Part III. Perineum/urogenital triangle/ischioanal fossae pg 79-86 Flashcards
(140 cards)
1
Q
Perineum refers to what?
A
External surface and a shallow body compartment that is separated from the pelvic cavity by pelvic diaphragm
2
Q
What is the anterior osseofibrous border of the perineum?
A
Pubic symphysis
3
Q
What is the anteriorlateral osseofibrous border of the perineum?
A
Ischiopubic rami
4
Q
What is the lateral osseofibrous border of the perineum?
A
Ischial tuberosity
5
Q
What is the posterolateral osseofibrous border of the perineum?
A
Sacrotuberous ligament
6
Q
What is the posterior osseofibrous border of the perineum?
A
Inferior sacrum and coccyx
7
Q
An Imaginary transverse line connecting ischial tuberosities subdivides perineum into:
A
Anal triangle and urogenital triangle
8
Q
What is contained in the anal triangle?
A
Anus bounded by two ischioanal fossae
9
Q
What closes anterior opening in pelvic diaphragm?
A
Perineal membrane
10
Q
What is the Attachment point for erectile bodies associated with external genitalia?
A
Perineal membrane
11
Q
The urethra (both sexes) and vagina (females) perforate what structure in the urogenital triangle?
A
Perineal membrane
12
Q
Where is the perineal body located?
A
Midpoint of transverse line, posterior to vestibule of vagina or bulb of penis and anterior to anus and anal canal
13
Q
What muscles attach to the perineal body?
A
- Superficial transverse perineal muscle
- deep transverse perineal muscle
- External anal sphincter
- bulbospongiosus m.
14
Q
What muscles span along the posterior aspect of perineal membrane to support and anchor perineal body in providing support to the pelvic floor?
A
Superficial transverse perineal m.
Deep transverse perineal m.
15
Q
What innervates Superficial Transverse Perineal M and Deep Transverse Perineal M?
A
Deep perineal nerve (a branch of pudendal nerve)
16
Q
Damage to the perineal body in females may result in what?
A
Prolapse of vagina
17
Q
What procedure reduces attenuation of perineal body during childbirth?
A
Episiotomy
18
Q
What structure in the male urogenital triangle is located in superficial perineal pouch, attached to perineal membrane?
A
Root of penis
19
Q
The root of the penis consists of what?
A
- crura
- bulb of penis
20
Q
The bilateral slender masses of erectile tissue?
A
Crura of penis
21
Q
Where is the crura of the penis attached?
A
To internal part of each ischial ramus (anterior to ischial tuberosity
22
Q
The crura of the penis is continuous with what structure in the body of the penis?
A
Corpora cavernosa
23
Q
The crura of the penis is surrounded by what muscle?
A
Ischiocavernosus m.
24
Q
What occurs when ischiocavernosus muscle contracts?
A
forces blood from crus into corpus cavernosum of penis and compresses Deep Dorsal vein of penis which increases turgidity of penis
I.e erection
25
The body of the penis is the free, pendulous elongated part of the penis that is suspended from pubis by what?
Suspensory ligament of the penis
26
What are the 3 cylindrical bodies of erectile tissue bound to deep fascia?
- two corpora cavernosa
| - corpus spongiosum
27
Which is dorsally located, corpora cavernosa or corpus spongiosum?
Corpora cavernosa is located dorsally in the penis
| Corpus spongiosum is located ventrally in penis
28
What is the thick fibrous structure surrounding the corpora cavernosa?
Tunica albuginea
29
________ expands distally to form the glans penis, while _____ does not extend into glans penis?
- corpus spongiosum
| - corpora cavernosum
30
The bulb of the penis is continuous with what?
Corpus spongiosum in the body of the penis
31
What surrounds the spongy urethra?
Corpus spongiosum
32
The spongy urethra opens from the distal end of the glans (Continuous with corpus spongiosum) where?
External urethral orifice
33
The expanded distal end of the corpus spongiosum?
