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Anatomy Week 11 BT > Parker SC (Perineum/ some Pelvis) > Flashcards

Parker SC (Perineum/ some Pelvis) Flashcards

1
Q

What separates the pelvis and perineum?

A

Muscular pelvic diaphragm

- Composed of Levator ani and cocygeus

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2
Q

What are the boundaries of the perineum?

A 
Anterior: Pubic Symphysis 
Anterolateral: Ischiopubic Ramus
Lateral: Ischial Tuberosity
Posterolateral: Sacrotuberous ligaments
Posterior: Coccyx 
Roof: Pelivic diaphragm
Inferior: Continuations of scarpas
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3
Q

What is the dividing line between the 2 ∆’s?

A

A line between the two ischial tuberosities

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4
Q

What are the ischioanal fossae?

A

wedge shaped spaces on either side of the anal canal

*found inside of anal ∆

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5
Q

What are the contents of the ischioanal fossa?

A
  • Pudendal Canal (w/ internal pudenal a., pudendal n.)
  • made by specialization of obturator internus fascia
  • inferior rectal nn. and vessels transverse the fossae
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6
Q

T or F: the rectum is found in the anal ∆

A

True, the part of the rectum distal to the pelvic diaphragm is in the anal ∆

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7
Q

T or F: the ischioanal fossae extend anteriorly into the UG ∆ superior to the UG diaphragm

A

True

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8
Q

What muscles are located into the anal ∆?

- innervation?

A
  • Only 1 muscle: external anal sphincter

- Innervation: inferior rectal n. (somatic)

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9
Q

What two membranes bound the superficial space?

A
  • Superior - Perineal membrane

- Inferior - Colle’s fascia

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10
Q

What are the neurovascular structures of the perineum?

A
  • Internal Pudendal a.

- pudendal n.

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11
Q

Describe the path of the pudendal a. as it enters the anal ∆.

A
  1. Exit via greater sciatic foramen
  2. Pass over the sacrospinous ligament
  3. Enter the lesser sciatic foramen
  4. Enter perineum
  5. Pudendal Canal on obturator internus in ischioanal fossa of anal ∆
  6. Target
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12
Q

What are the contents of the anal ∆?

A
  1. Ischioanal fossa
    - pudendal canal (with pudenal n. and internal pudendal a.)
    - Rectal vessels transverse the ischioanal fossa
  2. Anal canal and anus
  3. Part of rectum distal to pelvic diaphragm
  4. External anal sphincter
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13
Q

What are the 3 muscles of the superficial Perineal space?

A

Ischiocavernosus
Bulbospongiosus
Superficial transverse perineus

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14
Q

What is the terminal branch of the perineal n.?

A

Posterior Scrotal/Labial n.

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15
Q

T or F: the external genitalia and its roots are part of the deep/superior perineal space

A

False, they are in the superficial space

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16
Q

What are the roots of the penis/vagina?

A
  • R and L crura

- Bulb or Penis/Vestibule (females)

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17
Q

What part of the urethra is located in the superficial perineal space in males?

A
  • Spongy Urethra in males

* Note females don’t have different parts to their urethra

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18
Q

What nerve enters anteriorly into the superficial perineal space?
- What is this nerve a branch of?

A
  • anterior Scrotal/Labial n.

- Branch of Ilioinguinal

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19
Q

What is the common innervation of all muscle in the superficial perineal space?
- Where does this nerve enter?

A
  • Perineal n.

- Enters POSTERIOLY from anal ∆

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20
Q

What is contained in the superficial perineal space?

A
  1. External genitalia and its roots
    - R and L crus, bulb of the penis/vestibule
  2. 3 Muscles
    - Ischiocavernosus, bulbospongiosus, SUPERFICIAL transverse perineus
  3. Perineal a. and n.
  4. Perineal Body
  5. SPONGY urethra in males, urethra in females
  6. GREATER vestibular glands (aka bartholin’s) (FEMALES)
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21
Q

What two muscles lie in the deep perineal membrane?

A
  • External Sphincter Urethrae

- Deep Transversus Perineus

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22
Q

T or F: the external urethral sphincter is under somatic control.

A

True

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23
Q

What nerve PIERCES the posterior border of the urogenital diaphragm?

A
  • Dorsal n. of the Penis/Clitoris
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24
Q

What arteries are found in the deep perineal space?

A
  1. Artery to the bulb
  2. Deep artery of the penis/clitoris
  3. Dorsal a. of the penis/clitori
  4. Artery to Urethra
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25
Q

What part of the urethra is found in the deep perineal space?

A

The membranous urethra

26
Q

What glands are found in the deep perineal space?

A

Bulbourethral glands (cowper’s) glands (males only)

27
Q

What part of the urethra do the Cowper’s glands empty into?

A

Empty into the Spongy Urethra in the Superficial Space (Even though the glands are in the deep space)

28
Q

T or F: the perineal body is part of both superficial and deep spaces of the perineum.

A

True

29
Q

What muscles interdigitate at the perineal body?

A
  • Superficial Transversus Perineus
  • Deep Transversus Perineus
  • Bulbospongiosus
  • External anal Sphincter
30
Q

What are the contents of the deep perineal space?

