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113 Cards in this Set
- Front
- Back
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where's the pelvis, what are its boundaries?
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pelvis is bowl-shaped region deep within hip bones
is inferior and posterior to pelvic brim has pelvic viscera including urinary bladder, rectum and uterus floor - pelvic diaphragm which is composed of muscles |
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where's the perineum and its borders?
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perineum is region superficial to pelvic diaphragm
contains anal canal in anal triangle and external genitalia in urogenital triangle perineal should not be confused with peritoneal or with peroneal peroneal is an old-fashioned adjective describing lateral aspect of leg |
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what do i need to know about the hip bones?
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hip bones make up pelvic girdle, as do sacrum and coccyx
hip bones also known as coxal bones, innominate bones, and ossa coxae formed by fusion during puberty of 3 bones: ilium, ischium, pubis ilium, ischium, pubis meet near center of acetabulum, which is socket of hip joint iliac crest, iliac fossa - know where these are ilium articulates with the sacrum at broad iliosacral joints inferiorly located ischium forms, with muscles, most of lateral walls of true pelvis anteriorly, pubis formed from 2 rami and is part of anterior wall of true pelvis left pubis and right pubis meet one another at pubic symphysis pubic arch angle formed by pubic rami anatomical position of bony pelvis is tilted anteriorly so plane of pelvic brim is at 45 degree angle to floor opening into pelvis called pelvic inlet or superior pelvic aperture size and shape of inlet often related to complications in childbirth inferior pelvic aperture or pelvic outlet is opening defined posteriorly by coccyx, laterally by ischial tuberosities and sacrotuberous ligaments, anteriorly by inferior part of pubic symphysis |
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what are the differences between the male and femal bony pelvises?
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is variation in shape of bony pelvis in individuals
exceptions to generalizations made about the bony pelvis can lead to complications during childbirth pelvic assessment is used in pregnant woman to determine size and orientation of birth canal 1. angle of pubic arch in women is wide, men narrow 2. superior pelvic aperture in women is oval or rounded, in men heart-shaped 3. inferior pelvic aperture in women is large, in men partially obstructed 4. obturator foramen in women is oval, men is round |
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what are ligaments and foramena that i should know about the pelvis?
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sacroiliac ligaments - strongest ligaments in body
bind hip bones to sacrum at sacroiliac joint sacrospinous ligmaent goes from sacrum to spine of ischium, closes greater sciatic notch, forming greater sciatis foramen sarotuberous ligament joins sacrum with ischial tuberosity, forming lesser sciatic formaen obturator foramen between the ischium and pubis sacral foramena obturator membrane covers most of obturator foramen obturator canal is a small gap in obturator membrane and is route followed by nerves and vessels into medial part of thigh major route followed by vessels, nerves into anterior thigh is deep to inguinal ligament |
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what is the pelvic diaphragm, what forms it, what does it do, what pierces it?
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inverted dome formed by muscular floor of true pelvis
formed anteriorly by levator ani muscles formed posteriorly by coccygeus muscles funnel-shaped group of muscles that support pelvic viscera supports abdominal and pelvic viscera pierced by urethra, rectum, and in women vagina |
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where do the levator ani muscles come from, where do they insert, what are the parts of the muscle?
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origin: from or near pubis and tendinous arch of obturator internus muscle
insertion: pelvic viscera or coccyx at midline 3 parts: 1. puborectalis 2. pubococcygeus 3. iliococcygeus |
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what's the origin, insertion, function of coccygeus muscle?
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origin: ischial spine and sacrospinous ligament
insertion: coccyx formation: posterior part of pelvic diaphragm |
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what are the functions of the levator ani and coccygeus muscles?
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1. support pelvic viscera
2. assist abdominal muscles in increasing abdominal pressure 3. support and anchor prostate and vagina puborectalis muscles = puborectalis portion of pubococcygeus muscles form puborectal sling - is part of external anal sphincter when sling relaxed, it allows rectum to straighten, helping in defecation |
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what is a clinical correlate for the muscles of the pelvic diaphragm?
