The Perineum Flashcards
body & ligamentous boundaries of the perineum:
the perineum is the ___-shaped, ___-filled area b/n the ___
it extends from the inferior aspect of the ___ to the ___ & contains the external openings of the ___ & ___ tracts
the lateral boundaries of the perineum are formed by a series of ___ &___
diamond
tissue
thighs
pelvic diaphragm
skin
urogenital
gastrointestinal
bones
ligaments
body & ligamentous boundaries of the perineum:
boundaries:
superior: ___
inferior: ___
anterior: ___
anterior & lateral: ___
posterior & lateral: ___
posterior: ___
pelvic diaphragm skin of teh perineal region pubis symphysis ischiopubic ramus sacrotuberous ligament coccyx
body & ligamentous boundaries of the perineum:
an imaginary line passing b/n the two ___ divides the perineum into ___ & ___ triangles
ischial tuberosities
urogenital
anal
the urogenital triangle:
the urogenital triangle contains the external openings of the ___ (in both males & females) & the ___ (in females)
within the urogenital triangle there are two pouches: ___ & ___
the perineal pouches contain ___, ___, & other ___
urethra
vagina
superficial perineal pouch
deep perineal pouch
muscles
glands
tissues
the urogenital triangle:
the superficial perineal pouch:
the superficial perineal pouch is an enclosed compartment located b/n the ___ layer of ___ (inferior border) & the ___ (superior border)
membranous
superficial fascia
perineal membrane
the urogenital triangle:
the superficial perineal pouch:
membranous layer of superficial fascia:
the membranous layer of superficial fascia of the ___ wall (___ fascia) extends into the perineal region & over the ___ & ___
when it enters the perineum, the membranous layer of superficial fascia is called ___ fascia
within the perineum, the membranous layer of superficial fascia is firmly attached to the ___ & ___
abdominal
Scarpa’s
penis
scrotum
colle’s
ischiopubic rami
ischial tuberosities
the urogenital triangle:
the superficial perineal pouch:
membranous layer of superficial fascia:
posteriorly, along a line drawn b/n the two ___ (i.e., at the border b/n the urogenital & anal triangles), the membranous layer of superficial fascia fuses to the ___
this is the ___ found in the perineum that’s attached to the ___
this is also known as the ___
ischial tuberosities
pernieal membrane
fibrous membrane
ischiopubic rami
inferior fascia of the urogenital diaphragm
the urogenital triangle:
boundaries of the superficial perineal pouch:
the space b/n the ___ layer of ___ & the ___
it is continuous superiorly onto the ___ wall as the potential space b/n ___ & the ___ covering the abdominal musculature (i.e., external oblique muscle)
membranous
superficial fascia
perineal membrane
anterior abdominal
scarpa’s fascia
deep fascia
the urogenital triangle:
boundaries of the superficial perineal pouch:
it extends posteriorly only as far as the boundary b/n the ___ & ___
therefore, it does not extend into the ___
it is limited laterally in the perineum by fusion of the ___ to the ___
it extends as a potential space within the ___ & ___
urogential & anal triangles
anal triangle
perineal fascia
ischiopubic rami
scrotum
penis
the urogenital triangle:
boundaries of the superficial perineal pouch:
it extends into the ___ where it fuses w/ the ___ along a line just below & parallel to the ___
posteriorly, the fusion of the ___ layer of ___ & the ___ form the ___
thigh
deep fascia of the thigh (the fascia lata)
inguinal ligament
membranous
superficial fascia
perineal membrane
posterior boundary
the urogenital triangle:
contents of the superficial pouch (3)
root (erectile tissue)
muscles
glands
the urogenital triangle:
contents of the superficial pouch:
root (2)
bulb
crura
the urogenital triangle:
contents of the superficial pouch:
root:
bulb:
bulb of the penis in the male / ___ bulb in the female (comprised of a single body of ___ tissue in the male / divided by the ___ into two bodies in the female)
it is in the ___ & attached to the undersurface of the ___
it encloses the ___
the bulb is continued forward into the body of the penis & forms ___
it is invested by a thin sheath of ___
vestibular
erectile
vagina
midline
urogenital diaphragm
penile (spongy) urethra
corpus spongiosum
bulbospongiosus muscle
the urogenital triangle:
contents of the superficial pouch:
root:
crura:
crura of the ___ (male) / ___ (female) comprised of two bodies of erectile tissue
each crus is attached to the ___
the right & left crura join the ___ in the region of the ___
they come to lie side by side forming ___
their distal ends extend to the tip (___) of the penis
the ___ invest the crura of the corpora cavernosa; this thin sheath of skeletal muscles arise from the ___ at the absae of the crura
