The Perineum Flashcards

1
Q

Perineum

A

Trunk inferior to the pelvis
Diamond shaped
Can be viewed when the thighs are abducted

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2
Q

Perineum is bounded by

A

Coccyx
Ischial tuberosity
Pubis

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3
Q

A line through the ischial tuberosities divides perineum into

A

Two triangles
Anal Triangle
Urogenital Triangle

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4
Q

Anal canal can be divided into

A

Upper and lower halves

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5
Q

Upper half of anal canal

A

Is above the pectinate line
Derived from endoderm like the rest of the gut tube
Lined by columnar epitheliam
Anal columns present

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6
Q

Innervation of upper half of anal canal

A

Autonomic - only stretch and pressure receptors (no pain)

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7
Q

Arteries in upper half of anal canal

A

Superior rectal from IMA

Middle rectal from internal iliac

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8
Q

Veins in upper half of anal canal

A

Superior rectal - drains into IMV

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9
Q

Lymphatics in upper half of anal canal

A

Drains to inferior mesenteric nodes

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10
Q

The lower half is

A

Below the pectinate line
Derived from ectoderm like the skin
Is lined by stratified squamous epithelium
Anal columns are absent

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11
Q

Innervation of lower half of anal canal

A

Somatic - you feel pain here - hemorrhoids (ouch)

Inferior rectal branch of pudendal

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12
Q

Arteries of lower half of anal canal

A

Inferior rectal off int. pudendal

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13
Q

Veins of lower half of anal canal

A

Inferior rectal drains into internal pudendal

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14
Q

Lymphatics of lower half of anal canal

A

drains to superficial inguinal nodes

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15
Q

Anal Sphincters

A

Internal and External

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16
Q

Internal anal sphincter

A

One part

Involuntary

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17
Q

External Anal Sphincter

A
Three parts (deep, superficial, subcutaneous)
Voluntary - innervated by inferior rectal off the pudendal
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18
Q

Ischioanal Fossa Boundaries

A

Skin, Levator Ani, Obturator Internus, Ischium, Sacrotuberous and sacrospinous ligaments, Deep transverse perineal muscles

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19
Q

The anterior recess of the ischioanal fossa extends into the

A

UG triangle

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20
Q

Contents of the Ischioanal Fossa

A
  1. Fat - a lot of it! - expansion
  2. Connective tissue
  3. Pudendal Canal
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21
Q

Pudendal Canal includes

A
  1. Pudendal nerve (S2-S4)
  2. Internal pudendal artery which branches into inferior rectal and external genitalia arteries
  3. Internal pudendal vein
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22
Q

Homology to Testes

A

Ovaries

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23
Q

Homology to Body of Penis

A

Body of Clitoris

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24
Q

Homology to Penile Raphe and Spongy urethra

A

Labium Minora

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25
Q

Homology to Scrotum

A

Laba Majora

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26
Q

Homology to Bulbourethral Gland

A

Greater vestibular gland (bartholin gland)

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27
Q

Homology to Prostate Gland

A

Paraurethral (lesser vestibular) gland

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28
Q

Homology to Gubernaculum

A

Round and ovarian ligaments

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29
Q

Contents of Urogenital traingle in male

A

Scrotum and Penis

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30
Q

Anatomical position of the penis

A

Erect

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31
Q

Scrotum contains

A

Testes, epididymis, and part of spermatic cord

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32
Q

Penis contains

A
Root = attached to body
Erectile tissue = bulb, right and left crura
Body = Corpus spongiosum (contains urethra and expands to form glans)
Corpus Cavernosa (x2) - bounded by deep penile fascia, crura
33
Q

M - Superficial Perineal Pouch Contains:

A
  1. Proximal spongy urethra
  2. Root of penis
  3. Bulbospongiosus muscle
  4. Ischiovacernous muscle
  5. Perineal body
  6. Superficial transverse perineal muscle
  7. Perineal branches of the pudendal nerve
34
Q

M - Bulbospongiosus Muscle - Where

A

Superficial Perineal Pouch

Paired muscles covering the bulb and distal crura of the penis

35
Q

M - Bulbospongiosus Muscle - What it does

A

When contracted it empties the urethra of residues, maintains erection by increasing pressure on the erectile tissue in the root and compressing venous return

36
Q

M - Innervation of bulbospongiosus muscle

A

Perineal nerve of pudendal

37
Q

M - Ischiocavernous Muscle - where

A

Superficial perineal pouch

Paired muscles covering the proximal crura of the penis

38
Q

M - Ischiocavernous Muscle - What it does

A

Achieves and maintains erection via compression of the crura, forcing blood distally and compressing venous return

39
Q

M - Innervation of Ischiocavernous Muscle

A

Perineal nerve of pudendal

40
Q

M - Perineal Body - Where

A

Superficical perneal pouch

Small fibrous mass in center of perineum

41
Q

M - Perineal Body - What it does

A

Structures attach to perineal body including the anal sphincter, bulbospogiosus and superficial perineal muscles

