S3_L3: Perineum Flashcards

1
Q

Determine the corresponding descriptions of the spaces in the perineum

  1. Space between posterior surface of urinary bladder and the anterior surface of uterus
  2. Space between middle and upper rectum and the uterus
  3. Found on the sides of rectum
  4. Between superior part of urinary bladder and the upper and middle rectum

A. Pararectal space
B. Vesicouterine pouch
C. Rectovesical pouch
D. Rectouterine pouch/Pouch of Douglas

A
  1. B
  2. D
  3. A
  4. C
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2
Q

Determine the corresponding descriptions of the halves of the anal canal

  1. Has anal columns (Morgagni Columns) joined together at lower ends by anal valves (Morgagni Crypts)
  2. Supplied by somatic inferior rectal (hemorrhoidal) nerve
  3. Drains to pararectal node then to inferior mesenteric nodes
  4. Lined by stratified squamous epithelium
  5. Derived from the hindgut entoderm
  6. Sensitive to pain, touch, temperature and pressure

A. Upper half of anal canal
B. Lower half of anal canal

A
  1. A
  2. B
  3. A
  4. B
  5. A
  6. B
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3
Q

Determine the corresponding descriptions of the halves of the anal canal

  1. Lined by columnar epithelium
  2. Drains to medial group of superficial inguinal nodes
  3. Has no anal columns
  4. Supplied by autonomic hypogastric plexus, sensitive to stretch
  5. Derived from ectoderm of the proctodeum
  6. Blood supply is superior rectal

A. Upper half of anal canal
B. Lower half of anal canal

A
  1. A
  2. B
  3. B
  4. A
  5. B
  6. A
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4
Q

Determine the corresponding descriptions of the parts of the anal sphincter

  1. Attached to perineal body in front and coccyx behind
  2. Encircles upper end of anal canal
  3. Encircles lower end of anal canal
  4. The only part with bony attachment
  5. Puborectalis fibers of levatores ani blends with this part to form a sling
  6. Just beneath the skin, most superficial

A. Subcutaneous
B. Superficial
C. Deep

A
  1. B
  2. C
  3. A
  4. B
  5. C
  6. A
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5
Q

Determine the corresponding descriptions of the layers of the superficial fascia

  1. At the scrotum, it is replaced by the dartos muscle
  2. Continuous with superficial fascia of anterior abdominal wall (Scarpa’s fascia) and continues over the penis/clitoris
  3. Forms a distinct layer continuous with superficial fascia of scrotum/labia majora
  4. Also referred to as Camper’s fascia
  5. Continuous with the fat of the ischioanal fossa and superficial fascia of thigh
  6. Attached to the posterior part of perineal body and perineal membrane and laterally to pubic arch

A. Superficial fatty layer
B. Deep membranous layer

A
  1. A
  2. B
  3. B
  4. A
  5. A
  6. B
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6
Q

Determine the corresponding descriptions of the parts of the penis

  1. Foreskin, the hoodlike folk of skin that covers the glans
  2. Made of 2 corpora cavernosa and 1 corpus spongiosum
  3. Connects the glans to urethra orifice
  4. Composed of 3 cylindrical erectile tissue enclosed in tubular fascia
  5. Made of 3 masses of erectile tissue, has a bulb and right and left crura
  6. Distal expanded part of corpus spongiosum

A. Root
B. Body
C. Glans penis
D. Prepuce
E. Frenulum

A
  1. D
  2. B
  3. E
  4. B
  5. A
  6. C
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7
Q

Determine the corresponding covering of the testis and spermatic cord with the ff layers of the abdominal wall

  1. Cremasteric fascia and muscle
  2. Dartos muscle and Colles fascia
  3. Skin
  4. External spermatic fascia

A. Skin
B. Superficial fascia (Camper and Scarpa)
C. External oblique muscle
D. Internal oblique muscle

A
  1. D
  2. B
  3. A
  4. C
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8
Q

Determine the corresponding covering of the testis and spermatic cord with the ff layers of the abdominal wall

  1. Internal spermatic fascia
  2. Extraperitoneal fat
  3. Tunica vaginalis
  4. This does not continue into scrotal area

