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88 Cards in this Set

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What are the contents of the male Superficial perineal pouch?
Superficial transverse perineal muscles
:
Ischiocavernosus mm
Crus (crura) of the corpora cavernosa
Bulbospongiosus mm
Bulb of the penis
Perineal membrane
What are the contents of the male deep perineal pouch?
Membranous urethra
External urethral sphincter
Compressor urethrae
Deep transverse perineal m
Bulbourethral glands
Anterior recess of the ischioanal fossa
What are the contents of the female Superficial perineal pouch?
Superficial transverse perineal m
ischiocavernosus m
Crus cavernosa
Bulbospongiosus m:
Vestibular bulbs
Greater vestibular glands (Bartholin’s)
Perineal body
Perineal membrane
What are the contents of the female deep perineal pouch?
Vagina
UG diaphragm:
Deep transverse perineal m
External urethral sphincter
Urethrovaginal sphincter
Compressor urethrae
Anterior recess of the ischioanal fossa
List the superficial fascia continuities of pelvis/genitals in males...
Scarpa’s fascia
superficial fascia of penis
Dartos fascia of scrotum
Colle's Fascia-aka Superficial perineal fascia Membranous
List the Continuities of
deep layers of fascia in males
EAO
Suspensory ligament of the penis
Buck’s fascia
External spermatic fascia
Deep perineal fascia
Where is the perineal cleft?
The portion of the superficial perineal pouch
between deep perineal fascia and Colle’s fascia.
The preineal cleft is is continuous with
the space between tunica dartos and external spermatic fascia in the...
scrotum
The preineal cleft is is continuous with
the space between fascia of EAO and Scarpa’s fascia in the...
abdomen
The preineal cleft is is continuous with the space between Buck’s and superficial fascia of penis in the...
Penis
The perineal cleft is NOT continuous with ...
Anal triangle
medial thigh
back
What are the parts of the male urethra
Prostatic urethra
Intermediate (membranous) urethra
Spongy urethra
In a straddle or false passage injury:
If the injury takes place superior to the
perineal membrane, the bloody urine will
be restricted to the deep pouch and the abdominopelvic diaphragm
In a straddle or false passage injury:
If the injury takes place inferior to the perineal membrane:
the bloody urine will enter the perineal cleft after it is Forced to break through the corpus spongiosum
What are the Major branches of the internal pudendal artery in women? (5)
Inferior rectal artery(s)
Dorsal artery of the clitoris
Deep artery of the clitoris
Perineal artery
Artery of the bulb
What are the Major branches of the internal pudendal artery in men?
Inferior rectal artery(s)
Dorsal artery of the penis
Artery of the bulb
Deep artery of the penis
What are the 3 major branches of the pudendal nerve?
Inferior rectal nerve(s)
Perineal nerve: Superficial and deep branches
Dorsal nerve of the penis/clitoris
Lymphatic drainage from the deep
perineal tissues accompany?
internal pudendal
vessels and drain into internal iliac nodes
Lymphatic drainage from the superficial tissues....
occurs mainly at the superficial inguinal nodes
lymphatic drainage of the
gonads...
occurs at the lumbar nodes
pudendal nerve comes from what levels
(S2,3,4)
What is the name of the gland found in the deep pouch in males?
Bulbourethral glands (of Cowper)
What perineal muscle is most likely found only in males?
Deep transverse perineal muscle
Name the urethral sphincters in males
Sphincter urethrae
Compressor urethrae
Name the urethral sphincters in females
Sphincter urethrae
Sphincter urethraevaginalis
Compressor urethrae
What does (NAVAN) stand for?
Dorsal nerve of the penis
Dorsal artery of the penis
Deep dorsal vein of the penis
Dorsal artery of the penis
Dorsal nerve of the penis
What vessles and nerves are in the superficial pouch in women?
Perineal branches of internal pudendal AV, pudendal Nerve
What vessles and nerves are in the superficial pouch in men?
Perineal branches of internal pudendal AV, pudendal Nerve
In females,what glands are located
just posterior to the bulbs of the vestibule?
The greater vestibular glands (of
Bartholin’s)
What are the muscles of the superficial perineal pouch
Ischiocavernosus
Bulbospongiosus
Superficial transverse perineal muscles
What defines the Deep perineal pouch?
between pelvic diaphragm
and perineal membrane
What defines the Superficial perineal
pouch
(deep) perineal membrane
and Colle’s fascia
What defines the Perineal
Cleft
That portion of the superficial pouch bet. deep perineal fascia
and Colle’s fascia...
Why is the perineal cleft of clinical importance?
space where infection can spread
Anal Canal: Ectodermally derived- where does lymph go?
inguinal lymph nodes
Anal canal Superior to pectinate line, where does lymph go?
internal iliac nodes
What are internal hemmohorids?
External?
Internal hemorrhoids- distension of
veins of internal venous plexus
(e.g., portal hypertension)

External hemorrhoids- distension of
veins of external venous plexus
(e.g., blockage of drainage)
"Features" of anal canal... (3)
anal Sinuses
anal columns
anal valves
What are the bony boundaries of the
perineum? (5)
Pubic symphysis
Ischiopubic rami
Ischial tuberosities
Sacrotuberous ligaments
Coccyx
Where does the perineum begin?
What does it include?
inferior to the pelvic diaphragm:
includes external genitalia, muscles, and the anal canal
What makes up the Linea terminalis
Arcuate line of ilia
Pectineal line of pubis
The measurement from the sacral promontory to inf. border of the pubic symphisis is...
Diagonal conjugate
The measurement from the sacral promontory to superior border of the pubic symphisis is...
True (obstetrical) conjugate
Compare difference between men and womens' pelvis
Women
Wider, shallower
Large oval-shaped brim
Wider ischial tuberosities & spine
Straighter sacrum
Oval obturator foramen
Subpubic angle >80°

