Term
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Definition
| arbitrary division between abdomen and pelvis, about the level of the superior most point of the pubic symphysis |
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Term
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Definition
| name the region above the pelvic brim, but below the iliac crest |
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Term
| it lies just superior to the bladder |
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Definition
| where is the bottom level of the peritoneum in relation to the urinary bladder? |
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Term
| the PERINEUM (not perineal membrane) is below deep and superficial pouches, connecting the ischiopubic rami this is INFERIOR to the bladder and prostate |
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Definition
| where is the bottom level of perineum in relation to the urninary bladder? |
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Term
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Definition
| funnel shaped structure made of skeletal muscle, that has hole for structures to pass through, and is located below the peritoneal cavity |
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Term
| deep/superficial perineal pouches + perineal membrane |
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Definition
| what lies below the pelvic diaphragm? |
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Term
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Definition
| below the pelvic diaphragm, but above the perineal membrane is called the _____ |
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Term
| superficial perineal pouch |
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Definition
| below the perineal membrane, and the location of the genitalia |
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Term
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Definition
| foramen bound by both sacrotuberous and sacrospinous ligaments |
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Term
1) piriformis muscle
2) superior*/inferior gluteal vessels
3) internal pudendal vessels
3)Nerves:
sup*/inf-erior gluteal nerves
pudendal nerve
sciatic nerve
posterior femoral cutaneous nerve
Nerve to obturator internus
Nerve to quadratus femoris
* means above the piriformis |
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Definition
| what structures pass though the greater sciatic foramen? (which are above the muscle, which are below?) |
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Term
sacrospinous is deep (spINous is INside more)
sacrotuberous is superficial & bigger
(remember that tuber is like the word super) |
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Definition
| which ligament is deep, and which is superficial in reation to the other between the sacrospinous and sacrotuberous ligaments? which is bigger? |
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Term
1) coccygeus
levator ani:
2) pubococcygeus
3) puborectalis
4) iliococcygeus |
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Definition
| list the muscles of the pelvic diaphragm |
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Term
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Definition
| holds the 2 sides of the pelvic diaphragm together anterior to the anal canal and posterior to the external genitalia |
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Term
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Definition
| ring of muscle that is not part of the pelvic diaphragm, attaches to pubococcygeus |
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Term
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Definition
| tendon that looks like a ribbon |
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Term
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Definition
this muscle originates at the ischial spine and sacrospinous ligament (is inseparable from it), and inserts on the coccyx and sacrum
cole doesn't know the action, but wikipedia says it pulls the coccyx forward after defecation |
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Term
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Definition
| what connects: the point where the left and right external anal sphincter fibers fuse, to the coccyx? |
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Term
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Definition
Muscle that originates from the ischial spine and posterior part of the arcus tendineus.
It inserts on the coccyx and anococcygeal raphe.
It is the most posterior part of the levator ani muscles. |
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Term
| pubococcygeus muscle (PC muscle) |
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Definition
origin: back of pubis and anterior obturator fascia
insertion: coccyx and sacrum
action: controls urine flow, contracts during orgasm |
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Term
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Definition
hip rotator muscle that's tendon comes out the lesser sciatic foramen.
has thick fascia |
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Term
| puborectalis (part of pubococcygeus and the levator ani group) |
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Definition
| this muscle forms a sling around the anal canal and lies deep to the the external anal sphincter |
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Term
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Definition
| thickened fascia just inferior to the obturator internus muscle that suspends the pelvic diaphragm and runs from the ischial spine to the pubis |
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Term
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Definition
| this structure helps with fecal continence |
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Term
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Definition
| levator ani and coccygeus are innervated mostly by what spinal level? |
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Term
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Definition
| what spinal nerves form the sciatic nerve? |
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Term
male: urethra, nerves, dorsal vein of penis
female: urethra, vaginal canal, nerves, vein of the clitoris, BIGGER |
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Definition
| what is in the urogenital hiatus for males and females? which is bigger? |
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Term
| urogenital hiatus (THIS IS FORMED BY A GAP IN MUSCLE) |
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Definition
| what is the gap between the anteriormedial borders of the pelvic diaphragm called? |
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Term
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Definition
| what ligament separates greater and lesser sciatic foramens? |
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Term
1) pudendal nerve
2) internal pudendal vessels
3) nerve to obturator internus
4) obterator internus muscle (tendon) |
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Definition
| what structures pass through the lesser sciatic foramen? |
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Term
| the obturator nerve and vessels |
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Definition
| what is found in the obturator canal? |
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Term
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Definition
| what supports the pelvic viscera(bladder, uterus, rectum) from beneath? |
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Term
the PD weakens with age, and prolonged childbirth can compress nerves and cause nerve damage.
