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Block 4 Anatomy > Perineum > Flashcards

Perineum Flashcards

(115 cards)

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1
Q

What are the Anterior, Anterolateral, Lateral and Posterolateral boundaries of the Perineum?

A

Anterior‐Symphysis Pubis
Anterolateral—Ischiopubic ramus
Lateral—Ischial Tuberosity
Posterolateral—Sacrotuberous Ligament and Gluteus Maximus

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2
Q

What are the Posterior, Floor and Roof of the perineum?

A

Posterior—Coccyx
Floor—Skin and Fascia
Roof—Pelvic Diaphragm (Levator Ani Portion)

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3
Q

The anterior urogenital triangle and the posterior anal triangle are divided by a line between which two bony structures

A

the Two Ischial tberosities

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4
Q

List the contents of the anal triangle

A
  1. lower part of the anal canal
  2. anus
  3. pudendal canal
  4. two deep wedges called the ischioanal fossae
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5
Q

What is the function of the ichioanal fossae?

A

Allow for the expansion of the anal canal during defecation

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6
Q

boundaries of the ischianal fossae?
Base
Superior medial wall
Lateral Wall

A

Base: overlying skin and connective tissue
Superior medial wall: inferior surface of the levator ani and the external anal sphincter
Lateral Wall: Obturator internus muscle

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7
Q

What fascia forms the pudendal canal that transmists the branches of the internal pudendal vessels and pudendal nerve into the perineum

A

The splitting of the obturator internus Fascia

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8
Q

What is the ischioanal Fossae bounded posteriorly by?

A

Gluteus maximus muscle

sacrotuberous ligament

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9
Q

Between which two boney structures does the sacrotuberous ligament attach

A

Sacrum

Ischial Tuberosity

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10
Q

What is the path of the inferior rectal vessels and nerves to reach the anal canal

A

They traverse lateral to medial through the center of each fossa to reach the anal canal

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11
Q

The external anal sphincter attaches posteriorly to the ________ and passes around the anus and anal canal to attach to the ______ _____ anteriorly.

A

Coccyx

Perineal Body Anteriorly

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12
Q

What Vessels and nerves supply this Skeletal muscle sphincter?

A

Inferior rectal vessels and nerves

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13
Q

How does the pudendal Canal reach the anal triangle?

A

Travels along the medial surface of the obturator internus muscle that connects and transmits structures passing across the dorsal surface of the ischial spine and sacrospinous ligament through the lesser sciatic foramen into the anal canal

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14
Q

The Pudendal Nerve (S__-S__) is derived from the sacral plexus and provides the primary motor and sensory innervation for the urogenital and anal triangles of the perineum.

A

S2-S4

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15
Q

The the pudendal nerve crosses the ischial spine, it divides into what 3 branches ?

A

Perineal nerve
dorsal nerve of the penis/clitoris
inferior rectal nerves

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16
Q

Which nerve is the most medial of the three and crosses through the ischioanal fossa

A

inferior rectal nerves

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17
Q

The perineal nerve enters the perineal space of the UG triangle by passing superficial to which diaphragm

A

UG diaphragm

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18
Q

Once in the superficial perineal space the perineal nerve becomes what and innervates what?

A 
Posterior labial(scrotal) nerves 
-- provide sensory innervation to the posterior aspect of the labia or the scrotum
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19
Q

The dorsal nerve of he penis/clitoris is the most ____ of the three pudendal nerves and is embedded in the ________ fascia.

A

lateral

obturator

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20
Q

The dorsal nerve of he penis/clitoris enter the ____ ______ space by piercing that posterior border of the ________ diaphragm

A

Deep perineal space

urogenital diaphragm

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21
Q

The internal pudendal artery and vein enter the pudendal canal and anal triangle by crossing the ______ spine

A

ischial spine

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22
Q

The superficial (inferior) boundary of the superficial perineal space in both the male and female is the membranous layer of the superficial fascia known as ______ fascia

A

Colles’ Fascia

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23
Q

Colles Fascia is a continuation of what deep membranous layer of the superficial layer fascia of the lower abdominal wall?

