A

Diamond Shape

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2
Q

Where is the Perineum located?

A

Below the pelvic outlet (pelvic diaphragm)

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3
Q

The Perineum diamond shape is divided into 2 triangles called…

A
  • Urogential Triangle

- Anal Triangle

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4
Q

Urogenital Triangle

A

Opening for Urinary and reproductive systems

urethra and vagina

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5
Q

Anal Triangle

A

Opening for GI system

anus

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6
Q

Are the Urogenital and Anal triangles on the same plane?

A

NO- urogenital is more horizontal in the anatomical position and the anal triangle is more on a posterior oblique direction

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7
Q

What are the borders of the perineum

A

Anteriorly: Pubic symphysis
Laterally: Coccyx
Posteriorly: Iscial Tuberosity

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8
Q

What divides the ischial tuberosities between the triangles

A

Imaginary line between ischial tuberosities divide the triangles

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9
Q

Because the pelvic diaphragm is curved over the pelvic outlet, but the perineal membrane and ligaments run across at straight planes…what is formed?

A
  • Ischio-anal fossae

- Recesses

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10
Q

What fills the

  • Ischio-anal fossae
  • Recesses
A

fat but infections can form too

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11
Q

Ischio-anal fossae

A

larger space on the posterior side where anal opening is
-Space is filled with fat because as fecal material moves down, you want fat so it can easily be pushed out instead of having bone/ligaments there

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12
Q

Recesses

A

Small anterior recess going to the urogenital triangle- filled with fat
-Alot smaller than anal triangle

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13
Q

Perineal Body

A
  • Connective tissue which serves as an important attachment point for muscles in the pelvic floor and perineum
  • Between perineal membrane and external anal sphincter
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14
Q

Perineal Membrane

A

-Associated with Urogential Triangle ONLY in the front
-Thick connective tissue attached to ischiopubic rami
-erectile tissue anchor here
-has opening for urethra and vagina
-

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15
Q

what seperates the deep and superficial perineal pouches?

A

Perineal membrane

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16
Q

Borders of Anal Triangle

A

“line” between ischial tuberosities, cocyx, and sacrotuberous ligaments

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17
Q

Muscular Content on anal triangle

A

External anal sphincter

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18
Q

What is external anal sphincter innervated by

A

Pudenendal Nerve (inferior rectal branch)

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19
Q

What surrounds anal opening

A

The fat of the ischio-anal fossa

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20
Q

What is in the anal triangle?

A
  • Anal Opening
  • External anal aphincter (voluntary sphincter)
  • The rest is full with fat
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21
Q

Perineal pouch borders

A
  • Pubic Symphasis

- “line” from ischiial tuberosities, pubic rami

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22
Q

Location of deep pouch

A

Between pelvic diaphragm and perineal membrane

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23
Q

Describe Deep Pouch in Males

A
  • Muscles (deep transverse perineal, external urethral sphincter)
  • Membranous Urethra
  • Cowper’s glands (bulbo-urethral glands)
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24
Q

Describe Deep Pouch in Females

A
  • Muscles (deep transverse perineal, external urethral sphincter)
  • Urethra
  • Vagina
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25
Q

Superficial Pouch Location

A

Between perineal membrane and superficial fascia of the perineum

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26
Q

Describe Superficial Pouch in Males

A
  • Muscles (ischiocavernous and bulbospongiosus, Superficial transverse perineal muscle)
  • Erectile Tissue: Crura and bulb of penis (root)
  • Part of spongy urethra
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27
Q

Describe Superficial Pouch in females

A
  • Muscles (ischiocavernous and bulbospongiosus, superficial transverse perineal muscle)
  • Erectile tissue: Crura and bulbs of clitoris
  • Bartholin’s Glands (greater vestibular glands)
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28
Q

Muscles of Urogenital Diaphragm

A
  • Deep Transverse Perineal Muscle

- External Urethral Sphincter

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29
Q

Deep Transverse Perineal Muscle

A

Together the pair spans distance between ischial rami; in females, lies posterior to vagina

