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Anatomy Perineum
KYCOM Block 2
175
Anatomy
Graduate
09/24/2012

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Term
what binds the perineum, what side
Definition
pubic symphysis anteriorly, coccyx posteriorly, ischial tuberosity (laterally)
Term
what is the shape of the perineum
Definition
diamond
Term
what is above the perineum
Definition
levator ani
Term
what is the urogenital triangle
Definition
anterior part of the pubic symphysis
Term
what is the anal triangle
Definition
the posteior part of the pubic symphys
Term
in a male, what is the order of the openings in the perinerum from pubic symphysis to coccyx
Definition
urethra, perineal body, anus
Term
what forms the pelvic diaphragm
Definition
levator ant, coccygus, their fascia
Term
why is the pelvic diaphragm incomplete and where
Definition
anteriorly it has an opening for urethra or vagina
Term
what opening marks the midline of the pelvic diaphragm
Definition
anus
Term
what is the ischial recta fossa
Definition
fat filled fossa on each side of the anus
Term
what nerve supplies the skin by the anus
Definition
inferior rectal
Term
where does the lymph of the anus go to
Definition
medial superificial inguinal nodes
Term
what marks the lateral sides of the pelvic diaphragm
Definition
ischial tuberosity
Term
what is the sacrotuberous ligament
Definition
ligament that is by the ischial tuberosities and has the gluteus max msucle above it
Term
what is tposterior to the anal canal
Definition
anococcygeal body
Term
what is the anococcygeal body
Definition
mass of fibrous tissue that lies between anal canal and coccyx
Term
what is lateral to the anal canal
Definition
ischiorectal fossa
Term
what is anterior to the anal canal in male
Definition
perineal body, urogenital diaphragm, membranous urethra, blub of penis
Term
what is anterior to the anal canal in females
Definition
preineal body, urogenital diaphgram, lower vagina
Term
where is the muscosal lining of the upper half of the anal canal derived from
Definition
hind gut endoderm
Term
what is the endothelium type of the upper anal canal
Definition
simple columnar epithelium
Term
what is the anal columns
Definition
muscos in verticle folds joined at elower ends by anal valves in the muscos in the upper half of the anal canal
Term
what are the anal valves
Definition
semilunar folds ar teh ends of the anal columns in the mucosa of the upper half of the anal canal
Term
what are the remnents of the cloacal membrane
Definition
anal columns, anal valves
Term
what nerves supply the upper anal canal
Definition
autonomic hypogastric plexus
Term
what stimulation is the anal canal sensitive to
Definition
stretch
Term
what artery supplies the anterior upper anal canal, where does it come from
Definition
superior rectal artery, inferior mesenteric
Term
what vein drains the upper anal canal, where does it train to
Definition
superior recctal, inferior mesenteric and portal
Term
where does the lymph from the upper anal canal go
Definition
along superior rectal a to pararectal nodes and then inferior mestnteric nodes
Term
where is the mucosa from the lower anal canal derived from
Definition
ectoderm
Term
what type of epithelium is the lower anal canal
Definition
stratified squamous epithelium
Term
what is the perianal epiderms
Definition
what the stratified squamous epithelium gradually merges with at the anus
Term
what are the lower anal canal anal columns
Definition
there are none HA
Term
what nerve supplies the lower anal canal
Definition
somatic inferior nectal nerve
Term
what stimulus is the lower anal canal sensitive to
Definition
pain, temp, touch, and pressure
Term
what arteries supply the lower anal canal, where does it come from
Definition
inferior rectal from the internal pudenal a
Term
what veins drain the lower anal canal, what does that drain into
Definition
inferior rectal vein to the internal pudendal vein to the internal iliac
Term
where does the lymph from the lower anal canal go
Definition
dow to the medial group of superificial inguinal nodes
Term
what is the pectinate line
Definition
level where the upper and lower anal canals join, where valves are located
Term
which anal spinctor is involuntary, what is it made of, where is it located
Definition
internal, smooth muscle, upper
Term
what anal sphinctor is voluntary, what is it made of, where is it located
Definition
external, skeletal muscle, lower
Term
what is the deep external sphinctor
Definition
upper anal canal
Term
what is the superificial external sphinctor
Definition
attached to coccyx in back and perineal body in front
Term
what is the subcutanous external sphinctor
Definition
lower, connected to skin
Term
what is the puborectalis
Definition
part of levator ani
Term
what is the relationship between the puborectalis and rectum
Definition
it makes a sling around the rectal junction on the external sphinctor
Term
where is the puborectalis attached, what is this called
Definition
to the pubic symphysis in the acute angle
Term
what is the analrectal ring
Definition