Glans of penis forms the head of the penis
34
What is the expanded rim beyond end of corpora cavernosa?
Corona of glans
35
What is the constriction between corona of glans and body of penis?
Neck of glans
36
What is the double layer of skin extending from neck to cover glans of penis?
Prepuce (foreskin)
37
What is the ventral median fold of skin from prepuce to glans?
Frenulum of prepuce
38
Thin layer of adipose-free fascial connective tissue adjacent to skin of the penis?
Superficial penile fascia
39
What contains superficial neurovasculature supplying penile skin?
Superficial penile fascia
40
What connective tissue surrounds corpora cavernosa and corpus spongiosum?
Deep penile fascia
41
The deep dorsal neurovasculature of the penis is found where and what does it supply?
Enclosed in deep penile (bucks) fascia, then penetrates tunica albuginea and supplies erectile tissue
42
Where does the suspensory ligament of the penis extend from?
From anterior surface of the pubic symphysis to the root of the penis, effectively anchoring erectile bodies of the penis to the pupil symphysis
43
Internal Pudendal A supplies most penile tissue via the following branches:
- dorsal artery of the penis
| - deep artery of the penis
44
What artery is located between deep penile fascia and tunica albuginea?
Dorsal artery of penis
45
What artery supplies fascial CT and majority of penile skin?
Dorsal artery of penis
46
What artery passes through center of corpora cavernosa and is responsible for erection of penis?
Deep artery of the penis
47
What artery supplies bulb, corpus spongiosum and spongy urethra?
Artery of bulb
48
What supplies blood to the proximal penile skin?
Deep and superficial external pudendal arteries that branch from femoral artery
49
What vein is located in deep (bucks) penile fascia and drains erectile tissue?
Deep Dorsal V of penis -> prostatic venous plexus -> Internal Iliac V
50
What is located in superficial (dartos) fascia and drains skin of the penis?
Superficial Dorsal V of penis -> Superficial External Pudendal V -> External Iliac V
51
Most lymphatic efferents of the penis drain to where?
superficial inguinal lymph nodes
52
What provides sensory innervation of skin and glans penis?
Dorsal N of the penis
53
Dorsal N of penis is a terminal branch of what?
Pudendal N
54
What nerve parallels Dorsal A and Deep Dorsal V of penis?
Dorsal N of penis
55
What nerve is composed of parasympathetic fibers branching from prostatic plexus of nerves and innervates Deep A of penis and responsible for erection?
Cavernous nerve
56
female external genitalia is called
Vulva or Pudendum
57
What is the function of the Vulva/Pudendum?
- Sensory and erectile tissue for sexual arousal and intercourse
- Directs flow of urine
- Prevents entry of foreign material into urogenital tract
58
What is the mons pubis?
Rounded, fatty prominence covered with coarse pubic hairs (after puberty)
59
The mons pubis is located anterior to what?
pubic symphysis, superior pubic rami and pubic tubercles
60
The prominent folds of skin on either side of pudendal cleft?
Labia majora
61
The labia majora are connected by anterior and posterior ___________.
labial commissures
62
What female structure is homologous to the two halves of scrotal sac in males?
Labia majora
63
Where does the Round L of uterus terminate?
Labia majora
64
What is the function of the labia majora?
Provide protection for clitoris and urethral/vaginal orifices
65
Folds of fat-free, hairless skin enclosed in pudendal cleft by labia majora
Labia minora
66
The labia minora is connected posteriorly in young women and virgins by what?
frenulum of labia minora
67
What female structure is homologous to skin that covers body of penis in males?
Labia minora
68
Erectile organ located where labia minora meet anteriorly
Clitoris
69
What forms the prepuce of clitoris?
Anterior part of labia minora
70
The root of the clitoris is continuous with what?
Corpus Cavernosum in body of clitoris
71
The root of the clitoris is comprised of 2 crura located along internal surface of ischial rami. Each crus is surrounded by what?
Ischiocavernosus M
72
Bulbospongiosus M originates at perineal body and inserts where?
