Rapid Pelvic Anatomy

Question 1

What is the perineum

Answer 1

An anatomical area of pelvis, separated from the pelvic cavity by the pelvic floor

Question 2

What is the difference between the anatomical perineum and the clinical perineum

Answer 2

Clinical- area between external genitalia and anus Anatomical- an area containing certain borders. This includes the external genitalia and anus

Question 3

What are the anatomical borders of the perineum?

Answer 3

Anterior- pubic symphysis Posterior- tip of the coccyx Lateral- inferior pubic rami and inferior ischial rami Roof- pelvic floor Base- skin and fascia

Question 4

How is the perineum divided?

Answer 4

By a line that is theoretically drawn between ischial tuberosities. This plots the perineum into the anal triangle and the urogenital triangle.

Question 5

What are the boundaries of the anal triangle? What are the contents of the anal triangle?

Answer 5

• coccyx, sacrotuberous ligament, line between inferior ischial tuberosisties - anal aperture, external anal sphincter, ischioanal fossa,pudendal nerve

Question 6

What are the borders of the urogenital triangle? What are the layers of the urogenital triangle?

Answer 6

-Pubic symphysis, ischiopubic rami, theoretical line between ischial tuberosisties - Deep perineal pouch, perineal membrane superficial perineal pouch perineal fascia

Question 7

What is found in the -skin of the perineum -perineal fascia

Answer 7

Skin- the urethral and vaginal open out here onto the skin Perineal fascia- a continuity of the abdominal fascia that has two components: Deep fascia- covers superficial perineal muscles and protruding strhtjfesz Superficial fascia- continues with campers fascia, continues with scarpas fascia

Question 8

What is found in the superficial perineal pouch

Answer 8

A potential spreads between membrane and fascia, it contains the coropora cavernosa, corpus spongiosum (erectile tissue) and ischiocavernosus, bulbospongiosus, superficial perineal muscles (muscles). Bartholins glands are also located here.

Question 9

What is found in the - Perineal membrane - Deep perineal pouch

Answer 9

Perineal membrane- a layer of tough fascia which is perforated h the urethra, provides attatchemt for muscles of the external genitalia Deep perineal pouch- a potential space between the deep fascia of the pelvic floor and the perineal membrane. It contains the urethra, external urethral sphincter. In females it also includes the vagina, in males it also includes the bulbourethral glands and the deep transverse perineal muscles.

Question 10

What are the 3 major parts of the hip bone?

Answer 10

Pubis (middle-anterior region) Ilium (inferior-anterior region) Ischium (superior- posterior region) They are joined together by the triradiate cartilage

Question 11

The hip bones have 3 main articulation. What are they?

Answer 11

Hip bone to hip bone- pubic symphysis Acetabulum to femur- Hip joint Sacrum to ilium- sacroiliac joint

Question 12

-What is the Ala of the ilium? - how is the iliac crest formed?

Answer 12

• The superior wing of the ilium - the top of the ilium is thickened

Question 13

What are the two surfaces of the ilium and how are they relevant?

Answer 13

Inner surface- has a concave shape, produces the iliac fossa, site of origin of the iliacus muscle External surface- gluteal surface, has a convex shape and provides attachment for the gluteal muscles

Question 14

What are the three parts of the pubic bone?

Answer 14

Pubic body- located medically it articulates with with the opposite pubic body at the pubic symphysis. It contains the pubic body and extends laterally as the pubic tubercle Superior pubic ramus- extends laterally from the body to form part of the acetabulum Inferior pubic ramus- projects two wards the ischium

Question 15

What opening do the superior and inferior rami of the pubis enclose.

Answer 15

The obturator foramen through which the obturator nerve, artery and vein pass through to reach the lower limbs.

Question 16

What are the two important ligaments that attach to the ischium

Answer 16

Sacrospinous ligament- runs from the ischial spine to the sacrum, thus creating the greater sciatic foramen Sacrotuberous ligament- runs from the sacrum to the ischial tuberosisty forming the lesser sciatic foramen

Question 17

What is the perineal body

Answer 17

A fibromuscluar mass, located centrally near the anus, it acts as an attachment point for the muscles of the perineum. In woman it acts as a tear resistant body, preventing prolapse. In an appesiotomy it may be accidentaly cut

Question 18

What muscles attach to the perineal body?

Answer 18

Levator ani bulbospongiosus superficial and deep transverse perineal muscles external anal sphincter external urethral spnhincter muscle fibres

Question 19

Where is the nerve supply of the perineum derived from

Answer 19

The pudendal nerve, (S2-S4)

Travels down through inner surface of ischial tuberosistes, through a canal fromed by thickening of the obturator fascia. it travels dwon through each layer of fascia.