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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is A?

A

Pubic symphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is B?

A

Ischial tuberosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is C?

A

Coccyx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is D?

A

Urogenital triangle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is E?

A

Anal triangle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which bony prominences separate each of the triangles?

A

Ischial tuberosities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Branches of what nerve supplies all muscles of the perineum?

A

Branches of pudendal nerve (S2-S4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

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

A

Significant bleeding, long term pain or dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What makes up the pelvic diaphragm?

A

Urogenital diaphragm

Rectal hiatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What structures pierce through the pelvic diaphragm?

A

Urethra

Vagina

Anal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is A?

A

Rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is B?

A

Prostatic urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is C?

A

Membranous urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is D?

A

Root of penis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is E?

A

Bulb of penis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is G?

A

External urethral orifice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is H?

A

Spongy urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is I?

A

Prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is J?

A

Pubic symphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

Corpus spongiosum

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
    • Pudendal nerve
53
Q

What nerves supplies the external urethral sphincter?

A

Pudendal nerve

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?

A

Clitoris

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 space

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?

A

Rectum

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

82
Q

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

A
  • Artery in males supplies the bulb of the penis and adjacent part of the urethra and bulbourethral gland. In females it supplies the bulb of the vestibule and greater vestibular gland
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.