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30
Q

Origin and insertion of Deep Transverse Perineal Muscle

A

O- Ischial Rami

I- Midline central tendon of perineum; some fibers into vaginal wall in females

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31
Q

Action of Deep Transverse Perineal Muscle

A

Supports Pelvic Organs; steadies central tendon

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32
Q

Deep Transverse Perineal Muscle nerve supply

A

Pudendal Nerve

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33
Q

External Urethral Sphincter description

A

Muscle encircling urethra and vagina (in females)

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34
Q

External Urethral Sphincter Origin and Insertion

A

O-Ischiopubic Rami

I-Midline raphe

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35
Q

External Urethral Sphincter Action

A

Constricts Urethra; allows voluntary inhibition of urination; helps support pelvic organs

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36
Q

External Urethral Sphincter nerve supply

A

Pudendal Nerve

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37
Q

What tissues is erectile tissue composed of?

A
  • Corpora Cavernosa

- Corpus Spongiosum

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38
Q

What structures does Corpus Spongiosum make?

A
  • Glands of penis

- Shaft arounf Urethra on the ventral side

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39
Q

What is the shaft also composed of?

A

2 columns of corpus cavernosum (dorsal)

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40
Q

Dorsal VS Ventral Orientation

A

(anatomical position-Erect penis)

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41
Q

What is the root attachment of penis

A

stuff attached to perineum membrane

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42
Q

What are the the root attachments of the penis

A

-Crura of Penis attached to ischiopubic ramis and perineal membrane and they continue distally and to shaft of penis and they are composed of corpora cavernosa (going to be on dorsal side of shaft of penis)

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43
Q

Corpous spongiosum makes the __

A

Bulb of penis (part that attaaches to perineal membrane) and continues to shaft as one column of corpus spongiosum tissue and it also makes up the glans penis

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44
Q

Urethra passes thru… and goes out the…

A

Urethra passes thru corpus spongiosum and goes out at gland as external urethral opening

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45
Q

Lubricating glands is deep to…

A

perineal membrane (not in bulb, on deep side of perineum membrane)

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46
Q

What makes up root of penis?

A
  • bulb-attached to perineal membrane

- Cura

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47
Q

Erection occurs when…

A

Parasympathetic Signals dilate specific vessels to allow corpura cavernosa to fill with blood

48
Q

Erectile tissue is composed of what set of tissues

A
  • Corpora Cavernosa

- Corpus Spongiosum (bulbs of the vestibule in females)

49
Q

Clitoris parts

A
  • Glans-Open in the perineum
  • Clitoris Body-superiorly
  • Crus
  • Bulbs
50
Q

Do females have a single bulb or 2?

A

No singular bulb because vaginal opening in midline- so bulb is split in 2. made up of same tissue as in male (called bulbs of vestibule)

51
Q

Another name for Bartholin’s Glands

A

Greater Vestibular Glands

52
Q

Bartholin’s Glands

A

Glands on posterior-lateral side of vaginal opening

-Secrete lubrication

53
Q

What are Bartholin’s Glands homologous to in men?

A

Bulbourethral Glands

54
Q

Difference between erectile tissue in men and women

A

-precursoer tissue of male erectile tissue is similar to female erectile tissue but testosterone makes the male erectile tissue bigger.

55
Q

Can Bartholin’s Glands be infected?

A

Yes-Glands can be infected and enlarge- its on the bottom side of vaginal opening

56
Q

Muscles in Superficial Perineal Pouch

A
  • Ischiocavernosus
  • Bulbospongiosus
  • Superficial transverse perineal
57
Q

Ischiocavernosus- Position and Function

A
  • Run over crus of erectile tissue near pubic rami

- Function: help direct blood into erctile tissue

58
Q

Bulbospongiosus-Position and Function

A
  • From perineal body around vaginal opening and clitoris in women and bulb of the penis in men
  • Function: blood flow direction and responsible for pulsatile ejaculation in men and clearing urine from urethra after urination
59
Q

