Anatomy of Perineum
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Questions and Answers

What is the function of the tunica albuginea in the testis?

  • To connect to the epididymis
  • To produce testosterone
  • To produce spermatozoa
  • To provide a layer of protection (correct)

    • Which muscles are derived from the internal oblique muscle in the scrotum?

  • External oblique muscle
  • Dartos muscle
  • Internal oblique muscle
  • Cremaster muscle (correct)

    • What is the purpose of the efferent ductules in the testis?

  • To connect the seminiferous tubules to the epididymis (correct)
  • To store and mature spermatozoa
  • To produce spermatozoa
  • To produce testosterone

    • Which of the following is NOT a layer of the scrotum?

    <p>Epididymis</p> Signup and view all the answers

    What is the purpose of the testis being 1-3°C cooler than abdominal temperature?

    <p>To facilitate spermatogenesis</p> Signup and view all the answers

    What is the function of the dartos muscle in the scrotum?

    <p>To regulate the temperature of the testis</p> Signup and view all the answers

    What is the origin of the internal spermatic fascia?

    <p>Transversalis fascia</p> Signup and view all the answers

    What is the layer of tunica vaginalis that covers the testis and epididymis?

    <p>Visceral layer</p> Signup and view all the answers

    What is the function of the potential space between the two layers of tunica vaginalis?

    <p>Allows testis to move freely in scrotum</p> Signup and view all the answers

    What is the abnormal fluid accumulation in the potential space between the two layers of tunica vaginalis?

    <p>Hydrocele</p> Signup and view all the answers

    What is the muscle attached to the ischiopubic rami?

    <p>Crura of penis</p> Signup and view all the answers

    What is the nerve that innervates the superficial perineal muscles?

    <p>Pudendal nerve</p> Signup and view all the answers

    What is the part of the penis that is connected to the pubic symphysis via the suspensory ligament?

    <p>Body</p> Signup and view all the answers

    What is the layer of tunica vaginalis that covers the inner aspect of the internal spermatic fascia?

    <p>Parietal layer</p> Signup and view all the answers

    What is the inferior border of the pubic symphysis in relation to the perineum?

    <p>Anterior angle</p> Signup and view all the answers

    What is the posterolateral border of the perineum?

    <p>Sacrotuberous ligament</p> Signup and view all the answers

    Which muscle is a part of the superomedial wall of the ischioanal fossa?

    <p>External anal sphincter muscle</p> Signup and view all the answers

    What is the location of the pudendal nerve and internal pudendal vessels within the ischioanal fossa?

    <p>Along lateral wall in pudendal (Alcock's) canal</p> Signup and view all the answers

    What is the contents of the ischioanal fossa?

    <p>Large amounts of fat, pudendal n. and internal pudendal vessels, inferior rectal n. and vessels</p> Signup and view all the answers

    What is the boundary between the anal triangle and urogenital triangle?

    <p>Sacrotuberous ligament</p> Signup and view all the answers

    What is the apex of the coccyx in relation to the perineum?

    <p>Posterior angle</p> Signup and view all the answers

    What is the region of the perineum that contains the anal canal in the midline?

    <p>Anal triangle</p> Signup and view all the answers

    Which muscle converges at the perineal body?

    <p>All of the above</p> Signup and view all the answers

    What is the boundary of the urogenital triangle?

    <p>Ischiopubic ramus and pubic symphysis</p> Signup and view all the answers

    Which nerve innervates the external anal sphincter?

    <p>Inferior rectal nerve</p> Signup and view all the answers

    What is the location of the spermatic cord?

    <p>All of the above</p> Signup and view all the answers

    What is the division of superficial fascia in the urogenital triangle

    <p>All of the above</p> Signup and view all the answers

    What forms the superior wall of the ischioanal fossa?

    <p>Levator ani muscle</p> Signup and view all the answers

    What is the posterior angle of the perineum?

    <p>Coccyx</p> Signup and view all the answers

    What is the inferior border of the deep perineal pouch?

    <p>Perineal membrane</p> Signup and view all the answers

    What is the main component of the lateral wall of the ischioanal fossa?

