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Endo/Repro Final > Male And Female Peritoneum > Flashcards

Male And Female Peritoneum Flashcards

1
Q

What is the perineum?

What shape is it?

What is the superior boundary?

Inferior boundary?

A

Most inferior region of the trunk including external genitalia and anal canal

Diamond shaped area between the thighs

Superior boundary: pelvic diaphragm (separates perineum from pelvic cavity)

Inferior boundary: skin associated with external genitalia and anal canal

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2
Q

What are the boundaries of the perineum?

A

Anterior: pubic symphysis

Lateral: ischiopubic ramus, ischial tuberosity, sacrotuberous ligament, obturator internus muscle

Posterior: coccyx

Superior: pelvic diaphragm (levator ani and coccygeus muscle)

Inferior: skin of the buttocks (ischiorectal fascia) and external genitalia

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3
Q

What boundary of the perineum aids in defecation?

What are its boundaries?

A

Ischiorectal fossa: fat filled space inferior to the perineum on either side of the anal canal that allows the anal canal to expand during defecation without compressing vital structures

Lateral wall: obturator internus and ischium

Superomedial wall: levator ani and anal canal

Base: skin of perineum

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4
Q

What two triangles form when the perineum is divided by a line joining the ischial tuberosities?

What are the boundaries of these two triangles?

A

Urogenital triangle (anterior): pubic symphysis, ischiopubic rami, imaginary line

Anal triangle (posterior): coccyx, sacrotuberous L, imaginary line

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5
Q

What does the anal canal contain?

A

Internal anal sphincter: circular smooth muscle; parasympathetics of pelvic splanchnic nerves S2-S4

External anal sphincter: circular skeletal muscle; sympathetics of pudendal N

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6
Q

What two anchors does the external anal sphincter attach to?

What is the innervation of the external anal sphincter?

A

Anteriorly: perineal body

Posteriorly: anococcygeal ligament

Inferior rectal N (branch of pudendal N)

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7
Q

What structure travels within the muscle fascia of the medial obturator internus muscle and the lateral walls of the ischiorectal fossae?

What are the contents of this structure?

What are its branches passing from pudendal canal to the anal canal and traveling through the ischiorectal fossae?

A

Pudendal canal: pudendal N, internal pudendal A, internal pudendal V

Inferior rectal N, inferior rectal A, inferior rectal V

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8
Q

What is the anal canal above and below the pectinate line derived from?

What sensory neurons does it contain?

A

Above the pectinate line: endoderm; visceral afferent sensory neurons

Below the pectinate line: ectoderm; somatic sensory neurons

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9
Q

Describe the pathway of the pudendal N and internal pudendal A

What does the pudendal N contain?

What does the internal pudendal A supply?

A

Come from the pelvis, exit the greater sciatic foramen, wrap around the sacrospinous L, and enter the lesser sciatic foramen to the perineum

S2-S4; Contains motor (somatic and autonomic fibers) plus sensory fibers (somatic and visceral)

Branches supply perineum

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10
Q

What is the blood supply of the anal canal and rectum?

Nerve supply?

A

Internal pudendal A ->inferior rectal A

Superior rectal V, middle rectal V, inferior rectal V

Inferior rectal N (S2-S4)

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11
Q

Where do abscesses collect in the male perineum?

A

Ischiorectal fossa

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12
Q

What are parts of the male urethra and what do they pass through?

A

Prostatic urethra; prostate

Membranous urethra; urogenital diaphragm

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13
Q

What is the deep perineal pouch in males?

What are its contents?

A

Part of the urogenital triangle and includes the urogenital diaphragm

Membranous urethra, external urethral sphincter surrounding the membranous urethra, deep transverse perineous muscle that inserts the perineal body, and bulbourethral glands

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14
Q

What is the function of the bulbourethral glands in males?

A

Produces a clear mucous into the penile urethra just prior to ejaculation that lubricates the urethra

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15
Q

What is in the male superficial perineal space?

What three muscles are contained in the male superficial perineal space and where are they located?

A

Root of penis: L cruz, R crura, bulb of penis (continuous with corpus spongiosum)

Ischiocavernosus muscle: surround free surface of each crus, attaches to ischiopubic rami, and insert into corpus cavernous

Bulbospongiosus muscle: arises from the perineal body and raphe of penis, wraps around the bulb of penis and posterior part of corpus spongiosum (voluntary control; empties spongy urethra of urine or semen)

Superficial transverse perineus muscle: located along the posterior border of the UG diaphragm

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16
Q

Bulb of penis is attached to perineal body and is surrounded by a layer of fascia called ____.

This fascia also covers ____.

This is located in the _____ space.

A

Deep fascia of the penis (Buck’s fascia)

Three sets of erectile tissue including corpus spongiosum and bilateral corpus cavernosum

Superficial perineal space

17
Q

How is an erection maintained?

What muscles are used?

A

Blood fills the corpus cavernosum and corpus spongiosum in the penis

Ischiocavernosus muscle and bulbospongiosus muscle contract and compress the veins, preventing the blood from draining from the corpus cavernosum; thus maintaining an erection

18
Q

What is the pathway of the internal pudendal A?

What does the internal pudendal A supply in males?

External pudendal A?

