Unit 7: Biological Male Pelvis Flashcards
What is the perineum?
An anatomical region in the pelvis, located between the thighs and represents the most inferior part of the pelvic outlet
Is the space between the pelvic floor and the skin.
What systems do structures within the perineum support?
Urogential and gastrointestinal systems
What are the anatomical borders of the perineum?
Anterior - pubic symphysis
Posterior - tip of the coccyx
Laterally - inferior pubic rami and inferior ischial rami and the sacrotuberous ligament
Roof - pelvic floor
Base - skin and fascia
How and what two regions is the perineum divided into?
The perineum is divided into theoretical regions, by drawing a line transversly between the ischial tuberosities.
This creates a anterior urogenital triangle and a posterior anal triangle.
What are the surface landmarks of the perineum?
Anteriorly - mons pubis in females, base of penis in males
Laterally - medial surface of the thighs
Posterior - superior end of the intergluteal cleft
What is the main contents of the anal triangle?
The anal aperture (found centrally)
External anal sphincter muscle
Ischioanal fossae x2 (lateral spaces to the anal apeture)
Pudenal nerve - supplies the perineum with somatic fibres
What is the function of the ischioanal fossa?
Contain fat and connective tissue, allows for expansion of the anal canal during defecation.
Extend from the anal region to the pelvic diaphragm.
What makes up the urogenital system?
The external genitalia and the urethra
What are the layers of the urogenital triangle?
(deep to superficial)
Deep perineal pouc
Perineal Membrane (not in anal triangle)
Superfifical perineal pouch
Perineal fascia
Skin - the urethral and vaginal orifices open out onto the skin
What is the deep perineal pouch?
A potential space between the deep fascia of the pelvic floor and the perineal membrane
It contains part of the urethra, external urethral sphincter and the vagina in females.
May also contain the bulbourethral glands and deep transverse perineal muscles
What is the perineal membrane?
A layer of tough fascia, perforated by the urethra and vagina. Provides a surface for attachement of muscles of the external genitalia
What is the superficial perineal pouch?
A potential space between the perineal membrane and the superficial perineal fascia.
Contains erectile tissue for the penis and clitoris
Muscles: ischiocavernous, bulbospongiosus, superficial transverse perineal muscles.
The greater vestibular glands
Bound posterior to the perineal body
What is the perineal fascia?
A continuity of the abdominal fascia that has two components:
Deep fascia: covering superficial perineal muscles and protruding structues
Superfifical fascia - made of a superficial later continous with the Campers fascia of anterior abdominal wall, deep layer continous with scarpa’s fascia of the anterior abdominal wall.
What is the perineal body?
An irregular fibromuscular mass
At the junction between the urogential and anal triangles
Lies just deep to the skin, acts as a point of attachment.
What muscle attach to the perineal body?
The levator ani
The bulbospongiosus muscle
The superficial and deep transverse perineal muscle
External anal sphincter
External urethral sphincter muscle
What is the anatomical difference of the perineal body in males and females?
Females - tear resistant between the vagina and external anal sphincter, supports the posterior vaginal wall against prolapse
Males - between the bulb of the penis and the anus
What is the major neurovascular supply to the perineum?
Pudendal nerve S2 to S4, travels along the inner surface of ischial tuberosities, thorugh Alcocks canal through a thickening of the obturator fascia
Internal Pudendal artery
What muscles make up the pelvic floor?
Coccygeus
levator Ani
What is the function of the pelvic floor?
Support pelvic viscera
Resist intra-abdominal pressure
Maintain fecal continence
What innervates the pelvic floor?
S2 3 4
Keep the ** off the floor
What is pelvic organ prolapse?
Caused be weakness in the pelvic floor muscles
When organs in the pelvic cavity slip down from their normal position and buldge into the vagina (females) or anus (males and females)
This is not life-threatening but can cause pain or discomfort.
What are the three muscles that make up the levator ani?
Pubococcygeus
Iliococcygeous
Puborectalis
How does puborectalis help maintain faecal continence?
Forms a sling around the rectum at the anorectal function.
This creates an anal rectal angle that is maintained by contraction of the puborectalis muscle at 80 degrees.
What other muscles, not in the pelvic floor are important?
The piriformis - leaving by the greater sciatic fossa
Obturator internus
What is the iliac wing?
The inner surface of the ilium underneath the iliac crest
Where is the linea terminalis/arcuate line?
A landmark on the pelvis, is the circular brim between the true (lesser) and false (greater) pelvis.