Men:Heart-shaped (?) brim
Narrower
More curved sacrum
Round obturator foramen
Subpubic angle <70°
List the muscles of the lesser pelvis
Piriformis
Obturator internus
Coccygeus m.
Levator ani
What are the parts of Levator Ani?
Iliococcygeus m
Pubococcygeus m.
Puborectalis
What are the parts of Pubococcygeus?
Puborectalis

Pubovaginalis
Puboprostaticus
Weakness of the pelvic diaphragm
can result in what dysfunctions?
urinary stress incontinence, bowel incontinence, and herniation or prolapse of pelvic viscera through the
perineum
Obturator nerve spinal cord levels
How do you find it?
(L2-4)
medial to psoas
Lumbosacral trunk spinal cord levels
How do you find it?
inf. ½ of ant. ramus L4 + ant. ramus L5
Crosses sacral ala
to join sacral plexus
Superior gluteal nerve spinal cord levels
How do you find it?
What does it innervate?
(L4-S1) Exits greater sciatic
foramen, superior to Piriformis
m.
lesser gluteal mm
Inferior gluteal nerve spinal cord levels
How do you find it?
What does it innervate?
(L5-S2) (supplies gluteus maximus)
exits greater sciatic foramen, inferior to piriformis
Posterior cutaneous nerve of the thigh spinal cord levels...
How do you find it?
(S1-3) Runs with sciatic
Sciatic nerve spinal cord levels
How do you find it?
What two nerves does it comprise...
(L4-S3) (=tibial & fibular nn.) Exits greater sciatic foramen, exits posterior to piriformis.
Pudendal nerve spinal cord levels
How do you find it?
(S2-S4)
crosses the ischial spine
goes out greater sciatic foramen and into lesser sciatic foramen
between obturator internus and levator ani.
Nerves to levator ani come from what branches of the sacral plexus?
(S3,4)
Nerves to obturator
internus come from what branches of the sacral plexus?
(L5, S1,2)
Posterior Division branches of Internal Illiac
Superior Gluteal
Iliolumbar
Lateral Sacral
How can you find the superior gluteal artery quickly?
It runs between the Lumbosacral
trunk & S1 ant. ramus diving posterior into the GSF
What are the branches of the anterior division of the internal illiac?
Umbilical artery
Obturator artery
Uterine artery/Vaginal Artery
Inferior vesical artery (males)
Middle rectal artery
Inferior gluteal artery
Internal pudendal artery
what does the Umbilical artery become?
Medial umbilical ligament
Superior vesical artery:
Whats unique about the Obturator artery?
it sometimes (20%) has an accessory abbarant obturator that comes from inferior epigastrics and crosses pubic ramus
what branches from the uterine artery?
vaginal artery
Put in order anterior to posterior:
Ureter, Vaginal a., Uterine a.
Uterine a.
Ureter
Vaginal a.
What supplies the inferior bladder?
Inferior vesical artery in males
vaginal arteries in females
Where does the inferior veisical artery come from?
Can be from the middle rectal a. or a direct branch of internal iliac
What does the inferior vesicular artery supply?
inferior bladder, ductus deferens,
seminal vesicle, and prostate
What are the three arteries of the rectum and where do they originate from?
Superior - IMA
Middle Rectal -anterior division of internal iliac
Inferior rectal - internal pudendal
What's in Alcock’s canal?
Pudendal n.
Int. pudendal a.
Ext. pudendal a.
What are the folds in the rectum called
Transverse folds or valves of houston
Wht is the transition into the rectum called?
rectosigmoid junction
what is the posterior part of the rectum called? What does it do?
Rectal ampulla
allows for expansion of fecal matter
whats the relationship between Ureter to uterine a
posterior
What is the relationship between Ureter to ductus deferens
inferior
What are the spaces/pouches in the pelvis? (4)
Retropubic space
Rectouterine pouch
vesicouterine pouch
retovesical pouch
What's the name of the ligament from the uterus to the ovaries?
Embryological Origin?
Proper Ovarian Ligament
Gubernaculum
What are the parts of the uterine tube
Fimbrae
Infundibulum
Ampulla
Isthmus
Uterine
orifices
Parts of the uterus
Fundus
Body
Isthmus
Cervix
Layers of the Uterus
Perimetrium
myometrium
endometrium
Uterine ligaments (5)
Uterosacral ligaments
Cardinal ligament (=transverse
cervical ligaments)
Broad Ligament
Suspensory ligament of ovary
proper ovarian ligament
Each ejaculatory duct
opens into?
prostatic urethra
Parts of ductus defferens from testes to penis
Epididymis
Ductus deferens
Ampulla of d.d.
Ejaculatory duct
Prostate
Semen =
sperm cells +
secretions of seminal
vesicles, prostate, and
bulbourethral glands
what openings are in the prostate?
Openings of prostatic ducts
Opening of an ejaculatory duct
What are enlarged prostate lobes called?
Hyperplastic
What are the names of the prostatic lobules
Superomedial lobule
Anteromedial lobule
Inferolateral lobule
Inferoposterior lobule
Isthmus of the prostate
what is the Isthmus of the prostate composed of? What does it secrete?
smoothe and skeletal muscle
no secretions
What is the most common site of prostatic carcinoma? Why is this concerning?
Inferoposterior lobe
Prostatic venous plexus lacks
valves, communicates with the
internal vertebral venous plexuses
• Creates a pathway for metastasis
of prostatic cancer to the vertebral
column