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39 Cards in this Set
- Front
- Back
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Line connecting ischial tuberosities divide 2 triangles..what are they?
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urogenital triangle: anterior
anal triangle: posterior |
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What are their orientations according to anatomical positions?
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anal triangle: posteroinferiorly
urogenital triangle: horizontally (ASIS and superior edge of pubic symphysis are in the same vertical plane) |
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What are the layers of the urogenital triangle?
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1. skin
2. superficial fascia -fatty layer -membranous layer (Colle's fascia) 3. perineal membrane (inferior fascia of urogenital diaphragm) 4. Urogenital diaphragm -sphincter urethrae/deep transverse perineal muscles 5. superior fascia of urogenital diaphragm |
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Perineal spaces of urogenital triangle
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Superficial perineal space
-between Colle's fascia and inferior fascia of urogenital diaphragm deep perineal space: -between superior and inferior fascia of urogenital diaphragm |
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Superficial perineal space
-contents in males |
-root of penis and associated muscles
-prox. portion of spongy urethra -bulbospongiosus, ischiocavernosus, superficial transverse perineal muscle -branches of internal pudendal artery/vein -perineal branch of pudendal nerve |
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Superficial perineal space
-contents in females |
-root of clitorus and assoc. muscles
-part of the urethra -superficial transverse perineal muscle -branches of internal pudendal artery/vein -perineal branch of pudendal nerve -greater vestibular glands (Bartholin's glands) |
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ischiocavernosus muscle
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covering crura of penis
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bulbospongiosus muscle
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covering bulb of penis and proximal corpus spongiosum
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superficial transverse perineal muscles
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transverse muscle
(helps form a triangle with ischiocavernosus and bulbospongiosus muscle) |
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What do the two crura come together and form?
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corpora cavernosa
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What does the bulb become?
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corpus spongiosum
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What does each of the corpora cavernosa contain?
corpus spongiosum contain? |
corpora cavernose: deep artery of the penis
corpus spongiosum: spongy urethra |
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Body of the penis
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-covering of skin (superficial/deep-Buck's fascia)
-superficial dorsal vein of penis -deep dorsal vein, dorsal artery, and dorsal nerve of the penis (deep to deep fascia of the penis) |
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FEMALES
-superficial perineal pouch |
ischiocavernosus muscle:
-covering crura of clitoris bulbospongiosus muscle: -covering bulbs of vestibule superficial transverse perineal muscles: -make triangle |
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The crura of the clitoris are proximal parts of what?
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corpora cavernosa
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What corresponds to the proximal part of the corpus spongiosum in the male?
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bulbs of the vestibule
(females do not have corpus spongiosum) |
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Bartholinitis
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greater vestibular (Bartholin's) glands
-site of infection with inflammation |
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Deep perineal space
-contents in males |
-membranous portion of urethra
-urogenital diaphragm -branches of internal pudendal artery/vein -dorsal nerve of penis -bulbourethral (Cowper's) glands |
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deep perineal space
-contents in females |
-part of urethra and vagina
-urogenital diphragm -branches of internal pudendal artery/vein -dorsal nerve of clitoris |
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Urogenital hiatus
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-anteriorly to urogenital triangl
-U-shaped -allows passage of urethra and vagina |
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Urogenital diaphragm
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-covers above the superficial perineal contents
-urogenital hiatus partly closed from below by diaphragm |
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What are the structures that make up the urogenital diaphragm?
-and what is the purpose? |
perineal membrane
-thick fascial sheet inferiorly deep perineal pouch -where urogenital diaphragm is found =purpose is to help support the pelvic structures above =inferior surface of perineal membrane provides attachments for external genitalia |
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External urethral sphincter
(males) |
around membranous part of urethra to provide voluntary control of micturition
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deep transverse perineal muscle(males)
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paralleling the posterior margin of perineal membrane
bulbourethral glands also in deep perineal pouch |
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Muscles of deep perineal pouch in females
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external urethral sphincter
-voluntary control of micturition deep transverse perineal muscle -paralleling post. margin of perineal membrane sphincter urethrovaginalis/compressor urethrae -act with external sphincter to close urethra |
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perineal body or central tendon of perineum
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irregular muscolo-fibrous mass in midline between anal canal and vagina (or bulb of penis)
=perineal body larger in females to provide support for pelvic vescera -if torn: cause prolapse of uterus/bladder/recturm in vagina -surgically incised during childbirth to prevent jagged tears |
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anal triangle
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-anal canal
(begins at anorectal junction: where puborectalic portion forms sling around rectum) |
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ischioanal fossa
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contains ischioanal fossae on either side of anal canal
-infection can spread behind anal canal into other ischioanal fossa |
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anal canal subdivided into upper and lower part
(divided by pectinate line) |
upper part derived by embryonic hindgut
-innervated by GVA fibers (painless) -blood: superior rectal artery -inferior mesenteric vein-portal venous sytem -lymph: internal iliac lymph nodes lower part: ectodermal depression (proctodeum) -GSA fibers (painful) -blood: middle/infer. rectal arteries -vein: internal pudendal-->IVC -lymph: superficial inguinal lymph nodes |
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Hemorrhoids
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enlarged subucosal retal veins and may be a source of rectal bleeding
-prolapse through anal aperture from internal recdtal plexus -strangulation and ulceration |
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What is the major somatic nerve supply to the perineum?
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pudendal nerve:
-innervates both skin and skeletal muscles -leaves pelvis through greater sciatic foramen -enters perineum through lesser sciatic foramen -accompanied by internal pudendal artery/vein |
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What are the 3 branches of the pudendal nerve?
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inferior rectal: motor external anal sphinter
Dorsal nerve of the penis (clitoris) perineal nerve -motor to muscles in urogenital triagnle -sensory to skin on post. serface of scrotum (labia majora) |
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pudendal nerve block
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anesthesize skin of perineum to relieve pain during childbirth
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transvaginal method
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-bony landmark is ischial spine
-needle inserted through vaginal mucosal membrane and through sacrospinous ligament -anesthetic injected around pudendal nerve |
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Perineal method
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-bony landmark is ischial tuberosity
-needle inserted through buttock and medial to ischial tuberosity -pudendal canal is approx. 1 inch superior to the inferior segment of ischial tuberosity |
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lymphatic drainage from perinuem
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-mainly to superficial and deep inguinal lymph nodes
-EXCEPT: testis drain to lateral aortic nodes in abdomen -some follow round ligament of uterus-->superficial inguinal nodes |
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Episiotomy
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-surgical incision of vulva to pervent laceration at time of child delivery and facilitate vaginal surgery
-prevent irregular tear of perineal muscles -incision commonly made through perineal skin and bulbospongiosus/transverus perineal muscles (mediolateral direction) |
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Pelvic sympathetic innervation
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-causes contraction of smooth muscle in internal urethral sphincter in males
-inhibing emptying of urinary bladder -prevent reflux of semen into the bladder (retrograde ejaculation) -contraction of internal anal sphincter (males/females) to inhibit defecation -contraction of smooth muscle of ductus deferens, seminal vesical and prostate during ejaculation (males) |
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Pelvic parasympathetic innervation
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-contraction of detrusor muscles to empty urinary bladder
-(males) inhibits internal urethral sphincter -inhibits contraction of internal anal sphincter in defecation -causes vasodilation in erectile bodies (penis or clitoris) to produce erection |