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they can be injured during childbirth
can result in urinary incontinence, fecal incontinence, prolapse of uterus through vagina kegel exercises (training) teach women to strengthen those muscles of pelvic diaphragm and to relax them during childbirth while they are increasing intraabdominal pressure with other muscles |
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sacral plexus - what is it? where is it? what are its major branches? what are their paths?
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what it is:
weave-work of nerves composed of lumbosacral trunk which is part of L4 and ventral rami of L5 + ventral rami of S1-S4 where: on and in anterior surface of piriformis muscle branches: most leave true pelvis via greater sciatic foramen EXCEPTIONS: nerves of piriformis muscle, nerves to muscles of pelvic diaphragm, some cutaneous nerves major branches: sciatic nerve = L4-S3 pudendal nerve = S2-S4 superior and inferior gluteal nerves obturator nerve not derived from sacral plexus - is from branches of L2-L4 passes through obturator canal to medial thigh |
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what's the path of the pudendal nerve?
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exits pelvis via greater sciatic foramen
returns to perineum via lesser sciatic foramen after looping around sarospinous ligament |
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what's a clinical correlate involving the sciatic nerve?
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sciatica = painful
from compression of roots that make up sciatic nerve compression of lumbosacral trunk or rami of L4, L5 by herniated nucleus pulposus or slipped disc can also be caused by spasms in piriformis muscle, piriformis syndrome common in athletic women |
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what's the blood supply to the pelvis?
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near pelvic brim, common iliac artery divides into external and internal iliac arteries
external iliac artery will be principal blood supply of lower limb branches of internal iliac artery supply pelvic viscera, perineum and gluteal region lots of variation in branches of internal iliac artery 2 divisions: anterior or visceral and posterior or parietal most constant vessels from anterior: umbilical artery obturator artery to medial thigh inferior vesical artery in males vaginal artery in females uterine artery sometimes a branch of umbilical artery middle rectal artery internal pudendal artery to perineum inferior gluteal artery to butt major branches of posterior division: superior gluteal artery, also to butt beware: inferior gluteal artery often a branch of posterior division and not anterior division umbilical artery has many branches, including superior vesical arteries, supplying bladder umbilical artery becomes medial umbilical ligament as approaching the anterior abdominal wall |
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what's a clinical correlate relating to the uterine artery?
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ureter can be injured when uterine artery clamped during hysterectomy
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what are the boundaries of the gluteal region? what makes up the butt? what can you feel in there? what nerve innervates the muscles of the leg, where is the leg?
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superior boundary of gluteal region: iliac crest
inferior boundary: gluteal fold butt = gluteus maximus muscle + gluteus medius muscle + superficial fascia ischial tuberosities can be palpated deep to gluteus maximus leg is area between knee and ankle all muscles of leg and foot innervated by branches of sciatic nerve sciatic nerve enters lower limb deep to gluteus maximus muscle |
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what are the muscles of the gluteal region divided into?
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1. the glutei = gluteus maximus, medius, minimus
2. short lateral rotators of thigh = piriformis |
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what kind of joint is the hip joint, what does this mean for its actions? what can the muscles of the gluteal region do to the thigh?
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ball and socket joint
extension = moving thigh dorsally flexion = moving thigh ventrally adduction = moving thigh toward midline abduction = moving thigh away from midline rotation and circumduction are possible muscles of gluteal region extend, rotate, abduct thigh |
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review the muscles of the glutei - what are their origins, insertions, innervations, actions?
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gluteus maximus
origin: ilium, sacrum, sacrotuberous ligament insertion: broad band of connective tissue running along lateral surface of thigh, called iliotibial band or tract also runs along femur innervation: inferior gluteal nerve enters gluteal region through greater sciatic foramen action: principal extensor of thigh gluteus medius origin: broad, from external surface of ilium insertion: greater trochanter of femur action: keeps pelvis from tilting from side to side while walking location: superficial in superiolateral part of butt covered by gluteus maximus in other places innervation: superior gluteal nerve gluteus minimus location: deep to gluteus medius innervation: superior gluteal nerve action: assists gluteus medius in stabilizing pelvis and abduction of thigh medial or internal rotator of thigh |
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what's a significant clinical correlate to know about the butt?