Weak PD can cause Uterine prolapse(stuff falls out the UG hiatus), and urinary incontinence |
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Definition
| how can the pelvic diaphragm become damaged, and what are the consequences of this? |
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Term
pubovesical ligament
transverse cervical(cardinal) ligament
uterosacral ligament |
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Definition
| list the ligaments that suspend the pelvic organs in females that originate off of the thickened fascia covering the pelvic diaphragm |
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Term
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Definition
| this ligament anchors the bladder anteriorly to the tendonous arch to the pubic bone |
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Term
| transverse cervical(cardinal) ligament |
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Definition
| this ligament is the most important in females to suspend the reproductive orgams |
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Term
| uterosacral ligament (attaches anteriorly to the uterus fascia) |
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Definition
| this ligament suspends the anus/rectum in females and attaches posteriorly to the sacrum |
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Term
the cervix and uterus fall down the vagina
small intestine can fall down into where the uterus used to be (remember the abdominal and pelvic cavities are not separated) |
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Definition
| what happens in uterine prolapse? what else can go with the uterus? |
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Term
| bladder suspension surgery - the ligaments suspending the bladder are tightened, and if necessary, an artificial sling is put in |
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Definition
| what is one of the most common regions to operate on post-menopausal women? describe it. |
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Term
| when the bladder prolapses into the vagina |
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Definition
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Term
| the rectum folds forward into the vagina and starts prolapsing out |
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Definition
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Term
| when small bowel falls between the uterus and rectum and prolapses out |
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Definition
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Term
urogenital tirangle holds genitalia
anal triangle holds the anus |
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Definition
| in which division of perineum can you find the anus? which division holds the genitalia of both sexes? |
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Term
the pubic symphysis is the tip with the ischial tuberosities forming each corner of the base of the triangle
(the anal triangle has the same base, but the tip is at the end of the coccyx) |
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Definition
| what makes the borders of the urogenital triangle? |
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Term
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Definition
| what structure sits at the same level as the tip of the coccyx in an upright human? |
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Term
UG triangle is horizontal
anal triangle is at an angle |
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Definition
| which division of perineum is more horizontal, which is more at a 40ish degree angle? |
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Term
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Definition
| Position in which the patient is on their back with the hips and knees flexed and the thighs apart. The position is often used for vaginal examinations and childbirth. |
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Term
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Definition
| what covers the GU triangle, and forms its floor, but does not form the floor of the anal triangle? |
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Term
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Definition
| what ligament sits right below the pubic symphysis? |
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Term
| dorsal vein to penis/clitoris |
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Definition
| what is found in the gap between the pubic symphysis and the perineal membrane? |
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Term
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Definition
| where do the perineal membrane and pelvic diaphragm attach? |
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Term
| superficial transverse perineus (sits right in front of the anus) This is pictured on 1 slide, and mentioned later |
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Definition
| what muscle is superficial to the perineum and runs from the ischial tuberosity to the perineal body along the posterior edge of the perineal membrane? |
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Term
| inferior rectal artery, branch of the IMA |
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Definition
| from what artery does the anal sphincter receive blood directly? (what major vessel is this a branch of?) |
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Term
inferior rectal nerve (S2-S4 ventral rami)
1)caries somatic motor * the important part
2) somatic sensory
3) sympathetics (sweat glands) |
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Definition
| what nerve innervates the external anal sphincter? what spinal levels does it come from? what info does it carry? |
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Term
| lots of fat that is liquid at room temp. It takes up space, but is compressible for the passage of feces |
