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Block 3 Week 5 Meg > Sievert: Anal Triangle > Flashcards

Sievert: Anal Triangle Flashcards

1
Q

What does the sacrospinous ligament connect?

A

the sacrum to the ischial spine

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2
Q

What does the sacrotuberous ligament connect?

A

the sacrum to the ischial tuberosity

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3
Q

Above the ischial spine is a large notch, the (blank), which is converted into a foramen by the sacrospinous ligament

A

greater sciatic notch

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4
Q

Final segment of vertebral column

A

coccyx

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5
Q

Why are the greater and lesser sciatic foramen important?

A

They allow for nerves and vessels to leave the pelvis and enter the perineum without puncturing the pelvic floor.

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6
Q

The obturator foramen is filled with the (blank)

A

obturator membrane

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7
Q

What two muscles arise from the obturator membrane and act on the hip joint?

A

the obturator externus and the obturator internus

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8
Q

How does the obturator internus leave the pelvis to attach to the femur?

A

It passes through the lesser sciatic foramen

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9
Q

The area inferior to the pelvic diaphragm between the coccyx and the pubis and including all the structures in the two triangles

A

perineum

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10
Q

Pyramidal fibromuscular mass in the middle line of the perineum at the junction between the urogenital triangle and the anal triangle

A

perineal body

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11
Q

Perineal body is found in both males and females. In males, it is found between the (blank) and the anus; in females, is found between the (blank) and anus

A

bulb of the penis; vagina

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12
Q

Two muscles that make up the pelvic floor

A

levator ani and coccygeus

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13
Q

T/F: There is a dense connective tissue membrane over the obturator internus that forms a tendinous arch

A

True

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14
Q

The anal triangle in the female is identical to that of the male, but the UG triangle in the female has an additional opening for the (blank)

A

vagina

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15
Q

How do you get nerves and blood vessels out of the pelvis?

A

Through the greater sciatic foramen

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16
Q

Vessels and nerves can leave the pelvis through the greater sciatic foramen and then pass into the perineum by running superficial to the (blank) lig. but deep to the (blank) lig

A

sacrospinous; sacrotuberous

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17
Q

What is the purpose of the vessels leaving the pelvis through the greater sciatic foramen to enter the perineum?

A

Does not compromise the integrity of the pelvic floor

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18
Q

Boundaries of the ischio anal fossa

A

Medial: external anal sphincter and Pelvic diaphragm
Lateral: obturator muscle and ischium
Superior: pelvic diaphragm
Posterior: sacrotuberous lig. and gluteus maximus Inferior: Skin
Anterior boundary extends all the way forward to the pubis as the anterior recess

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19
Q

3 things in the anal triangle

A
  1. anal canal
  2. ischioanal fossa
  3. pudendal nerves and vessels as they pass thru on their way to the UG triangle
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20
Q

As the pudendal nerves pass through the anal triangle toward the UG triangle, what is the first branch they give off?

A

inferior rectal vessels and nerves

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21
Q

THis muscle is key, because superior gluteal nerves and vessels enter the gluteal region superior to the muscle, while inferior gluteal nerves and vessels enter inferior to this muscle

A

piriformis muscle

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22
Q

The pudendal nerve exits the pelvis via the greater sciatic foramen, passes superficial to the (blank) ligament, and enters the perineum passing deep to the (blank) ligament

A

sacrospinous; sacrotuberous

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23
Q

Once in the ischioanal fossa, the pudendal nerve gives off the (blank) and then enters the pudendal canal to travel anteriorly towards the UG triangle.

A

inferior rectals

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24
Q

The pudendal nerve supplies (blank) innervation to the external sphincter and UG triangle muscles, and (blank) innervation to the perineum.

A

motor; sensory

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25
Q

The internal pudendal artery and vein follow the (blank) into the canal giving off similar branches.

