Repro Anatomy 4 Flashcards by Robbie Pollock

The perineum lies inferior to the pelvic diaphragm and is the most inferior portion of the trunk. It can be divided into two triangular areas.

What bony landmarks create the boundaries of the perineum?

Pubic symphysis

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The perineum lies inferior to the pelvic diaphragm and is the most inferior portion of the trunk. It can be divided into two triangular areas.

What bony landmarks create the boundaries of the perineum?

Ischial tuberosities, ischiopubic rami and sacrotuberous ligament

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The perineum lies inferior to the pelvic diaphragm and is the most inferior portion of the trunk. It can be divided into two triangular areas.

What bony landmarks create the boundaries of the perineum?

Tip of coccyx

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Which triangle is shown by the shaded orange area above?

Which triangle is shown by the shaded green area above?

orange = urogenital triangle

green = anal triangle

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Which bony prominences separate each of the triangles?

ischial tuberosities

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A thin sheet of deep fascia stretches between right and left sides of the pubic arch, below the pubic symphysis.

What is the name given to this fascia?

pelvic fascia

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Support to the organs of the perineum is provided by the _______ of the perineum and ______ planes – there are some anatomical variations between the male and female perineal muscles, these will be highlighted through this section

muscles

fascial

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what supplies the msucles of the perineum?

Branches of Pudendal Nerve

(S2 to S4)

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muscle - External anal sphincter

what is its main action?

Voluntary sphincter to control bowel movements

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muscle - Superficial transverse perineal

what is its main action?

Fixes and stabilizes the perineal body

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muscle - Deep transverse perineal

what is its main action?

Forms urogenital diaphragm and anchors the perineal body, thus supporting the pelvic viscera, compress uretha to maintain urinary continence

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muscle - External urethral sphincter

what is its main action?

Compress urethra to maintain urinary continence

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muscle - Bulbospongiosus (Male)

what is its main action?

Relaxed when peeing but contacts to stop urine flow. Aids in fully emptying the urethra after urination. Contacts rhythmically during ejaculation to create a series of wave-like contractions within the corpus spongiosum, this facilitates movement of ejaculate through urethra, constrictions veins in bulb of penis to maintain erection

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muscle - Bulbospongiosus (Female)

what is its main action?

Contributes to clitoral erection and the contraction of orgasm, and closes the vagina. Serves to empty the canal of the urethra after the bladder has expelled its contents, its relaxed during peeing and only contracts at the end

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muscle - Ischiocavernosus (Male)

what is its main action?

Help impeding venous return from corpora cavernosa of the penis, aiding in maintenance of erection. Rhythmic contraction with bulbospongiosus during ejaculation. Contraction help maintain erection and possibly aid moving ejaculate through urethra

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muscle - Ischiocavernosus (Female)

what is its main action?

Pushes blood from root of clitoris to body i.e. maintains erection of clitoris, tenseness vagina during orgasm

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What are the potential consequences if the perineal body is damaged/ruptured during childbirth?

prolapse of pelvic viscera

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There are 2 layers of fascia important as additional support for the pelvic organs within the perineum

These are the _______ and _______ fascia, making up the pelvic diaphragm

superior

inferior

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Which structures pierce through the pelvic diaphragm?

urethra

anal canal

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is the urethra longer in males and females and why?

The urethra is longer in males compared to females due the number of structures it has to traverse

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Rectum

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Preprostatic part of urethra

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Prostatic urethra

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Urethra – external sphincter, membranous part of urethra

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Corpus spongiosum

Urinary bladder

Pubic symphysis

Prostate

Spongy part of urethra

External urethral meatus

What are the 3 parts of the male urethra?

preprostatic prostatic spongy part

Which are the widest and narrowest parts of the male urethra and why?

