202-203- Perineal anatomy

Question 1

What are the boundary points of the perineum

Answer 1

pubic symphysis (ant), ischial tuberosities/obturator internus muscle (laterally), coccyx (post), pelvic diaphragm (superiorly)

Question 2

What are the subdivisions of the perineum?

Answer 2

Urogenital triangle (urethra and vag pass thru)
Anal triangle (anus passes thru)
Perineal body is right in between.

Question 3

urogenital diaphragm is composed of___

Answer 3

two fascia (superior and inferior (or perineal membrane))

Question 4

what two mm. are w/in the UG diaphragm? what else does it contain?

Answer 4

external urethral sphincter , deep transverse perineal muscle. In males, bulbourethral gland is w/in it.

Question 5

what forms the deep pouch

Answer 5

its in between the two layers of the UG diaphragm

Question 6

Superficial pouch: what is it in males and females? what encloses it? Where can fluids in it go? what does the pouch contain

Answer 6

scrotum and labia majora. Colles’ fascia. Blood or urine can only pass upward into body wall. Contains everything superficial to UG diaphragm (penis, clit, ischiocavernosus and bulbospongiosus mm., etc)

Question 7

what is cut in midline episiotomy? mediolateral?

Answer 7

Midline: central tendon of perineum and wall of vagina.
Mediolateral: UG diaphragm, bulbospongiosus, superficial transverse perineal muscle, and wall f vagina

Question 8

What rami form the pudendal nerve? what are the three branches?

Answer 8

Ventral rami of S2,3,4. Somatic innervation of both diaphragms, genitals, ext anal sphinc, skin of perineum. Inferior rectal, perineal, dorsal nerve of penis or clitoris.

Question 9

difference b/w pudendal nerve block and sacral epidural

Answer 9

pudendal: anesthetizes UG and pelvic diaphragms. Epidural: also does cervix

Question 10

where do blood vessels to pelvic viscera come from?

Answer 10

internal iliac except: upper rectum (inf mesenteric), gonads (test/ovarian arteries from aorta)

Question 11

name all erectile tissues of penis and mm. surrounding them

Answer 11

left and right crus, bulb, L&R corpus cavernosa, corpus spongiosum, glans.

Ischio-cavernosus around each crus facilitates erection. Bulbospongiosus around bulb expels last drops of urine and contracts during ejaculation

Question 12

mesosalpinx vs mesovarium vs mesometrium

Answer 12

upper part of broad ligament, post extension of broad ligament, broad ligament

Question 13

Where does ovarian artery travel?

Answer 13

through suspensory ligament of the ovary