~6 - Perineum

Front 1

a diamond-shaped region in the inferior pelvic aperture; between the anus and vagina in the female

Back 1

perineum

Front 2

the anterior bony boundary of the perineum is the __________

Back 2

pelvis symphysis

Front 3

lateral perineum borders:
the lateral-most bony border (that forms a corner of the diamond) is ______A_______; the anterior lateral bony border is formed by _____B_____; the posterior lateral border is formed by the ____C______ lig.

Back 3

A: lateral point: ischial tuberosity
B: anteriolateral: ischiopubic ramus
C: posterolateral: sacrotuberous ligament

Front 4

the posterior-most bony boundary of the perineum is the ______

Back 4

sacrum & coccyx

Front 5

name the 2 triangles of the perineum

what divided them?

Back 5

anterior: urogenital triangle
posterior: anal triangle

imaginary line between ischial tuberosities

Front 6

the __________- is a fibromuscular mass located posterior to the vestibule of the vagina or the bulb of the penis, and anterior to the anus; site of convergence of several mm.

Back 6

perineal body

Front 7

name the 5 mm that converge at the perineal body

Back 7

bulbospongiosis m, external anal sphincter, superficial and deep transverse perineal mm.

Front 8

CC: perineum

surgical incision from the posterior edge of the vaginal orifice towards the perineal body. used to assist delivery

Back 8

episiotomy

Front 9

name the 3 types of episiotomies

Back 9

1) midline- straight from posterior edge of vagina to perineal body
2) mediolateral- angled cut from edge of vagina
3) hockey stick- curved cut; orig. from post. edge of vagina, moves straight inferiorly and curves away from perineal body at the end

Front 10

what is the angulation of the anal canal.

Back 10

it is posteriorly angled (not straight up) and also has an 80 angulation at the anorectal junction

Front 11

the __________ m produces the puborectal sling that maintains fecal continence

Back 11

puborectalis m.

Front 12

is ___________ fossa is a wedge-shaped area lateral to the rectum and filled with fat

Back 12

ischiorectal or ischioanal fossa

Front 13

name the boundaries of the ischoanal/rectal fossa:

medial, lateral, inferior, posterior

Back 13

medial: levator ani m.
lateral: obturatior internus m.
inferior: skin
posterior: sacrotuberous lig. and gluteus maximus m.

Front 14

the ___________ fossa contains fat (Camper's fascia); inferior rectal vv, aa, and nn; and the pudendal (Alcock's) canal

Back 14

ischiorectal/anal canal

Front 15

the pudendal canal contain what?

Back 15

the pudendal n. and internal pudendal vessels

Front 16

CC: pundendal canal

anesthetic applied to the pudendal nerve near the ischial spine (proximal to the pudendal canal) to block the pudendal nerve. used during labor **use finger inside to make sure not injected into fetuses head**

Back 16

pudendal nerve block

Front 17

name the 7 layers of the urogenital triangle inferior to superior

Back 17

inferior --> superior
1) skin
2) superficial fascia (Camper's --> Colles')
3) superficial perineal pouch (space)
4) perineal membrane
5) deep perineal pouch (space)
6) superior layer of urogenital diaphragm
7) levator ani mm.

Front 18

what 2 fascia's make up the superficial fascia of the urogenital triangle

Back 18

inferior: Camper's fascia (fatty)
superior: Colles' fascia (con't of membranous Scarpa's fascia)

Front 19

what mm are located in the superficial perineal pouch vs. the deep perineal pouch? (3 each)

Back 19

superficial: superficial transverse perineal m., ischiocavernosus m., and bulbospongiosus m.

deep: deep transverse perineal m., external urethral sphincter m., urethrovaginal sphincter m (females only)

Front 20

what vessels are found in superficial vs. deep perineal pouches? (3 are found in both, and there are 2 additional in superficial)

Back 20

both: artery of bulb, deep and dorsal aa. of penis/clitoris

superficial: perineal a. & posterior scrotal/labial aa.

Front 21

the perineal a, the artery of the bulb, and the dorsal and deep arteries come off of what artery?

Back 21

the internal pudendal a.

Front 22

branches of what nerve are found in both the superficial and deep perineal pouches?

Back 22

the pudendal n.

(normally follow aa)

Front 23

in males, which pouch (sup/deep) are the gland found in, and what are they called?

in females?

Back 23

males: bulbourethral (Cowper's) gland in the deep perineal pouch

females: greater vestibular glands (Bartholin's) in the superficial perineal pouch

Front 24

which perineal pouch are the clitoris and bulbs of the vestibule located in?

Back 24

superficial

Front 25

what perineal pouch are the bulb of the penis, bulb and crura of the penis located in?

Back 25

superificial

Front 26

in both sexes, where is the membranous part of the urethra located?

Back 26

in the deep perineal pouch

Front 27

the ____________ membrane is between the superficial and deep perineal pouches and is also know as the inferior layer of the urogenital diaphragm

Back 27

perineal membrane

Front 28

the ___________ layer of the urogenital diaphragm forms the ceiling of the deep perienal pouch

Back 28

superficial

Front 29

the ______________ m. forms the floor of the pelvic cavity

Back 29

levator ani m.

Front 30

the urogenital diaphragm consists of what layers of the urogenital triangle?

Back 30

the perineal membrane, deep perineal pouch, and superficial layer of the urogenital diaphragm

Front 31

the internal pudendal a. first enters what triangle of the perineum to give off what aa?

Back 31

the anal triangle

the inferior rectal aa.

Front 32

the internal pudendal a. gives a branch to the superficial pouch, what is it and what does it terminate as?

Back 32

IPA --> perineal a --> posterior scrotal/labial a.

Front 33

the perineal a. gives branches to the mm. of the superficial pouch before terminating as the ___________ a. what mm. does it supply?

Back 33

posterior labial/scrotal aa.

the superior transverse perineal m., bulbospongiosus m., ischiocavernosis m.

Front 34

the internal pudenal a. continues into the ___________ pouch of the urogential triangle of the perineum and gives off 3 branches... name them. Where do the branch to?

Back 34

deep perineal pouch

a. of the bulb, deep a. of penis/clitoris, and dorsal a. of penis/clitoris

branch into the superficial perineal pouch

Front 35

what is the target of the artery of the bulb in males? in females?

Back 35

M: the bulb of the penis

F: the bulb of the vestibule

Front 36

the track of the pudendal n. follows what a.?

Back 36

the internal pudendal a.

Front 37

the pudendal n. first enters what triangle of the perineum to give off what nn?

Back 37

anal triangle

inferior rectal nn.

Front 38

the pudendal n. splits to give a branch to the superficial perineal pouch and the deep perineal pouch. name these branches

Back 38

superficial: perineal n.
deep: dorsal n. of penis/clitoris

Front 39

what branches does the perineal n. give off, and where do they go? what does is terminate as?

Back 39

branches: muscular branches to mm. of superficial pouch (sup. trans. peri., bulbospongiosus, ischiocavernosus mm) and to mm of deep pouch (deep trans peri, internal urethral sphincter, and the urethrovaginal sphincter (females) mm)

termination: posterior labial/scrotal n

Front 40

what is the terminal branch of the pudendal n. in the deep perineal pouch? where does it go?

Back 40

terminal: PuN --> Doral n. of penis/clitoris

runs in deep pouch then pierces the perineal membrane to enter the superficial pouch

Front 41

what type of fibers run in the pudendal n?

Back 41

sensory and motor