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Flashcards in Perineum Deck (56):
1

What muscle's fascia forms the Alcock's Canal/Pudendal Canal?

fascia of Obterator Interus**

2

What artery can be accidentally tied off during hernia surgery because it is near the Inferior Epigastric?

Abnormal Obturator A.

3

What is the anchoring point/ collection of tendons of the UG diaphragm called?

Perineal Body

4

What forms the ejaculatory duct?

Seminal Vesicle + Vas Deferens

5

What neuromuscular bundle exits through the lesser sciatic foramen? What was this bundle's original course?

Pudendal N. + Internal Pudendal A. + Nerve to Obturator Internus exits through the Greater Sciatic Foramen, loops around SacroSPINOUS ligament, and comes back out through the LESSER SCIATIC FORAMEN

- tendon to OBTERATOR INTERNUS also leaves via LESSER SCIATIC FORAMEN

6

What is a site of possible infection/tumors in females?

Rectouterine Pouch (behind the uterus)

POUCH OF DOUGLAS*

7

What muscle covers the BULB? The crura?

1. Bulbospongiosus

2. Ischiocavernosus

8

What muscles are the components of the DEEP POUCH

1. Deep Transverse Perineal Muscle

2. Sphincter Urethrae Muscle

9

What two branches does the PUDENDAL N. spit into?

Inferior Rectal N.

&

Perineal N.

10

Scarpa's fascia becomes _______ fascia in the Perineum

COLLES

11

The uterus has 2 rotations

What is it called at the junction of uterus & vagina?

What is the bend between body of uterus & cervix proper?

1. Anteverted


2. Anteflexion

12

What muscles form the pelvic diaphragm?

Levator Ani + Coccygeus (Iliococcygeus & Pubococcygeus)

13

How is the weakness in the anterior portion of the Pelvic diaphragm strengthened?

UG DIAPHRAGM

14

Where do the inferior Rectal N and Inferior Rectal A. originate from?

Pudendal N.

&

Internal Pudendal Artery

15

What is the order of layers of the UG diaphragm looking up through the legs?

1. Inferior Fascia
2. UG Muscle
3. Superficial Fascia

16

What is the Bulb of the penis covered with? (Is this present in the female?)
What travels through this?

Bulb covered with CORPUS SPONGIOSUM

- Urethra Travels through this

- no Corpus Spongiosum in female

17

Where are the bulbourethral glands/ GREAT VESTIBULAR Glands located in the female? Where are the Cowper's glands located in the male?

1. Superficial Pouch

2. DEEP pouch

18

What is another word for the inferior fascia?

Perineal Membrane

19

What two muscles are found within the UG Diaphragm Proper (Deep pouch)?

1. Sphincter Urethrae

2.Deep Transverse Perineus Muscle

20

What is the path the Pudendal Nerve travels? What nerve roots contribute to the Pudendal N.?

(S2, 3 ,4)

- Leaves the inside of pelvis via GREATER SCIATIC FORAMEN
- hooks the Sacrospinous Ligament
- Re-enters the LESSER SCIATIC FORAMEN

-to access the PERINEUM

21

What is an ectopic pregnancy? Why does this occur?

Implantation in the uterine tube

- Ovulation occurs EXTRA-PERITONEALLY

22

What are the three subsets of the BROAD Ligament?

1. Mesovarium (mesentery of ovary)
2. Mesosalphinx (of uterine tube)
2. Mesometrium ( of endometrium)

23

What ligament suspends the ovary laterally to the pelvic wall? What is the blood supply to the ovary? Where does this artery come off of?

SUSPENSORY ligament

- Ovarian Artery (of the AORTA--> Gonadal)

24

What passes under the Uterine Artery?

URETER
-- must be careful off this during Hysterectomy

25

The inferior vesicle artery of the male is replaced by______ in the female. The uterine Artery is a branch of what?

VAGINAL Artery

(textbooks says Uterine A. & Vaginal A can be separate or together)

- Uterine A. is a branch of Anterior Division of Internal Iliac

26

During a Straddle Injury, trauma can cause blood to pool into what area?

- blood from damage to the spongy urethra (mainly a male thing) can flow up the potential space between:

1. the rectus sheath and

2. Scarpa’s fascia

27

Where do the ovaries point? What is the course of the ROUND Ligament?

ovaries --> point posteriorly

Round Ligament = inserted on labia major

28

The true pelvis is found above or below the Arcuate Line?

Below

29

What are the boundaries of the PERINEUM? (4)

1. Pubic Symphysis
2. Coccyx
3. TWO Ischial Tuberosities ( on sides)

30

Who has a shorter urethra and thus a higher risk of bladder infections?

FEMALES

31

What forms the body of the clitoris?

Of the penis?

1. 2 Crus --> Corpus Cavernosum

2. 2 Corpus Cavernosum + 1 Corpus Spongiosum

32

Who has a split BULB? Male or females?

