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Flashcards in The Perineum Deck (46):
1

body & ligamentous boundaries of the perineum:

the perineum is the ___-shaped, ___-filled area b/n the ___

it extends from the inferior aspect of the ___ to the ___ & contains the external openings of the ___ & ___ tracts

the lateral boundaries of the perineum are formed by a series of ___ &___

diamond
tissue
thighs

pelvic diaphragm
skin
urogenital
gastrointestinal

bones
ligaments

2

body & ligamentous boundaries of the perineum:
boundaries:

superior: ___
inferior: ___
anterior: ___
anterior & lateral: ___
posterior & lateral: ___
posterior: ___

pelvic diaphragm
skin of teh perineal region
pubis symphysis
ischiopubic ramus
sacrotuberous ligament
coccyx

3

body & ligamentous boundaries of the perineum:

an imaginary line passing b/n the two ___ divides the perineum into ___ & ___ triangles

ischial tuberosities
urogenital
anal

4

the urogenital triangle:

the urogenital triangle contains the external openings of the ___ (in both males & females) & the ___ (in females)

within the urogenital triangle there are two pouches: ___ & ___

the perineal pouches contain ___, ___, & other ___

urethra
vagina

superficial perineal pouch
deep perineal pouch

muscles
glands
tissues

5

the urogenital triangle:
the superficial perineal pouch:

the superficial perineal pouch is an enclosed compartment located b/n the ___ layer of ___ (inferior border) & the ___ (superior border)

membranous
superficial fascia
perineal membrane

6

the urogenital triangle:
the superficial perineal pouch:
membranous layer of superficial fascia:

the membranous layer of superficial fascia of the ___ wall (___ fascia) extends into the perineal region & over the ___ & ___

when it enters the perineum, the membranous layer of superficial fascia is called ___ fascia

within the perineum, the membranous layer of superficial fascia is firmly attached to the ___ & ___

abdominal
Scarpa's
penis
scrotum

colle's

ischiopubic rami
ischial tuberosities

7

the urogenital triangle:
the superficial perineal pouch:
membranous layer of superficial fascia:

posteriorly, along a line drawn b/n the two ___ (i.e., at the border b/n the urogenital & anal triangles), the membranous layer of superficial fascia fuses to the ___

this is the ___ found in the perineum that's attached to the ___

this is also known as the ___

ischial tuberosities
pernieal membrane

fibrous membrane
ischiopubic rami

inferior fascia of the urogenital diaphragm

8

the urogenital triangle:
boundaries of the superficial perineal pouch:

the space b/n the ___ layer of ___ & the ___

it is continuous superiorly onto the ___ wall as the potential space b/n ___ & the ___ covering the abdominal musculature (i.e., external oblique muscle)

membranous
superficial fascia
perineal membrane

anterior abdominal
scarpa's fascia
deep fascia

9

the urogenital triangle:
boundaries of the superficial perineal pouch:

it extends posteriorly only as far as the boundary b/n the ___ & ___

therefore, it does not extend into the ___

it is limited laterally in the perineum by fusion of the ___ to the ___

it extends as a potential space within the ___ & ___

urogential & anal triangles

anal triangle

perineal fascia
ischiopubic rami

scrotum
penis

10

the urogenital triangle:
boundaries of the superficial perineal pouch:

it extends into the ___ where it fuses w/ the ___ along a line just below & parallel to the ___

posteriorly, the fusion of the ___ layer of ___ & the ___ form the ___

thigh
deep fascia of the thigh (the fascia lata)
inguinal ligament

membranous
superficial fascia
perineal membrane
posterior boundary

11

the urogenital triangle:
contents of the superficial pouch (3)

root (erectile tissue)
muscles
glands

12

the urogenital triangle:
contents of the superficial pouch:
root (2)

bulb
crura

13

the urogenital triangle:
contents of the superficial pouch:
root:
bulb:

bulb of the penis in the male / ___ bulb in the female (comprised of a single body of ___ tissue in the male / divided by the ___ into two bodies in the female)

it is in the ___ & attached to the undersurface of the ___

it encloses the ___

the bulb is continued forward into the body of the penis & forms ___

it is invested by a thin sheath of ___

vestibular
erectile
vagina

midline
urogenital diaphragm

penile (spongy) urethra

corpus spongiosum

bulbospongiosus muscle

14

the urogenital triangle:
contents of the superficial pouch:
root:
crura:

crura of the ___ (male) / ___ (female) comprised of two bodies of erectile tissue

each crus is attached to the ___

the right & left crura join the ___ in the region of the ___

they come to lie side by side forming ___

their distal ends extend to the tip (___) of the penis

the ___ invest the crura of the corpora cavernosa; this thin sheath of skeletal muscles arise from the ___ at the absae of the crura

penis
clitoris

ischiopubic ramus

corpus spongiosum
pubic arch

corpora cavernosa

glans

ischiocavernosus muscles
ischial rami

15

the urogenital triangle:
contents of the superficial pouch:
muscles (3)

bulbospongiosus muscle
ischiocavernosus muscle
superficial transverse perinei muscles