A

Scarpa’s Fascia

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24
Q

The in Males the Colles fascia is continuous with the _____ fascia of the scrotum and the ____ penile fascia

A

Dartos fascia

Superficial Penile fascia

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25
What layer continues into the perineum providing the fatty content of the labia majora ?
Caper's Layers (fatty layer)
26
The deep (superior) boundary of the superficial space of both sexes is the ________ membrane.
Perineal Membrane | Inferior fascia of the urogenital diaphragm
27
The _______ membrane is a strong fascial layer on the inferior surface of the urogenital diaphragm that serves as a platform for what?
--Perineal membrane --platform for the suspension of the external genitalia
28
The anterior scrotal or labial cutaneous nerves (branches of the __________ nerve) enter the superficial space _________.
Branches of the ilioinguinal nerve | anteriorly
29
The deep perineal space is a muscular layer composed of the urogenital diaphragm that is bounded inferiorly by the ____ membrane and superiorly by the _____ fascia of the UG diaphragm
perineal membrean superior fascia of the UG diaphragm
30
The prepuce of the penis cover the _____ penis
Glans
31
What is deep to the skin of the Penis?
Subcutaneous CT layer | Superficial Penile Fascia = Superficial Perineal Fascia
32
What structure is located in the Superficial Penile Fascia?
Superficial Dorsal Vein
33
Where does the Superficial Penile Vein drain?
Via External Pudendal Veins into Greater Saphenous Vein
34
What is deep to Superficial Penile Fascia?
Deep Penile Fascia
35
The Deep Penile Fascia functions to encircle the ______ bodies. It then continues into the ______ ________ space as muscular fascia
cavernous superficial perineal
36
What vessels/structures are deep to Deep Penile Fascia?
Deep Dorsal Vein | Dorsal Arteries of the Penis (2 Dorsal Nerves of the Penis (2) Paired: artery and nerve)
37
Location of structures above? Deep Dorsal Vein: Dorsal artery and nerve:
Deep Dorsal Vein: Midline, dorsum of penis | Dorsal artery and nerve: Each dorsum side of midline
38
The deep Dorsal vein drains deeply into the _______ ________ Plexus by passing the gap between the __________ and the __________.
Prostatic Venous Plexus Symphysis Pubis and UG Diaphragm
39
What forms the body of the penis?
2 Corpora Cavernousa Penis 1 Corpus Spongiosum (3 Cylinders)
40
What is the relationship of the Copora cavernousa and the corpus spongiosum?
``` Corpus Spongiosum (ventral) 2 Corpora Cavernosa Penis (dorsal) ```
41
Function of the the Copora cavernousa and the corpus spongiosum?
Engorge with blood during erection
42
What encloses the Copora cavernousa and the corpus spongiosum?
Dense, fibrous layer (Tunica Albuginia)
43
Which of the three cylinders conveys the urethra?
Within the center of the Corpus Spongiosum
44
What is the Glans Penis?
Distal end of the Corpus Spongiosum
45
What is the proximal end of Corpus Spongiosum?
Bulb of Penis
46
The Deep Artery of the penis courses in the center of each _______ ________?
Corpus cavernosum
47
The anterior scrotal nerves enter the scrotum from the anterior abdominal wall via the ______ _______ of the inguinal canal
superficial ring
48
The anterior scrotal nerves are breaches of ilioinguinal nerve from the _______ plexus and are sensory to the anterior surface of the scrotum
Lumbar
49
Origin and path of Perineal Nerve?
Branch of Pudendal Nerve | Courses superficial to the urogenital diaphragm into the superficial perineal space from the anal triangle
50
What occurs to the Perineal Nerve in the Superficial Perineal Space?
Branches Posterior Scrotal Nerves Muscular Branches to 5 Muscle of UG Triangle Nerve to Bulb of Penis
51
What separates the scrotum into 2 halves?
Scrotal Septum
52
What makes up the root of hte penis
The crura of the penis and | the bulb of the penis
53
What is the course of the Corpora Cavernosa?
Courses along the Ischiopubic Rami on each side of the UG Triangle
54
The origin of the Corpora Cavernosa is referred to as?
Begins as Crura of the Penis
55
Where is the Ischiocavernosus Muscles located?
On the surface of each Crus of the Penis
56
