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Anatomy Test 3 > The Perinuem > Flashcards

The Perinuem Flashcards

1
Q

Define the boundaries of the perineal region?

A

a diamond shaped area bounded by the pubic symphysis, ischial tuberosities and coccyx

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2
Q

how is the perineum subdivided?

A

a line between the ischial tuberosities divide the region into an anterior urogenital triangle and a posterior anal triangle

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3
Q

what structure forms the floor of the pelvis (pelvic diaphragm)?

A

levator ani

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4
Q

where are the ischioanal (rectal) fossae located?

A

on either side of the rectum/anal canal below the levato ani

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5
Q

where does the anal canal begin?

A

on the inferior aspect of the levator ani (floor of the pelvic cavity)

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6
Q

what is the dentate/pectinate line?

A

a line drawn that connects the inferior aspect of the anal valves

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7
Q

what is the white/anocutaneous line?

A

a line inferior to the dentate/pectinate line where the epithelium changes from mucous to stratified squamous

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8
Q

what is the anal valve?

A

a flap of mucosa bridging two anal columns and spanning an anal sinus in the wall of the anal canal

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9
Q

what is the anal column?

A

longitudinal column-like protrusions of epithelium between the anal valves

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10
Q

what is the clinical implication of this vavular arrangement?

A

the small cusp-like flaps of mucosa have anal glands emptying into them. accumulation of fecal material in these cusps can lead to infected glands and abscess situations

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11
Q

what are the 2 sphincters of anal canal?

A

internal and external anal sphincters

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12
Q

which of these two sphincters is under voluntary control?

A

the external is skeletal (voluntary) muscle, the internal smooth (involuntary) muscle

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13
Q

what are the 3 components of this latter sphincter?

A

the subcutatneous, superficial, and deep portions

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14
Q

to which two structures is the superficial portion of this sphincter connected?

A

anteriorly to the perineal body and posteriorly to the coccyx via the anococygeal ligament

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15
Q

how does the puborectalis function in assisting the action of the anal sphincter for bowel control

A

it pulls the lower rectum forward, “kinking” it to add a biochemical sphincter-like feature for continence

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16
Q

why is the anocutaneous (white) line important?

A

it is a major watershed area (shift in supply) for numerous anatomical features/supply

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17
Q

list the artererial changes in or around the anocutaneous line

A

above–superior rectal from inferior mesenteric artery, middle rectal from internal pudendal
below–inferior rectal from internal pudendal

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18
Q

List the venous changes in or around the anocutaneous line.

A

above–to primarily portal system

below–to completely caval system

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19
Q

List the lymphatic changes in or around the anocutaneous line.

A

above–to deep (para-aortic) nodes

below–superficial inguinal nodes

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20
Q

List the sensory changes in or around the anocutaneous line.

A 
above--visceral afferents (diffuse pain)
below somatic (sharp, well localized pain) and temperature
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21
Q

List the motor changes in or around the anocutaneous line.

A

above–ANS from pelvic splanchnics to smooth muscle

below–somatomotor from pudendal nerves to skeletal muscle

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22
Q

what fills the ischioanal fossa?

A

fat

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23
Q

what forms the roof of the ischioanal fossa?

A

the underside of the levator ani muscle and deep investing fascia

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24
Q

what forms the lateral wall of the ischioanal fossa?

A

the medial aspect of the obturator internus muscle

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25
Q

what forms the medial wall of the ischioanal fossa?

A

the underside of the levator ani muscle and deep investing fascia

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26
Q

what is the relationship of the anterior recess of the ischioanal fossa to the UG diaphragm (deep transverse perineal muscles)?

A

it is a cavity immediately above the UG diaphragm, continuous with the posteriorly located ischioanal fossa

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27
Q

what structures are found within a sheath along the lateral wall of the ischioanal fossa?

A

the internal pudendal artery and vein and pudendal nerve

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28
Q

what is the function of the internal pudendal vessels?

A

they supply the perineal region and external genitalia

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29
Q

what is the pathway of the internal pudendal artery and pudendal nerve prior to its appearance in this fossa?

A

they left the pelvic cavity via the greater sciatic foramen, passes under the sacrospinous ligament and entered the perineum via the lesser sciatic foramen by passing over the top of the sacrotuberous ligament

30
Q

be able to label a coronal section thru the male and female pelvic/perineal regions

A

this objective is done in more detail later

31
Q

what is scarpa’s fascia?

A

the deep aspect of the superficial fascia of the lower abdomen and pelvis

32
Q

what does scarpa’s fascia form?

A

the membraneous layer of superficial fascia (scarpa’s) can be subdivided into a number of continuous fascial layers in the perineum (buck’s, colle’s, etc.) that essentially define the outermost extent of the superficial space/pouch

33
Q

what are the contents of the deep perineal space/pouch?