FEMALES --> form the vagina

33

What are the 2 superficial terminal branches of the Pudendal Nerve? What are the 3 deep branches?

1. Perineal N. (becomes Posterior Labial/Scrotul N.)

2. Inferior Rectal

1. Artery to the Bulb
2. Deep Artery to Penis/Clitoris
3. Dorsal Artery to Penis/Clitoris

34

What muscles are found within the superficial pouch? Which sex has the Greater Vestibular Glands in this pouch?

1. IschioCavernosum (covering CRUS)

2. Bulbospongiosum (covering the Bulb)

3. Superficial Tranvserse Perineus

+ Crura & Bulb = erectile tissue*

FEMALES!!!!

- superficial pouch = between Colles' Fascia & Inferior Fascia of UG

35

What are the layers of the Perineum from the deepest part to the most superficial?

MUST IMAGINE MRI view (through legs)


(at the bottom)

- SKIN
1. Colles Fascia
2. Superficial Pouch
- Crura/Bulb
- Muscle
3. Inferior Fascia
4. Deep Pouch
5. Superior* Fascia

- looking through legs --> SEE INFERIOR FASCIA FIRST*

36

What 3 nerves does the Pudendal Nerve split into after entering the Perineum?

1. Perineal
2. inferior Rectal (deep)
3. Dorsal N. of Penis/Clitoris

37

Where is the superficial pouch?

Between the inferior fascia & Colles' Fascia

38

What penetrates the SUPERIOR Fascia?

Vagina & Uterus

39

What is the origin and support for Levator Ani Muscle?

ARCUS TENDINEUS
- thickening across Obturator Internus Muscle

40

What artery enters the Cavernous Bodies of the Penis/Clit?

DEEP Artery of the Penis/Clitoris

41

What are the origin of the 3 rectal arteries?
1. Superior Rectal
2. middle Rectal
3. Inferior Rectal

1. Superior Rectal = IMA

2. Middle Rectal = ANTERIOR INTERNAL ILIAC

3. Inferior Rectal = Internal Pudendal A.

TEST!!!!

42

What muscles attach at the central tendon?

1. Ischiocavernosus
2. Bulbospongiosus
3. Superficial Transverse Perineal

43

What kind of injury leads to one splitting the urethra? Which pat of the urethra is usually injured? What is likely to occur ?

1. STRADDLE INJURY

- more likely in males (longer urethra)

SPONGY URETHRA can tear

--> blood will move internally through the area between COLLES' Fascia (Scarpa's) &

Rectus Sheath

FROM SUPERFICIAL POUCh (continuous w/ Colles' Fascia & Rectus SHeath)

44

Arteries to GI structures branch _____. arteries to non go branch____

1. Anteriorly

2. Laterally

45

Parasympathetic innervation of the:

1. Foregut/Hindgut

2. Hindgut

1. Vagus

2. Pelvic Splanchnics

increase peristalsis, decrease sphincter

46

Sympathetic innervation of the:

1. Foregut/Hindgut

2. Hindgut

1. Greater, lesser, least Splanchnics

2. Lumbar Splanchnics

47

If arteries off of the abdominal aorta are blocked, what are the compensatory anastomoses?

1. Superior Epigastric + Inferior Epigastric

2. Superior Pancreaticoduodenal + Inferior Epigastric

3. Middle Colic --> Left Colic

4. Superior Rectal + Middle/Inferior Rectal

48

What are the 3 sites of anastomoses of portal & systemic system?

1. Left Gastric & Esophageal

2. Superior Rectal + Inferior & Middle Rectal

3. Paraumbiilcal + Superficial & Inferior Epigastric

49

Above pectinate line ? Below Pectinate Line

1. Internal hemorrhoids

2. External Hemorrhoids

50

A landmark for the pudendal nerve block would be what part of the lateral wall of the pelvis?

Ischial Spine

51

PED &

TIP

Peroneal Everts & Dorsiflexes, if injured, FOOT DROP

Tibial Inverts & Plantarflexes, if injured, can't stand on TIP toes

52

Ear, Tonsils, Bottom to top

- Describe the Brachial Pouch Derivatives

1 Ear
2 Tonsils
3 Inferior Parathyroid (Bottom)
3 Thymus (to)
4 Superior Parathyroid (Top)

53

Describe the Brachia Arch Derivatives

1
2
3
4
&
6

1 = Mastication (5)

2 = Facial expression (7)

3 = Stylopharyngeus (9)

4 - Swallow (cricothyroid m.)

6 = speak (all the laryngeal muscles)

54

Where does the round ligament insert?

Labia Majora

55

What is related to the gubernaculum of the testes?

Mesovarium

56

Where is erectile tissue found?

SUPERFICIAL POUCH --> the bulb