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gluteus medius, not maximus receives intramuscular injections because injecting into maximus risks going deep to muscle and injuring underlying sciatic nerve
to test right gluteus medius, ask patient to stand on right foot if left iliac crest dips down, right gluteus medius may be weak this is a positive trendelenburg sign left gluteus medius is tested by asking patient to stand on left foot weak gluteus medius may indicate easly states of neuromuscular disease |
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what's the location, insertion, significance, innervation of piriformis muscle?
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location: exits pelvis via greater sciatic forament
insertion: greater trochanter of femur significance: is landmark of gluteal region nerves and vessels are referred to as superior or inferior depending on their relation to piriformis innervation: in pelvis by branches from sacral plexus |
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what are other short, lateral rotators of thigh? what are their origins, pathways, insertions?
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numerous other short, lateral rotators of thigh, but i only need to know one other - obturator internus
origin: in pelvis pathway: exits through lesser sciatic foramen insertion: greater trochanter of femur significance of finding obturator internus in gluteal region is that it will help me locate lesser sciatic foramen |
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what are the nerves i need to know in the gluteal region? where do they originate, if that's signficant? what are their passageways in gluteal region? what do they innervate?
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sciatic nerve in gluteal region
largest nerve in body composed of two nerves; tibial nerve and common fibular or peroneal nerve these are wrapped together in common connective tissue sheath pathway: enters gluteal region via greater sciatic foramen passes inferiorly and deep to gluteus maximus sciatic nerve does NOT supply muscles in gluteal region, but innervates muscles of leg, foot and posterior thigh besides sciatic nerve: pudendal nerve internal pudendal artery these both pass from pelvis through greater sciatic foramen, wrap around sacrospinous ligament, enter perineum via lesser sciatic foramen nerve to obturator internus muscle follows similar course |
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what's another clinical correlate concerning the sciatic nerve and its splitting in the lower limbs?
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another reason for targeting intramuscular injections away from gluteus maximus
sciatic nerve usually splits into tibial and common fibular in thigh sometimes split is in gluteal region if this happens, may be near greater sciatic foramen this would mean that the common fibular nerve may pass through or even superior and superficial to priformis muscle |
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what should i know about the latin word for bladder and why?
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latin for bladder is vesica
structures associated with bladder named with prefix vesico... or suffix vesical |
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what are the parts of the bladder that i should know?
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apex - top of bladder, most anterior
base - posterior surface of bladder superior surface - top two inferolateral surfaces - just the sides umbilical ligament is attaching to apex |
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what flattens the base of the bladder?
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vagina or rectum
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what are in contact with the inferolateral surfaces of the bladder?
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levator ani muscles
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what does the full bladder look like compared to an empty one?
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empty = iron
full = round can extend up to umbilicus |
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what's the trigone part of the bladder?
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only part of the inside of the bladder that's not corrugated
is triangular patch lining base |
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where do the ureters enter the bladder?
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near superior angles of trigone
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where does the urethra form in the bladder/
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inferior angle of trigone
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what's in the wall of the bladder? what does it form at neck of bladder?
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smooth muscle
near neck of bladder where urethra begins, muscles form involuntary internal sphincter |
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what's the innvervation to the bladder?
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parasympathetic
motor to smooth muscle inhibitory to involuntary sphincter when fibers stimulated by distension of bladder, they force bladder to contract, expelling urine into urethra this can be controlled by higher brain centers |
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describe the urethra in the female - where is it located and where does it end?
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is short, muscular tube
runs near anterior surface of vagina ends at external urethral orifice in vestibule of vagina = space tween labia minora |
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what are the parts of the urethra in the male? what are they surrounded by?