    <p>Obturator internus muscle</p> Signup and view all the answers

    What structures perforate the urogenital triangle in a female?

    <p>Urethra, vagina, and branches of internal pudendal vessels</p> Signup and view all the answers

    What is the location of the dorsal nerve of penis/clitoris?

    <p>Deep perineal pouch</p> Signup and view all the answers

    What is the region of the perineum that contains the urethra and vagina?

    <p>Urogenital triangle</p> Signup and view all the answers

    What is the main component of the inferior wall of the ischioanal fossa?

    <p>Skin</p> Signup and view all the answers

    What is the boundary between the anal and urogenital triangles?

    <p>Perineal body</p> Signup and view all the answers

    What is the contents of the pudendal canal?

    <p>Pudendal nerve and internal pudendal vessels</p> Signup and view all the answers

    What is the boundary of the perineum?

    <p>Pelvic diaphragm</p> Signup and view all the answers

    What muscle is also known as the external urethral sphincter?

    <p>Sphincter urethrae</p> Signup and view all the answers

    What is the location of the pudendal nerve within the perineum?

    <p>Pudendal canal</p> Signup and view all the answers

    Which of the following muscles is NOT found in the superficial perineal pouch?

    <p>Deep transverse perineal muscle</p> Signup and view all the answers

    What is the name of the glands that are homologous to the prostate gland in males?

    <p>Skene's glands</p> Signup and view all the answers

    What is the boundary between the anterior and posterior regions of the perineum?

    <p>Perineal body</p> Signup and view all the answers

    What is the location of the internal pudendal vessels within the perineum?

    <p>Pudendal canal</p> Signup and view all the answers

    What is the contents of the deep perineal pouch?

    <p>Sphincter urethrae muscle and internal pudendal vessels</p> Signup and view all the answers

    Which of the following muscles forms the superomedial wall of the ischioanal fossa?

    <p>Levator ani</p> Signup and view all the answers

    What is the inferior border of the pubic symphysis in relation to the perineum?

    <p>Anterior</p> Signup and view all the answers

    Which of the following structures is NOT located in the ischioanal fossa?

    <p>Dartos muscle</p> Signup and view all the answers

    What is the region of the perineum that contains the anal canal in the midline?

    <p>Anal triangle</p> Signup and view all the answers

    What forms the lateral wall of the ischioanal fossa?

    <p>Obturator internus muscle</p> Signup and view all the answers

    What is the contents of the pudendal canal?

    <p>Pudendal nerve and internal pudendal vessels</p> Signup and view all the answers

    Which muscle converges at the perineal body?

    <p>All of the above</p> Signup and view all the answers

    What is the main component of the inferior wall of the ischioanal fossa?

    <p>Skin</p> Signup and view all the answers

    What is the main component of the lateral wall of the ischioanal fossa?

    <p>Sacrotuberous ligament</p> Signup and view all the answers

    Which muscle converges at the perineal body?

    <p>All of the above</p> Signup and view all the answers

    What is the location of the dorsal nerve of the penis or clitoris?

    <p>Within the deep perineal pouch</p> Signup and view all the answers

    What is the inferior border of the deep perineal pouch?

    <p>Perineal membrane</p> Signup and view all the answers

    Which of the following structures perforates the urogenital triangle?

    <p>All of the above</p> Signup and view all the answers

    What is the contents of the superficial perineal pouch?

    <p>All of the above</p> Signup and view all the answers

    What is the location of the pudendal nerve and internal pudendal vessels within the ischioanal fossa?

    <p>Lateral wall</p> Signup and view all the answers

    What is the contents of the deep perineal pouch in a male?

    <p>Deep transverse perineal muscle and part of urethra</p> Signup and view all the answers

    What is the region of the perineum that contains the urethra and vagina?

    <p>Urogenital triangle</p> Signup and view all the answers

    What is the contents of the deep perineal pouch in a female?