junction of the internal sphinctor, rectum, anal canal, deep external, puborectalis
Term
what does the ischiorectal fossa do
Definition
supports anal canal, fat allows for distension
Term
what forms the medial wall of the ischiorectal fossa
Definition
slope of levator ani and anal canal
Term
what forms the lateral wall of the ischiorectal fossa
Definition
lower obturator internus and pelvic fasica
Term
what is the pundendial canal also called
Definition
fasical canal
Term
what is in the pundendial canal
Definition
pudendial nerve, internal pudendial vessels,
Term
what do the pudendial NOT INTERNAL, and internal pudendial vessels have to cross to get into the anal canal
Definition
fossa
Term
where are the pudendial nerve and INTERNAL pudendial vessels located
Definition
on lateral wall of ischerorectal fossa
Term
where does the pudendial nerve originate
Definition
sacral plexus
Term
desscribe the path of the pudendial nerve
Definition
exits pelvic cavity > greater sciatic foramen > gluteal m > lesser sciatic foramen pudendial canal > skin, muscles, external anal sphinctor
Term
what are the main branches of the pudendial nerve
Definition
inferior rectal, dorsal, perineal
Term
where is the inferior rectal nerve located
Definition
ischiorectal fossa
Term
what does the inferior rectal nerve supply
Definition
external anal sphinctor, mucosa of lower anal canal, perineal skin
Term
what does the dorsal nerve of the penis supply
Definition
penis / clitoris
Term
what does the perineal nerve supply
Definition
urogenital triangle, skin of posterior scortum or labia majora
Term
where does the interior pudendial artery come from
Definition
internal iliac
Term
describe the path of the interior pudendial artery
Definition
pelvis > greater sciatic foramen > enters perineum at lesser sciatic foramen > branches
Term
what are the branches of the interior pudendial artery
Definition
inferior rectal artery, penis / labia clitoris
Term
what does the inferior rectal artery supply
Definition
lower anal canal
Term
what veins drain the pudendial canal
Definition
interior pudendial
Term
what arteries supply the pudendial canal
Definition
interior pudendial
Term
what are the boundries of the urogenital triangle
Definition
pubic arch in front and ischial tuberosities laterally
Term
what are the layers of the superficial fascia of the urogenital triangle
Definition
fatty and mambranous
Term
what is the name of the fatty layer of the urogenital triangle
Definition
camper's fascia
Term
what is the camper's fascia of the urogenital triangle continous with
Definition
fat of the ischiorectal fossa and superficial fascia of the thighs
Term
describe the camper's fascia of the scrotum
Definition
it was turned into smooth dartos muscle
Term
what is the function of the dartos muscle
Definition
contracts in response to cold and reduces the surface area of the scrotal skin
Term
what is the name of the membranous layer of the urogenital triangle
Definition
colle's fascia
Term
where does the colles fascia attach
Definition
posterior to the border of the urogenital diaphragm and laterally to the margins of the pubic arch, anteriorly it is continous with the membranous layer of the superficial fascia of the abdominal wall, it covers the sheath of the clitoris or penis and forms a layer in the scrotum or labia majora
Term
what forms the superficial perineal pouch
Definition
below is the mambranous superficial fascia, above is the urogenital diaphragm, behind is the fusion of these two layers, lateral it is closed by the membranous layer of the superficial fascia and urogenital diaphragm to the margins of the pubic arch, anterior it freely communicates with the potential space between the superficial fascia of the abdominal wall and anterior abdominal muscles
Term
what is the urogenital diaphragm made of
Definition
musculofascia
Term
what is behind the urogenital diaphragm
Definition
perineum
Term
what fills the gap of the pubic arch
Definition
urogenital diaphragm
Term
what is the inferior layer of fascia of the urogenital diaphragm called
Definition
perineal membrane
Term
anteriorly, at the pubic symphysis, what does the urogenital diaphragm do
Definition
the two layers of fascia (superior and inferior)fuse leaving a small gap beneath the symphysis
Term
how does the urogrnital diaphragm fascia end posteriorly
Definition
two layers fuse with eachother and with the membranous layer of the superificial fascia and perineal body
Term
how does the fascia of the urogenital diaphragm end laterally
Definition
attach to the pubic arch
Term
what is the deep perineal pouch
Definition
closed space that is contained between the superificial and deep layers of fascia
Term
in a male what does the urogenital triangle contain
Definition
penis and scrotum
Term
what is the root of the penis
Definition
three masses of erectile tissue called the bulb, left, and right cura that is fixed to the body at the urogenital diaphragm
Term
what muscle covers the bulb of the penis
Definition
bulbospongiosus
Term
what do the cura of the penis attach to
Definition