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urethra is longer than in female
3 parts: 1. prostatic urethra 2. intermediate or membranous urethra 3. spongy urethra prostatic surrounded by prostate gland posterior surface of prostatic urethra marked by many openings of prostatic ductules and openings of ejaculatory ducts intermediate urethra is short stretch of tubing tween prostatic urethra and bulb of penis surrounded by phincter urethrae muscle spongy urethra in bulb of penis and corpus spongiosum of penis |
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what constitutes the male internal genitalia?
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1. ductus deferens
2. seminal vesicles 3. ejaculatory ducts |
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what is the ductus deferens? where is it located, where does it end? what's an important clinical correlate related to it?
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what it is:
also called vas deferens is continuation of epididymis or epididymides location: enters abdomen in spermatic cord enters true pelvis along lateral walls just deep to peritoneum enlarges at posterior base of bladder into area called ampulla ends: ends at ampulla ampulla fuse together and with duct of seminal vesicle to become the ejaculatory duct clinical correlate: deferentectomy or vastectomy involve ligation or removal of section of ductus deferens is common method of sterilization |
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what do the seminal vesicles do, where are they? what's their relation to the ejaculatory ducts? where do the ejaculatory ducts lead?
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location of seminal vesicles:
tween bladder and rectum function: not storage of semen, like name suggests are principal source of seminal fluid pathway: empty into short duct that fusees with duct of ampulla to form ejaculatory ducts pathway of ejaculatory ducts: empty into prostatic urethra near orifice of prostatic utricle prostatic utricle = tiny, vestigial developmental homolog of uterus |
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where is the prostate, how big is it? what does it do? what are its parts called?
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location:
surrounds prostatic urethra tween bladder and urogenital diaphragm size: is walnut-sized gland function: approximately 20% of seminal fluid fluid enters urethra through 20-30 ducts in posterior wall base of prostate - vesicular surface apex related to urogenital diaphragm |
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what's a clinical correlate to note for the prostate?
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posterior surface of prostate near rectum, where can be felt
enlarges with age can obstruct flow of urine benign hypertrophy leads to nocturia = need to void at night and dysuria = pain during urination 80% of men over 80 prostatic carcinoma 30% of men over 75 years early detection critical don't confuse seminal vesicles with cancerous prostate |
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what is the prostrate? what is it made up of?
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there are lobes seen in embryo, not obvious in adult
is collection of different glands that empty into urethra central, peripheral 70-75%, radiate laterally from urethra major site of prostatic carcinoma periurethral, transitional both major sites of benign prostatic hyperplasia |
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what are the parts of the internal female genitalia that i should know?
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1. vagina
2. uterus 3. uterine tubes 4. ovaries 5. uterine ligaments |
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what's the vagina? where is it? what parts does it have?
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vagina is muscular tube
location: from vaginal vestibule to cervix of uterus posterior to bladder, anterior to rectum through both urogenital diaphragm and pelvic diaphragm parts: fornix is recess formed around cervix |
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what's an important clinical correlate for the vagina?
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posterior wall of fornix thin and formed by peritoneum partly
damage from trauma like a coat-hanger abortion can result in peritonitis blood or ascites in peritoneum will pool in recctouterine pouch which can be detected by palpation culdocentesis refers to putting a needle through wall of posterior fornix to draw a sample of perioneal fluid |
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where is the uterus, what parts does it have, what ligaments does it have, what are the pouches around it, and what are the layers of the uterine wall?
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location:
near superior wall of bladder at right angle to vagina parts: 2; body and narrow cervix isthmus = where body meets cervix fundus = superior part of body surfaces of uterus - vesicle related to bladder and intestinal ligaments: broad ligament of uterus - folds of peritoneum suspends body and allows it to move posteriorly as bladder fills vesicouterine pouch = pocket-like projection of peritoneal cavity tween uterus and bladder rectouterine pouch = tween uterus and rectum extends inferiorly to posterior wall of vaginal fornix 3 layers to wall of uterus: 1. perimetrium peritoneum and pelvic visceral fascia 2. myometrium = smooth muscle 3. endometrium = mucous coat sloughed off each month |
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what's the blood supply to the uterus?