    <p>All of the above</p> Signup and view all the answers

    Study Notes

    Testis

    • Function: produce spermatozoa via spermatogenesis, and production of testosterone
    • Need to be 1-3°C cooler than abdominal temperature
    • Surrounded by tunica albuginea
    • Interior divided into lobules via fibrous septa
    • Each lobule contains 1-3 seminiferous tubules
    • Open into rete testis
    • Efferent ductules connect rete testis to epididymis

    Epididymis

    • Storage and maturation of spermatozoa
    • Parts: head, body, and tail (continuous with vas deferens)

    Scrotum

    • Layers: skin, tunica dartos, external spermatic fascia, cremaster m. & fascia, internal spermatic fascia, and tunica vaginalis
    • Tunica dartos: derived from superficial fascia of anterior abdominal wall, contains dartos m. (smooth m.)
    • Tunica vaginalis: derived from peritoneum, lower expanded part of processus vaginalis, visceral layer covers testis and epididymis, parietal layer covers inner aspect of internal spermatic fascia, has potential space between the two layers

    Penis

    • Parts: body and root
    • Body: proximal part connected to pubic symphysis via suspensory lig., 2 corpora cavernosa, 1 corpus spongiosum, glans penis, and prepuce (foreskin)
    • Root: within superficial perineal pouch, inferior to perineal membrane, formed by posterior ends of corpora cavernosa and corpora spongiosum

    Superficial Perineal Muscles

    • All innervated by perineal branch of pudendal n.
    • Muscles: bulbospongiosus m.

    Perineum

    • Most inferior portion of trunk
    • Inferior to pelvic diaphragm
    • Angles (as viewed I -> S): anterior, posterior, and lateral
    • Borders: anterolateral, posterolateral
    • Regions: posterior (anal triangle) and anterior (urogenital triangle)

    Ischioanal Fossa

    • Walls: inferior wall, superomedial wall, and lateral wall
    • Extends into urogenital triangle
    • Contents: large amounts of fat, pudendal n. & internal pudendal vessels, and inferior rectal n. & vessels

    Perineum

    • The perineum is the most inferior portion of the trunk, located inferior to the pelvic diaphragm
    • It has three angles: anterior, posterior, and lateral
      • Anterior angle: inferior border of pubic symphysis
      • Posterior angle: apex of coccyx
      • Lateral angle: ischial tuberosities
    • The perineum has two regions: posterior (anal triangle) and anterior (urogenital triangle)

    Anal Triangle

    • Contains the anal canal in the midline and the ischioanal (ischiorectal) fossa on each side of the anal canal

    Urogenital Triangle

    • Attached to each side of the ischiopubic ramus
    • Anterior border separated from the pubic symphysis by the deep dorsal vein (of penis/clitoris)
    • Perforated by the urethra, bulbourethral ducts (in males), and vagina (in females)
    • Also perforated by branches of internal pudendal vessels and the dorsal nerve (of penis/clitoris)

    Ischioanal Fossa

    • Walls:
      • Inferior wall: skin
      • Superomedial wall: levator ani muscle, external anal sphincter muscle
      • Lateral wall: lower part of obturator internus muscle, ischial tuberosity
    • Extends into the urogenital triangle
    • Contents: large amounts of fat, pudendal nerve and internal pudendal vessels, and inferior rectal nerve and vessels

    Superficial and Deep Perineal Pouches

    • Superficial perineal pouch:
      • Located between Colles' fascia and the perineal membrane
      • Contents: superficial perineal muscles, perineal nerve and vessels, crura of clitoris, bulbs of vestibule, and greater vestibular glands
    • Deep perineal pouch:
      • Inferior border: perineal membrane
      • Superior border: inferior fascia of the pelvic diaphragm
      • Contents: deep transverse perineal muscles, sphincter urethrae muscle (aka external urethral sphincter muscle), part of urethra, part of vagina, dorsal nerve of clitoris, and internal pudendal vessels

    Male Genitalia

    • Spermatic cord:
      • Location: begins at the deep inguinal ring, passes through the inguinal canal, and exits through the superficial inguinal ring
      • Components: vas deferens, testicular artery and vein, artery of ductus deferens, cremasteric artery, lymph vessels, and autonomic nerves of clitoris