Clitoris
73
What is the function of the bulbospongiosus muscle in females?
Covers bulb of vestibule and weakly constricts vagina
74
What is the body of the clitoris composed of?
2 corpora cavernosa
75
What is the function of the glans clitoris?
functions solely as an organ of sexual arousal
76
Space between labia minora where urethra and vagina open externally
Vestibule of Vagina
77
The thin fold of mucous membrane covering vaginal orifice
Hymen
78
What is the shape of the hymen?
Usually crescent shaped posteriorly but may cover vaginal orifice completely
79
What structure must be perforated at puberty to allow menstrual flow and is reduced to remnants after coitus?
Hymen
80
Paired masses of elongated erectile tissue deep to labia minora?
Bulb of Vestibule
81
The bulb of the vestibule is continuous with ______.
glans clitoris
82
The bulb of the vestibule is covered by ______.
Bulbospongiosus M
83
What female structure is homologous to the bulb of penis and corpus spongiosum in males?
Bulb of vestibule
84
Round or oval glands located on each side of vestibule posterolateral to vagina
Vestibular glands
85
What female structure is homologous to bulbourethral glands in males?
Vestibular glands
86
Where do the ducts of the vestibular gland open?
into vestibule near orifice of vagina
87
Vestibular glands are partially surrounded by what muscle?
Bulbospongiosus M
88
What is the function of the vestibular glands?
Secrete mucous during sexual arousal to moisten labia and vestibule
89
What supplies skin and superficial fascia of the vulva with blood?
Deep and superficial External pudendal arteries that branch from femoral nerve
90
What supplies blood to the erectile tissue of the clitoris?
Internal Pudendal A (via Deep A of Clitoris)
91
What is the venous drainage of the vulva?
Internal Pudendal V -> Internal Iliac V
92
Efferent lymphatic drainage of the vulva is via what?
superficial inguinal lymph nodes
93
What supplies somatic innervation of the vulva?
- Ilioinguinal N forming Anterior Labial N
- Genitofemoral N innervating anterolateral perineum
- Pudendal N terminating as Posterior Labial N (from Superficial Perineal N)
94
Parasympathetic innervation of the vulva is via what?
Cavernous N from uterovaginal nerve plexus
95
What is the effect of parasympathetic innervation to the vulva?
Increases vaginal secretion and erection of clitoris
96
The fatty superficial layer of the superficial perineal fascia is continuous with ________ in the abdomen?
Camper’s fascia
97
The membranous deep layer of the superficial perineal fascia is called what?
Colles’ fascia
98
In females, the fatty superficial layer of the superficial perineal fascia extends where?
into labia majora and over mons pubis
99
In males, the fatty superficial layer of the superficial perineal fascia extends where?
reduced, replaced by smooth muscle in penis/scrotum
100
Colle’s fascia attaches laterally to _________.
Fascia lata of the thigh
101
Colle’s fascia is continuous with ________ in the abdomen and ________ in the penis and scrotum?
Scarpa’s fascia in the abdomen
| Dartos fascia in the penis and scrotum
102
What fascia invests Ischiocavernosus M, Bulbospongiosus M & Superficial Transverse Perineal M?
Deep Perineal (Gallaudet) Fascia
103
The Deep Perineal (Gallaudet) Fascia attaches laterally to what?
Ischiopubic rami
104
The Deep Perineal (Gallaudet) Fascia fuses anteriorly with what?
Suspensory L of either penis or clitoris
105
The Deep Perineal (Gallaudet) Fascia is continuous with what?
deep fascia of anterolateral abdominal wall
106
What is the Superficial Perineal Pouch?
Potential space between Colles’ fascia and perineal membrane
107
What is contained in the superficial perineal pouch in males?
- Crura and bulb of penis, Ischiocavernosus M, Bulbospongiosus M
- Proximal part of spongy urethra
- Superficial Transverse Perineal M
- Deep Perineal Branches of Internal Pudendal AV and Pudendal N
108
What is contained in the superficial perineal pouch in females?