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to body - uterine arteries, branches of internal iliac artery
ovarian arteries, from aorta |
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what's another name for the rectouterine pouch?
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pouch of douglas
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what's an important clinical correlate for the uterus?
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position of it determind by bimanual exm
retroverted uterus more likely to prolapse during and after menopause, body of uterus shrinks until it's about same size as cervix |
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where are the uterine tubes,
what parts does it have? |
location:
connect uterus with peritoneal cavity near ovary parts: 1. uterine part surrounded by myometrium of uterus 2. isthmus = short, thick-walled portion near uterus 3. ampulla - longest part, usually site of fertilization 4. infundibulum = distal, funnel-shaped part that opens to peritoneal cavity 5 abdominal osteum = opening surrounded by 6. fimbrae = finger-like projections that sweep up oocytes into abdominal osteum |
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what's a clinical correlate for the uterine tubes?
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direct connection tween peritoneal cavity and outside world means that infections in vagina can spread to peritoneal cavity and result in peritonitis
infections in peritoneal cavity can also spread into uterine tubes if zygote unable to pass into uterus after fertilization, can implant in walls of uterine tube this results in an ectopic tubal pregnancy that would cause rupture of uterine tubes, which can be lethal |
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what do the ovaries look like,
where are they, what are their relations, what ligaments are they associated with, |
appearance:
almond-shaped atrophy following menopause small in most female cadavers location: near lateral walls of true pelvis in peritoneal cavity ligaments: mesovarium = fold of peritoneum actually, not ligament attaches anterior surface of ovaries to posterior surface of broad ligament suspensory ligament of ovary = another fold of broad ligament anchors ovaries to lateral walls of pelvis suspensory ligament AND MESOVARIUM = carries ovarian vessels and nerves ligament of ovary = band of connective tissue anchors each ovary to uterus fimbria ovarica - specialized fimbrium anchors ovary to infundibulum of uterine tube |
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what's a clinical correlate we should know for the ovaries?
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presence of enlarged lymph nodes can indicate infection or cancer
ovarian cancer progresses without early detection because lymph nodes of ovaries are deep within abdomen, near origins of ovarian vessels care must be taken when clamping ovarian artery prior to their surgical removal so that nearby ureter is not damaged |
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what do i need to know about the broad ligament?
what anchors it to what? what is it? what parts does it have? what does it cover? |
mesovarium anchors ovary to broad ligament
broad ligament = sheet thrown over uterine tubes mesosalpinx - part of broad ligament tween ovary + its ligaments and uterine tube mesometrium = broad ligament tween ovaries and uterus broad ligament covers cords of connective tissue ligamentum teres or round ligament of uterus ovarian ligament suspensory ligament of ovary |
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where is the ligamentum teres or round ligament of the uterus? where does it start and exit through pelvis?
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origin - near fundus of uterus
path - lateral to wall of true pelvis, exits abdominal cavity through deep ring of inguinal canal |
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where's the ovarian ligament?
where does it start, where does it insert? |
ovarian ligament - short
origin: near fundus insertion: uterine surface of ovary |
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what are the remnants of the gubernaculum in the female?
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ligamentum teres, or round ligament of uterus and
ovarian ligament |
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what's the gubernaculum do in the female?
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is a cord-like structure that pulls ovaries into pelvis from posterior abdominal wall
IN EMBRYO ONLY |
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where's the suspensory ligmament of the ovary? what does it do?
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attaches lateral surface of ovary to lateral walls of pelvis
also is conduit for ovarian vessels |
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what are the ligaments of the uterus?
