Some perineum stuff

Question 1

Innervation of the ovaries and uterine tubes (Pain)

Answer 1

They are intraperitoneal, therefore they are superior to the pelvic pain line. Visceral afferent pain fibers ascend retrogradely with the descending sympathetic fibers of the ovarian plexus and lumbar splanchnic nerves to cell bodies in the T11-L1 spinal sensory ganglia

Question 2

Innervation of the uterus (Pain)

Answer 2

Visceral afferent fibers conducting pain impulses from the intraperitoneal uterine fundus and body follow the sympathetic innervation retrograde to reach cell bodies in the inferior thoracic-superior lumbar spinal ganglia. Afferent fibers conducting pain impulses from the subperitoneal uterine cervix and vagina (inferior to the pelvic pain line) follow the parasympathetic fibers retrograde through the uterovaginal and inferior hypogastric plexuses and pelvic splanchnic nerves to reach cell bodies in the spinal sensory ganglia of S2-S4.

Question 3

Layers of fascia surrounding the uterus

Answer 3

perimetrium, myometrium, and endometrium

Question 4

Innervation of vagina

Answer 4

Nerves from the uterovaginal nerve plexus (travel with the uterine artery); Inferior one fifth to one quarter of the vagina innervated by deep perineal nerve (branch of the pudendal) which conveys sympathetic and visceral afferent fibers but no parasympathetic fibers. Sensitive to touch and temperature (S2-S4)

Question 5

Superficial perineal pouch components (males):

Answer 5

Root (bulb and crura of penis and associated muscles (ishciocavernosus and bulbospongiosus), proximal (bulbous) part of the spongy urethra, superficial transverse perineal muscles, deep perineal branches of the internal pudendal vessels and pudendal nerves

Question 6

Superficial perineal pouch components (females):

Answer 6

Clitoris and associated muscle (ischiocavernosus), bulbs of the vestibule and surrounding muscle (bulbospongiosus), greater vestibular glands, superficial transverse perineal muscles, and related vessels and nerves (deep perineal branches of the internal pudendal vessels and pudendal nerves)

Question 7

Colles fascia

Answer 7

the superficial perineal fascia

Question 8

Investing fascia

Answer 8

deep perineal fascia or gallaudet fascia

Question 9

Deep perineal pouch contains:

Answer 9

part of the urethra, centrally, the inferior part of the external urethral sphincter muscle, above the center of the perineal membrane, surrounding the urethra
anterior extensions of the ischio-anal fat pads.

In males:
intermediate part of the urethra, deep transverse perineal muscles, bulbo-urethral glands, dorsal neurovascular structures of the penis

In females:
Proximal part of the urethra, mass of smooth muscle in the place of deep transverse perineal muscles on the posterior edge of the perineal membrane, dorsal neurovasculature of the clitoris