A

pudendal nerve

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26
Q

Rectum is approximately 10 cm in length and begins at the (blank) vertebra and extends to the (blank).

A

S3; rectoanal junction

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27
Q

Where does the anal canal begin? Where does it end?

A

At the superior limit of the pelvic diaphragm-where the rectal ampulla narrows; anus

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28
Q

The pectinate line marks the point where (blank) motor and sensory above give way to (blank) motor and sensory below

A

viscero; somatic

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29
Q

The pectinate line is also the point of junction between the embryonic (blank) and the proctodeum.

A

hindgut

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30
Q 
Three blood supplies to the anal canal
Which vessel(s) are a branch of the IMA?
Which vessel(s) are a branch of the common iliacs?
A

superior, middle, and inferior rectals
Superior rectal from the IMA
Middle and inferior from the pectinate, which comes off of the common iliacs

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31
Q

Three vessels drain the anal canal with anastomoses, two return to the (blank) and one to the (blank). What can portal hypertension cause?

A

systemic; portal; varices in the venous plexuses

32
Q

Above the pectinate line, where do lymph nodes drain? Below the pectinate line, where do lymph nodes drain? Where does all of the lymph ultimately go?

A

iliac nodes; inguinal nodes; cysterna chyli and thoracic duct

33
Q

What nerves supply the anal canal above the pectinate line?

A

hypogastric plexus

34
Q

What maintains the tone of the internal sphincter? What inhibits tone and evokes peristalsis?

A

sympathetics; parasympathetics

35
Q

Above the pectinate line, where do afferents to the spinal cord travel? Below the pectinate line?

A

S2-4 pelvic splanchnics; inferior rectal nerves

36
Q

Below the pectinate line, afferent nerves are somatosensory. What does this mean?

A

They are sensitive to all normal stimuli

37
Q

This muscle serves an important function in preventing untimely flatulence and defecation during relaxation of the involuntary internal anal sphincter

A

puborectalis

38
Q

What innervates the external anal sphincter?

A

inferior rectals off of the pudendal (S2-4)

39
Q

What innervates the levator ani?

A

small branches off the sacral plexus (S4) and some from the inferior rectal

40
Q

The UG triangle extends from the ischial tuberosities to the (blank) and is filled in by the (blank).

A

pubis; UG diaphragm

41
Q

Does the urethra pass through the UG triangle? What else passes through in the female? What is contained in the UG triangle?

A

yes; vagina; muscles and erectile tissues of the external genitalia

42
Q

Two muscles of the UG diaphragm in males

A

deep transverse perineal

sphincter urethrae

43
Q

The two muscles of the UG diaphragm are encased above and below by a dense connective tissue envelope-the superior and inferior fascia. The inferior fascia is very thick and is referred to as…?

A

perineal membrane

44
Q

The perineal membrane serves as the major attachment site of the (blank)

A

external genitalia

45
Q

These glands are located in the UG diaphragm. The ducts of the glands enter the urethra more superiorly.

A

bulbourethral glands

46
Q

Discuss the barriers of the “deep pouch”

A

extends superiorly from the perineal membrane to the investing fascia of the pelvic diaphragm

47
Q

What are the equivalent glands in the female to the bulbourethral gland? Where are these glands located? Where do they drain to?

A

Bartholin’s glands; located entirely within the superficial pouch; drain to vagina

48
Q

What are the three bodies of erectile tissue attached to the perineal membrane?

A

two crura laterally and one midline bulb housing the urethra

49
Q

What covers the erectile tissues directly? What then covers the deep layer, and binds the tissues together to form the penis?

A

dense CT called tunica albuginea; deep perineal fascia (Buck’s fascia)

50
Q

mushroom shaped cap of erectile tissue covered over by foreskin in the uncircumcised male.

A

glans

51
Q

This surrounds the corpus spongiosum of the penis

A

corpus cavernosum

52
Q

What do the crura of the penis become?