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1. broad ligament
2. ligamentum teres or round ligament of uterus 3. ovarian ligament 4. suspensory ligament |
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where is the perineum?
what does it look like? what are its borders? what's a major landmark of perinum? |
location:
most inferior part of trunk found tween thighs and butt appearance: shaped like diamond when thighs abducted consists of two triangles; the urogenital and anal triangles borders: anterior - pubic symphysis posterior - tip of coccyx lateral points - ischial tuberosities major landmark: perineal body - tendinous center at midpoint of line tween ischial tuberosities |
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what are the most prominent components of the urogenital triangle?
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terminal part of urethra, external genitalia
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what is contained within the anal triangle?
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anal canal, vessels and nerves, fascia
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what does the perineal body DO?
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is tendinous center of perineum
many muscles attach to it, including levator ani, transverse perineal muscles and bulbospongiosus |
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what's an important clinical correlate for the perineum?
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perineal body can be damaged during difficult childbirth
this will result, if not repaired, in prolapse of pelvic viscera |
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what is the urogenital diaphragm?
what's the controversy surrounding it? what composes it? what do its parts DO? |
what it is:
floor of true pelvis is subflooring thin sheet of striated muscle and fascia spanning pubic arch parts of: deep transverse perineal muscle, also called transversus perinei sphincter urethrae muscle deep transverse perineal muscle or transversus perinei assists pelvic diaphragm in supporting pelvic viscera sphincter urethrae is voluntary sphincter of urethra and vagina controversy is that this muscle does not actually exist |
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where's the anal canal?
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most inferior part of large intestine
begins at angle formed by puborectal sling ends at anus |
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what are anal columns?
what should i know about them? where do they end, what structure do they form? |
what they are:
series of longitudinal folds on inner lining of superior part of anal canal should know: they are highly vascularized ending: have semilunar valves at end pectinate line = undulating line formed by semilunar valves at ends of anal columns |
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what, again, is the pectinate line
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is undulating line formed by semilunar valves at ends of anal columns
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what is the embryological significance of the pectinate line?
what significance does it have for the anal canal? |
origins (embryological):
where endoderm-derived hindgut met ectoderm-derived anal pit significance for anal canal: because of different embryological origins, either side of pectinate line has different blood supply, innervation, lymph drainage |
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what are internal hemorrhoids?
how do they feel? contrast this with external hemorrhoids; what are they and how do they feel? why is there this difference? |
internal hemorrhoids:
varicosities or dilations of veins in anal columns SUPERIOR to pectinate line mucosa here derived from endoderm, so is INSENSITIVE to pain can be undetected for long time external hemorrhoids varicosities of veins in wall of anal canal INFERIOR to pectinate line richly innervated by inferior rectal nerve, branch of pudendal nerve VERY SENSITIVE to pain differences tween two from their embryological origins |
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what's a major cause of hemorrhoids and why is this?
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hemorrhoids result from weakening of anal canal from sitting too long
can also indicate increased pressure in valveless portal system (heart problems) dilations of veins in anal columns caused by portal-caval anastomosis at anal wall |
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how does portal-caval anastomoses in anal wall happen?
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apparently,
rectum and SUPERIOR part of anal canal blood drains into superior rectal vein which then goes into the inferior mesenteric vein, which drains into the PORTAL system vs. INFERIOR part of anal canal drains into inferior RECTAL vein which drains into inernal iliac vein which drains into IVC |
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what are the two sphincters surrounding the anal canal?
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1. internal or involuntary sphincter and
ring of smooth muscle innervated by parasympathetic fibers from pelvic SPLANCHNIC nerves 2. external or voluntary anal sphincters contains puborectal sling supplied by inferior rectal nerve, branch off pudendal nerve |
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where's the rectum come from?
where is it located? what surrounds it? what shape does it take on? what are some of its relations? what does it DO? |
part of pelvic viscera
origin: continuation of sigmoid colon begins at S3, deep to peritoneum surrounding: peritoneum around anterior and lateral walls of SUPERIOR THIRD of rectum middle third - anterior surface only covered inferior third - in pelvic fascia shape: right angle at puborectal sling (from puborectalis portions of levator ani muscles) under that angle is anal canal rectum = straight also has 3 transverse rectal folds seen in coronal sections of rectum function: storage of the feces inferior third of rectum highly distensible called ampulla |
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what's an important clinical correlate of the rectum?
