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Structure and Function Test 1 > Perineum > Flashcards

Flashcards in Perineum Deck (94):
1

Diamond shaped region between the thighs containing the external genitalia, anal canal, and the neurovascular structures that supply them

Perineum

2

The perineum is bordered anteriorly by the

Pubic symphysis

3

The perineum is bordered anterolaterally by the

Ischiopubic rami

4

The perineum is bordered posterolaterally by the

Sacrotuberous ligaments

5

The perineum is bordered posteriorly by the

Coccyx

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By extending a line from ischial tuberosity to ischial tuberosity, the perineum is divided into which two triangles?

1.) Urogenital (anterior)
2.) Anal (posterior)

7

Contains the anal canal in the midline with the ischioanal fossae on either side

Anal triangle

8

Approximately 4cm in length extending between the anorectal junction (perineal flexure) and its opening

Anal canal

9

The mucosa of the proximal 2/3 of the canal is thrown into folds by underlying branches of the suerior rectal blood vessels. These folds are called called

Anal columns

10

The base of the anal column marks the transition between the

Hindgut (endoderm) portion and the proctodeum (ectoderm) derived distal 1/3

11

Marks the transition between the hindgut (endoderm) portion and the proctodeum (ectoderm) derived distal 1/3

Base of the anal canal

12

This area of transition is called the

Pectinate line

13

Fecal continence is controlled by which two muscular sphincters?

1.) Internal anal sphincter
2.) External anal sphincter

14

Involuntary smooth muscle under autonomic controll

Internal anal sphincter

15

Voluntary skeletal muscle under somatic motor control

External anal sphincter

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What is the embyonic derivation above the pectinate line

Hindgut (endoderm)

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What is the motor innervation above the pectinate mind?

Autonomic

18

What is the sensory innervation of the anal canal above the pectinate line?

Visceral afferent and pressure

19

What is the arterial supply to the anal column above the pectinate line?

Superior rectal artery

20

What is the venous return from the anal canal above the pectinate line?

Superior rectal vein to hepatic portal venous system

21

What is the lymphatic drainage from the anal canal above the pectinate line?

Internal iliac nodes

22

Hemorrhoids of the anal canal ABOVE the pectinate line are

Internal and covered with mucosa

-Painless

23

Hemorrhoids BELOW the pectinate line are

External and covered by skin

-painful

24

Fat-filled triangular shaped spaces that allow for the distension and contraction of the anal canal during defecation

Ischioanal fossae

25

The pelvic diaphragm and its inferior fascia form the MEDIAL wall of the

Ischioanal fossae

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Form the lateral walls of the ischioanal fossae

Obturator internus muscle and its fascia

27

Formed within the fascia of the obturator internus muscle where it lines the LATERAL wall of the ischioanal fossae

Pudendal canal

28

The contents of the pudendal canal include:

Pudendal nerve and internal pudendal artery and vein

29

The internal pudendal artery and vein are passing through the pudendal canal as they travel to the

Urogenital triangle

30

Inferior rectal branches of the pudendal nerve and internal pudendal artery and vein traverse the ischioanal fossae MEDIALLY to supply the

External anal sphincter, anal canal, and inferior aspect of pelvic diaphragm

31

The peroneal structures in the urogenital triangle are contained within which two pouches?

1.) Deep perineal pouch
2.) Superficial perineal pouch

32

Lies between the superior fascia of the urogenital diaphragm (roof) and the inferior fascia (perineal membrane) of the urogenital diaphragm (floor)

Deep perineal pouch

33

Formed by the deep pouch, its contents, and the fascial layers that enclose it

Urogenital diaphragm

34

What are the muscles of the deep perineal pouch in both males and females?

Sphincter urethra and deep transverse perineal muscle

35

What are the viscera structures in the MALE deep perineal pouch?

Urethra and bulbourethral glands

36

What are the visceral structures in the FEMALE deep perineal pouch?

Urethra and vagina

37

Extends from deep to superficial between the perineal membrane of the urogenital diaphragm (facial roof) and the superficial perineal fascia (fascial floor)

Superficial perineal pouch

38

Constructing the SUPERFICIAL perineal pouch from deep to superficial, what is the FIRST layer?

Erectile bodies

39

Attach to the perineal membrane and ischiopubic rami

Erectile bodies

40

Constructing the SUPERFICIAL perineal pouch from deep to superficial, what is the SECOND layer?

Deep penile fascia (Buck's)

41

Covers erectile bodies

Deep penile fascia

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Constructing the SUPERFICIAL perineal pouch from deep to superficial, what is the THIRD layer?

Skeletal muscle

43

The skeletal muscle of the third layer covers part of the erectile bodies and attaches to the

Central tendon (perineal body)

44

Constructing the SUPERFICIAL perineal pouch from deep to superficial, what is the FOURTH layer?

Superficial perineal fascia

45

Constructing the SUPERFICIAL perineal pouch from deep to superficial, what is the FIFTH layer?

Skin

46

In the MALE and FEMALE, what are the muscles of the superficial perineal pouch?

Bulbospongiosus, ischiocavernosus, and superficial transverse perineal muscles

47

What is the main difference in the viscera of the superficial perineal pouch of the MALE?

Bulb of the penis, corpus spongiosum, crura of the penis, and corpa cavernosa

48

What is the main difference of the superficial perineal pouch of the FEMALE?