A

boundaries of the deep perineal space are: the superior fascial layer of the deep transverse perineal muscle, and the inferior fascial layer of the deep transverse perineal muscle–the perineal membrane
contents–the deep transverse perineal muscle, the sphincter urethra muscle, the membranous urethra and the bulbourethral glands (in the male). in the female–urethra and vagina

34
Q

what the contents of the superficial perineal space/pouch?

A

the crura of the penis/clitoris and the ischiocavernosus muscle, the bulb of the penis in the male and the vestibular bulbs in the female, and the overlying bulbospingiosus muscle. in the female the greater vestibular glands are also found in the space.

35
Q

how is the spread of extravasated urine contained?

A

the membranous layer of the superficial fascia (scarpa’s) fuses with the UG diaphragm posteriorly and with the fascia lata of the thigh laterally. it does not therefore spread posteriorly or inferiorly into the thigh.

36
Q

in which space/pouch is this extravasated urine located?

A

the superficial perineal space/pouch

37
Q

what structures form what used to be called the urogenital (UG) diaphragm?

A

the deep transverse perineal muscle and the sphincter urethra

38
Q

where is the UG diaphragm located in the male?

A

at the inferior border of the prostate

39
Q

which of the two structures of the UG diaphragm form is major component?

A

the deep transverse perineal muscle

40
Q

what structures pierce the UG diaphragm in the male?

A

the membranous urethra

41
Q

what structures are found along the posterior edge of the deep transverse perineal muscle?

A

the superficial transverse perineal muscle

42
Q

the penis is composed of how many cylinders of erectile tissue?

A

3

43
Q

what are the 2 paired dorsal ones called?

A

corpora cavernosa

44
Q

what is the thick CT capsule of these two cylinders called?

A

the tunica albuginea

45
Q

what is the single, unpaired ventral cylinder called?

A

the corpus spongiosum

46
Q

what doesn’t the unpaired cylinder have a thick CT capsule?

A

it does not become as rigid during erection

47
Q

what is the implication of having the urethra traverse this unpaired cylinder?

A

the urethra must remain patent to allow ejaculation so it does not become as rigid

48
Q

what is the dilated distal end of the corpus spongiosum called?

A

the glans penis

49
Q

what is the dilated proximal portion of the corpus spongiosum called?

A

the bulb of the penis

50
Q

what does the shaft of the penis consist of?

A

3 cylinders of erectile tissue

51
Q

what structures lie under the deep transverse perineal muscle in the male?

A

the crus and bulb of the penis

52
Q

what muscle layers come the bulb of the penis?

A

bulbospongiosus

53
Q

what muscle layers cover the crura of the penis?

A

the ischiocavernosus

54
Q

what fascial layer overlies all of these muscles?

A

the membranous layer of the superficial (colle’s) fascia

55
Q

Be able to label a diagram of the male perineal region in both the lithotomy and coronal views.

A

The diagrams on the bottom left of page 261 and bottom of page 264 are important and have been used on the exam before

56
Q

what is the outer serous lining on the testis?

A

the visceral tunica vaginalis

57
Q

where did this serous lining come from?

A

the peritoneum

58
Q

where is the parietal counterpart to this visceral serous membrane?

A

on the inside of the scrotal wall

59
Q

what separates one testis from the other?

A

a fibrous median septum

60
Q

what gives the scrotum its wrinkled appearance? why?

A

the dartos muscle. the fibers of this muscle insert directly into the skin (no deep fascia covers it)

61
Q

what is the function of the dartos muscle?

A

it elevates/lowers the testes to keep them at a constant 95 degree temperature. ideal for spermatogensis

62
Q

be aware of the contents of the pudendal cleft in the female, in order from anterior to posterior

A

clitoris, urethral opening, vaginal opening

63
Q

what is the frenulum and where is it found?

A

the anterior union of the labia minor, just under the glans clitoris

64
Q

what is the fourchette and where is it found?

A

the posterior union of the labia minor just posterior to the vagina opening

65
Q

what structures pierce the deep transverse perineal muscle in the female?

A

the urethra and vagina

66
Q

what structure has separated the bulb of the penis into two smaller bulbs in the female?

A

the vagina

67
Q

what structures lie under the deep transverse perineal muscle in the female?

A

the crura of the clitoris and the vestibular bulbs

68
Q

what muscle layers cover the bulbs of the vestibule?

A

the bulbospongiosus

69
Q

what muscle layer covers the crura of the clitoris?

A

ischiocavernosus

70
Q

what fascial layers overlies all of the female perineal muscles?

A

the membranous layer of superficial (colle’s) fascia

71
Q

Be able to label a diagram of the female perineal region in both the lithotomy and coronal views as well as a sagittal section through the pelvis that would include the internal reproductive organs.

A

These diagrams (page 262 and bottom of page 265) have been used on the exam before

Anatomy Test 3 (8 decks)

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