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Definition
| what is found in the anal triangle that is important, but not pictured in our slides? |
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Term
1) crus of penis(corpus cavernosum) & crus of clitoris
2) bulb of penis (corpus spongiosum) & bulbs of vestiblule [2 of them] |
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Definition
| what are the erectile tissues of males and females? |
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Term
| bulb of penis (corpus spongiosum) |
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Definition
| name the erectile tissue around the male urethra that is adhered to the perineal membrane(in both sexes) and possibly bone (in males only) |
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Term
| it surrounds the vagina and urethra opening |
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Definition
| why is the bulb of the vestibule split in 2 in females? |
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Term
| superficial, all genitalia is superficial to the membrane (vagina doesn't count) |
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Definition
| are the erectile tissues deep or superficial to the perineal membrane? |
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Term
| superior to the membrane (so deeper) but superficial to the prostate(inferior) |
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Definition
| where is the sphincter urethrae found in males in relation to the prostate and perineal membrane? |
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Term
| between prostate urethra and penile urethra |
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Definition
| where is membranous urethra found? |
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Term
| 1) sphincter urethrae (both) 2) urethrovaginalis (females) 3) compressor urethrae (females) 4) deep transverse perineus (males if present) NOTE: muscles of the deep pounch have to do with urinary function |
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Definition
| list the 4 muscles deep to the perineal membrane, but superficial to the pelvic diaphragm, & what sex they are found in |
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Term
| 1) bulbospongiosus (both) 2) ischiocavernosus (both) 3) superficial transverse perineus (both) NOTE: these have to do with maintaining blood flow to the erectile tissue, |
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Definition
| list the 3 muscles found superficial to the perineal membrane and what sex they are found in |
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Term
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Definition
| all muscles of the perineum are skeltal muscle, which means they are innervated by what? |
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Term
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Definition
| what muscle, found in females only, goes partially around the urethra to kink it shut? |
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Term
| sphincter utrethrovaginalis, found in deep pouch (between perineal membrane and pelvic diaphragm) |
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Definition
| what muscle loops around both the vagina and urethra? what pouch is it found in? |
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Term
| deep transverse perineal muscles, found in males only, in deep pouch |
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Definition
| what muscle associated with the perineal membrane may have smooth muscle fibers and is variably present? what pouch is it in? |
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Term
muscles in the deep pouch (the urinary sphincters)
the inferior fascia = the perineal membrane |
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Definition
| what does the "urogeintal diaphragm" refer to? what is the inferior fascia of the UG diaphragm? |
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Term
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Definition
| the bulbospongiosus of both males and females attaches to this |
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Term
| the muscle is more superficial |
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Definition
| which is more superficial, the ischiocavernosus muscle, or the crus of the penis/clitoris? |
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Term
| epimysium of the bulbospongiosus and ischiocavernosus |
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Definition
| what is the external perineal fascia made of? |
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Term
| Colle's fascia, encloses the superficial perineal pouch, fused posteriorly to perineal membrane |
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Definition
| what is more external than the external perineal fascia? what does it enclose? what does it fuse to? |
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Term
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Definition
| what is superficial to colle's fascia? |
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Term
1)skin
2) fat
3) colle's fascia
Superficial perineal pouch:
4)external perineal fascia
5) erectile tissue muscles
6) erectile tissue
7) perneal membrane
deep perineal pouch: (anal triangle and UG triangle)
8) liquid fat
9) urethral/anal sphincter muscles
10) Pelvic diaphragm |
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Definition
| starting with skin and going deep to the pelvic diaphragm, list the layers/structures you would encounter. |
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Term
| Scarpa's fascia in the abdomen (no fat) Superficial fascia in the penis Dartos layer in the scrotum |
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Definition
| what does colle's fascia correspond to in the abdomen? the penis? the scrotum? |
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Term
perineum: unnamed superficial fat layer