What is the origin of the Ischiocavernosus Muscles?
Ischium
57
Path and insertion of the Ischiocavernosus Muscles?
Extend short distance onto the shaft of Penis | Insert into each Corpus Cavernosum
58
What is the function of the Ischiocavernosus Muscles?
Assists in maintaining erection
59
Proximally, what happens to the Corpus Spongiosum?
In the midline, it enlarges to form the Bulb of the Penis
60
What nerve originates from the Ilioinguinal Nerve (Lumbar Plexus) to enter the scrotum via inguinal canal on the Spermatic Cord to supply the scrotum?
Anterior Scrotal Nerves
61
Which branch of Pudendal Nerve courses superficial to the urogenital diaphragm into the superficial perineal space from the anal triangle
Perineal Nerve
62
What occurs to the Perineal Nerve in the Superficial Perineal Space?
Branches into: Posterior Scrotal Nerves Muscular Branches to 5 Muscle of UG Triangle Nerve to Bulb of Penis
63
Which part of the Penis courses along the Ischiopubic Rami on each side of the UG Triangle
Corpora Cavernosa as the Crura of the Penis
64
What are the attachments of Crura of the Penis?
Attaches to the Ischiopubic Rami | lateral aspects of the Urogenital Triangle
65
What muscles is located on the surface of each Crus of the Penis
Ischiocavernosus Muscles
66
What is the 3rd Pair of Muscles in the superficial perineal space that attaches to Perineal body at the midline and attaches laterally to the Ischial Tuberosities
Superficial Transverse Perineus Muscle
67
All muscles in the superficial Space -- bulbouspongiosus, ichiocavernosus, and superficial transverse perineus are all innervated by what nerve?
Muscular branches of the perineal nerve
68
What is the central tendinous point? Where is it located?
(a.k.a.- Perineal Body) At the midpoint of the perineum between the anus and the scrotal sac It’s a dense, fibromuscular tissue mass where the muscular fibers of the external anal sphincter, superficial and deep transverse perineus, and bulbospongiosus muscles interdigitate
69
What is the Location of perineal membrane. Between in the male?
Between the Ischiopubic Rami and the bulb of the penis
70
What does the Perineal Membrane form?
Covers the inferior surface of the Urogenital Diaphragm | Forms the deep boundary of the Superficial Perineal Space
71
What forms the deep perineal space?
Muscular Urogenital Diaphragm
72
What makes up the Muscular Urogenital Diaphragm?
Anteriorly: Sphincter Urethrae Muscle Posteriorly: Deep Transvers Perineus Muscle
73
What Nerve innervates the UG diaphragm?
Muscular Branch of the Perineal Nerve
74
What occurs at the point where the urethra penetrates the diaphragm?
A circular investment of fibers forms a sphincter around the urethra
75
Where is the Prostate Gland located?
Superior to the UG Diaphragm | ( right above where the sphincter forms around the urethra
76
What does the Perineal Membrane form anteriorly to separate a small space from it and the symphysis pubis from ?
Transverse Perineal Ligament
77
What passes anterior to the Transverse Perineal Ligament?
Deep Dorsal Vein of the Penis
78
Where does the Deep Dorsal Vein of the Penis terminate?
In the Prostatic Venous Plexus (in the pelvis)
79
What is embedded in the sphincter urethrae muscle on either side of the membranous urethra?
Two bulbourethreal glands
80
What is the path of the ducts from the bulbourethral glands?
Penetrate the perineal membrane and empty into the urethra as it passes through the bulb of the penis in the superficial perineal space
81
Both the Internal Pudendal Vessels and the Dorsal Nerve of the Penis travel together along what path?
Courses through the lateral aspects of the urogenital diaphragm along the ischiopubic ramus
82
Which branch of the Pudendal Nerve enters the deep perineal space from the ischioanal fossa by penetrating the posterior free margin of the urogenital diaphragm?
Dorsal nerve of the penis
83
In the UG diaphgram, the internal pudendal artery gives rise to two branches, the artery to the ______ and the _______ artery.
Artery of the bulb | Urethral Artery
84
The Internal pudendal artery after giving rise to the Artery of the bulb and the Urethral Artery continues on and terminates by dividing into the _____ artery of the penis and the ______ artery of the penis