penis
clitoris
ischiopubic ramus
corpus spongiosum
pubic arch
corpora cavernosa
glans
ischiocavernosus muscles
ischial rami
the urogenital triangle:
contents of the superficial pouch:
muscles (3)
bulbospongiosus muscle
ischiocavernosus muscle
superficial transverse perinei muscles
the urogenital triangle:
contents of the superficial pouch:
muscles:
bulbospongiosus muscle:
covers the ___
compresses the ___ part of the ___, emptying it of the residual urine or semen
compresses the ___ vein of the penis impending the venous drainage, assisting in the process of the ___ of the penis
bulb of the penis (male) / vestibular bulb (female)
penile
urethra
deep dorsal
erection
the urogenital triangle:
contents of the superficial pouch:
muscles:
ischiocavernosus muscles:
cover the ___ of the penis/vestibular bulb
compresses the ___ to assist in the process of hte ___
crura
crura
erection
the urogenital triangle:
contents of the superficial pouch:
muscles:
superficial transverse perinei muscles:
they fix the ___ in the center of the prineum
perineal body
the urogenital triangle:
contents of the superficial pouch:
glands (1)
in females, secretes a ___
greater vestibular glands
lubricating fluid
the urogenital triangle:
the deep perineal pouch:
location:
the deep perineal pouch refers to the space located ___ to the ___
it is the space b/n the ___ & ___ of the ___
superior
perineal membrane
perineal membrane
superior fascia
urogenital diaphragm
the urogenital triangle:
the deep perineal pouch:
location:
laterally, both the perineal membrane & superior fascia of the urogenital diaphragm are firmly fused to the ___ & ___, thus forming a lateral boundary of the deep perineal pouch
posteriorly, both the superior fascia of the urogenital diaphragm & the perineal membrane are fused along a line drawn b/n the two ___ (i.e., at the border b/n the ___ & ___), thus forming the posterior boundary of the deep perineal pouch
ischiopubic rami
ischial tuberosities
iscial tuberosities
urogenital & anal triangles
the urogenital triangle:
contents of the deep perineal space (pouch) in the male (5)
sphincter urethrae muscle deep transverse perineal muscles internal pudendal artery & vein branches of the perineal nerve bulbourethral glands in male
the urogenital triangle:
contents of the deep perineal space (pouch) in the male:
sphincter urethrae muscle:
it arises from the ___ on both sides & passes medially to encircle the ___
it is supplied by the ___ branch of the ___ nerve
it compresses the ___ part of the ___ & relaxes during voluntary control of ___
pubic arch
urethra
perineal
pudendal
membranous
urethra
micturition
the urogenital triangle:
contents of the deep perineal space (pouch) in the male:
deep transverse perineal muscles:
located posterior to the ___ muscle
each muscle arises from the ___ & passes medially to be inserted in the ___
sphincter urethrae
ischial ramus
perineal body
the urogenital triangle:
contents of the deep perineal space (pouch) in the male:
bulbourethral glands in male:
two small glands that lie beneath the ___ muscles
their ducts pierce the ___ & enter the ___
these glands are homologous to the ___ glands in the female
sphincter urethrae
perineal membrane
penile urethra
greater vestibular
the urogenital triangle:
contents of the deep perineal pouch in the female:
the same as those of the male but w/ the following differences:
absence of the ___
presence of the ___
the sphincter urethrae are pierced by the ___ & ___
greater vestibular glands
vagina
urethra
vagina
the urogenital triangle:
contents of the deep perineal space (pouch) in the male (5)
sphincter urethrae muscle deep transverse perineal muscles internal pudendal artery & vein branches of the perineal nerve bulbourethral glands in male
the urogenital triangle:
urogenital diaphragm:
a ___ diaphragm filling the gap of the ___
consists of ___ & ___ muscles along w/ the ___ covering them
triangular musculo-fascial
pubic arch
sphincter urethrae
deep transverse perinei
fasciae
the urogenital triangle:
contents of the deep perineal space (pouch) in the male:
deep transverse perineal muscles:
located posterior to the ___ muscle
each muscle arises from the ___ & passes medially to be inserted in the ___
sphincter urethrae
ischial ramus
perineal body
the urogenital triangle:
contents of the deep perineal space (pouch) in the male:
bulbourethral glands in male:
two small glands that lie beneath the ___ muscles
their ducts pierce the ___ & enter the ___
these glands are homologous to the ___ glands in the female
sphincter urethrae
perineal membrane
penile urethra
greater vestibular