Bulbospongiosus difference in male and female

A

Muscles that sits over bulband spongy tissue- in men its 2 muscles coming together at midline, in female they don’t go to midline, they surround the bulb of vestibule

-Much more developed in male perineum but very thin in females

60
Q

Superficial transverse perineal Position and Function

A
  • On posterior side of perineal membrane
  • 2 muscles coming togehr, When attached together, have a stornger function then when they are not
  • Function: Support perineal body
61
Q

The Urethra extends from the base of the bladder to the…

A

External opening

62
Q

Urethra in Women

A
  • Short
  • Passes through pelvic floor
  • Has internal and external urethral sphincters
  • Urinary function only
63
Q

Urethra in Men

A

-longer, bends 2x, passes through erectile tissue (corpus spongiosum)

64
Q

Male Urethra Labeled

A
  • Pre-prostatic
  • Prostatic
  • Membranous
  • Penile (spongy)
65
Q

-Pre-prostatic part of Urethra

A

Has INTERNAL URETHRAL SPHINCTER which is smooth muscle

-Passes thru bladder before entering prostate

66
Q

-Prostatic Urethra

A

Passes through the prostate, enterance of reproductive system
-Where Urethra joins reproductive system, and ejaculate enters urethra

67
Q

Membranous Urethra

A

Contains EXTERNAL URETHRAL SPHINCTER: skeletal muscle voluntary control

68
Q

Association of Urethra and erectile tissue in males and females

A

In females: urethra is not associated w/ erectile tissue, just opens up in perineum- doesn’t go thru erectile tisssue

In males: urethra is associated w/ erectile tissue. It DOES goes thru erectile tissue, goes thru column made up of corpus spongeosum tissue (called spongy/ penile urethra)

69
Q

Urinary catheter in males and females

A

easy in females since it is short but in men have to consider that the bends, and in older men- the prostate, and then into the bladder, but the first bend- you can unfold the hanging penis; bbut the second bend you cant and if too forceful cause injusy to root

70
Q

The bladder is innervated by…

A

Sensory nerves that sense stretch

71
Q

Bladder wall contains a layer of…

A

Detrusor Muscle

72
Q

Detrusor Muscle

A

-activated by the parasympathetic nervous system to contract and expel urine

  • when it squeezes, pushes on bladder causing it to
    Same thing: sympathetic would relax muscle and para could contract muscle to squeeze it for urine to exit
73
Q

Effect of PNS on Internal sphincter

A

PNS relaxes the internal sphincter and contracts detrusor muscle

74
Q

Effect of SNS on internal sphincter

A

SNS inhibits urination: relaxes detrusor muscle and contracts internal sphincter

75
Q

Describe urinary reflex we have as babies

A

As babies- we only have reflex control of urine so as we get bigger, we can control external so we can urinate when appropriate

76
Q

Vulva

A

Female external genitalia

77
Q

Labia Majora

A

Surrounds labia minora and forms mons pubis anteriorly, posteriorly labia are seperated by posterior commissue (over the perineal body)

-came from same precursor tissue as scrotum in males and with testosterone- precursor tissue instead of forming 2 separate tissues, it forms 1 tissue (becoming the scrotum)

78
Q

Labia Minora

A

Tissue fold forming frenulum and hood (prepuce) of the cliitoris anteriorly. The body of the clitoris is found under the prepuce

79
Q

Inside the labia minora is the…

A

Vestibule

80
Q

Vestibule

A

Opening for vagina (covered by hymen) and urethra (anterior to vagina)

81
Q

Where do Labia Majoras connect in the front and the back

A
  • Labias majora come together in the front and back
    • In the front, come together: near mons pubis
  • in the back, come together: by where perineal body is (called posterior commissure)
82
Q

Where do Labia Minoras connect in the front and the back

A
  • Labia minora also meet anteriorly and posteriorly
    • In the front, come together: covering of clit (part of erectile tissue that can be seen externally in women- just the head)
    • *foreskin of slit is same as foreskin in men but just a lot smaller
    • in the back, come together: Foresha. L
83
Q