Deep artery of the penis Dorsal artery of the penis
85
The deep arteris course in the center of the _______ _______ and are largely responsible for the erection process
Corpora cavernosa
86
The dorsal artery and dorsal nerve of the penis can be identified on the _____ of the penis and supply the superficial and deep aspects of the penile _____.
dorsum body
87
What is the termination of the superficial, membranous fascia from the abdominal wall (Scarpa’s Fascia)?
``` Terminates by attaching to: Skin of labia Majora Inguinal Ligament Ischiopubic Rami Urogenital Diaphragm ```
88
What forms the superficial boundary of the superficial perineal space in the female?
Superficial Membranous Fascia (Scarpa’s)
89
Define the Vestibule.
``` Midline cleft (separation) Through it the urethra, vagina, and ducts of the Greater Vestibular Gland open to the exterior ```
90
Lateral boundaries of the vestibule?
Bounded by the Labia Majora and Minora
91
Define Labia Majora.
Rounded lateral folds of skin that contain large amounts of fat from the Campers fascial layer
92
Innervation to Labia Majora and Minora?
Anterior and Posterior Labial Nerves
93
What forms anteriorly, when the Labia Majora blend as a Rounded fatty bulge, above the pubis?
Mons Pubis
94
What is the area where the labia meet?
Anterior labial commissure | Midline, superior to the clitoris
95
What part of the external female genitalia divides superior to the clitoris to form the Prepuce of the Clitoris Posterior to and inferior of the clitoris to form the Frenulum?
Labia Minor
96
What forms most of the body of the clitoris?
2 Corpora Cavernosa
97
Function of the 2 corpora cavernosa?
Erectile bodies
98
Why is there no corpus spongiosum in the female?
Because the course of the urethra is separated from the clitoris
99
What caps the corpora cavernosa?
Small glans clitoris
100
What forms the small Glans Clitoridis?
Superior ends of the Bulb of the Vestibule
101
What is found on the dorsum of the clitoris? Comparison of structures to the male?
Dorsal Nerves and Arteries | Much small than in male
102
Location of the 2 corpora cavernosa?
Along the ischiopubic rami, deep into the superficial perineal space
103
Deep into the superficial perineal space, what do the corpora cavernosa form?
Crura of the Clitoris
104
What covers each crus of the clitoris?
Ischiocavernosus Muscle
105
Where is the bulbospongiosus muscle and what is its function?
In a circular ring around the labia majora covering covering the bulb of the vestibule
106
Where does the bulbouspongious muscle originate and insert?
Originates: perineal body Insertion: Perineal membrane Corpora cavernosa dorsum of the clitoris
107
What part of the Bulb of the Vestibule forms part of clitoris?
A small extension of erectile tissue extends superiorly along the ventral surface of the clitoris
108
What is located at the posterior ends of the Bulb of the Vestibule?
Greater Vestibular Glands (lodged in the superficial perineal space)
109
What is the Location of the perineal body in the female?
Centrally between the anus and the vagina
110
Describe perineal body in a female
Strong CT interdigitation of the bulbospongiosus, external anal sphincter, and superficial and deep transverse perineus muscle
111
Describe the Location of the Perineal Membrane in the female
Between the Bulb of the Vestibule and the Ischiopubic rami | Spans across the ischiopubic rami on the inferior surface of the urogenital diaphragm
112
What is the difference in the muscles of the UG diaphragm in a man versus a woman ?
Female Sphincter Urethrea is more fragmented and does not complete the muscular sling between the ischiopubic rami because the vagina also passes through the diaphragm
113
What courses in the fibers of the urogenital diaphragm along the Ischiopubic Rami?
Dorsal Nerve of Clitoris | Terminal parts of Internal Pudendal Artery
114
What are the branches from the Internal Pudendal Artery?
Artery of the bulb of the vestibule Urethral artery Deep and dorsal artery of the clitoris
115
Where can the dorsal artery and nerve be found?
Dorsum of the clitoris

Block 4 Anatomy (4 decks)

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