penis: no analogue
scrotum: no analogue |
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Definition
| What is the analogue of Camper's fascia in the perineum? the penis? the scrotum? |
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Term
perineum: external perineal fascia (deep to colle's covering the muscle)
abdomen: no analogue
scrotum: no analogue |
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Definition
| what is the analogue of Buck's fascia of the penis in the perineum? the abdomen? the scrotum? |
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Term
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Definition
| what communicates posteriorly with the ischiorectal fossa? |
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Term
| continuous with Scarpa's fascia and it attaches to bone |
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Definition
| what is the superficial fascia of the penis continuous with and what does it attach to? |
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Term
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Definition
| what is Buck's fascia on the penis continuous with? |
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Term
deep to superficial fascia:
superficial dorsal vein(medial) + external pudendal arteries (lateral)
deep to buck's fascia:
dorsal nerve (most lateral) + dorsal artery (mid-lateral) + dorsal vein (midline) |
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Definition
| list the veins, arteries and nerves of the penis. which are mores superficial? which are more medial/lateral? |
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Term
| between Scarpa's fascia and the external abdominal oblique |
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Definition
| between which two layers of the abdomen is there a potential space? |
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Term
straddle injuries
infection like an untreated STD's(bacterial abscess)
careless catheterization |
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Definition
what can cause injury to the urethra so that it would spill out into the communicating spaces such as the spermatic cord & superficial perineal pouch?
in other words what can cause extravasation of urine? |
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Term
superiorly: scarpa's fascia is fused with deep fascia @ costal cartilages
inferiorly: fusion of Scarper's fascia and fascia lata of the thigh and iliac crest (below inguinal ligament)
posteriorly: fusion of scarpa's and thoracolumbar fascia |
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Definition
| what limits the extravasation of urine (what keeps it from spreading all over the body when the urethra breaks)? |
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Term
| it goes in the greater sciatic foramen, lateral to the sacrospinous, and medial to sacrotuberous lig. and out the lesser sciatic foramen into the pudendal canal which wraps around behind the ischium |
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Definition
| how does the pudendal nerve travel onces it branches off the sciatic nerve right after exiting the sacrum? |
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Term
| the pudendal nerve, artery, and vein |
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Definition
| Just medial to obturator internus and formed by its fascia on the inferior part is the pudendal canal. what are its contents? |
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Term
| S2-S4 (it branches off the sciatic) |
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Definition
| what spinal levels is the pudendal nerve formed from? |
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Term
1) inferior rectal nerve
SPLIT
2) dorsal nerve of penis/clitoris
3) perineal nerve
off perineal:
4) deep perineal nerve is superior
5) superficial perineal nerve goes inferior
off superficial perineal:
6) posterior scrotal/labial nerve |
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Definition
| list the branches (in order of its path from the spine) of the pudendal nerve |
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Term
deep pouch (Above membrane): dorsal nerve of penis
superficial pouch (below membrane): perineal nerve |
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Definition
| the pudendal nerves splits to go to the deep and superficial pouches at a gap right behind the pubic symphysis, what is it called above and below the perineal membrane? |
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Term
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Definition
| what innervation info is carried by the dorsal nerve to the penis/clitoris? |
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Term
sensory and motor
-it splits going through the perineal membrane |
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Definition
| what info is carried by the perineal nerve? where does it split to deep and superficial? |
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Term
deep: sensory AND motor, supplies sphincters in the deep pouch above the membrane, and superficial muscles on the other side of the membrane
superficial perineal, like the dorsal nerve is sensory only |
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Definition
| what info does the deep perineal nerve carry? what does it supply? what info does the superficial perineal nerve carry? |
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Term
1) inferior rectal (does sphincter and skin over it)
2) split to artery of penis/clitoris and
3) perineal artery which is found superficial in the UG triangle
-branches off the artery to penis/clitoris:
4) artery to bulb
5) deep artery to penis/clitoris
6) then it becomes the dorsal artery to penis/clitoris |
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Definition
| describe the arteries coming off of the internal pudendal artery after it branches from the internal iliac artery |
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