    Female Genitalia

    • Bulbs of vestibule:
      • Erectile tissue along labia minora
      • Homologue of bulb of penis
      • Covered by bulbospongiosus muscle
      • Become enlarged with clitoris during sexual excitation
    • Greater vestibular glands:
      • Posterior ends of bulbs of vestibule
      • Homologue of bulbourethral glands
      • Secrete mucus that lubricates vulva
    • Paraurethral glands:
      • Aka Skene's glands
      • Homologue of prostate
      • Closer to lower end of urethra, mucous glands

    Pudendal Nerve

    • Branch of sacral plexus
    • Ventral rami S2-S4
    • Leaves pelvis via greater sciatic foramen, inferior to piriformis, posterior to ischial spine
    • Enters perineum via lesser sciatic foramen
    • Travels anterior in pudendal canal along lateral wall of ischioanal fossa
    • Branches as it gets to urogenital triangle, including the perineal nerve and internal pudendal vessels

    Perineum

    • The perineum is the most inferior portion of the trunk, located inferior to the pelvic diaphragm
    • It has three angles: anterior, posterior, and lateral
      • Anterior angle: inferior border of pubic symphysis
      • Posterior angle: apex of coccyx
      • Lateral angle: ischial tuberosities
    • The perineum has two regions: posterior (anal triangle) and anterior (urogenital triangle)

    Anal Triangle

    • Contains the anal canal in the midline and the ischioanal (ischiorectal) fossa on each side of the anal canal

    Urogenital Triangle

    • Attached to each side of the ischiopubic ramus
    • Anterior border separated from the pubic symphysis by the deep dorsal vein (of penis/clitoris)
    • Perforated by the urethra, bulbourethral ducts (in males), and vagina (in females)
    • Also perforated by branches of internal pudendal vessels and the dorsal nerve (of penis/clitoris)

    Ischioanal Fossa

    • Walls:
      • Inferior wall: skin
      • Superomedial wall: levator ani muscle, external anal sphincter muscle
      • Lateral wall: lower part of obturator internus muscle, ischial tuberosity
    • Extends into the urogenital triangle
    • Contents: large amounts of fat, pudendal nerve and internal pudendal vessels, and inferior rectal nerve and vessels

    Superficial and Deep Perineal Pouches

    • Superficial perineal pouch:
      • Located between Colles' fascia and the perineal membrane
      • Contents: superficial perineal muscles, perineal nerve and vessels, crura of clitoris, bulbs of vestibule, and greater vestibular glands
    • Deep perineal pouch:
      • Inferior border: perineal membrane
      • Superior border: inferior fascia of the pelvic diaphragm
      • Contents: deep transverse perineal muscles, sphincter urethrae muscle (aka external urethral sphincter muscle), part of urethra, part of vagina, dorsal nerve of clitoris, and internal pudendal vessels

    Male Genitalia

    • Spermatic cord:
      • Location: begins at the deep inguinal ring, passes through the inguinal canal, and exits through the superficial inguinal ring
      • Components: vas deferens, testicular artery and vein, artery of ductus deferens, cremasteric artery, lymph vessels, and autonomic nerves of clitoris

    Female Genitalia

    • Bulbs of vestibule:
      • Erectile tissue along labia minora
      • Homologue of bulb of penis
      • Covered by bulbospongiosus muscle
      • Become enlarged with clitoris during sexual excitation
    • Greater vestibular glands:
      • Posterior ends of bulbs of vestibule
      • Homologue of bulbourethral glands
      • Secrete mucus that lubricates vulva
    • Paraurethral glands:
      • Aka Skene's glands
      • Homologue of prostate
      • Closer to lower end of urethra, mucous glands

    Pudendal Nerve

    • Branch of sacral plexus
    • Ventral rami S2-S4
    • Leaves pelvis via greater sciatic foramen, inferior to piriformis, posterior to ischial spine
    • Enters perineum via lesser sciatic foramen
    • Travels anterior in pudendal canal along lateral wall of ischioanal fossa
    • Branches as it gets to urogenital triangle, including the perineal nerve and internal pudendal vessels

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