- Crura of clitoris and Ischiocavernosus M
- Bulb of vestibule and Bulbospongiosus M
- Greater vestibular glands
- Superficial Transverse Perineal M
- Deep Perineal Branches of Internal Pudendal AV and Pudendal N
109
Where is the deep perineal pouch located?/
above perineal membrane and open superiorly to ischioanal fossae
110
What are the contents of the deep perineal pouch in males?
- Membranous urethra and bulbourethral glands
- External Urethral Sphincter M
- Deep Transverse Perineal M
111
What are the contents of the deep perineal pouch in females?
- Proximal part of urethra
- External Urethral Sphincter M
- Deep Transverse Perineal M
112
The urethral sphincter muscle in males is innervated by what?
Dorsal nerve of the penis
| Branch of pudendal nerve
113
The urethral sphincter muscle in females is innervated by what?
Dorsal nerve of the clitoris
| Branch of pudendal nerve
114
Wedge shaped spaces located between skin of anal region and pelvic diaphragm
Ischioanal fossae
115
Where does levator ani muscle originate from?
Obturator Internus fascia
116
How do the two ischioanal fossae communicate?
via a postanal space
117
What is the function of the ischioanal fossae?
It is filled with adipose and connective tissue which permits expansion of anal canal during passage of feces
118
What is the lateral boundary of the ischioanal fossa?
Ischium and Obturator Internus M (fascia)
119
What is the medial boundary of the ischioanal fossa?
Anal canal surrounded by Levator Ani M and External Anal Sphincter
120
What is the posterior boundary of the ischioanal fossa?
Sacrotuberous L and Gluteus Maximus M
121
What is the anterior boundary of the ischioanal fossa?
Pubic bones inferior to origin of Puborectalis m.
122
The anterior recess of the ischioanal fossa extends forward superior to ________.
perineal membrane
123
Where is the Pudendal Canal located?
Lateral wall of the ischioanal fossa (on medial aspect of obturator fascia)
124
What does the pudendal canal contain?
- Internal Pudendal AV
- Pudendal N
- N to Obturator Internus M
125
The contents of the pudendal canal enter where?
at lesser sciatic notch inferior to ischial spine
126
Internal Pudendal A branches to form:
- Inferior Rectal A
- perineal A
- Deep A of the penis/clitoris
- dorsal A of the penis/clitoris
127
What does the inferior rectal artery supply?
External Anal Sphincter and perianal skin
128
What does the perineal artery supply?
supplies muscles of superficial pouch
129
What supplies the erectile tissue in males?
Deep A of Penis and Dorsal A of Penis
130
What supplies the erectile tissue in females?
Deep A of Clitoris and Dorsal A of Clitoris
131
The terminal branches of perineal artery in the female?
Posterior Labial A and Artery of Bulb of Vestibule
132
The terminal branches of perineal artery in the male?
Posterior Scrotal A and Artery of Bulb of Penis
133
Pudendal N branches to form:
- Inferior Rectal N
- Perineal N
- Dorsal N of Penis/Clitoris
134
What does the Inferior Rectal N supply innervation to?
External Anal Sphincter and perianal skin?
135
What does the perineal N supply?
supplies urogenital triangle
136
The perineal nerve branches into what?
Superficial perineal nerve (terminates as posterior labial/scrotal a) and deep perineal nerve (terminates as Artery to bulb of the penis/vestibule)
137
What does the superficial perineal nerve supply in males?
Cutaneous innervation to scrotum via posterior scrotal nerve
138
What does the superficial perineal nerve supply in fe males?
Cutaneous innervation to the labia via posterior labial nerve
139
What does the deep perineal nerve supply?
- Motor to muscles of deep/superficial perineal pouches
| - Sensory for inferior part of vagina and its vestibule
140
What does the dorsal nerve of the penis/clitoris supply?
Primary sensory nerve of glans (of penis or clitoris)