A. Transversus abdominis muscle
B. Transversalis fascia
C. Extraperitoneal fat
D. Parietal peritoneum

A
  1. B
  2. C
  3. D
  4. A
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9
Q

Determine the corresponding descriptions of the vestibular glands

  1. Secrete lubricating mucus during sexual intercourse
  2. Lie on each side of the vestibule
  3. Pair of small mucus secreting glands that lie under cover of the posterior parts of bulb of vestibule and labia majora
  4. Open into the vestibule by small ducts on each side of the external urethral orifice

A. Greater vestibular (Bartholin’s) glands
B. Lesser vestibular (Paraurethral) glands

A
  1. A
  2. B
  3. A
  4. B
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10
Q

Determine the corresponding counterparts of the male and female urogenital triangle

  1. Penis
  2. Scrotum
  3. Bulbourethral glands in male
  4. Appendix testis
  5. Bulb of Penis
  6. Prostate gland

A. Fallopian tubes
B. Clitoris
C. Bulb of Vestibule
D. Labia Majora
E. Paraurethral glands
F. Greater vestibular, Bartholin glands

A
  1. B
  2. D
  3. F
  4. A
  5. C
  6. E
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11
Q

Determine the corresponding descriptions of the contents of the female urogenital triangle

  1. Situated at Apex of vestibule anteriorly
  2. Female genital canal (birth canal) and excretory duct for menstrual flow
  3. Collective name for area of the female external genitalia
  4. Traverses the sphincter urethra and lies immediately in front of vagina
  5. Muscular tube extending up and back between the vulva and uterus
  6. Equivalent to Male penis

A. Vulva
B. Clitoris
C. Vagina
D. Urethra

A
  1. B
  2. C
  3. A
  4. D
  5. C
  6. B
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12
Q

Determine the corresponding descriptions of the contents of the superficial perineal pouch in females

  1. Found between lower end of vagina and anal canal
  2. Fibers extend to corpora cavernosa of clitoris
  3. Assists supporting the posterior wall of vagina
  4. Reduces size of vaginal orifice and compresses the deep dorsal vein of the clitoris assisting in erection
  5. Fibrous point in the middle line of the perineum
  6. Larger, wider than in males

A. Bulbospongiosus muscle
B. Ischiocavernosus muscle
C. Superficial transverse perineal muscle
D. Perineal body

A
  1. D
  2. A
  3. D
  4. A
  5. D
  6. D
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13
Q

Determine the corresponding descriptions of the ff clinical notes

  1. Coital injury, picket fence type of impalement injury, and vagina perforation caused by water under pressure
  2. Tying and division of uterine tube as permanent birth control
  3. Closeness of peritoneal cavity to the posterior vaginal fornix enables physician to drain a pelvic abscess through vagina without performing a major operation
  4. Implantation and growth of fertilized ovum occur outside the uterine cavity in the wall of the uterine tube
  5. Rupture of the tube (tubal abortion) occurs and effusion of large quantity of blood into the peritoneal cavity takes place

A. Culdocentesis
B. Vaginal trauma
C. Ectopic pregnancy
D. Tubal ligation

A
  1. B
  2. D
  3. A
  4. C
  5. C
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14
Q

Determine the corresponding descriptions of the ff clinical notes of the pelvic and perineal area

  1. A factor contributing to this is pressure of gravid uterus on inferior vena cava and inferior mesenteric vein
  2. Can cause severe painless hemorrhage by 28th week that can cause expansion of lower half of uterine wall
  3. Premature separation of placenta in which normal implantation has occurred
  4. Implantation of placenta in lower half of the body
  5. Can suddenly contract and the baby is born before 40th week
  6. Can be a result of an increase in progesterone levels that cause relaxation of smooth muscles in wall of veins and venous dilation
    and an impaired venous return

A. Placenta abruption
B. Placenta previa
C. Varicose veins and hemorrhoids

A
  1. C
  2. B
  3. A
  4. B
  5. B
  6. C
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15
Q

Determine the corresponding vaginal supports of the sections of the vagina

  1. perineal membrane
  2. levatores ani and transverse cervical, pubocervical, and sacrocervical ligaments
  3. perineal body

A. Upper third
B. Middle third
C. Lower third

A
  1. B
  2. A
  3. C
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16
Q

Determine the corresponding lymph drainage of the sections of the vagina

  1. internal iliac nodes
  2. superficial inguinal nodes
  3. internal and external iliac nodes

