Endo-Repro Anatomy 1 Flashcards Preview

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Flashcards in Endo-Repro Anatomy 1 Deck (39):
1

Inferior hypogastric 

 provides autonomic nerves to pelvic viscera, and contains sympathetic fibres, and parasympathetic fibres from pelvic splanchnic nerves (S2, 3, 4).

2

Internal Iliac artery: (ADD DIAGRAM)
Branches:

1. Obturator artery
2. Superior vesical and obliterated umbilical artery
3. Uterine artery in female (lying under ureter, close to cervix) – replaced by middle rectal artery in male
4. Vaginal artery (female) or inferior vesical artery (male)
5. Superior and inferior gluteal arteries (pass ino the buttock)
6. Internal pudendal artery (winding around the ischial spine)

3

Muscles of Pelvic sidewall and the pelvic floor 

Obturator internus
Piriformis
Levator ani
Coccygeus

4

Obturator internus
Action
Innervation

Abducts & externally rotates thigh, and stabilizer of the hip during walking
Nerve to obturator internus (L5, S1, S2)

5

Piriformis
Action
Innervation

External rotator of the thigh L5, S1 and S2

6

Levator ani
Action
Innervation

Supports contents of pelvic cavity Levator ani nerve (S4)
Inferior rectal nerve from pudendal (S3,4)

7

Coccygeus
Action
Innervation

pulls coccyx forward after defecation, closing in the back part of the outlet of the pelvis
S4, S5`

8

Perineum:
Boundaries of the perineum and its divisions:

• Urogenital triangle
• Anal triangle
• Ischioanal/ischiorectal fossa

9

Urogenital triangle Boundaries

Pubic symphisis
Tip fc coccyx
Ischeal tuberoscity

10

Urogenital triangle Contents

• Posterior scrotal nerves / Posterior labial nerves
• Urethra
• Vagina
• Bulbourethral gland / Bartholin's gland
• Muscles
o Transversus perinei superficialis muscle
o Ischiocavernosus muscle
o Bulbospongiosus muscle
• Crus penis / Clitoral crura
• Bulb of penis / vestibular bulb
• Urogenital diaphragm
• Muscular perineal body
• Superficial and Deep perineal pouch
• Blood vessels and lymphatic

11

Urogenital triangle What is the perineal membrane

It is the superior border of the superficial perineal pouch, and the inferior border of the deep perineal pouch.

Its lateral margins are attached on either side to the inferior rami of the pubis and ischium, above the crus penis.
Its base is directed toward the rectum, and connected to the central tendinous point of the perineum.The base is fused with both the pelvic fascia and Colle's fascia

12

What is the perineal body

is a pyramidal fibromuscular mass in the middle line of the perineum at the junction between the urogenital triangle and the anal triangle. It is found in both males and females. In males, it is found between the bulb of penis and the anus; in females, is found between the vagina and anus, and about 1.25 cm in front of the latter

13


Anal triangle: Boundaries

Obturator internus laterally
Tip of coccyx, ischeal tuberoscity and levator ani medially

14


Anal triangle:
Contents

Anus
External anal sphincter muscle
Ischeo-anal fossa (fat filled)
Levator ani
Obturator

15


Anal triangle: Which nerve controls the external anal sphincter

Pudendal nerve

16


Ischioanal/Ischiorectal fossa:
Which two muscles does this space lie between?

Obturator internus
Levator ani

17


Ischioanal/Ischiorectal fossa:
Which blood vessels and nerves run through this space

Internal pudendal artery/vein
Pudendal nerve

18

Deep and superficial perineal pouches: Which glands are located in these pouches in the male and female?

Deep Bulbourethral gland (males).

Superficial  Bartholin gland (female)

19

Deep and superficial perineal pouches: Transverse perineal muscles

Superficial and deep perineal muscle

20

Pudendal Nerve: What are its root values

Sacral nerves S2, S3, S4

21

Pudendal Nerve: What does it supply

 It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum.
 Motor supply to various pelvic muscles, including the external urethral sphincter and the external anal sphincter.

22

Pudendal Nerve: How does it exit the pelvis/enter the perineum

The pudendal nerve passes between the piriformis muscle and ischiococcygeus muscles and leaves the pelvis through the lower part of the greater sciatic foramen.[2] It crosses over the lateral part of the sacrospinous ligament and reenters the pelvis through the lesser sciatic foramen

23

Pudendal Nerve: Function

It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well the motor supply to various pelvic muscles, including the external urethral sphincter and the external anal sphincter.

24

1. Parietal pelvic fascia 

over obturator internus and piriformis

25

2. Endo-pelvic fascia (between levator ani and peritoneum)

a. Condenses to form ligaments which provide support for pelvic viscera

26

Peritoneal membrane  attachment for

roots of genitalia

27

Clitoris: Blood supply 

1. The deep artery of clitoris and dorsal artery of clitoris is a branch of the internal pudendal artery.

28

Clitoris: Venous drainage

 The superficial dorsal veins of clitoris is a tributary of the external pudendal vein.
 The deep dorsal vein of clitoris is a vein which drains to the vesical plexus.

29

Clitoris:Innervation

The dorsal nerve of the clitoris is a nerve in females that branches off the pudendal nerve to innervate the clitoris.

30

Penis root

Fixed, attached to the perineal membrane

31

Glans penis covered by

Prepuce

32

Crura attachment

begins at the inferior ramus of the pubic bone

33

Blood supply

all of the penile arteries arise from the internal pudendal artery from the internal iliac artery

34

Penis: Venous drainage

the veins of the penis break through the tunica albuginea and open via the circumflex veins in the unpaired deep dorsal vein, which empties into the venous plexus of Santorini. The superficial dorsal vein lies external to Buck's fascia.

35

Penis:Lymph drainage

superficial inguinal and subinguinal lymph nodes. The proximal urethra drains into the pelvic lymph nodes (internal iliac and common iliac lymph nodes).

36

Skin of scrotum

Skin of the scrotum is pigmented and rugose and has a median raphe

37

Subcutaneous tissues of scrotum

Continuous with Camper’s fascia of abdominal wall

38

Dartos muscle function

Smooth muscle fibers interspersed within the dartos fascia (superficial fascia of scrotum), causing contraction of the scrotum, as when experiencing a cool environmental temperature.

39

Lymph drainage of scrotum

Lumbar Lymph nodes

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