Perineum Flashcards

1
Q

What are the boundaries of the perineum?

A
Roof = skin
Floor = pelvic diaphragm
Anterior = pubic symphysis
Lateral = ischial tuberosities
Posterior = coccyx
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2
Q

What is the urogenital triangle and what are its borders?

A

It is the anterior triangle of the perineum.
Anterior = Pubic symphysis
Posterolaterally = ischial tuberosities
Inferior = perineal membrane

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3
Q

Where is the anal triangle located and what are its borders?

A

It is the posterior triangle of the perineum.
Antero/Lateral = Ischial tuberosities, obturator internus muscle, sacrotuberous ligaments
Posterior = Coccyx
Roof = pelvic diaphragm

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4
Q

What is within the anal triangle?

A

Anal canal, ischioanal fossa, pudendal canal

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5
Q

Where is the neurovascular bundle of the internal pudendal artery, vein, and nerve located?

A

Pudendal canal.

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6
Q

Where is the perineal membrane located and what are the borders?

A

It fills the urogenital triangle.
Anterior and lateral = pubic arch
Posterior = no border! but attaches to perineal body

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7
Q

Where can one find the levator ani muscle and coccygeus muscle?

A

In the pelvic floor of the pelvic diaphragm.

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8
Q

Where is the superficial perineal pouch located? What does it contain, for males and for females?

A

It is located superior to the perineum membrane and below the perineal fascia.
Males: Root of penis (bulb and crura), ischiocavernosus, superficial transverse perineal, and bulbospongiosus muscles, and spongy urethra
Famales: clitoris, greater vestibular glands, bulbs of vestibule, ischiocavernosus, bulbospongiosus, and superficial transverse perineal muscles

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9
Q

Where is the deep perineal pouch located? What does it contain in both men and women?

A

It is located inferior to the perineal membrane and superior to the pelvic diaphragm.
Males: external urethral sphincter (sphincter urethrae membranacea), part of urethra, deep transverse perineal muscle, bulbo-urethral gland, nvb to dorsum of penis
Females: external sphincter of urethra (sphincter urethrovaginalis), urethra, smooth muscle, nvm to clitoris

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10
Q

Where is the anal canal located? What 3 structures does it contain?

A

It is within the anal triangle, between the rectum and anus. It contains the anal columns, anal valves, and anal sinuses.

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11
Q

What is the pectinate line?

A

The upper 2/3 (endoderm) of the canal is separated from the lower 1/3 (ectoderm) anal pit by the pectinate line.

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12
Q

What supplies the area above the pectinate line in the anal canal? What supples the area below the line? What are the innervations of this area?

A

Above: superior rectal artery and vein - from IMA and into IMV; autonomic inferior hypogastric plexus
Below: internal rectal artery and vein - from inferior pudendal artery and into internal pudendal vein; inferior anal and rectal nerves off of pudendal nerve

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13
Q

Where is the internal anal sphincter and is it voluntary or involuntary?

A

It is around the anal canal - upper 2/3 - and is involuntary.

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14
Q

Where is the external anal sphincter and is it voluntary or involuntary? What is its innervation?

A

It is found around the internal anal sphincter and is voluntary. It is innervated by the inferior rectal branch of the pudendal nerve.

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15
Q

Where are the superior rectal artery and vein located?

A

In the anal columns of the anal canal.

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16
Q

What is erectile tissue in men made of?

A

1) 2 copora cavernosa - attached to pubic arch and perineal membrane; crura converge in dorsal body and end in glans penis
2) 1 Corpus spongiosum - begins as bulb, encloses urethra, ends in glans penis

17
Q

What is the external genitalia of the male?

A

1) Scrotum

2) Penis

18
Q

What is female erectile tissue made of?

A

1) 2 corpora cavernosa - attached to pubic arch and perineal membrane; crura converge in clitoris, end in glans clitoris
2) 2 bulbs of the vestibule - sacs of erectile tissue that surround vestibule and urethra

19
Q

What is the external genitalia of the female?

A

1) Vulva
2) Clitoris
3) Vestibule
4) Hymen
5) Paraurethral (skene’s) glands = lesser vestibular glands
6) labia minora
7) labia majora
8) greater vestibular glands
9) external urethral orifice

20
Q

What supplies blood and drains blood from erectile tissue?

A

The helicine arteries supply blood and efferent veins drain blood.

21
Q

How is blood supplied and drained from erectile tissue during sexual arousal?

A

Parasympathetic neurons make the helicine arteries relax and straighten so blood flow is increased –> puts pressure on the tunica albuginea –> compress efferent veins. At max stretch of tunica albuginea, pressure –> erectile tissue expands. At climax, the arteries are innervated by sympathetic neurons and make them coil in pulsatile waves –> increased pressure –> urethra ejaculates vs decreased pressure –> efferent veins drain blood and tissue contracts

22
Q

The corpora cavernosa is surrounded by a dense connective tissue sheath called what?

A

The tunica albuginea.

23
Q

Why doesn’t the corpus spongiosum have a connective tissue sheath?

A

Because that would compress the urethra and prevent ejaculation.

24
Q

Ischiocavernosus

A

Ischial tuberosity and ramus; crus of penis and clitoris
Inn: Pudendal
F: move blood from crura into body of erect clit or penis

25
Q

Bulbospongiosus

A

Perineal body; perineal membrane, corpus canvernosus
Inn: Pudendal
F: Move blood from part of penis/clit to glans; men - remove urine left over in urethra after peeing, pulsatile emission of semen during ejaculation

26
Q

Superficial transverse perineal

A

Ischial tuberosity and ramus; perineal body
Inn: Pudendal
F: stabilize perineal body

27
Q

Deep transverse perineal

A

Ischial tuberosity and ramus; perineal body
Inn: Pudendal
F: stabilize perineal body

28
Q

What is an episiotomy?

A

The proactive cutting of the perineal body in order to control the tear during birth. Theory = will heal better and lessen prolapse. Has not been proven to have long term benefits.