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anatomy year 3 > Reproduction 4 - Pelvis and Perineum 2 > Flashcards

Reproduction 4 - Pelvis and Perineum 2 Flashcards

1
Q

What are the 2 triangles the perineum can be divided into?

A

Urogenital triangle

Anal triangle

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2
Q

What is A?

A

Pubic symphysis

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3
Q

What is B?

A

Ischial tuberosity

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4
Q

What is C?

A

Coccyx

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5
Q

What is D?

A

Urogenital triangle

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6
Q

What is E?

A

Anal triangle

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7
Q

Which bony prominences separate each of the triangles?

A

Ischial tuberosities

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8
Q

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?

A

Perineal membrane

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9
Q

What is support to the organs of the perineum provided by?

A

Support to the organs of the perineum is provided by the muscles of the perineum and fascial planes – there are some anatomical variations between the male and female perineal muscles

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10
Q

List the muscles and fascia of the perineum?

A
  • External anal sphincter
  • Superficial transverse perineal
  • Deep transverse perineal
  • External urethral sphincter
  • Bulbospongiosus
  • Ischiocavernosus
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11
Q

For external anal sphincter:

  • main actions
  • innervation
A
  • Main actions
    • Constricts anal cavity during peristalsis, resisting defication, supports and fixes perineal body
  • Innervation
    • Branches of pudendal nerve (S2-S4)
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12
Q

For superficial transverse perineal muscle:

  • main actions
  • innervation
A
  • Main actions
    • Support and fix perineal body (pelvic floor) to support abdominal pelvic viscera and resist increased intra-abdominal pressure
  • Innervation
    • Branches of pudendal nerve (S2-S4)
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13
Q

For deep transverse perineal:

  • main actions
  • innervation
A
  • Main actions
    • Support and fix perineal body (pelvic floor) to support abdomninal pelvic viscera
    • Resist increased intra-abdoinal pressure
    • Compress urethra to maintain urinary continence
  • Innervation
    • Branches of pudendal nerve (S2-S4)
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14
Q

For external urethral sphincter:

  • main actions
  • innervation
A
  • Main actions
    • Compress urethra to maintain urinary incontinence
  • Innervation
    • Branches of pudendal nerve (S2-S4)
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15
Q

For bulospingiosus (male):

  • main actions
  • innervation
A
  • Main actions
    • Compresses bulb of penis to expel last drops of urine/semen
    • Assist erection by compressing outflow via deep perineal vein and by pushing blood from bulk into body of penis
  • Innervation
    • Branches of pudendal nerve (S2-S4)
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16
Q

For bulbosponiosus (female):

  • main actions
  • innervation
A
  • Main actions
    • “Sphincter” of vagina assists in erection of clitoris
    • Compressed greater vestibular gland
  • Innervation
    • Branches of pudendal nerve (S2-S4)
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17
Q

For ischiocavernosus (male):

  • main actions
  • innervation
A
  • Main actions
    • Maintains erection of penis by compressing outflow veins and pushing blood from root of penis into body
  • Innervation
    • Branches of pudendal nerve (S2-S4)
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18
Q

For ischiocavernosus (female):

  • main actions
  • innervation
A
  • Main actions
    • Maintains erection of clitoris by compressing outflow veins and pushing blood from root of clitoris into body
  • Innervation
    • Branches of pudendal nerve (S2-S4)
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19
Q

Branches of what nerve supplies all muscles of the perineum?

A

Branches of pudendal nerve (S2-S4)

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20
Q

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

A

Significant bleeding, long term pain or dysfunction

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21
Q

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

A

These are the levatores ani and coccygei muscles and parietal fascia, making up the pelvic diaphragm.

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22
Q

What makes up the pelvic diaphragm?

A

Levator ani and coccygei muscles

and parietal fascia

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23
Q

What structures pierce through the pelvic diaphragm?

A

Urethra

Vagina

Anal canal

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24
Q

Is the urethra longer in males or females?

A

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

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25
Q

What is A?

A

Rectum

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26
Q

What is B?

A

Prostatic urethra

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27
Q

What is C?

A

Membranous urethra

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28
Q

What is D?

A

Deep perineal space

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29
Q

What is E?

A

Bulb of penis

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30
Q

What is G?

A

External urethral orifice

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31
Q

What is H?

A

Spongy urethra

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32
Q

What is I?

A

Prostate

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33
Q

What is J?

A

Pubic symphysis

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34
Q

What is K?

A

Urinary bladder

35
Q

What are the 3 parts of male urethra?

A
  1. Prostatic urethra
  2. Membranous urethra
  3. Spongy urethra
36
Q

What is the narrowest part of male urethra?

A

Membranous urethra?

37
Q

What is the widest part of male urethra?

A

Prostatic urethra

38
Q

The urethra in males is at risk of becoming narrowed due to what?

A

Enlargement of prostate

39
Q

What does the male external genitalia comprise of?

A

Testes, scrotum and penis

40
Q

What are the different parts of the penis?

A
  • Left and right corpus cavernosa
  • Single corupus spongiosum
  • Glans penis (terminal part)
  • Prepuce (foreskin)
41
Q

The penis provides transit for urethra via what?