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remember during a sigmoidoscopy that there are angles and folds in rectum so don't just push your way through
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what the hell is the ischiorectal fossa
where is it? what does it look like? what is it made of and what does it do? |
named for lateral and medial borders:
ischium and anal canal is wide inferiorly, narrow superiorly described as wedge-shaped base covered with skin apex bounded by ischium and inferior origins of muscles of pelvic diaphragm anterior - goes up to urogenital diaphragm, where is called "ANTERIOR RECESS OF ISCHIOANAL FOSSA" filled with fat, fibrous bands of ct support anal canal and allow expansion during defection |
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where is the pudendal canal
what does the pudendal nerve do, what does it form depending on gender |
composition:
in canal are pudendal nerve, internal pudendal artery and vein location: exit true pelvis through greater sciatic foramen wrap around sacrospinous ligament enters perineum via lesser sciatic foramen in perineum, run through fibrous tunnels along lateral walls of ischioanal fossae = pudendal canals can also think of pudendal canal running in deep fascia of obturator internus muscle near inferior margin supplies most of perineum males - forms dorsal nerve of penis females - forms dorsal nerve of clitoris and perineal nerves |
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what's a clinical correlate involving the ischioanal fossa?
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be careful of it
it spread laterally, involving contents of pudendal canal spread too far and have debilitation? inferior rectal nerve traverses ischioanal fossa from pudendal canal - DON'T INJURE IT when treating area for infections |
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what are the contents of the male urogenital triangle?
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scrotum, penis, membranous urethra, superficial perineal muscles
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what are the parts of the penis?
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root, body, glans
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what makes up the penis?
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corpus spongiosum penis and
corpus cavernosum penis |
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where can the corpus spongiosum be found? what's in it?
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corpos spongiosum expanded proximally in root of penis to form bulb of penis
urethra pierces bulb, continues in corpus spongiosum penis to external urethral orifice found along ventral midline of body of penis expands distally to form glans |
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where are the corpora cavernosa? what do they form and where?
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2 of them
dorsally on either side of corpus spongiosum penis in body of penis in root, corpora cavernosa separate into left and right crura these are attached to inferior pubic rami |
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what's a clinical correlate of the penis?
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erection caused by release of NO in erectile tissue
regulated by parasympathetic nerves NO activates enzyme that converts GTP to cGMP cGMP initiates signaling cascade that causes signaling cascade allowing smooth mucle in penis and clitoris to relax this results in increased blood flow cGMP broken down by enzyme called phosphodiesterase-5 drugs like sildenafil or viagra are phosphodiesterase-5 inhibitors |
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how many superficial perineal muscles are there and what are their names?
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3
1. superficial transverse perineal muscles 2. bulbospongiosus muscles 3. ischiocavernosus muscles |
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describe the superficial transverse perineal muscles
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they are thin strips of muscle arising from ischial tuberosity
inserting on perineal body anterior to anal canal |
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where is the bulbosponiosus muscle in men, what does it do? where is it in women, what does it do for women?
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location in men:
associated with bulb of penis contraction aids in expulsion of semen, urine from urethra aid penile erection by inhibiting flow of blood through deep vein of penis women: on either side of vagina from perineal body to clitoris act as vaginal sphincter |
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where are the ischiocavernosus muscles in men and women, what do they do?
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in both men and women, they surround crura of penis and clitoris
contraction forces blood from root into body of clitoris or penis, helping to maintain erection |
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what innervates the superficial perineal muscles?
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perneal nerves
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what's a clinical correlate for the superficial perineal muscles in women?
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kegel exercises strengthen them to assist pelvic diaphragm to support vagina and uterus
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what's the name for the entire area of female external genitalia, and what makes it up?
