Exam 4: Perineum

Question 1

Perineum

Answer 1

A diamond-shaped space that is part of trunk below the pelvic diaphragm. Divided into 2 triangles by a line connecting 2 ischial tuberosities.

Question 2

Triangles of perineum

Answer 2

Urogenital triangle

Anal triangle

Question 3

Urogenital Triangle position

Answer 3

Lies in horizontal plane

Question 4

Anal Triangle position

Answer 4

Tilted upward

Question 5

Urogenital triangle boundaries

Answer 5

1. Anterior: pubic symphysis
2. Anterolateral: ischiopubic rami
3. Posterior: Transverse line through ischial tuberosities

Question 6

Layers of urogenital triangle

Answer 6

1. Skin
2. Superficial Perineal Pouch
3. Perineal Membrane
4. Deep Perineal Pouch
5. Inferior Fascia of the Pelvic Diaphragm

Question 7

Superficial Perineal Pouch made up of

Answer 7

1. Superficial perineal fascia

2. Deep perineal Fascia

Question 8

Superficial Perineal Fascia

Answer 8

Fatty Layer (superficial)
Membranous layer (deep)

Question 9

Colles’ Fascia

Answer 9

Membranous layer of superficial perineal pouch. Continuous with Dartos layer of the scrotum and Scarpa’s fascia

Question 10

Superficial Perineal Pouch contents

Answer 10

1. Perineal body
2. Superficial transverse perineal muscle
3. Ischiocavernosus muscle
4. Crura of the Penis (Clitoris)
5. Bulbospongiosus Muscle
6. Bulb of the Penis (Vestible)
7. Greater Vestibular Gland (females)
8. Branches of the internal pudendal artery
9. Branches of the Pudendal Nerve

Question 11

Perineal body

Answer 11

Fibromuscular mass located between anal canal and bulb of penis

Question 12

Muscle attachments on Perineal body

Answer 12

1. Superficial transverse perineal
2. Deep Transverse Perineal
3. Bulbospongiosus
4. Levator Ani
5. External Anal sphincter

Question 13

Episiotomy

Answer 13

Incision from posterior vaginal wall to perineal body. Prevents uncontrolled tearing of perineum

Question 14

Muscle that does NOT attach to perineal body

Answer 14

Ischiocavernosus

Question 15

Superficial Transverse Perineal Muscle Nerve

Answer 15

Perineal branch of pudendal nerve

Question 16

Ischiocavernosus Nerve

Answer 16

Perineal branch of pudendal nerve

Question 17

Bulbospongiosus muscle (Male)

Answer 17

Perineal branch of pudendal nerve

Impedes venous return by compressing the bulb of the penis, maintaining the erection. Constricts corpus spongiosum to empty the urethra at the end of micturition and during ejaculation

Question 18

Bulbospingosus (Female)

Answer 18

Pudendal Nerve

Constricts vaginal orifice and maintains erection of clitoris

Question 19

Greater Vestibular Gland

Answer 19

2 ovoid glands which are located in the superficial perineal pouch, posterior to the bulb of the vestibule

Question 20

Greater Vestibular Gland homologous to:

Answer 20

Bulbourethral gland in the male.

Secretes mucus which lubricates the vagina during sexual intercourse

Question 21

Mechanism of Erection

Answer 21

1. Parasympathetic activation (S2,3,4)
2. Flow of blood compresses venous plexuses
3. Bulbospongiosus and ischiocavernosus contract

Question 22

Deep Perineal Pouch contents

Answer 22

1. Deep transverse perineal muscle
2. External urethral sphincter
3. Membranous part of urethra
4. Bulbourethral gland (males)
5. Branches of internal pudendal artery
6. Pudendal nerve

Question 23

Deep transverse perineal muscle

Answer 23

Inserts of median raphe in males or walls of the vagina in females

Stabilizes the perineal body and supports the prostate gland or vagina

Question 24

External urethral sphincter Muscle

Answer 24

May be damaged during parturition and can lead to incontinence

Question 25

External Urethral Sphincter muscle (males)

Answer 25

Inferior Part | Superior part

Question 26

Inferior Part of external urethral sphincter muscle (male)

Answer 26

True anatomical sphincter which encircles the urethra below the prostate

Question 27

Superior part of external urethral sphincter muscle (male)

Answer 27

Trough-like portion within the isthmus of the prostate

Question 28

External urethral sphincter muscle (female)

Answer 28

Sphincter urethrovaginalis Compressor urethrae Superior part

Question 29

Sphincter urethrovaginalis

Answer 29

Inferior part of External urethral sphincter muscle that encircles the urethra and vagina

Question 30

Compressor Urethrae

Answer 30

Forms a band anterior to the urethra

Question 31

Superior part of External urethral sphincter muscle (female)

Answer 31

Trough-like portion

Question 32

Function of External urethral sphincter muscle

Answer 32

Compresses urethra at the end of micturition

Question 33

Bulbourethral glands

Answer 33

2 glands that lie in the deep perineal pouch

Question 34

Bulbourethral glands homologous to:

Answer 34

Greater vestibular glands of the female Secrete a mucus-like substance (minor part of semen)

Question 35

Bulbourethral gland empties into:

Answer 35

Spongy urethra

Question 36

Anal triangle Boundaries

Answer 36

Anterior: transverse line trough ischial tuberosities Posterolateral: sacrotuberous ligament Posterior: tip of the Cocccyx

Question 37

Contents of anal triangle

Answer 37

Anal canal, external anal sphincter, ischioanal fossa

Question 38

Ischioanal fossa Lateral wall

Answer 38

Formed by obturator fascia

Question 39

Ischioanal Fossa contains

Answer 39

1. Fat 2. Pudendal canal 3. Inferior rectal nerve and vessels 4. Perineal branch of posterior cutaneous nerve of thigh

Question 40

Pudendal canal

Answer 40

Formed by the obturator fascia and lies on the lateral wall of ischioanal fossa

Question 41

Pudendal canal transmits

Answer 41

Internal pudendal vessels and pudendal nerve

Question 42

Blood supply to perineum

Answer 42

Internal Pudendal artery

Question 43

Internal Pudendal Artery

Answer 43

Arises from internal iliac artery. Travels in pudendal canal with the pudendal nerve

Question 44

Branches of Internal Pudendal Artery

Answer 44

1. Inferior rectal artery 2. Perineal Artery 3. Posterior scrotal (Labial) artery 4. Artery of the bulb 5. Urethral Artery 6. Deep artery of the penis or clitoris 7. Dorsal artery of the penis or clitoris

Question 45

External Pudendal artery

Answer 45

Small branch of femoral artery tat supplies male and female external genitalia

Question 46

Innervation of Perineum

Answer 46

Pudendal nerve (S2,3,4)

Question 47

Branches of the Pudendal nerve

Answer 47

1. Inferior Rectal Nerve 2. Perineal Nerve 3. Dorsal Nerve of the Penis or Clitoris

Question 48

Inferior Rectal Nerve

Answer 48

Supplies external anal sphincter muscle and skin around anus

Question 49

Perineal Nerve branches

Answer 49

Deep- muscles of perineum | Superficial- sensory to scrotum or labia majora

Question 50

Dorsal nerve of the Penis or Clitoris

Answer 50

Supplies skin, prepuce, and glans of the penis or clitoris