A

corpora cavernosa

53
Q

What does the bulb of the penis become?

A

corpus spongiosum

54
Q

What layer of fascia is continuous with the deep perineal fascia? What layer of fascia lines the scrotum and ultimately blends with the membranous layer of the abdominal wall?

A

Buck’s fascia; Dartos fascia

55
Q

In the female external genitalia, the bulb is split into two and is separated by the vestibule of the vagina. It does not contribute to the formation of the (blank)

A

clitoris

56
Q

What forms the glans of the clitoris?

A

extensions of the crura on either side

57
Q

The female external genitalia are contained in a dense connective tissue called the (blank)

A

tunica albuginea

58
Q

Two muscles of superficial perineal pouch

A

bulbospongiosus

ischiocavernosus

59
Q

In males, what are the two muscles of the external genitalia? What covers all three muscles? This layer is continuous with the investing fascia of the anterior abdominal wall muscles.

A

bulbospongiosus
ischiocavernosus
deep perineal fascia called Gallaudet’s (same as Buck’s on the penis)

60
Q

Nerves of the perineum: After the pudendal gives off the inferior rectals, it gives off (blank) branches to the muscles, (blank) branches to the skin, and the (blank) nerve to the penis.

A

deep perineal; superficial perineal; dorsal nerve

61
Q

This nerve is entirely sensory to the penis

A

dorsal nerve

62
Q

Blood flow to the perineum is similar to nerve supply, with the addition of two arteries.

A

An artery to the bulb and one deep artery running through each crura of the penis

63
Q

The internal pudendal artery gives off (blank) branches, an artery to the (blank), a (blank) artery to each crura and the (blank) artery of the penis

A

perineal; bulb; deep; dorsal

64
Q

Venous return is similar to arterial flow with one exception

A

dorsal vein of the penis drains to the prostatic plexus no the internal pudendal vein

65
Q

T/F: The pudendal nerve in the female follows the exact pattern as that in the male

A

True

66
Q

T/F: The arterial supply and venous draining in the female is identical to that in the male

A

True

67
Q

Internal pudendal artery first gives off inferior rectal artery, then (blank) branches, then an artery to the (blank), (blank) arteries to the crura, and a (blank) artery of the clitoris.

A

perineal; bulb; deep; dorsal

68
Q

This fascia replaces the fatty layer and has smooth muscle in the scrotum

A

Dartos fascia

69
Q

This fascia is the membranous layer of the superficial fascia

A

Colles’ fascia

70
Q

This is an investing layer on the penis and is continuous with Gallaudet’s over the muscles of the genitalia and the UG diaphragm

A

Buck’s fascia

71
Q

(blank) fascial layers extend into the anal triangle, but the (blank) fascial layers stop at the posterior border of U-G diaphragm. Both stop at the (blank).

A

superficial; deep; fascia lata

72
Q

The (blank) of the vagina is the space between the labia minora. What openings does it contain?

A

vestibule; urethra, vagina, and greater and lesser vestibular glands

73
Q

This is the area of skin that overlies the pubic symphysis

A

mons pubis

74
Q

Empty into the urethral orifice and secrete a watery fluid similar to that secreted by the prostate

A

Paraurethral (Skene’s) glands

75
Q

Three components of the male urethra

A 
prostatic urethra (runs through prostate gland)
membranous urethra
spongy urethra (longest and lengthiest portion)
76
Q

The pelvic cavity of the true pelvis has the pelvic floor as its inferior border. The perineum has the pelvic floor as its superior border.

Some sources do not consider “pelvic floor” and “pelvic diaphragm” to be identical, with the “diaphragm” consisting of only the levator ani and coccygeus, while the “floor” also includes the perineal membrane and deep perineal pouch.[2] However, other sources include the fascia as part of the diaphragm.[3] In practice, the two terms are often used interchangeably.

A

Yep.

Block 3 Week 5 Meg (8 decks)

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