A. Upper third
B. Middle third
C. Lower third

A
  1. B
  2. C
  3. A
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17
Q

Determine the corresponding descriptions of the parts of the clitoris

  1. Consists of 2 corpora cavernosa covered by ischiocavernosus muscle
  2. Has 2 bulbs instead of 1
  3. Small mass of erectile tissue that caps the body of the clitoris
  4. 3 erectile tissue called bulb of vestibule, right and left crura of clitoris
  5. Hidden by prepuce
  6. Provided by numerous sensory findings

A. Root
B. Body
C. Glans

A
  1. B
  2. A
  3. C
  4. A
  5. C
  6. C
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18
Q

Determine the corresponding descriptions of the clinical notes on hemorrhoids

  1. Mucous membrane of lower half of anal canal or skin covers this
  2. Varicosities of the superior rectal vein
  3. Varicosities of the tributaries of inferior rectal vein running laterally from the anal margin
  4. Usually within the anal canal, but if enlarged, it can extrude from canal during defacation
  5. Sensitive to pain, temperature, touch and pressure

A. External hemorrhoids
B. Internal hemorrhoids

A
  1. A
  2. B
  3. A
  4. B
  5. A
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19
Q

Determine the corresponding descriptions of the phases of defecation

  1. Puborectalis and external anal sphincter relax
  2. Internal and external anal sphincters relax
  3. Puborectalis, external and internal anal sphincters contract
  4. Levator ani, abdominal muscles and diaphragm contract
  5. Rectum contracts

A. Holding
B. Initiation
C. Completion

A
  1. B
  2. C
  3. A
  4. B
  5. C
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20
Q

Determine the corresponding contents of the superficial perineal pouch / space in male and female

  1. Perineal nerves and vessels
  2. Bulb of the penis plus the bulbospongiosus muscles
  3. Crura of clitoris plus the ischiocavernosus muscles
  4. Bulbs of the vestibule plus the bulbospongiosus muscles
  5. Superficial transverse perineal muscles
  6. Crura of the penis plus the ischiocavernosus muscles

A. In Male
B. In Female
C. In Both

A
  1. C
  2. A
  3. B
  4. B
  5. C
  6. A
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21
Q

Enumerate the contents of the deep perineal pouch / space in female

A
  1. Part of the urethra
  2. Inferior part of the external urethral sphincter
  3. Neurovascular branches of the external genitalia
  4. Anterior recesses of the ischioanal fossae
  5. Vagina
  6. Bulbourethral glands
  7. Deep transverse perineal muscle
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22
Q

In both male (penis) and female (clitoris), the bulb is covered by the (1)___ muscle, while the crura are covered by the (2)___ muscle.

A
  1. bulbospongiosus
  2. ischiocavernosus
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23
Q

Refers to the tubular fascia that encloses the 3 cylindrical erectile tissue of which the body of the penis is composed of

A

Buck’s fascia

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24
Q

TRUE OR FALSE: The glans is bigger than the penis body so that during intercourse, the sperm does not backflow.

A

True

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25
Q

The peak of sexual response cycle characterized by the involuntary, or autonomic limbic system, and is accompanied by quick cycles of muscle contraction in the lower pelvic region.

A

Orgasm

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26
Q

Laceration of vaginal wall (especially posterior fornix) can cause violation of ___ and cause prolapse of small intestine to vagina

A

Pouch of Douglas

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27
Q

Determine the corresponding blood supply of the contents of the female urogenital triangle

  1. Vaginal artery (branch of internal iliac artery) and vaginal branch of uterine artery
  2. External and internal pudendal arteries
  3. Internal pudendal artery

A. Vulva
B. Clitoris
C. Vagina
D. Urethra

A
  1. C
  2. A
  3. B
28
Q

Determine the corresponding nerve supply of the contents of the female urogenital triangle

  1. Inferior hypogastric plexus
  2. Its posterior part is supplied by branches of perineal nerve and posterior cutaneous nerve of thigh
  3. Pudendal nerve
  4. Its anterior part is supplied by ilioinguinal nerve and genital branch of genitofemoral