A

Branch off internal iliac, enters perineum by lesser sciatic foramen, enters pudendal canal

Internal pudendal A: supplies anal canal, ischiorectal fossa, deep perineal space; superficial branches to superficial perineal space and posterior scrotum; branches of helicine arteries into penis (dorsal arteries of penis)

External pudendal A (branch off femoral A): sends deep and superficial branches to anterior scrotum and penis

19
Q

What nerve supplies the male perineum?

A

Pudendal N

Superficial branches supply superficial perineal pouch (muscles and scrotum)

Deep branches supply deep perineal pouch (penis)

20
Q

Inferior hypogastric plexus sends sympathetic and parasympathetic to ___ and ___ in a male.

What can occur during a prostectomy?

A

Prostate and penis

In removing the prostate, parasympathetic fibers in the prostate that travel to the penis can also be removed; preventing future erections

21
Q

What are possible causes of male impotence/erectile dysfunction?

A

Prostectomy, neuropathy from diabetes, spinal cord injury, hernia, athrosclerosis

22
Q

What are homologous perineal structures between males and females?

A

Scrotum -> Labia majora

Raphe of penis -> Labia minora

Gland penis -> clitoris

23
Q

What are the contents of the female deep urogenital pouch?

A

Urethra, vagina, deep transverse perineus muscle that inserts the perineal body, compressor muscles that close the urethra

24
Q

What openings are on either side of the female urethra orifice?

What openings are on either side of the vagina? Fx?

A

Openings for paraurethral glands

Openings for greater vestibular glands (Bartholin’s glands): releases a clear mucous during sexual activity between the Labia minora (vestibule of the vagina); lubricates the vulva

25
Q

What is included in the female vulva?

What is contained in the vestibule of the vagina?

A

Glans clitoris, Labia majora, Labia minora

External urethral orifice with external urethral sphincter, vaginal orifice, openings of the paraurethral glands, greater vestibular glands

26
Q

What are the contents of the female superficial pouch?

What are the contents deep to the skin?

A

Labia majora (unite anteriorly to form the mons pubis), Labia minora, R and L cruz of clitoris

Bulbs of the vestibule, greater vestibular glands, superficial transverse perineus muscles (attach to perineal body)

27
Q

What are the parts of the clitoris?

Each crus is continuous with ____ that is composed of _____ tissue.

What surrounds the crus and corpus cavernosum and what is its function?

A

R and L crura, two corpus cavernosum that fuse to form one body, glans clitoris (only visible part)

Corpus cavernosum; erectile tissue

Ischiocavernosus muscle: contracts during sexual arousal to stop venous blood draining from the corpus cavernosum

28
Q

Blood supply of the female perineum?

A

Internal pudendal A: supplies anal canal, ischiorectal fossa, deep perineal space; superficial branches to superficial perineal space; branches of helicine arteries into clitoris

External pudendal A (branch off femoral A): sends deep and superficial branches to Labia majora and clitoris

29
Q

Nerve supply to the female urogenital triangle

What is contained in this nerve?

What cutaneous nerve supplies the perineum?

A

Pudendal nerve: S2-S4; sends branches to all structures supplied by the internal pudendal A

Preganglionic parasympathetic fibers: glands and smooth m

Somatic motor fibers: skeletal m

Somatic sensory fibers: sensory receptors in perineal skin, distal anal canal, distal vaginal canal

Postganglionic sympathetic fibers: glands and smooth m

Posterior femoral cutaneous N

30
Q

What drains into the superficial inguinal nodes?

What a drains into the internal iliac nodes?

A

Superficial perineal space, distal portion of vagina, distal portion of anal canal below pectinate line

Deep perineal space, proximal portion of vagina, proximal portion of anal canal above the pectinate line

31
Q

What is an episiotomy?

What are the types?

A

Surgical incision made in the area between the vagina and anus; during the last stages of labor and delivery; expands the opening of the vagina to prevent tearing of the perineum during delivery

Medio-lateral (most common), midline, lateral, J-shaped

32
Q

What is cut during a medio-lateral episiotomy?

What are the steps to surgically repairing an episiotomy?

A

Posterior vaginal wall, bulbospongiosus m, superficial transverse perineus muscles, skin and associated subcutaneous fascia

Does not go through the perineal body

Suture vaginal wall, muscle layer, subcutaneous fascia and skin

33
Q

What are the contents of the anal triangle?

What are the contents of the urogenital triangle?

A

Ischiorectal fossae, anal canal

Deep and superficial perineal pouches (spaces)

34
Q

What is the urogenital diaphragm?

The muscular diaphragm is split in half by the ____ in females.

The superior and inferior (perineal membrane) fascia are fused along the ____ borders

____ is attached to the midpoint of the posterior border

A

Part of the deep pouch in the urogenital triangle; continuous sheet of muscle that spans the gap between the ischiopubic rami

Vagina

Anterior and posterior borders

Perineal body

35
Q

What is the superficial perineal space?

In females, the space is split in half by the ____.

A

Potential space deep to the perineal skin that covers the external genitalia

Vestibule of the vagina

36
Q

Where is the bulb of the vestibule?

What are the bulbs composed of?

What covers the bulbs and what is its location and fx?

A

Deep to the skin of the Labia minora

Erectile tissue

Bulbocavernosus muscle: attached to the perineal body; during sexual arousal they compress the bulbs of the vestibule and stop the draining of venous blood

Endo/Repro Final (20 decks)

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