Flashcards in Perineum Deck (39)
1
Levator ani forms
Floor of pelvis and roof of perineum
2
Blood supply and innervation of perienum
Internal pudendal artery
Pudendal nerve
3
How do internal pudendal artery and pudendal nerve leave pelvis and enter perineum
Greater sicatic foramen
Lesser sicatic foramen
4
Roof/floor of lesses sciatic foramen
Roof - sacrotuberous lig
Floor - Sacrospinous lig
5
Pudendal canal
Internal pudendal artery and pudendal nerve become covered with deep fascia and lie on obturator internus
6
Branches of internal pudendal artery nad pudendal nerve
Inferior rectal artery and nerve
7
Perineum boundaries
Pubic symphysis
L/R ischiopubic ramus
L/R ischial tuberosities
Coccyx
8
Two triangles of perineum
Urogenital triangle (anterior )
Anal triangle (posterior)
9
Orientations of triangle
Urogen - horizontal with floor
Anal - vertical
10
Urogenital triangle divided into
Deep and superficial pouch of perineum
11
Deep pouch location, composition, innervation
Below levator ani and expands entire urogen triangle
Muscle and conn tissue membrane
Voluntrary control by perineal branches of pudendal nerve
12
What must happen before micturition can occur?
Muscles of deep pouch must relax
13
Perineal membrane
Inferior membrane of deep pouch
14
External genitalia location
Below deep pouch
In the superficial pouch
15
Contents of deep pouch
Deep transverse perineal muscle
External urethral sphincter muscle
Compressor urethra (female)
Membranous urethra
Bulbourethral glands (males)
Branches of pudendal nerve - dorsal nerve and arteries of the penis and clitoris
16
Superficial pouch muscle and location to perineal membrane
Inferior
Crura of penis/clitoris
Bulb of penis/vestibular bulbs
Ischicavernosus m
Bulbospongiosus m
Greater vestibular gland m (females)
Superficial transverse perineal muscle
17
Perineal body...attachment points for
Mass of tissue in btween ischial tuberosities
Levaotr ani
Deep perineal membrane
Bulbospongiosus membrane
External anal sphincter
18
Tears of perineal body lead to
Compromise structure of pelvis/perineum...prolapse of organs and urinary incontinence
19
Scarpas fascia
Abdominal region
20
Dartos fascia
Region of scrotum and penis (no superficial fatty fascia here)
21
Colles fascia
Region of urogenital triangle (superficial fatty has disappeared)
22
Exceptions to fascial cleft between superficial and deep fascia
Scarpas fascia will fuse to fascia lata
Lateral and posterior edge of Colles will fuse to perineal membrane
23
What does Colles connection to perineal result in?
No communication between deep pouch and anal trinalge
24
Anal canal divides anal triangle into
Ischioanal fossae
25
Boundaries of anal trinalge
Superior and medial - sloping of levator ani (pelvic diaphragm)
Lateral - Obturator internus (important)
Posterior - skin
26
Pudendal (Alcock's) canal formed by ____ and contains ____
Obturator fascia
Internal pudendal artery, vein, and pudendal nerve
27
What emerges from pudendal canal
Inferior rectal arteries and nerves
28
When does rectum end?
When puborectalis encircles it
29
Internal anal sphincter composed of
Thickened continuation of inner circular layer of smooth muscle from retum
30
External sphincter composed of
Skeletal muscle
31
Anocyccygeal rphe
Attaches external sphincter to coccyx
32
Anal columns and sinuses
Folds and recesses between columns of anal canal
Mucous membrane
33
Anal valves
Join anal columns at inferior ends
34
Anal crypts and why significant?
Spaces behind anal valve
Focal point for infection...can lead to ischioanal fossa fistula
35
Pectinate line formed from
Lower margins of anal valves
36
Arterial supply above and below pec line
above - inferior mesenteric by superior rectal arteries
Below - internal pudendal by inferior rectal arteries
37
Venous drainage change at pec line
Above - hepatic portal vein by superior rectal vein
Below - caval system by inferior rectal veins
38
Lymphatic drainage change at pec line
Above - internal iliac lymph nodes (deep)
Below - inguinal lymph nodes (superficial)
39