A. Vulva
B. Clitoris
C. Vagina
D. Urethra

A
  1. C
  2. A
  3. B
  4. A
29
Q

Determine the corresponding lymph drainage of the contents of the female urogenital triangle

  1. Drains to internal iliac nodes or to the deep inguinal nodes
  2. Its skin drains into medial group of superficial inguinal nodes

A. Vulva
B. Clitoris
C. Vagina
D. Urethra

A
  1. B
  2. A
30
Q

Determine the corresponding descriptions of the degrees of internal hemorrhoids (piles)

  1. It extrudes from canal but returns at end of defecation
  2. It prolapses on defecation and remains outside of the anus
  3. It is within the canal

A. First-degree
B. Second-degree
C. Third-degree

A
  1. B
  2. C
  3. A
31
Q

Two paraurethral mucous glands at the lower end of the urethra on either side of the external urethral meatus and drains into the lateral margin of the urethral orifice.

A

Paraurethral glands (Skene’s glands)

32
Q

The (1)___ half of vagina lies above the pelvic floor inside the true pelvis, while the (2)___ half of vagina is within the perineum between urethra and anal canal.

A
  1. Upper
  2. Lower
33
Q

A type of hymen where the female individual is menstruating but no blood is coming out, so it will have to be repaired.

A

Imperforate hymen

34
Q

A thin mucosal fold which is perforated at the center. It is seen in the vaginal orifice of a virgin.

A

Hymen

35
Q

Arrange the following structures that the catheter passes through in catheterization from outermost to innermost

Choices: Urethral floor, Membranous part of urethra, External orifice at glans penis, Preprostatic urethra, Spongy urethra, Bladder, Prostatic part of urethra

A
  1. External orifice at glans penis
  2. Spongy urethra
  3. Membranous part of urethra
  4. Prostatic part of urethra
  5. Preprostatic urethra
  6. Urethral floor
  7. Bladder
36
Q

The purpose of circumcision is to expose the __ of the penis. There will be no more prepuce as it will be cut during circumcision.

A

glans

37
Q

It is the space posterior to glans clitoris and between the labia minora. It contains the openings of urethra, vagina, and ducts of greater and lesser vestibular glands.

A

Vestibule

38
Q

Enumerate the 7 components of the vulva

A
  1. Mons pubis
  2. Labia majora
  3. Labia minora
  4. Clitoris
  5. Vestibule
  6. Vestibular bulbs
  7. Greater vestibular glands
39
Q

Determine the corresponding descriptions of the ff clinical notes

  1. Elongated ulcer that is extremely painful and common in the midline posterior area
  2. The result of torn anal mucosa by hard feces
  3. Congenital weakness of vein walls
  4. Due to chronic constipation that causes lack of support provided by superficial part of external sphincter
  5. Infection and inflammation of anal canal spread between the sphincters
  6. Patient develops infection and inflammation of anal canal (sinuss or crypts) which can spread to ischio-anal fossae

A. Ischio-anal Abscess
B. Intersphincteric fistulas
C. Anal Fissure
D. Hemorrhoids

A
  1. C
  2. A
  3. D
  4. C
  5. B
  6. A
40
Q

Determine the corresponding descriptions of the ff perineal structures

  1. Thick fibrous sheet that fills the urogenital triangle
  2. Its lateral wall is kept in position by the levatores ani muscle and anal sphincter
  3. In females, it is located between the vagina and anus
  4. Embryonic attachment of the urorectal septum to the cloacal membrane
  5. About 1.5 in. long passing down and backward for rectal ampulla to anus

A. Perineal body
B. Perineal membrane
C. Anal triangle
D. Anal canal
E. Anal sphincter
F. Anorectal ring

A
  1. B
  2. D
  3. A
  4. A
  5. D
41
Q

Determine the corresponding descriptions of the ff perineal structures

  1. Bounded by imaginary line, tip of coccyx, ischial tuberosity, and sacrotuberous ligament
  2. Found at the anorectal junction
  3. Anchored in front to perineal body and laterally to pubic arch
  4. Central tendon of perineum
  5. Composed of involuntary internal sphincter and voluntary external sphincter
  6. Posterior half of the perineum

