Sept5 M3-Pelvis_Anatomy_lecture_4

Question 1

boundaries of the urogenital triangle

Answer 1

(will be formed by some boundaries of pelvic outlet)

• pubic symphysis
• ischiopubic rami
• imaginary line between the ischial tuberosities

Question 2

IRL tilt of the UG triangle when pelvis properly tilted

Answer 2

horizontal. surface of triangle facing down.

Question 3

3 parts of levator ani (extend into the UG triangle)

Answer 3

• iliococcygeus (most lat and post)
• pubococcygeus
• puborectalis (most medial and ant)

Question 4

levator ani and coccygeus muscle relation to SS ligament

Answer 4

are deep to it in the body so are anterior to SS lig

Question 5

iliococcygeus comes off what bone

Answer 5

ischial spine

Question 6

perineal membrane def

Answer 6

thin sheet of tought CT (fascia) covering the UG triangle

• dividing point between UG and anal triangles so dividing point between rectum and vagina (**SAME BOUNDARIES AS UG TRIANGLE)
• urethral opening (hole in perineal membrane) for urethra
• vaginal opening (hole in perineal memb) post to urethral one

Question 7

perineal body def

Answer 7

center point of the diamond formed by the UG and anal triangles.
-small mass of fibrous tissue between rectum and vagina and at midpoint between ischial tuberosities

Question 8

perineal body relations

Answer 8

• anterior: vestibule (opening) of the vagina OR bulb of the penis
• posterior: anal canal

Question 9

muscles attaching to the perineal body

Answer 9

• levator ani
• superficial and deep transverse perineal muscles
• bulbospongiosus muscle

Question 10

perineal body clinical significance

Answer 10

can be damaged during difficult childbirth. consequence = possible prolapse of pelvic viscera

Question 11

deep and superficial perineal pouch

Answer 11

pouches (spaces) deep and superficial to the perineal membrane

Question 12

structures in deep perineal pouch in the male

Answer 12

• membranous urethra (part of urethra between prostatic and penile)
• bulbourethral (Cowper’s) glands on each side of membranous urethra, pierce through perineal membrane to enter penile urethra
• external urethral sphincter (muscle). voluntary control
• deep transverse perineal muscle (thin). O and I = right pubic rami to left pubic rami. same for superficial
• perineal nerves and vesseks (in back of perineal membrane)

Question 13

origin of perineal nerve

Answer 13

pudendal n

Question 14

origin of perineal vessels

Answer 14

internal pudendal a (takes same path as pudendal n). when it reaches the back of the UG triangle, it gives superficial and deep branches)

Question 15

bulbourethral (Cowper’s) glands fct

Answer 15

• secrete pre-ejaculate to lubricate the urethra

- neutralize traces of acidic urine

Question 16

structures in the deep perineal pouch in the female

Answer 16

• proximal urethra
• external urethral sphincter (muscle)
• vagina
• deep transverse perineal muscles
• perineal vessels and nerves
• no glands*

Question 17

structures of superficial perineal pouch in the female (except muscles and neurovascular supply)

Answer 17

• vestibule (opening of vagina and urethra)
• greater vestibular glands (Bartholin’s) (give ducts opening on side of vagina)
• bulb of the vestibule (2 bulbs of erectile tissue lat to vestibule and extending anteriorly) (in men, becomes corpus spongiosum)
• fourchette (posterior portion of the vagina)
• urethral orifice
• vaginal orifice
• body of clitoris (containing corpora cavernosa)
• crura of the clitoris (lying against the ischiopubic rami). come together at midline to form body of clitoris

Question 18

greater vestibular glands (Bartholin’s)

Answer 18

• secrete mucus to lubricate the vagina

- homologous to BU glands in male

Question 19

external genitalia in the female

Answer 19

• mons pubis (over pubis symphysis)
• clitoris (ant)
• labia majora
• labia minora
• anus

Question 20

muscles in the superficial perineal pouch in the female

Answer 20

• superficial transverse perineal m (along back border of perineal membrane)
• ischiocavernosus m (covering the crura of the clitoris)
• bulbospongiosus m (muscle surrounding the vestibule). in the male, the bulb of the penis is continus with corpus spongiosum so name remained)