the urogenital triangle:
contents of the deep perineal pouch:
on the superior surface of the sphincter urethrae & deep transverse perineal muscles, the fascia is called the ___
the ___ is b/n this & the perineal membrane (which is also called the ___)
superior fascia of the urogenital diaphragm
deep space
infeiror fascia of the urogenital diaphragm
the urogenital triangle:
urogenital diaphragm:
a ___ diaphragm filling the gap of the ___
triangular musculo-fascial
the anal triangle:
contents of the ischioanal fossa (4)
fat (liquid at body temperature to allow dilation of the anal canal)
inferior rectal nerve & vessels
internal pudendal vessels & pudendal nerve
perineal branches of posterior femoral cutaneous nerve
the urogenital triangle:
urogenital diaphragm:
if a patient suffers a urethral rupture within the superficial perineal pouch, ___ will extravasate (leak) into the ___ when the patient attempts to urinate
urine
superficial perineal pouch
the anal triangle:
b/c the ischioanal fossae ___, an infection of the ischioanal fossa on one side can ___
communicate
spread to the other ischioanal fossa
the anal triangle:
the opening of the ___ lies in the middle of the anal triangle
the spaces on either side of the above structure are the ___, which is filled w/ fat b/n the ___ & the ___
the left & right above structures ___ w/ one another
anal canal
ischioanal (ischiorectal) fossae
skin
pelvic diaphragm
communicate (i.e., make contact)
the anal triangle:
the boundaries of the ischioanal fossa:
anterior: posterior borders of ___ muscles
posterior: ___ muscle & ___ ligament
lateral: ___ covering ___ muscle
superomedial: ___ & ___
inferior: ___ covering ___
transverse perinei
gluteus maximus
sacrotuberous
fascia
obturator internus
external anal sphincter
levator ani
skin
anal triangle
the anal triangle:
the ischioanal fossa extends as a potential space b/n the ___ & ___
this is called the ___ of the ___
therefore, infections within the ischioanal fossa may extend anteriorly to the ___
pelvic diaphragm
urogenital diaphragm
anterior recess
ischiorectal fossa
pubic bone
neurovascular supply of the perineum:
course of the internal pudendal vessels & the pudendal nerve from the pelvis to the perineum:
the structures exit the pelvis through the ___
the structures wrap around the ___
the structures pass through the ___ to enter the perineum
greater sciatic foramen
ischial spine
lesser sciatic foramen
the anal triangle:
perineal body:
the perineal body is a thickening of ___ that lies along the midpoint of a line drawn b/n the two ___
the perineal body may be damaged during ___
fascia
ischial tuberosities
parturition (child-bearing)
the anal triangle:
muscles attached to the perineal body (4)
superficial transverse perineal muscles
deep transverse perineal muscle
bulbospongiosus muscle
levator ani
neurovascular supply of the perineum:
the ___ nerve (ventral rami of levels ___) & the ___ artery (a branch of the ___ artery) supply the perineal structures
named branches of the ___ artery & ___ nerve serve specific perineal structures (e.g., the penis, clitoris, distal portion of the rectum, muscles, etc.)
pudendal
S2 - S4
internal pudendal
internal iliac
internal pudendal
pudendal
neurovascular supply of the perineum:
the ___ vein parallels the course of the internal pudendal artery & drains blood from all structures that it supplies except the ___ & ___
venous drainage from the above two structures travel directly to the ___
internal pudendal
penis
clitoris
pelvic venous plexus
neurovascular supply of the perineum:
course of the internal pudendal vessels & the pudendal nerve from the pelvis to the perineum:
the structures exit the pelvis through the ___
the structures wrap around the ___
the structures pass through the ___ to enter the perineum
greater sciatic foramen
ischial spine
lesser sciatic foramen
neurovascular supply of the perineum:
course of the internal pudendal vessels & the pudendal nerve from the pelvis to the perineum:
after entering the perineum, the structures lie in the ___, which lies against the ___ muscle
it is a sleeve of ___ that encloses the internal pudendal vessels & the pudendal nerve
the structures leave the ___ & branch out as named vessels & nerves to specific perineal structures (e.g., ___)
pudendal canal
obturator internus
obturator internus fascia
pudendal canal
penis, clitoris, distal portion of rectum, muscles, etc.
neurovascular supply of the perineum:
the pudendal nerve is often anesthetized to relieve ___ during parturition (childbirth)
the close relationship of the pudendal nerve to the ___ provides a useful landmark in performing a ___
perineal pain
ischial spine
pudendal nerve block