A. Perineal body
B. Perineal membrane
C. Anal triangle
D. Anal canal
E. Anal sphincter
F. Anorectal ring

A
  1. C
  2. F
  3. B
  4. A
  5. E
  6. D
42
Q

Determine the corresponding descriptions of the ff perineal structures

  1. Its muscle coat is composed of smooth muscle outer longitudinal and inner circular layers
  2. Important for stability of perineal integrity and function and it is the attachment of muscles and fascial layers
  3. Formed by internal sphincter, deep part of external sphincter and puborectalis muscle
  4. Its function is to support external genitalia
  5. In males, it is located between the attachment of bulb of penis and anus

A. Perineal body
B. Perineal membrane
C. Anal triangle
D. Anal canal
E. Anal sphincter
F. Anorectal ring

A
  1. D
  2. A
  3. F
  4. B
  5. A
43
Q

Determine the corresponding nervous systems associated with the ff details in erection and ejaculation

  1. Vasoconstriction of arteries
  2. Relaxes smooth muscles around
  3. Roots of S2-4
  4. Dorsal artery is embedded in erectile tissue so erection is stimulated by tactile (touch), vision, imagination, smell, taste
  5. Reaches a climax, ejaculation

A. Parasympathetic
B. Sympathetic

A
  1. B
  2. A
  3. A
  4. A
  5. B
44
Q

Determine the corresponding nervous systems associated with the ff details in erection and ejaculation

  1. Contraction of vas deferens and seminal vesicles
  2. Vasodilates the arteries, making the penis hard
  3. Relaxes bladder and closes sphincter
  4. Cause contraction of epididymis, so mature sperm goes out to prostatic urethra and exit to urethra
  5. Arousal

A. Parasympathetic
B. Sympathetic

A
  1. B
  2. A
  3. B
  4. B
  5. A
45
Q

What happens to the individual when their testis does not descend?

A

Become infertile (sperm will burn and die)

46
Q

TRUE OR FALSE: The penis no bone, but it is susceptible to fracture.

A

True

Tearing on the corpora cavernosa
(e.g., sexual activities, blunt force)

47
Q

The testis is initially in the abdomen, but as the male matures, the testis will descend and bring with it the layers of the abdominal wall. What abdominal wall layer does not join the testis?

A

Transversus abdominis muscle

48
Q

Determine the corresponding descriptions of the ff structures

  1. Contains the testes, epididymis, spermatic cord
  2. Traverses the bulb and the bulbospongiosus muscle
  3. Continued forward into body and from the corpus spongiosum
  4. Outpouching of the lower part of anterior abdominal wall
  5. Has a corona
  6. Found in the midline and is attached to undersurface of urogenital diaphragm attached to the perineal muscle

A. Glans penis
B. Scrotum
C. Bulb of penis
D. Urethra of penis

A
  1. B
  2. D
  3. C
  4. B
  5. A
  6. C
49
Q

Determine the corresponding descriptions of the anal sphincters

  1. Supplied by sympathetic fibers from inferior hypogastric plexuses
  2. Supplied by inferior rectal nerve (from pudendal nerve S2-4) and perineal branch of S4
  3. Formed from thickening of smooth muscle of circular coat at the upper end of anal canal

A. Voluntary external anal sphincter
B. Involuntary internal sphincter

A
  1. B
  2. A
  3. B
50
Q

Covers the anterior, medial, and lateral surfaces of the testis

A

Tunica vaginalis

51
Q

The large intestine continuously absorbs water, and while the individual is waiting for the feces to be ready, the water around it is continuously absorbed and the feces hardens, especially in instances where the individual doesn’t drink much water. This will lead to?

A

Constipation

52
Q

Arrange the sequence of events in defecation, using 1-6, 1 for the first event and 6 for the last.

___ Feces already went out of anal canal.
___ Feces in rectum stimulates stretch receptors.
___ Mucous membrane is returned to anal canal by tone of longitudinal fibers of anal wall and contraction of puborectalis.
___ Empty lumen of anal canal is closed by tonic contraction of anal sphincter.
___ Mucous membrane of lower anal canal is extruded.
___ Rise in intra-abdominal pressure by contraction of anterior abdominal wall muscle, inhibition of tonic contraction of internal and external anal sphincters (puborectalis muscle).

