Male and Female Pelvis and Perineum Flashcards Preview

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Flashcards in Male and Female Pelvis and Perineum Deck (102):
1

perineum division

line connecting ischial tuberosities

anal triangle
UG triangle

2

boundaries of anal triangle

anterior - posterior edge of UG diaphragm
posterolateral - ischial tuberosities and sacrotuberous ligament
posterior - coccyx

3

contents of anal triangle

anal canal
ischioanal fossa
vessels and nerves to perineum

4

external anal sphincter

voluntary muscle surrounding anal canal

5

divisions of anal triangle

subQ - circular fibers
superficial - tendon of perineum to coccyx
deep - encircles anal canal

6

attachment of tendon of perineum to coccyx

central tendon male
perineal body female

7

currugator cutis ani

superficial of external anal sphinchter

8

ischioanal fossa

below levator ani muscle
-between superficial anal triangle and pelvic diaphragm

posteriorly - left and right communicate
anterior - separation by anterior recesses

9

anterior ischioanal fossa

adipose tissue
- continuation of campers fascia

internal pudendal nerves
inferior rectal vessels
internal pudendal nerves

10

internal pudendal artery

1 of 2 terminal branches
-of internal iliac artery

leaves pelvis through greater sciatic foramen
-crosses ischial spine between sacrospinous ligament and sacrotuberous ligament

comes back into perineum via lesser sciatic foramen

11

alcocks canal

aka pudendal canal
-split of obturator fascia
-contains internal pudendal vessels and pudendal nerve

12

branches of internal pudendal artery

in ischioanal fossa
-inferior rectal - 1st branch
-perineal artery - 2nd branch
-deep and dorsal arteries of penis (clitoris)

13

inferior rectal artery

supplies sphincter, anal canal, skin of anus

first branch of internal pudendal artery

14

perineal artery

2nd branch of internal pudendal artery

arises - posterior edge of UG
-branches further:
-transverse perineal arteries
-posterior scrotal artery - males
-posteior labial artery - females

15

perineal artery blood supply to?

superficial perineal and deep perineal mm.

16

posterior scrotal (labial) artery

end branch of perineal artery from internal pudendal artery

17

terminal branch of internal pudendal arteries

deep and dorsal arteries of penis (clitoris)

18

nerves of anal triangle

similar to arterial distribution

pudendal nerve - S2-4
-same course as internal pudendal arteries

19

branches of pudendal nerve

inferior rectal nerves
perineal nerve
dorsal nerve of penis

20

perineal branches of posterior femoral cutaneous nerve

innervate lateral aspect of anal and UG regions
-down onto medial thigh

21

UG triangle borders

anterior - pubis
lateral - ischiopubic ramus
posterior - dorsal edge UG diaphragm
superior - pubococcygeus of levator ani (pelvic diaphragm)

22

male UG triangle

pierced by urethra
-sphincter urethrae m. and compressor urethrae m.

posterior edge - deep transverse perineal m. and superficial transverse perineal m.

23

insertion of superficial perineal m. in male?

central tendon

24

superficial UG diaphragm fascia

from transversalis fascia

25

inferior UG diaphragm fascia

from colles fascia

aka perineal membrane

26

deep perineal space

space between perineal membrane and superior perineal fascia

27

superficial perineal space in male

penis
bulbospongiosus
ischiocavernosus
scrotum

28

penis

male copulatory organ
-superficial fascia with overlying skin
-3 bodies

29

corpus spongiosum

along midline
-adherent to inferior fascia of UG diaphragm

contains urethra

enlarge proximal end - bulb of penis
enalrged distal - glans penis
-limited erectile function (mostly glans)

30

corpus cavernosa

2x
-start lateral and converge toward middle
-crura of penis - where they meet

anchored at ischiopubic rami
-converge at inferior margin of pubic symphysis**

each contain deep artery of penis
-from internal pudendal artery

31

tunica albuginea

thick CT around erectile tissue

spongiosum has thinner tunica albuginea
-prevents urethral collapse during erection