42
Q

M - Superficial Transverse Perineal Muscles - Where

A

Superficial Perineal Pouch

Arising from ischial tuberosity and inserting on perineal body

43
Q

M - Superficial Transverse Perineal Muscles - What it does

A

Fixes perineal body

44
Q

M - Superficial Transverse Perineal Muscles - Innervation

A

Perineal of the pudendal nerve

45
Q

M - Perineal branches of the pudendal nerve - what it innervates

A

Perineal muscles and skin

46
Q

M - Deep perineal pouch contains

A
  1. Intermediate urethra
  2. Bulbourethral glands
  3. Sphinter urethrae
  4. Deep transverse perineal muscle
  5. Dorsal nerve of penis
  6. Artery to bulb of penis
  7. Deep arteries of the penis
  8. Dorsal arteries of the penis
47
Q

M - Sphincter Urethrae

A

Surrounds the urethra

Voluntary muscle allows urine to be released

48
Q

M - Innervation of sphincter urethrae

A

Perineal branch

49
Q

M - Deep transverse perineal muscle

A

Extends from ischial ramus to perineal body, posterior to sphncter urethrae
Supports pelvic floor and expels residual semen and urine

50
Q

M - Deep transverse perineal muscle - innervation

A

Perineal branch of pudendal

51
Q

M - Dorsal Nerve of Penis innervates

A

skin of penis and glans penis

52
Q

M - Artery to bulb of penis supplies

A

posterior corpus spongiosum and bulbourethral gland

53
Q

M - Deep arteries of the penis fills

A

crura and corpora spongiosum and bulbourethral gland

54
Q

M - Dorsal arteries of penis supply

A

fibrous tissue around corpora and skin

55
Q

Female Urogenital Triangle Contains

A

Labia

Clitoris

56
Q

Labia

A

Majora - contains fat and terminal part of round ligament

Minora - prepuce, frenulum, vestibule

57
Q

Clitoris

A

Root
Erectile Tissue
Body

58
Q

Female Supericial Perneum Pouch Contains

A
Root of clit
Bulbospongiosus muscles
Greater vestubular glands
Paraurethral glands
Superifical transverse perineal muscles
Perineal body
Perineal branches of pudendal nerve
59
Q

F - Bulbospongiosus Muscles

A

o Covers the bulb of the vestibule and the greater vestibular glands
o Compresses the deep dorsal vein of clitoris and weakly constricts the vagina

60
Q

F - Bulbospongiosus Muscles Innervation

A

Perineal branch

61
Q

F - Ischiocavernosus Muscles

A

o Paired muscles covering the proximal crura of the clitoris

o Assists in erection of the clitoris

62
Q

F - Ischiocavernosus Muscles Innervation

A

Perineal nerve

63
Q

F - Greater Vestibular Gland

A

o Open into the vestibule, posterolateral to vaginal orifice

o Secrete lubricating mucus during sexual arousal

64
Q

F - Paraurethral Glands

A

o Open into the vestibule, lateral to the urethral orifice

o Secrete fluid into vestibule for distribution to labia

65
Q

F - Superficial transverse perineal muscles

A

Support and fix perineal body to support pelvic viscera and resist increased intraabdominal pressure

66
Q

F - Superficial transverse perineal muscles - innervation

A

Perineal

67
Q

F - Perineal branches of pudendal nerve - innervate

A
Bulbospongiosus muscles
Ischiocacvernosus muscles
Superficial transverse perineal muscles
Deep transvrse perineal muscles
External urethral sphincter
68
Q

F - Deep perineal pouch contains

A
Part of urethra
Part of vagina
Sphincter urethrae
Deep transverse perineal muscles
Posterior labial branches of internal pudendal artery
Artery to bulb of vestibule 
Deep artery of clitoris
Dorsal artery of clitoris 
Dorsal nerves of clitoris
69
Q

F - Sphincter Urethrae

A

o Compresses urethra to maintain urinary continence and compresses vagina
o Innervation  Perineal nerve

70
Q

F - Deep Transverse Perineal Muscles

A

o Internal surface of the ischiopubic ramus and ischial tuberosity to perineal body and external anal sphincter  location
o They support and fix perineal body to support abdominopelvic viscera and resist increased intraabdominal pressure
Innervation = perineal

71
Q

F - Posterior labial branches of internal pudendal artery supplu

A

skin of labia majora and minora

72
Q

F - Artery to the bulb of the vestibule supplies

A

bulb of vestibule and greater vestibular glands

73
Q

F - Deep artery of the clitoris supplies

A

erectile tissue of clitoris - responsible for erection

74
Q

F - Dorsal artery of clit supplies

A

Deep perineal pouch - erectile tissue of clitoris

75
Q

F - dorsal nerves of clitois innervate

A

skin of clitoris

76
Q

Innervation of Pelvic and perineal Organs - Somatic

A

Voluntary control via pudendal (S2-S4)
Present in pelvic floor muscles and external sphincters
Tonically active, so inhibition causes relaxation
Sensory from external anal and urethral sphincters, pelvic floor muscles, anal canal and urethra

77
Q

Innervation of Pelvic and Perineal Organs - Sympathetics

A

Involuntary T11-L2
Contracts internal anal sphncter and internal urethral sphincter
Contracts ductus deferns, seminal vesciles and prostatic muscles during sex
Most sensitive to feelings of distension

78
Q

Innervation of Pelvic and Perineal Organs - Parasympathetics

A

Involuntary S1-S4
Smooth muscle on organ walls
Contracts detrusor and rectal muscles
Sensory conveys normal sensation of bladder and rectal distension