A

(3) Feces already went out of anal canal.
(1) Feces in rectum stimulates stretch receptors.
(5) Mucous membrane is returned to anal canal by tone of longitudinal fibers of anal wall and contraction of puborectalis.
(6) Empty lumen of anal canal is closed by tonic contraction of anal sphincter.
(4) Mucous membrane of lower anal canal is extruded.
(2) Rise in intra-abdominal pressure by contraction of anterior abdominal wall muscle, inhibition of tonic contraction of internal and external anal sphincters (puborectalis muscle).

53
Q

It involves a coordinated reflex that results in the emptying of descending colon, sigmoid colon, rectum, and anal canal.

A

Defecation

54
Q

Enumerate the 3 branches of the pudendal nerve

A
  1. Inferior rectal nerve
  2. Dorsal nerve of the penis (or clitoris)
  3. Perineal nerve
55
Q

A position described by supine lying, with hips flexed and abducted. The feet are in stirrups.

A

Lithotomy position

56
Q

Enumerate the 5 layers of the urogenital triangle

A
  1. Skin
  2. Superficial perineal fascia
  3. Deep perineal fascia
  4. Superficial (inferior) perineal space (pouch)
  5. Deep (superior) perineal space (pouch)
56
Q

Determine the corresponding descriptions of the ff structures

  1. Four to eight anal glands drain into this structure at the level of pectinate line
  2. Wedge shape space on each side of anal canal
  3. Lies in the midline of the anal triangle
  4. It divides the anal canal into upper and lower canals
  5. Allows movement of pelvic diaphragm and expansion of anal canal during defacation

A. Dentate / pectinate line
B. Crypts of Morgagni
C. Ischioanal / Ischiorectal fossa (space)
D. Anus

A
  1. B
  2. C
  3. D
  4. A
  5. C
57
Q

Enumerate the contents of the ischiorectal fossa / ischioanal space

A
  1. Fat [which supports anal canal and allows it to distend during defacation]
  2. Pudendal nerve
  3. Internal pudendal vessel
  4. Inferior rectal vessels and nerve
58
Q

TRUE OR FALSE: The perineum is superficial to the pelvic diaphragm. The pelvic cavity is superficial to the perineum.

A

False (only 2nd statement)

From most superficial to deep: Perineum, pelvic diaphragm, pelvic cavity

59
Q

Arrange the layers of the deep perineal space and urogenital diaphragm from superficial to deep

Choices: Deep perineal space, Inferior fascia of urogenital diaphragm (perineal membrane), Superficial fascia of urogenital diaphragm

A
  1. Inferior fascia of urogenital diaphragm (perineal membrane)
  2. Deep perineal space
  3. Superficial fascia of urogenital diaphragm
60
Q

In the penis, the ___ is/are supplied by the deep arteries of penis and the ___ is/are supplied by the artery of the bulb and dorsal artery of the penis.

A
  1. corpora cavernosa
  2. corpus spongiosum
61
Q

The diamond-shaped area below the pelvic diaphragm

A

Perineum

62
Q

Determine the corresponding boundaries of the perineum

  1. points of ischial tuberosities
  2. anterior point of tip of coccyx
  3. inferior border of symphysis pubis
  4. ischiopubic rami anteriorly and sacrotuberous ligament posteriorly

A. Anterior
B. Posterior
C. Lateral Margin
D. Lateral

A
  1. D
  2. B
  3. A
  4. C
63
Q

Determine the corresponding boundaries of the anal canal

  1. perineal body, urogenital diaphragm, vagina
  2. ischiorectal fossae
  3. anococcygeal body
  4. perineal body, urogenital diaphragm, membranous part of urethra and bulb of penis

A. Anterior in males
B. Anterior in females
C. Posterior
D. Lateral

A
  1. B
  2. D
  3. C
  4. A
64
Q

Determine the corresponding boundaries of the urogenital triangle

  1. Ischiopubic rami and ischial tuberosities
  2. Pubic arch
  3. Between 2 ischial tuberosities

A. Anterior
B. Line intersecting
C. Lateral

A
  1. C
  2. A
  3. B
65
Q

Determine the corresponding boundaries of the ischiorectal fossa

  1. Ischium
  2. Levator ani muscle

A. Medial wall
B. Lateral wall

A
  1. B
  2. A