32

cavernosa in midline?

form vascular sinuses
-to equalize pressure on each side

33

support of penis


suspensory ligament - from deep fascia
-arises from pubic symphysis**

-deep to fundiform ligament (from superficial fascia)

34

suspensory ligament

inserts into deep fascia of penis

35

bulbospongiosus

surrounds bulb of penis
-compresses urethra

36

ischiocavernosus

erector of penis

37

fascia of penis

deep penile fascia - bucks
-forms suspensory ligament of penis

superficial penile fascia - colles
-dartos around scrotum

38

penis skin

hairless, thin skin

skin attached directly to erectile tissue at glans penis - prepuce (foreskin)

39

scrotum

skin and superficial fascia

split by midline septum - from dartos fascia

contains testes and ducts

40

scrotum vasculature

anterior scrotal branches from external pudendal artery

posterior scrotal branches from internal pudendal artery

41

innervation of scrotum

anterior scrotal branches from ilioinguinal nerves

posterior scrotal branches from perineal branch of pudendal nerve

42

mons pubis

subQ fat over pubic symphysis in females

not as distinct in male

43

labia majora

form boundaries of pudendal cleft
-UG vestibule

anterior and posterior commissures

homolog of scrotum in male

44

labia minora

homolog of urethral folds in male
join anteriorly around clitoris

prepuce of clitoris
frenulum - where the two sides meet (A and P)

45

UG triangle of female

same basic structure as male

sphincter urethrae muscle
compresser urethrae muscle

deep transverse perineal muscle - posterior to urethra

46

superficial transverse perineal muscle

posterior edge of UG diaphragm
-insert at central tendon

47

central tendon

aka perineal body

48

UG triangle in female

split by urethra and vagina

two vestibular bulbs (like bulbs of penis)
-are erectile

49

female corpus cavernosum

lead to body of clitoris

from ischiopubic rami to pubic arch

from crura of clitoris

50

bulbospongiosus in female

wrap around labia minora

51

fascia in female

superficial - interrupted by pudendal cleft

fascia continues into labia majora

deep - homolog to bucks in male
-suspensory ligament of clitoris

52

suspensory ligament of clitoris

from deep perineal fascia

53

vasculature of female UG triangle

internal pudendal artery

branches:
perineal artery
-transverse perineal artery - muscles
-supplies central tendon

posterior labial artery
-superficial perineal space

54

venous drainage of UG triangle

corresponds closely to arteries

most to internal pudendal vein

superficial dorsal vein - external pudendal vein
-to femoral vein

deep dorsal vein - large midline vein to deep fascia
-drains to prostatic plexus and pudendal plexus

helenic plexus drains into deep dorsal vein via circumflex veins which drain cavernosa

55

testes

left usually lower
-surrounded by several tunics from spermatic cord

tunica vaginalis - processus vaginalis (embryologic)
-partial cover

56

tunica albuginea

dense CT overs and divides testis to lobules
-each contains seminiferous tubules and rete testis

57

rete testis

at mediastinum of teste
-lead to epididymis (head)

58

epididymis

form as efferent ductules of rete testis pierce tunica albuginae

single epididymal duct thickens walls and forms vas deferens

59

vas deferens

passes into pelvis with spermatic cord via inguinal canal

60

inguinal ligament

from edge of external oblique
-superficial ring - split in external oblique aponeurosis

61

external spermatic fascia

fascia of external abdominal oblique m.
-passes down over spermatic cord and testis