each side of the pubic arch
Term
what covers the curs of the penis
Definition
ischiocavernosus muscle
Term
what is the continuation of the bulb of the penis into the body of the penis called
Definition
corpus spongiosum
Term
what is the continuation of the cura of the penis into the body of the penis called
Definition
corpacavernosa, 2
Term
what forms the glans penis
Definition
distal corpus spongiosum
Term
what is the external urethral meatus
Definition
opening of the urethra at the tip of the glans penis
Term
what is another word for foreskin
Definition
prepuce
Term
what is the foreskin
Definition
fold of skin that covers the glans of the penis, usually removed via circumcision
Term
describe the attachments of the fascia that supports the body of the penis
Definition
extend from the linea alba and symphysis pubis and attach to the fascia of the penis
Term
what arteries supply the corpora cavernosa
Definition
deep arteries of the penis
Term
what arteries supply the corpus spongiosum
Definition
artery of the bulb
Term
what are the branches of the internal pudendal artery that supply the penis
Definition
deep arteries of the penis, artery of the bulb, dorsal artery of the penis
Term
where do the veins of the penis drain to
Definition
pudendal veins
Term
where does the lymph of the skin of the penis drain to
Definition
superificial inguinal lymph nodes
Term
where does the lymph of the deep penis drain to
Definition
internal iliac nodes
Term
what nerve supplies the penis
Definition
pudendal nerve and pelcivc plexus
Term
what does the superificial pouch contain in males
Definition
structures forming the root of the penis and their coverings, bulbosspongiosus, posterior corpus spongiosum, ischiocavernosus m,
Term
what is the function of the bulbosspongiosus muscle in males
Definition
compress penile part of urethra to empty it of residual urine or semen
Term
what is the function of the ischiocavernosus muscle
Definition
compress cura and assist in erection of penis
Term
where are the superificial transverse perineal muscles in a male
Definition
in the posterior portion of the superificial pouch of the male
Term
what is the origin and insertion of the transverse perineal muscles in males
Definition
ischial ramus and the perineal body
Term
what is the function of the superificial transverse perineal muscle in males
Definition
fix perineal body in the center of the perineum
Term
what vessels and nerve supply the muscles of the superificial pouch in males
Definition
pudendal
Term
where is the perineal body attached in males
Definition
center of the posterior margin of the urogenital diaphragm
Term
what is the function of the perineal body in males
Definition
point of attachment for the external anal sphinctor, bulbospongiosus, superificial transverse perineal muscles
Term
where does the perineal branch of the pudendial nerve terminate, what does it then supply
Definition
on each side of the superificial perineal pouch and supplies the muscles and skin
Term
what is the shortest part of the urethra
Definition
membranous
Term
what surrounds the membranous urethra, what does this cause
Definition
the sphincter urethrae muscle, cause it to the be least dilatable part
Term
what part of the urethre is above the below the membranous in males
Definition
prostatic and penile
Term
what is the sphincter urethrae muscle attached to
Definition
pubic arch on both sides
Term
what innervates the sphinctor urethrae
Definition
perineal branch of the pudendal nerve
Term
what is the function of the sphinctor urethrae
Definition
compress the membranous urethra and relax during micturition
Term
where are the bulbourethral glands located
Definition
beneath the sphincter urethrae muscle
Term
where is the opening of the duts of the bulbourethral glands located
Definition
pierce the perineal membrane to enter the penile urethra
Term
what is the function of the bulbourethal glands
Definition
secrete a thick alkaline fluid to neutralize the enivornment of the penile urethra prior to ejaculation
Term
what is the deep transverse perineal muscle posterior to
Definition
sphinctor urethrae muscle
Term
what is the origin and insertion of the transverse perineal muscle
Definition
ischial ramus and perineal body
Term
what arteries run through the deep pouch in th emale
Definition
internal pudendal
Term
what nerve passes through the deep pouch in the male, where does it end
Definition
dorsal nerve of the penis, skin of penis
Term
what are the steps of an erection
Definition
1. efferent impulses
2. parasympathetic outflow
3. S2-4 nerves
4. inferior hypogastric (synapse)
5. fibers join pudendal arteries
6. enter erectile tissue of the penis
7. vasodilation of the arteries occur
8. blood fills erectile tissue spaces
9. corpoa cavernosa and corpus spongiosum expand and compress veins
Term
what are the steps of ejaculation
Definition
1. nervous impulse
2. sympathetic outflow (T1-L2)
3. synapse in 1st and 2nd lumbar ganglia or sacral ganglia
4. inferior hypogastric plexus
5. postganglionic fibers go to smooth muscle: vas deferens, seminal vesicles, prostate