Question 21

neurovascular supply in superficial perineal pouch in female

Answer 21

• perineal nerves (from pudendal n splitting in superficial and deep)
• perineal vessels (front internal pudendal a and v)

Question 22

path of pudendal n, a and v

Answer 22

• out of greater sciatic foramen with inferior gluteal
• reach gluteal region
• come back underneath in perineum (wraps around ischial spine)
• go below piriformis
• reach back of UG triangle
• give superficial and deep branches

Question 23

superficial perineal pouch structures in the male except neurovascular

Answer 23

• crura of the penis (crus on each side along ischiopubic rami) continuous with the corpora cavernosa
• bulb of the penis
• ischiocavernosus m (covers the crura)
• bulbospongiosus m (covers the bulb of the penis)
• penile urethra
• superficial transverse perineal m.
• (root of the penis, basically whole base with crura, bulb and their muscles)
• (shaft of the penis with the corpora cavernosa and spongiosum)

Question 24

neurovascular supply of superficial perineal pouch in the male

Answer 24

• perineal vessels

- perineal nerves

Question 25

muscles in shaft (body) of penis

Answer 25

none

Question 26

bottom vs top of penis

Answer 26

bottom = corpus spongiosum (from bulb) with penile urethra (which is therefore enclosed by bulb and corpus spongiosum) top = 2 corpora cavernosa (from crura) *and glans at end of the penis, top and bottom

Question 27

end of urethra name in male

Answer 27

external urethral meatus (orifice)

Question 28

internal urethral orifice is where

Answer 28

bladder

Question 29

start and end landmarks of the membranous urethra (male)

Answer 29

bottom of prostate to perineal membrane. surrounded by external urethral sphincter

Question 30

(important) structure in middle of corpora cavernosa

Answer 30

``` deep artery (comes from internal pudendal a) *no venule, vein ```

Question 31

veins and arteries (other than deep a) in the penis

Answer 31

- deep dorsal and superficial dorsal veins | - dorsal penile artery

Question 32

Buck's fascia is what

Answer 32

deep fascia surrounding the penis and separating the deep and superficial dorsal veins

Question 33

Dartos fascia is where in the penis

Answer 33

fascia surrounding the penis and that is superficial to the superficial dorsal veins. skin comes right after it

Question 34

Tunica albuginea is where in the penis

Answer 34

deep to the deep dorsal vein

Question 35

order of structures surrounding the penis

Answer 35

- tunica albugenia - deep dorsal vv AND DORSAL PENILE ARTERY - Buck's fascia - superficial dorsal vv - Dartos fascia - skin

Question 36

how erection is maintained

Answer 36

- penis filled with blood and this compresses on the thick non elastic Buck's fascia (superficial to deep dorsal v). - deep forsal v is compressed and blood can't leave

Question 37

structures surrounding the scrotum in the male (in to out)

Answer 37

- tunica vaginalis (from obliterated processus vaginalis = peritoneum coming in inguinal canal) - internal spermatic fascia (from transversalis fascia) - cremaster muscle (from internal oblique) - external spermatic fascia (from external oblique) - Dartos fascia (same as one in penis) (continuous with Scarpa's fascia in abdomen) and muscle - skin

Question 38

Scarpa's fascia is what

Answer 38

membranous layer of the superficial fascia in the abdomen (continuous with superficial fascia of the penis and scrotum = Dartos)

Question 39

Colle's fascia is what

Answer 39

piece of the Dartos fascia that extends in the pelvis to form the superficial perineal fascia

Question 40

perforation of urethra without penetration of Buck's fascia gives what

Answer 40

urine accumulates around the shaft (body) of the penis between Buck's fascia and tunica albugenia

Question 41

perforation of urethra with penetration of Buck's fascia gives what

Answer 41

urine in scrotum and all the way up the abdominal wall - between buck's fascia and dartos fascia in the penis body region - between buck's fascia and Scarpa's fascia in the dorsal penis shaft region - between Buck's fascia and Dartos fascia of scrotum and between Buck's fascia and Colle's fascia for region of ventral penis shaft