Widest part = Prostatic – receives ejaculatory ducts and prostatic ducts Narrowest part = membranous – runs through pelvic floor and is enclosed by the external urethral sphincter

the urethra is at risk of becoming narrowed due to enlargement of what?

the prostate

The male external genitalia comprise of what?

the testes, scrotum and penis

The penis is the male organ of copulation and is the common outlet for both urine and semen It comprises of the left and right corpus _______ and single corpus \_\_\_\_\_\_\_. The terminal aspect of the penis is the glans penis, covered by the prepuce (foreskin) and provides transit for the urethra via the external urethral meatus.

cavernosa spongiosum

The corpus cavernosa is covered by a fascial layer called the what?

tunica albuginea

The urethra is transmitted through the corpus....

spongiosum below the corpus cavernosa and in the middle of corpus spongiosum

he majority of the erectile tissue in the penis is in the corpus.....

cavernosa

Sensory innervation of the penis is through the dorsal nerve of the penis, a branch of the ________ nerve

pudendal

Where is the internal/vesical urethral sphincter located?

proximal end of the urethra at the neck of the bladder

Internal urethral pshincter - Is it voluntary or involuntary? What is its innervation?

involuntary sympathetic T10-L2

Where is the external urethral sphincter found in females?

deep perineal pouch at distal inferior boarder of bladder

Where is the external urethral sphincter found in males?

surrounds the membranous part of the urethra

extenral urethral sphincter - Is the sphincter voluntary or involuntary? What is its innervation?

voluntary S2-4

**_Clinical – Urinary Incontinence_**: In both the male and female urinary incontinence can develop due to disruption to one or both of the above. The aging process ________ the urinary sphincters making incontinence more likely, however other factors can contribute to this In **males** any form of ______ surgery to overcome urinary retention can make urinary incontinence more likely In the **female** ________ can weaken the ligaments supporting the pelvic floor, and can increase the risk of incontinence

prostatic childbirth weakens

**_Female External Genitalia:_** The vulva is the collective name for the female external genitalia. The contents of the vulva are:

1. Mons pubis 2. Labia majora 3. Labia minora 4. Vestibule 5. Bartholins gland 6. Clitoris These structures are collective supplied by the [pudendal nerve](https://www.anatomy.tv/anatomytv/html5ui_2018/#/product/har_pelvis_2014/type/Views/id/42823/layer/5/angle/35/structureID/537724), and [internal pudendal artery](https://www.anatomy.tv/anatomytv/html5ui_2018/#/product/har_pelvis_2014/type/Views/id/42823/layer/3/angle/32/structureID/538644)

The vestibule is the area enclosed by the _____ minora and contains the terminal aspects of the ______ and \_\_\_\_\_\_

labia vagina urethra

what is the clitoris?

Mirroring the corpus cavernosa in the male, the [clitoris](https://www.anatomy.tv/anatomytv/html5ui_2018/#/product/har_pelvis_2014/type/Text%20articles/id/42818/layer/5/angle/35/structureID/-1) is the erectile tissue found within the female external genitalia It is comprised of 2 crura, which meet in the midline to form the body. This then projects downwards to the prepuce and glans which lies in the anterior labial commissure There is no equivalent of the corpus spongiosum in females

what is the anal triangle and what does it contain?

The anal triangle is the area between the ischial spines and coccyx (see the green triangle on page 1). It contains the terminal part of the gastro-intestinal tract, the anus.

The anus runs from the rectum to the external environment and is approx. 4cm long. There are 2 sphincters controlling defaecation The [internal sphincter](https://www.anatomy.tv/anatomytv/html5ui_2018/#/product/har_pelvis_2014/type/Slides/id/9026285/structureID/339265536) under ________ control and the [external sphincter](https://www.anatomy.tv/anatomytv/html5ui_2018/#/product/har_pelvis_2014/type/Slides/id/9026285/structureID/339264512) under _________ control. Somatic sensation extends upwards from the external environment to the inter-sphincteric groove (the ‘white line’)

involuntary voluntary

Lateral to the anal canal and inferior to the pelvic floor are 2 fat containing fossa called the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. These allow the anal canal to expand during defaecation.

[ischio-anal (ischio-rectal) fossa](https://www.anatomy.tv/anatomytv/html5ui_2018/#/product/har_pelvis_2014/type/MRI%20Views/id/42865/layer/0/angle/4/structureID/1336332)

Rectum

Obturator internus

Iliococcygeus, Pubococcygeus and puborectalis

External anal sphincter

Anus/Anal canal

Obturator fascia

Pudendal canal

Ischio-anal fossa

A neurovascular bundle enters the ischio-anal (rectal) fossae through the lesser sciatic foramen. What structures are present in this bundle? What structures do these neurovascular structures supply?

internal pudendal artery internal pudendal vein pudendal nerve external genitalia external genitalia skin of external genitalia and skin around anus