A

Urethral meatus

42
Q

The corpus cavernosa is covered by a fascial layer called?

A

Buck’s fascia

43
Q

Through what part of the penis is the urethra transmitted through?

A

Corpus spongiosum

44
Q

The majority of the erectile tissue in the penis is in what part?

A

Corpus cavernosa

45
Q

Sensory innervation of the penis is through what?

A

Dorsal nerve of penis - a branch of pudendal nerve

46
Q

What is the dorsal nerve of the penis a branch of?

A

Pudendal nerve

47
Q

Where is the internal/vesical urethral sphincter located in females?

A

Located inferiorly at the neck of the bladder

48
Q

Is the internal/vesical urethral sphincter in females voluntary or involuntary?

A
  • Involuntary
    • Sympathetic fibres from T10-L2 through inferior hypogastric plexus then vesicle nervous plexus
49
Q

What nerves innervate the internal/vesical urethral sphincter in females?

A
  • Sympathetic fibres from T10-L2 through inferior hypogastric plexus then vesicle nervous plexus
50
Q

Where is the external urethral sphincter found in females?

A

distal and inferior to the internal urethral sphincter in the deep pernieal pouch

51
Q

Where is the external urethral sphincter found in males?

A

Deep perineal pouch, inferior to the prostate at level of the membranous urethra in males

52
Q

Is the external urethral sphincter voluntary or involuntary?

A
  • Voluntary
    • Somatic nervous system, S2-S4
53
Q

What nerves supplies the external urethral sphincter?

A

Somatic nervous system, S2-S4

54
Q

What can urinary incontinence develop due to in both males and females?

A

Disruption of internal and/or external urethra sphincters

55
Q

What are the biggest risk factors for males and females for urinary incontinence?

A
  • Males
    • Any form of prostatic surgery to overcome urinary retention
  • Females
    • Childbirth can weaken the ligaments supporting the pelvic floor
56
Q

What is the vulva?

A

The vulva is the collective name for the female external genitalia.

57
Q

What are the 6 contents of the vulva?

A
  1. Mons pubis
  2. Labia majora
  3. Labia minora
  4. Clitoris
  5. Vestibule
  6. Bartholin’ glands (vestibular glands)
58
Q

What nerve and artery supplies the structures of the vulva?

A
  • Nerve
    • Pudendal nerve
  • Artery
    • Internal pudendal artery
59
Q

What is the vestibule?

A

The vestibule is the area enclosed by the labia minora and contains the terminal aspects of the vaginal orifice and urethra

60
Q

The vestibule contains the inferior aspects of what?

A

Urethra, vagina and ducts of the greater and lesser vestibule glands

61
Q

What is the clitoris?

A

Mirroring the corpus cavernosa in the male, the clitoris is the erectile tissue found within the female external genitalia.

62
Q

What is the clitoris composed of?

A

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.

63
Q

What is the equivalent of the corpus cavernosa in females?

64
Q

What is the equivalent of the corpus spongiosum in females?

A

There is none

65
Q

The anal triange is the area between what?

A

The anal triangle is the area between the ischial spines and coccyx

66
Q

What does the anal triangle contain?

A

It contains the terminal part of the gastro-intestinal tract, the anus.

67
Q

How long is the anus?

A

Approx 4cm

68
Q

What are the 2 sphincters controlling defication and are they voluntary or involuntary?

A
  • Internal sphincter
    • Involuntary
  • External sphincter
    • Voluntary
69
Q

Somatic sensation in the anus extends upwards from where to where?

A

Somatic sensation extends upwards from the external environment to the inter-sphincteric groove (the ‘white line’)

70
Q

What is found lateral to the anal canal and inferior to the pelvic floor?

A

2 fat containing fossa called the ischio-anal (ischio-rectal) fossa

71
Q

What does the ischio-anal (ischio-rectal) fossa allow?

A

These allow the anal canal to expand during defaecation.

72
Q

What is A?

A

Obturator internus meatus

73
Q

What is B?

A

Levator ani muscle

74
Q

What is C?

A

external anal sphincter

75
Q

What is D?

A

Anal canal

76
Q

What is E?

A

Ischiorectal fossae

77
Q

What is F?

A

pudendal canal containing pudendal artery and vein

78
Q

What is G?

A

Pudendal nerve

79
Q

What is H?

80
Q

What allows a neurovascular bundle to enter the ischio-anal(rectal) fossae?

A

Lesser sciatic foramen

81
Q

What structres are in the neurovascular bundle entering the ischio-anal (rectal) fossae?

A

Internal pudendal artery and vein, pudendal nerve, obturator internus tendon and nerve to obturator internus

82
Q

What structures does the neurovascular bundle entering the ischio-anal (rectal) fossae supply?

A
  • External anal sphincter
  • Peri-anal skin
  • Superficial pouch
  • Deep pouch
83
Q

WHat can extent laterally into the ischio-anal fossa to form abscessed?

A

Anal crypts can extend laterally into the ischio-anal fossa forming abscesses within this relatively ischaemic area. These can spread rapidly with these peri-anal abscesses requiring drainage under general anaesthesia.

anatomy year 3 (18 decks)

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