A

Muscles:
Deep Transversus Perineus
External Sphincter Urethrae

Arteries/Veins:
Deep a. of the penis/clitoris
Artery of the bulb of the penis/clitoris
Urethral a. of penis/clitoris
Dorsal a. of the penis/clitoris

Nerves:
Dorsal n. of the penis/clitoris

Other:
MEMBRANOUS urethra
Bulbourethral gland (Cowper’s glands) in males

31
Q

What vessel is located in the superficial penile fascia?

A

Superficial Dorsal Vein of the Penis

32
Q

What vein lies superficial to the tunica albuginea and deep to Buck’s fascia?

A

Deep Dorsal Vein of the Penis

33
Q

Where do the Superficial and Deep Penile veins drian?

A

Superficial:
Pudendal –> Great Saphenous

Deep:
Prostatic Venous Plexus

34
Q

What is the only thing passing though the gap of the UG diaphragm and the pubic symphysis?

A

Deep Dorsal Vein of the penis

35
Q

What fascial layers surround the deep dorsal n. of the penis?

A
  • Buck’s Fascia superiorly
  • Tunica Albuginea deeply

**Note the paired dorsal nn. and aa. run deep to the deep penile fascia

36
Q

What is the relationship of the Deep dorsal vein and the dorsal aa. and nn.?

A 
* All lie in the same fascial plane
Medial to lateral:
1. Deep dorsal v. of penis (not paired)
2. Dorsal aa. of the penis (paired)
3. Dorsal nn. of the penis (paired)
37
Q

What lies immediately superior to the R and L crura?

A
  • ischiocavernosus mm.
38
Q

What lies immediately superior to the bulb of the penis?

A
  • Bulbospongiosus m
39
Q

What is the purpose of the ischiocavernosus and bulbospongiosus mm?

A

Help to maintain erection

40
Q

What nerves signal for erection?

A
  • Parasympathetic

- Pelvic Splanchnic S2-S4

41
Q

What nerves signal for emmision?

A
  • Sympathetic

- Lumbar Splanchnic L1-L2

42
Q

What nerves signal for ejaculation?

A
  • Somatic and Sympathetic
    Somatic:
    PERINEAL N. to bulbospongiosus muscle (from Pundendal n.)

Sympathetic:
Lumbar Splanchnics L1-L2

43
Q

What does the corpus spongiosum give rise to distally?

A

Glans Penis

44
Q

What forms the Glans Clitoris?

A

Bulb of the Vestibule

**Note this difference:
Males:
Bulb of Penis –> Corpus spongiosum –> Glans

Females:
Bulb of Vestibule –> Glans

45
Q

What forms the body of the clitoris?

A

2 corpora cavernosa

46
Q

In what space are the Bartholin’s glands located?

A
  • Superficial Perineal space
47
Q

What does the ischiocavernosus muscle do in females?

A

helps maintain erection of the clitoris

48
Q

What muscle is responsible for constricting the vaginal orifice during intercourse?

A

Bulbospongiosus muscle

49
Q

T or F: there is a small gap between the pubic symphysis and UG diaphragm.

A

True, this is an important route for the spread of infection

50
Q

What passes through the gap between the symphysis and the UG diaphragm?

A

Deep dorsal v. of Penis

51
Q

How would you perform a spinal n. block and what would be the ramifications of this procedure?

A
  • Lumbar puncture into subarachnoid space L3/L4

- Complete paralysis and anesthesia from the waist down

52
Q

How would you perform a caudal (EPIDURAL) n. block and what would be the ramifications of this procedure?

A
  • In-dwelling catheter in sacral canal into EPIDURAL space S2-S4
  • anesthesia of the entire pelvis, but preserves lower limb function from the
53
Q

How would you perform a pudendal n. block and what would be the ramifications of this procedure?

A
  • inject pudendal n. where it crosses the ischial spine
  • Numbs pudendal n. area
    aka Dorsal n. to clitoris, bulb of vestibule, posterior labia, Urethra
54
Q

What is the lymph drainage of the glans penis/clitoris and the labia MINora?

A

Deep Inguinal Nodes

55
Q

What drains the lymph of all parts of the penis/clitoris and scrotum/labia MAJora?

A

Superficial Inguinal Nodes

56
Q

WHERE IS THE LYMPH OF THE TESTIS?

A

Para aortic nodes (Lumbar nodes)

57
Q

What is the lymph drainage of the deep parts of the perineum?

A

Internal Iliac nodes

58
Q

What are the 3 branches of the pudendal n.?

A

Dorsal n. to the penis/clitoris
Perineal n.
Inferior rectal n.

59
Q

What are the relationships between:

  • Dorsal n. to the penis/clitoris
  • Perineal n.
  • Inferior rectal n.
A 
Most medially:
Inferior Rectal (extends from obturator internus to rectum)

Middle:
Perineal n. (travels below/superior to the UG diaphagm to innervate its MEDIALLY located muscles)

Laterally:
Dorsal n. to the clitoris/penis (travels IN the DEEP space medial to crus)

60
Q

Where does the Internal Pudendal artery branch from and what branches does it give off?

A

Branches From:
Internal Iliac a.

Gives off:
a. to urethra
a. to bulb
Dorsal a. of penis/clitoris
DEEP A. OF PENIS/CLITORIS
Perineal a. 
Inferior Rectal a.
61
Q

What artery passes superficial/inferior to the UG diaphragm, what nerve does it course with?

A
  • Internal Pudendal a.

- Perineal n.

Anatomy Week 11 BT (8 decks)

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