Speculum Exam

A

Into vag canal and see bottom of uterus and cervix on external surface

84
Q

Labia minora surrounds…

A

Labia minora -surrounds vestibule, vestibule contains opening for urethra, externeal urethral opening, and opening of vagina (entroitus)

85
Q

What can the Vagina opening be covered by

A

Vag opening can be covered by hymen (remnant tissue from embryological development where 2 tubes merged, purpose- no purpose)

86
Q

Scrotum has a midline embryonic fusion called…

A

Raphe- runs from anus to penis

87
Q

Parts of the Penis

A
  • Root
  • Body
  • Glans
  • External urethral Orifice
88
Q

Root of penis

A

attachment to perineal membrane: crura and bulb

89
Q

Body of penis

A

Shaft

90
Q

Glans of Penis

A

Head, covered by prepuce (foreskin-removed during circumcision)

91
Q

External urethral orifice of penis

A

for opening of urethra

92
Q

Superficial fascia of the UG triangle is continuous with…

A

Superficial fascia of the anterior abdominal wall

93
Q

Deeper Membranous layer (scarpas fascia) continues as…

A

Colles’ Fascia in the perineum

94
Q

Colles’ Fascia in the perineum defines…

A

Superficial border of superficial perineal pouch

95
Q

Colles’ Fascia ends at…

A

Fascia lata of the thigh and also does NOT continue into the anal triangle

96
Q

Smooth Muscle rich area covering scrotum/labia majora is…

A

Dartos Fascia- Wrinkling of scrotum

97
Q

Superficial layer of superficial fascia continues over the…

A

thigh

98
Q

What is superficial fascia

A

The Fascia underneath the skin before you get to organs or anything else

99
Q

In the abdomen below the umbilicus- there are 2 layers of superficial fascia called…

A
  • Campers Fascia

- Scarpus Fascia

100
Q

What does Dartos Fascia do

A

Controls thermoregulation like cremaster ligament, dartos doess same thing but more under autonomic control

101
Q

What happens where theres Urethral trauma/ urine leakage

A

there is urine leakage , urine collects deep to superficial fascia and doesn’t go to thigh or inguinal triangle- just around perineum could go up to umbilicus but not higher than there since that’s where that fascia ends

102
Q

Pudendal Nerve

A

Somatic (motor and sensory) innervation from S2-4

103
Q

Pudendal Nerve course

A

Exits pelvic cavity through the greater sciatic foramen and reenters through the lesser sciatic foramen

104
Q

Branches of Pudendal Nerve

A
  • Inferior Rectal
  • Perineal Nerve
  • Dorsal Nerve of the penis (travels down dorsal aspect/clitoris->skin)
105
Q

Inferior Rectal

A

external anal sphinter and part of pelvic diaphragm, anal triangle

106
Q

Perineal Nerve

A
  • Muscles of the superficial and deep perineal pouch

- Main Nerve of UG triangle

107
Q

Cavernous Nerves

A

Parasympathetic to Erectile tissue

  • DIlates blood vessels so blood reaches that area
  • As skeletal muscles tense, theyre going to constrict blood vessels and wont allow blood to leave
108
Q

Internal Pudendal Artery

A

From anterior trunk of internal iliac artery

  • Travels with pudendal nerve and supplies similar structures
  • Main artery of perineum
109
Q

Internal Pudendal Artery branches-

A
  • Inferior rectal-anal canal below pectinate line
  • Perineal
  • Deep and dorsal arteries of penis/clit
110
Q

External Pudendal Artery

A

Supplies skin over perineum (branch of femoral artery)

111
Q

Femoral artery comes from…

A

External iliac artery

112
Q

Lymphatics

A

Structures drain along lymph channels accompanying supplying blood vessels

113
Q

Most perineal and pelvic structures drain into…

A

Superficial/deep inguinal nodes and internal/external iliac nodes

114
Q

Gonads drain…

A

up to the abdominal cavity to thenodes around the abdominal aorta

115
Q

Are asis and pubic symphysis on the same plane?

A

yes

Anatomy (11 decks)

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