Vagina, vestibular bulb, greater vestibular gland, and crura of clitoris

49

Covers the erectile bodies and skeletal muscle of the superficial perineal pouch

Deep Penile Fascia (Buck's)

50

Forms the floor of the superficial perineal pouch and goes by a number of different names

Superficial perineal fascia

51

The part of the superficial perineal fascia that covers the penis

Superficial penile fascia

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The part of the superficial perineal fascia that covers the scrotum

Dartos fascia

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The part fo the superficial perineal fascia that is the region between the external ginitalia and the anal triangle

Colle's fascia

54

The superficial perineal fascia is continuous with the fascia of the anterior abdominal wall called the

Scarpa's fascia

55

What are the 4 types of superficial perineal fascia?

1.) Scarpa's
2.) Superficial
3.) Darto's
4.) Colle's

56

What are the 2 types of deep penile fascia

1.) Buck's (erectile)
2.) Investing (Muscle)

57

Can lead to extravasation of blood and/or urine

Urethral tears

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A urethral tear as it enters the bulb of the penis that also tears the Buck's fascia would allow fluid extravasation into the

Superficial pouch and the anterior abdominal wall

59

Pyrimidal shaped structure centrally located between the urogenital triangle and the anal triangle

Central tendon of the Perineum (Perineal Body)

60

The central tendon of the perineum (perineal body) consists of fibrous tissue and some smooth muscle and serves as an important attachment site for

Perineal and pelvic diaphragm muscles

61

We an see the importance of the perineal body as pelvic visceral support because when the perineal body is damaged, we see an increased incidence of

Prolapse of the pelvic viscers

62

Procedure where physicians cut the perineal body to prevent uncontrolled tearing during delivery

Episiotomy

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What are the perineal muscles that attach to the central tendon of the perineum (perineal body)?

Deep and superficial transverse perineal, bulbospongiosus, and external anal sphincter muscles

64

Which muscles of the pelvic diaphragm attach to the central tendon of the perineum (perineal body)?

Pubococcygeus and puborectalis

65

The arteries of the perineum are branches of the

Internal pudendal artery

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The internal pudendal artery arises in the pelvis from the

Internal Iliac Artery

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The internal pudendal artery exits the pelvis via the

Greater sciatic foramen

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The internal pudendal artery exits the pelvis via the greater sciatic foramen to enter the

Gluteal region

69

The internal pudendal artery then passes from the gluteal region to the ischioanal fossa via the

Lesser sciatic foramen

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In the ischioanal fossa, the internal pudendal artery runs within the pudendal canal to reach the

Urogenital triangle

71

Venous drainage of the erectile bodies is via the

Deep dorsal vein of the penis and clitoris

72

The deep dorsal vein of the penis and clitoris drain through a gap in the

Urogenital hiatus

73

The deep dorsal vein of the penis and clitoris drain through a gap in the urogenital hiatus into the

Prostatic venous and vesicle venous plexuses, respectively

74

Which types of innervation does the perineum receive?

Somatic, sympathetic, and parasympathetic innervation

75

The perineum receives SOMATIC innervation via the

Pudendal nerve (S2, S3, S4)

76

The pudendal nerve follows the same course as the

Internal pudendal artery and vein

77

The inferior rectal branch of the pudendal nerve provides MOTOR innervation to the

External nal sphincter and pelvic diaphragm

78

The inferior rectal branch of the pudendal nerve provides SENSORY innervation to the

Skin of the anal triangle

79

The dorsal nerve of the penis/clitoris provides SENSORY innervation to the

Dorsum of the penis/clitoris

80

The perineal branch of the pudendal nerve provides MOTOR innervation to

ALL muscles of the ddep and superficial perineal pouches

81

The Perineal branch of the pudendal nerve provides SENSORY innervation to the

Deep and superficial pouches and perineal skin

82

In the perineum, SYMPATHETIC innervation is primarily responsible for

Vasoconstriction

83

How many pathways of SYMPATHETIC innervation are there in the perineum?

Two

84

In BOTH pathways PREGANGLIONIC SYMPATHETIC NEURONS CELL BODIES ARE LOCATED AT

L1 and L2 levels of spinal cord

85

In pathway ONE, axons travel in

Lumbar splanchnic nerves to superior hypogastric plexus

86

In pathway ONE, axons travel in lumbar splanchnic nerves to the superior hypogastric plexus and then enter the pelvis via

Hypogastric nerves

87

In pathway ONE, PREGANGLIONIC SYMPATHETIC axons synapse on POSTGANGLIONIC cell bodies in the

Inferior hypogastric plexus

88

In pathway ONE, postganglionic axons join the

Internal pudendal artery (to travel to perineum)

89

In pathway TWO, axons travel down through sympathetic chain and synapse on cell bodies located in

Paravertebral ganglia (S2, S3, and S4)

90

In pathway TWO, postganglionic axons join ventral rami of spinal nerves S2, S3, and S4 and travel to the perineum in the

Pudendal nerve

91

In the perineum PARASYMPATHETIC innervation is primarily responsible for

Dilating arteries of erectile bodies to stimulate erection

92

PREGANGLIONIC PARASYMPATHETIC axons from cell bodies in S2, S3, and S4 reach the inferior hypogastric plexus by travelling on

Pelvic splanchnic nerves

93

In the inferior hypogastric plexus, PARASYMPATHETIC axons synapse and then travel in

Cavernous nerves

94

Pass through the urogenital diaphragm to reach erectile tissue

Cavernousnerves

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