16

the urogenital triangle:
contents of the superficial pouch:
muscles:
bulbospongiosus muscle:

covers the ___

compresses the ___ part of the ___, emptying it of the residual urine or semen

compresses the ___ vein of the penis impending the venous drainage, assisting in the process of the ___ of the penis

bulb of the penis (male) / vestibular bulb (female)

penile
urethra

deep dorsal
erection

17

the urogenital triangle:
contents of the superficial pouch:
muscles:
ischiocavernosus muscles:

cover the ___ of the penis/vestibular bulb

compresses the ___ to assist in the process of hte ___

crura

crura
erection

18

the urogenital triangle:
contents of the superficial pouch:
muscles:
superficial transverse perinei muscles:

they fix the ___ in the center of the prineum

perineal body

19

the urogenital triangle:
contents of the superficial pouch:

glands (1)

in females, secretes a ___

greater vestibular glands

lubricating fluid

20

the urogenital triangle:
the deep perineal pouch:
location:

the deep perineal pouch refers to the space located ___ to the ___

it is the space b/n the ___ & ___ of the ___

superior
perineal membrane

perineal membrane
superior fascia
urogenital diaphragm

21

the urogenital triangle:
the deep perineal pouch:
location:

laterally, both the perineal membrane & superior fascia of the urogenital diaphragm are firmly fused to the ___ & ___, thus forming a lateral boundary of the deep perineal pouch

posteriorly, both the superior fascia of the urogenital diaphragm & the perineal membrane are fused along a line drawn b/n the two ___ (i.e., at the border b/n the ___ & ___), thus forming the posterior boundary of the deep perineal pouch

ischiopubic rami
ischial tuberosities

iscial tuberosities
urogenital & anal triangles

22

the urogenital triangle:
contents of the deep perineal space (pouch) in the male (5)

sphincter urethrae muscle
deep transverse perineal muscles
internal pudendal artery & vein
branches of the perineal nerve
bulbourethral glands in male

23

the urogenital triangle:
contents of the deep perineal space (pouch) in the male:
sphincter urethrae muscle:

it arises from the ___ on both sides & passes medially to encircle the ___

it is supplied by the ___ branch of the ___ nerve

it compresses the ___ part of the ___ & relaxes during voluntary control of ___

pubic arch
urethra

perineal
pudendal

membranous
urethra
micturition

24

the urogenital triangle:
contents of the deep perineal space (pouch) in the male:
deep transverse perineal muscles:

located posterior to the ___ muscle

each muscle arises from the ___ & passes medially to be inserted in the ___

sphincter urethrae

ischial ramus
perineal body

25

the urogenital triangle:
contents of the deep perineal space (pouch) in the male:
bulbourethral glands in male:

two small glands that lie beneath the ___ muscles

their ducts pierce the ___ & enter the ___

these glands are homologous to the ___ glands in the female

sphincter urethrae

perineal membrane
penile urethra

greater vestibular

26

the urogenital triangle:
contents of the deep perineal pouch in the female:

the same as those of the male but w/ the following differences:

absence of the ___

presence of the ___

the sphincter urethrae are pierced by the ___ & ___

greater vestibular glands

vagina

urethra
vagina

27

the urogenital triangle:
contents of the deep perineal space (pouch) in the male (5)

sphincter urethrae muscle
deep transverse perineal muscles
internal pudendal artery & vein
branches of the perineal nerve
bulbourethral glands in male

28

the urogenital triangle:
urogenital diaphragm:

a ___ diaphragm filling the gap of the ___

consists of ___ & ___ muscles along w/ the ___ covering them

triangular musculo-fascial
pubic arch

sphincter urethrae
deep transverse perinei
fasciae

29

the urogenital triangle:
contents of the deep perineal space (pouch) in the male:
deep transverse perineal muscles:

located posterior to the ___ muscle

each muscle arises from the ___ & passes medially to be inserted in the ___

sphincter urethrae

ischial ramus
perineal body

30

the urogenital triangle:
contents of the deep perineal space (pouch) in the male:
bulbourethral glands in male:

two small glands that lie beneath the ___ muscles

their ducts pierce the ___ & enter the ___

these glands are homologous to the ___ glands in the female

sphincter urethrae

perineal membrane
penile urethra

greater vestibular

31

the urogenital triangle:
contents of the deep perineal pouch:

on the superior surface of the sphincter urethrae & deep transverse perineal muscles, the fascia is called the ___

the ___ is b/n this & the perineal membrane (which is also called the ___)

superior fascia of the urogenital diaphragm

deep space
infeiror fascia of the urogenital diaphragm

32

the urogenital triangle:
urogenital diaphragm:

a ___ diaphragm filling the gap of the ___

triangular musculo-fascial

33

the anal triangle:
contents of the ischioanal fossa (4)

fat (liquid at body temperature to allow dilation of the anal canal)

inferior rectal nerve & vessels

internal pudendal vessels & pudendal nerve

perineal branches of posterior femoral cutaneous nerve

34

the urogenital triangle:
urogenital diaphragm:

if a patient suffers a urethral rupture within the superficial perineal pouch, ___ will extravasate (leak) into the ___ when the patient attempts to urinate

urine
superficial perineal pouch

35

the anal triangle:

b/c the ischioanal fossae ___, an infection of the ischioanal fossa on one side can ___

communicate
spread to the other ischioanal fossa

36

the anal triangle:

the opening of the ___ lies in the middle of the anal triangle

the spaces on either side of the above structure are the ___, which is filled w/ fat b/n the ___ & the ___

the left & right above structures ___ w/ one another

anal canal

ischioanal (ischiorectal) fossae
skin
pelvic diaphragm

communicate (i.e., make contact)

37

the anal triangle:
the boundaries of the ischioanal fossa:

anterior: posterior borders of ___ muscles
posterior: ___ muscle & ___ ligament
lateral: ___ covering ___ muscle
superomedial: ___ & ___
inferior: ___ covering ___

transverse perinei

gluteus maximus
sacrotuberous

fascia
obturator internus

external anal sphincter
levator ani

skin
anal triangle

38

the anal triangle:

the ischioanal fossa extends as a potential space b/n the ___ & ___

this is called the ___ of the ___

therefore, infections within the ischioanal fossa may extend anteriorly to the ___

pelvic diaphragm
urogenital diaphragm

anterior recess
ischiorectal fossa

pubic bone

39

neurovascular supply of the perineum:
course of the internal pudendal vessels & the pudendal nerve from the pelvis to the perineum:

the structures exit the pelvis through the ___

the structures wrap around the ___

the structures pass through the ___ to enter the perineum

greater sciatic foramen

ischial spine

lesser sciatic foramen

40

the anal triangle:
perineal body:

the perineal body is a thickening of ___ that lies along the midpoint of a line drawn b/n the two ___

the perineal body may be damaged during ___

fascia
ischial tuberosities

parturition (child-bearing)

41

the anal triangle:
muscles attached to the perineal body (4)

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

42

neurovascular supply of the perineum:

the ___ nerve (ventral rami of levels ___) & the ___ artery (a branch of the ___ artery) supply the perineal structures

named branches of the ___ artery & ___ nerve serve specific perineal structures (e.g., the penis, clitoris, distal portion of the rectum, muscles, etc.)

pudendal
S2 - S4
internal pudendal
internal iliac

internal pudendal
pudendal

43

neurovascular supply of the perineum:

the ___ vein parallels the course of the internal pudendal artery & drains blood from all structures that it supplies except the ___ & ___

venous drainage from the above two structures travel directly to the ___

internal pudendal
penis
clitoris

pelvic venous plexus

44

neurovascular supply of the perineum:
course of the internal pudendal vessels & the pudendal nerve from the pelvis to the perineum:

the structures exit the pelvis through the ___

the structures wrap around the ___

the structures pass through the ___ to enter the perineum

greater sciatic foramen

ischial spine

lesser sciatic foramen

45

neurovascular supply of the perineum:
course of the internal pudendal vessels & the pudendal nerve from the pelvis to the perineum:

after entering the perineum, the structures lie in the ___, which lies against the ___ muscle

it is a sleeve of ___ that encloses the internal pudendal vessels & the pudendal nerve

the structures leave the ___ & branch out as named vessels & nerves to specific perineal structures (e.g., ___)

pudendal canal
obturator internus

obturator internus fascia

pudendal canal
penis, clitoris, distal portion of rectum, muscles, etc.

46

neurovascular supply of the perineum:

the pudendal nerve is often anesthetized to relieve ___ during parturition (childbirth)

the close relationship of the pudendal nerve to the ___ provides a useful landmark in performing a ___

perineal pain

ischial spine
pudendal nerve block

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