Perineum

Question 1

Scrotal Sac Innervation

Answer 1

Anteriorly: ilioinguinal & genital branchof genitofemoral n.

Posteriorly: scrotal branches of perineal n. (off pudendal n.) & posterior cutaneous nerve of thigh

Question 2

Pudendal Nerve

Answer 2

From sacral nerve S2-S4

Branches:
Inferior Anal/Rectal
Perineal 
Dorsal nerve of the Penis/Clitoris
Posterior Scrotal/Labial

Question 3

Alcocks Canal

Answer 3

Pudendal Canal

Formed by the obturator internus fascia.

It encloses the following:
Internal pudendal artery
Internal pudendal veins
Pudendal nerve

These vessels and nerve cross the pelvic surface of the obturator internus.

Question 4

Arterial supply of the Uterus

Answer 4

Proximal to Distal:

Ovarian from the abdominal aorta
Uterine from the internal iliac
Vaginal from the internal iliac
Internal Pudendal from the internal iliac

Question 5

Culdocentesis

Answer 5

Extraction of fluid from the rectouterine pouch (Pouch of Douglas)

The pouch is reached through the posterior fornix of the vagina

Question 6

TURP

Answer 6

Transurethral Resection of Prostate

resectoscope is inserted through the tip of the penis and into the urethra and trims away excess prostate tissue that’s blocking urine flow and increases the size of the channel.

Question 7

Innervation of urethral sphincters (males)

Answer 7

Internal urethral sphincter:
Sympathetics keep the sphincter closed. parasympathetics from pelvic splanchnics cause contraction of the bladder which results in relaxation of the sphincter muscles.

External Urethral Sphincter is innervated by the pudendal nerve

Question 8

Pain associated with cervix and upper vagina

Answer 8

Visceral afferents via pelvic splanchnics (S2-S4)

Question 9

Pain associated with lower vagina and Perineum

Answer 9

Visceral Afferents via pudendal nerve (S2-S4) (Somatics)

Parasympathetics

Question 10

Pain associated with Uterine contraction

Answer 10

Visceral Afferents via:

Uterovaginal and pelvic plexuses
Hypogastric nerves
Superior Hypogastric Plexus
Lower Aortic Plexus
Lumbar Splanchnic nerves

Question 11

Ligaments of the Uterus

Answer 11

Pubocervical

Transverse cervical (Cardinal)

Sacrocerical

Question 12

Procidentia

Answer 12

Uterine Prolapse

loss of support by the cardinal and/or uterosacral ligaments, and levator ani muscle

Question 13

Bladder and Rectal Control

Answer 13

Sensation of fullness:
- Afferents accompanying PSNS (pelvic splanchnics)

Contraction of muscles in bladder wall:
- PSNS (pelvic splanchnics)

Internal Sphincter:
- SNS contracts, PSNS relaxes

External Sphincter:
- Somatic control via pudendal nerve.

cortical control of external sphincters and voiding reflex is learned (continence of bladder and bowel)

Question 14

Erection and Ejaculation

Answer 14

Erection:
From pelvic splanchnics (PSNS) cause vasodilation

Ejaculation:
From sympathetics cause contractions of vas deferens along with secretions of the prostate and seminal vesicle

Question 15

Suprapubic cystic mass between umbilicus and apex of the bladder

Answer 15

Urachal Cyst

Question 16

Unicornuate uterus

Answer 16

failure in development of one of the paramesonephric ducts

Question 17

Tingling on the medial side of the thigh

Answer 17

Hernia through obturator canal resulting in compression of the obturator nerve.

Question 18

Innervation of medial side of knee

Answer 18

saphenous nerve

Question 19

Tender medial side of great toe and decreased dorsal pedal pulse

Answer 19

Calcification of 1st dorsal metatarsal artery.

Question 20

Dysfunction of external urethral sphincter

Answer 20

Damage to pudendal

Question 21

Impotence

Answer 21

Damage to internal pudendal