6. smooth muscle contracts
7. semen is ejected from urethra and the sphincter of the bladder contracts preventing reflux of semen into the bladder
Term
what is the widest and most able to dilate part of the male urethra
Definition
prostetic
Term
what part of the urethra is in the urogrnital diaphragm in males
Definition
mambranous
Term
what part of the urethra is in the bulb and corpus spongiosum of hte penis
Definition
penile
Term
what part of the urethra is in the glans penis
Definition
fossa terminalis (nacivular fossa) of the penile urethra
Term
what is in the female urogenital triangle
Definition
external genitalia, orifices of the urethra and vagina
Term
what structure corresponds to the penis
Definition
clitoris
Term
what marks the apex of the female urogenital triangle
Definition
clitoris
Term
what covers the glans of the clitoris
Definition
prepuce
Term
what is the root of the clitoris composed of
Definition
three masses of erectile tissue
Term
what structure corresponds to the bulb of the penis in a female
Definition
bulb of the vestibule
Term
what is different between the bulb of the penis and bulb of the vestible, why
Definition
the vestibule has two halves due to the presence of the vagina
Term
where is the bulb of the vestibule attached to
Definition
underside of the urogenital diaphragm
Term
what covers the bulb of the vestibule
Definition
bulbosspongiosus muscle
Term
what structure corresponds to the cura of the penis in females
Definition
cura of the clitoris
Term
what does the cura of the clitoris becone
Definition
corpora cavernosa
Term
what covers the cura of the clitoris
Definition
ischiocavernosus muscle
Term
what is the body of the clitoris composed of
Definition
two corpora cavernosa, some erectile tissue
Term
what is the cap on the top of the clitoris
Definition
the glans of the clitoris
Term
what is the blood supply and lymphatic drainage and nerves of the clitoris
Definition
same as male
Term
what is in the superificial perineal pouch in females
Definition
structures that form the root of the clitoris and the muscles that cover them
Term
where is the blubospongiosus muscle located in females
Definition
surroungs oriface of vagina and covers bulb of vestibule, fibers extend to corpora cavernosa
Term
what is the function of the bulbospongiosus in females
Definition
reduces size of the vaginal oriface and compresses the deep dorsal vein of the clitoris in erection
Term
what does contraction of the ischiocavernosus muscle in females cause
Definition
erection of the clitoris
Term
do females have a superificial transverse perineal muscle? compare it to the male
Definition
yes, identical
Term
what are the muscles in the female superificial pernieal pouch supplied by nerve wise
Definition
perineal branch of the pudendal nerve
Term
who has a bigger perineal body, male or female
Definition
female
Term
where is the perineal body located in females
Definition
between lower end of vagina and anal canal
Term
what attaches to the perineal body in females
Definition
perineal muscles, levator ani muscles
Term
what does the deep perineal pouch in the female contain
Definition
urethra, vagina, sphincter urethrae, deep transverse perineal muscles, internal pudendal vessels, dorsal nerve of clitoris
Term
what pierces the spinctor urethrae in females
Definition
urethra and vagina
Term
where is the urethra vestible located in relation to the clitoris
Definition
about an inch below
Term
what corresponds to the prostate in females
Definition
paraurethral glands
Term
where are the greater vestibular glands located
Definition
under posterior part of the bulb of vestibule and labia majora
Term
where do the greater vestibular glands drain into
Definition
vestibule via small duct
Term
what is the function of the greater vestibular glands
Definition
secrete lubricating mucus during sexual intercourse
Term
what vessels supply the vagina
Definition
vaginal branch of the internal iliac, vaginal branch of the uretine artery
Term
what drains the lymph of the upper third of the vagina
Definition
internal and external iliac nodes
Term
what drains the lymph of the middle third of the vagina
Definition
internal iliac nodes
Term
what drains the lymph of the lower third of the vagina
Definition
superificial inguinal nodes
Term
where do the nerves come from that innervate the vagina
Definition
from inferior hypogastric plexus
Term
what is the vulva
Definition
female external genitalia
Term
what does the vulva include
Definition
mons pubis, labia majora, labia minora, clitoris, vestibule of vagina, vestibular bulb, greater vestibular glands
Term
what vessels supply the vulva
Definition
external internal pudendal arteries on each side
Term
what drains the lymph of the vulva
Definition
medial group of the superificial inguinal nodes
Term
what nerve supplys the anterior vulva
Definition
ilioinguinal and genitofemoral
Term
what nerve supplys the posterior vulva
Definition
branches of the perineal nerves, posterior cutaneous nerve of the thigh
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