Anatomy: Pelvic And Perineum I

Front 1

Define the (5) boundaries of the perineum.

Back 1

Anterior: Pubic Symphysis
Posterior: Coccyx
Lateral: Ischial Tuberosity
Anterolateral: inferior ischiopubic rami
Posteriolateral: sacrotuberous ligament

Front 2

Define the (5) boundaries of the ischioanal fossae.

Back 2

Lateral: Obturator internus muscle and fascia
Superior: Levator ani group
Inferior: Skin
Medial: Anus/Anal Canal/External anal sphincter
Posterior: Gluteus maximus, sacrotuberous ligament
Anterior: fascia (Colle's and inferior UG diaphragm)

Front 3

Describe the course of the pudendal nerve.

Back 3

From S2,3,4
Leaves pelvis through the greater sciatic foramen, between the piriformis and the coccygeous muscles.
Hooks around the ischial spine and the sacrospinous ligament and enters the perineum through the lesser sciatic notch.

Front 4

What ligaments make up the greater and lesser sciatic foramen?

Back 4

Sacrospinous ligament and the sacrotuberous ligament

Front 5

Describe the branching of the pudenal nerve.

Back 5

Once it enters the perineum:
gives off inferior rectal branches, splits and becomes perineal nerve and the dorsal nerve of the penis or clitoris.

Front 6

Describe the branching of the internal pudendal artery.

Back 6

branches to give inferior rectal, branches to give perineal artery, branches into deep and dorsal artery of the penis (terminal).

Front 7

Describe the location and contents of the pudendal canal.

Back 7

Houses the pudendal nerve, artery and vein.

Located laterally in the ischioanal fossae in the fascia of the obturator muscle.

Front 8

Through what boney landmark do the vessels and nerves enter the pudendal canal?

Back 8

lesser sciatic notch

Front 9

What three bones form the hip?

Back 9

Ischium, Ilium, and the pubic

Front 10

What is the superior and inferior boundaries of the lesser sciatic foramen?

Back 10

Inferior: sacrotuberous ligament
Superior: ischial spine, sacrospinous ligament

Front 11

What bone forms the greater sciatic notch?

Back 11

Ilium

Front 12

What bone forms the lesser sciatic notch?

Back 12

Ischium

Front 13

What bones form the obturator foramen?

Back 13

pubic and ischium

Front 14

What structures will be in a vertical plane when the hip is in anatomical position?

Back 14

Anterior iliac crest and pubic tubercle

Front 15

What are the division of the anal sphincter?

Back 15

Subcutaneous, Superficial, and Deep

Front 16

The external anal sphincter has two points of attachment. Describe them.

Back 16

Muscle fibers attached to the perineal body anteriorly and posteriorly attached to the coccyx via the anococcygeal ligament.

Front 17

What arteries supply the anal sphincters and the perianal skin?

Back 17

Inferior rectal artery, branches of the internal pudendal

Front 18

What is unique about the deep part of the external anal sphincter?

Back 18

Contracts in unison with the levator ani. Receives the same innervation.

Front 19

What muscles are bound to the perineal body? (3 main, 6 total)

Back 19

1. Bulbospongiosus
2. External anal sphincter
3. Superficial and deep transverse perineal muscles
4. Smooth and voluntary slips of muscle from the external urethral sphincter, levator ani, and muscular coats of the rectum

Front 20

Which type of hemorrhoids bleed bright red blood and why?

Back 20

Internal hemorrhoids because of arteriole anastomosis

Front 21

Which hemorrhoids commonly occur in the absence of portal hypertension?

Back 21

internal

Front 22

What nerves innervate the anal canal superior to the pectinate line?

Back 22

Fibers from the inferior hypogastric plexus

Front 23

What type of fibers come off the inferior hypogastric plexus?

Back 23

Sympathetic, parasympathetic, and visceral afferent

Front 24

What type of sensory information is processed above the pectinate line?

Back 24

Stretch

Front 25

What nerve fibers maintain the tonus of the internal anal sphincter?

Back 25

Sympathetics

Front 26

What fibers relax the internal anal sphincter for defecation?

Back 26

Parasympathetics

Front 27

What fibers stimulate the peristaltic movements of the anal canal?

Back 27

Parasympathetics

Front 28

What nerve supplies the anal canal inferior to the pectinate line?

Back 28

inferior rectal branch of the pudendal nerve

Front 29

What kind of nerve fiber is the inferior rectal nerve?

Back 29

Somatic

Front 30

What type of sensory information is processed inferior to the pectinate line?

Back 30

Touch, Pain, Temperature

Front 31

What type of nerve fibers stimulate the contraction of the external anal sphincter?

Back 31

Somatic efferent fibers

Front 32

What arteries supply the anal canal superior to the pectinate line?

Back 32

Superior rectal artery from the IMA

Front 33

What artery forms anastomosis with the superior and inferior rectal arteries?

Back 33

Middle rectal artery

Front 34

Lymph that drains to the internal iliac nodes comes from _____.

Back 34

Above the pectinate line

Front 35

Below the pectinate line the lymph will drain to the ______.

Back 35

Superficial inguinal nodes

Front 36

What is the importance of the fat pad in the ischioanal fossae?

Back 36

To contract and expand to allow feces to pass.
Support the anal canal.