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vulva
composed of mons pubis, labia majora, labia minora, vestibule of vagina, clitoris, bulb of vestibule, greater vestibular glands, associated superficial perineal muscles |
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what's and where's the mons pubis?
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is eminence found superficial to pubic symphysis
covered with pubic hair |
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what do the labia majora look like? what are they? what do they do?
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they are crescent-shaped folds of skin that cover and protect labia minora, vaginal orifice, urethral orifice
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what's the pudendal cleft?
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slit-like opening tween labia majora
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what's the female homologue of the scrotum?
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labia majora
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what structures develop from the labioscrotal folds?
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labia majora in women and scrotum in men
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where are the labia minora, what do they do, what do they contain
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deep to labia majora
cover vestibule of vagina and contain spongy tissue that becomes engorged with blood during sexual response anteriorly, fuse to clitoral hood or prepuce inferiorly, fuse as fold of skin called frenuum |
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where is the vaginal vestibule, what's in it?
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tween labia minora
in it are urethral orifice vaginal orifice or introitus openings of ducts of greater and lesser vestibular glands |
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what do the greater and lesser vestibular glands secrete?
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mucus that lburicates labia and vestibule during sexual arousal
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where are the bulbs of the vestibule? what are they composed of?
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are deep to bulbospongiosus muscles on either side of vaginal orifice
partly within labia minora composed of spongy tissue like that found in penis |
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what happens with the bulbospongiosus muscles during sexual response?
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they contract
force blood from bulbs into crura of clitoris to help maintain erection |
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what's the clitoris? what composes it?
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it's an erectile organ
composed of two corpora cavernosa that form crura along inferior pubic rami bound together superiorly to form body of clitoris distal end of body is small, rounded glans |
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what's a clinical correlate relating to the greater vestibular glands?
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they're also called bartholin's glands (or used to be)
inflammation is stil called bartholinitis inflamed greater vestibular glands can reach 2-5 cm in size |
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what nerves provide cutaneous sensation to vulva?
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ilioinguinal nerve
genital branch of genitofemoral nerve perineal branch of posterior cutaneous nerve of thigh all above innervate mons pubis and lateral aspect of labia majora principal nerves to vulva are branches of pudendal nerve after exiting pudendal canal, pudendal nerve divides into several perineal nerves and dorsal nerve of clitoris |
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what's a clinical correlate related to treating pain during childbirth?
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inject anesthetic agent into tissue surronding pudendal nerve near where it enters perineum through lesser sciatic foramen at ischial spine
doesn't block pain associated with contractions of uterus and dilation of cervix |
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what is the sexual response technicallly involve?
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emotional, physiological processes
involves sensory, motor, autonomic nervous systems |
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what are three parts of sexual response in male
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erection, emission, ejaculation
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what causes erection for men?
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parasympathetic innervation causes relaxation of smooth muscle
blood flow increases outflow is clamped down resulting in erection |
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what's emission involve?
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sperm transfer
from epididymis to prostatic urethra sympathetic nervous system innervates smooth muscle in ductus deferens and seminal vesicles initial phases of orgasm preganglionic nerves involved from L1, L2 prostate gland: sympathetic nervous system closes off neck of bladder so that movement is 1 way |
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what's ejaculation involve?
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semen into spongy urethra
contractions of striated muscle (bulbospongiosus), not smooth, like in emission |
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what does point and shoot mean?
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point and shoot
point = erection, parasympathetic shoot = emission NOT ejaculation sympathetic |
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what's an important clinical correlate relating to spinal nerve injuries and sexual function?
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spinal cord levels involved in regulating erection, emissiona dn ejaculation are different
refexogenic erection = stroking perineum leading to erection without involvement of brain this is more common in people with higher cord lesions above L1 since reflex arc remains intact below lesion few spinal cord injured men father children chance is better for people with lower cord lesions below L1 that for men with higher cord lesions reason is that sympathetic innervation required for emission must be intact for sperm to get out of body |
