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MD3002 Reproductive > Perineum > Flashcards

Perineum Flashcards

1
Q

Describe the location of the perineum

A

Between:

  • inferior surface of pelvic diaphragm superiorly
  • skin inferiorly
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2
Q

Describe the divisions of the perineum, and the landmarks that define it

A
  • urogenital triangle anteriorly
  • anal triangle posteriorly
  • marked by pubic symphysis most anteriorly and coccyx most posteriorly and divided by line between right and left ischial tuberosities
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3
Q

Describe the fascia of the perineum

A
  • continuous with that of abdo fascia
  • superficial fatty layer is continuous with Camper’s fascia
  • deep membranous layer (Colle’s fascia) is continuous with Scarpa’s fascia
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4
Q

Describe how the fascia of the perineum changes in males

A
  • fatty layer fuses with membranous layer of superficial fascia of penis and scrotum to become dartos fascia and muscle
  • continuous posteriorly with ischio-anal fat pad in anal region
  • membranous layer continuous with dartos fascia and attached to posterior margin of perineal membrane and body
  • fuses with fascia lata
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5
Q

Describe how the fascia of the perineum changes in females

A
  • fatty layer of subcutaneous tissue makes up labia majora and is continuous posteriorly with ischio-anal fat pad in anal region
  • membranous layer attached to posterior margin of perineal membrane and body
  • fused with fascia lata
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6
Q

Describe the location of the perineal membrane

A
  • spans urogenital triangle between ischiopubic rami

- attaches to perineal body in midline posteriorly

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7
Q

What are the main features of the perineal membrnae?

A
  • major support for urogenital organs

- has anterior aperture for passage of nerves and vessels to penis or clitoris

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8
Q

Describe the division of the urogenital triangle

A
  • divided by perineal membrane
  • deep perineal (superior) pouch
  • superficial perineal (inferior) pouch
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9
Q

What are the boundaries of the perineal pouches?

A

Superficial:

  • roof: perineal membrane
  • floor: perineal fascia

Deep:

  • roof: inferior fascia of pelvic diaphragm
  • floor: perineal membrane and muscles
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10
Q

What is the contents of the deep perineal pouch in males?

A
  • membranous urethra
  • external urethral sphincter
  • bulbo-urethral glandes
  • deep transverse perineal muscles
  • dorsal neurovascular structures of penis
  • anterior recess of ischio-anal fossa
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11
Q

What is the contents of the deep perineal pouch in females?

A
  • proximal part of urethra
  • inferior part of external urethral sphincter
  • compressor urethra
  • urethrovaginal sphincter
  • deep transverse perineal muscles
  • dorsal neurovascular structures of clitoris
  • anterior recess of ischio-anal fossa
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12
Q

What is the contents of the superficial perineal pouch in males?

A
  • root of the penis (bulb and crura) and associated muscles (ischiocavernosus and bulbospongiosus)
  • proximal part of spongy urethra
  • superficial transverse perineal muscles
  • deep perineal branches of internal pudendal vessels pudendal nerves
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13
Q

What is the contents of the superficial perineal pouch in females?

A
  • crus of clitoris and ischiocavernosus muscle
  • bulbs of vestibule and bulbospongiosus muscle
  • greater vestibular glands
  • superficial transverse perineal muscles
  • deep perineal branches of internal pudendal vessels and pudendal nerves
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14
Q

What is the functions of the ischiocavernosus and bulbospongiosus muscles in females?

A

Ischiocavernosus:

  • covers crus of clitoris
  • maintains erection of clitoris

Bulbospongiosus:

  • encloses bulb and greater vestibular gland
  • sphincter of vagina
  • assists in erection of clitoris
  • compresses greater vestibular gland
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15
Q

Describe the location of the ischioanal fossa

A

Between:

  • skin of anal region
  • levator ani
  • obturator internus and ischium
  • anal canal
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16
Q

What is the contents of the ischioanal fossa?

A
  • fatty tissue that allows changes in position and size of anal canal and anus during defecation
  • inferior rectal vessels and nerves that supply external anal sphincter
  • perforating branches of S2 and 3
  • perineal branch of SA4
  • pudendal nerve and internal pudendal vessels
17
Q

Describe the position and contents of the pudendal canal

A
  • horizontal and within obturator fascia, along lateral wall of ischio-anal fossa

Contains:

  • pudendal nerve
  • internal pudendal artery
  • internal pudendal vein
18
Q

Describe the lymphatic drainage of the perineum

A
  • superficial structures (eg. penis, scrotum, labia) to superficial inguinal lymph nodes
  • deep structures (eg. c. cavernosa, c. spongiosum, bulb of penis, proximal vagina and urethra) to internal iliac nodes
19
Q

Describe the nerve supply of the perineum

A

somatic motor, sensation and autonomic is derived from S2-4 pudendal nerves and pelvic plexuses

20
Q

Describe the clinical significance of rupture of the urethra

A

If Membranous:

  • urine will escape into deep perineal pouch
  • may pass through UG hiatus and go extraperitoneally around bladder

If Spongy:

  • urine will escape through rupture into superficial perineal pouch
  • descend into scrotum and rise onto anterior abdo wall deep to superficial fascia
  • presents as bruising trapped under Scarpa’s and Colle’s fascia

MD3002 Reproductive (35 decks)

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