62

lowest fibers of internal abdominal obliques

cremaster muscle

with cremasteric fascia

incompletely wraps around spermatic cord

extends around testes within external spermatic fascia

63

internal spermatic fascia

derived from transversalis fascia

64

passing through deep inguinal ring

vas deferens
testicular vesels
nerves
lymphatics

65

processus vaginalis

peritoneal evagination extending into scrotal sac which forms during development

forms independently of testicular descent

66

tunica vaginalis

parietal layer and visceral layer

visceral - on testicle

from processus vaginalis

67

indirect inguinal hernia

if processus vaginalis does not fuse

68

hydrocele

patent processus vaginalis
-peritoneal fluid accumulates in scrotum

69

layers of scrotum and spermatic cord

in to out

tunica vaginalis
internal spermatic fascia
cremasteric fascia
cremaster muscle
external spermatic fascia
dartos fascia
skin

70

ilioinguinal nerve

enters inguinal canal, runs with spermatic cord

L1

to upper medial thigh, upper anterior scrotum, anterior scrotal nerve in male, anterior labial nerve in female

71

genitofemoral nerve

L1 and l2

femoral branch
genital branch
-passes through inguinal canal
-supplies cremaster muscle
-cutaneous to scrotum

72

testicular artery

from abdominal aorta
-descends abdomen and pelvis
-enters deep inguinal ring

73

pampiniform plexus

veins to testes

74

vas deferens course

crosses external iliac vessels anteriorly
crosses over bladder medial to ureters
converges with opposite duct posterior to bladder

at ampulla - joins semial vesicle

75

ejaculatory duct

where vas deferens and seminal vesicles join

course through prostate to prostatic urethra

76

seminal vesicles

arise from ductus deferens
-60% of seminal fluid

77

course of sperm

testis
epididymis
vas deferens
seminal vesicles
ejaculatory ducts
prostatic urethra

78

prostate gland location

anterior - pubis
posterior - rectum
superior - base of bladder
inferior - levator ani muscle

79

urethra through prostate

enlargement known as seminal culliculus
-openings of ejaculatory duct

80

seminal culliculus

will find openings of ejaculatory ducts

81

BPH

mainly central zone of prostate gland

hard for urination (voiding)

82

lobes of prostate

anterior
median
2x lateral
posterior

83

blood to prostate

inferior vesical artery

capsular (main portion) and urethral

84

venous drainage of prostate

prostatic plexus and vesicular plexus
-to internal iliac veins

85

ovaries

lie on lateral pelvic wall

along posterior surface of broad ligament

inferolateral to uterine tube
anterior to ureter

86

mesovarium

broad ligament to ovary

87

suspensory ligament of ovary

attached to upper pole of ovary via uterine tube

88

ovarian ligament

lower end of ovary to lateral border of uterus

89

uterine tube

medial to laterally
-open ended
-infundibulum - fimbriated at distal end
-open into peritoneal cavity

-ampulla - greatest diameter portion of tube
-isthmus - thick walled, constricted lumen
-uterine portion - within muscular wall of uterus, very constricted lumen

90

uterus

fundus - above uterine tubes
body - uterine cavity (main portion)
cervix - uterine os - forms fornix

91

uterus position

anteverted or retroverted
anteflexed or retroflexed

ante - forward
retro - backward
version - vagina
flexion - cervix

92

vagina

thin walled tube
CT and muscle
stratified squamous epithelium
-opens into urogenital vestibule

93

vaginal exam

bladder and urethra
uterus, uterine tubes, ovaries
small intestine loops
rectum
colon

94

broad ligament

peritoneal reflections from lateral uterus
-divides pelvis into anterior and posterior segments

divided to mesosalpinx, mesovarium, and mesometrium

95

mesosalpinx

broad ligament near uterine tubes

96

mesovarium

broad ligament to ovary

97

mesometrium

broad ligament to uterus to lateral pelvic wall

98

pouches in female

separated by broad ligament

recto-uterine pouch
vesico-uterine pouch

99

ovarian artery

from aorta
-travels in suspensory ligament of ovary

100

ovarian branch of uterine artery

passes laterally in broad ligament
-forms anastomose with ovarian artery**

101

venous drain of ovary

follows arterial branches

102

vaginal artery

terminal branch of inferior vesical artery

in females