Podcast
Questions and Answers
What is the structure that defines the superior boundary of the perineum?
What is the structure that defines the superior boundary of the perineum?
- Perineal body
- Superior perineal fascia (correct)
- Perineal membrane
- Deep perineal fascia
Which of the following structures is NOT a component of the deep pouch in females?
Which of the following structures is NOT a component of the deep pouch in females?
- Bulbourethral glands (correct)
- Compressor urethrae
- External urethral sphincter
- Sphincter urethrovaginalis
Which muscle is associated with the deep pouch in both males and females?
Which muscle is associated with the deep pouch in both males and females?
- Ischiocavenosus
- Sphincter urethrae
- Bulbospongiosus
- Deep transverse perineal muscle (correct)
What is the role of the perineal membrane in the urogenital triangle?
What is the role of the perineal membrane in the urogenital triangle?
Which structure is specifically associated with the male reproductive system?
Which structure is specifically associated with the male reproductive system?
Which erectile tissue is common to both males and females?
Which erectile tissue is common to both males and females?
What layer of fascia is derived from the deep investing fascia of the anterior abdominal muscles?
What layer of fascia is derived from the deep investing fascia of the anterior abdominal muscles?
Which of the following structures is included in the superficial pouch of the perineum for both genders?
Which of the following structures is included in the superficial pouch of the perineum for both genders?
What structure do the dorsal nerves travel along in both males and females?
What structure do the dorsal nerves travel along in both males and females?
Which fascia invests the dorsal nerves in the male?
Which fascia invests the dorsal nerves in the male?
Which type of nerve provides motor and sensory innervation to the perineum?
Which type of nerve provides motor and sensory innervation to the perineum?
Where do the pelvic splanchnic nerves derive their preganglionic parasympathetic fibers from?
Where do the pelvic splanchnic nerves derive their preganglionic parasympathetic fibers from?
Which structure provides sympathetic innervation to the erectile tissues?
Which structure provides sympathetic innervation to the erectile tissues?
The deep clitoral fascia in females corresponds to which fascia in males?
The deep clitoral fascia in females corresponds to which fascia in males?
What type of nerves contribute to the autonomic input to erectile tissues?
What type of nerves contribute to the autonomic input to erectile tissues?
What is the role of the inferior hypogastric plexus in the genital innervation?
What is the role of the inferior hypogastric plexus in the genital innervation?
What is the primary muscular structure that constitutes the deep pouch of the urogenital triangle?
What is the primary muscular structure that constitutes the deep pouch of the urogenital triangle?
What structure anchors the posterior border of the urogenital diaphragm?
What structure anchors the posterior border of the urogenital diaphragm?
Which of the following structures is located inferior to the deep transverse perineal muscle?
Which of the following structures is located inferior to the deep transverse perineal muscle?
Which anatomical feature acts as the anterior boundary of the deep pouch of the urogenital diaphragm?
Which anatomical feature acts as the anterior boundary of the deep pouch of the urogenital diaphragm?
What is the function of the perineal membrane in relation to the urogenital diaphragm?
What is the function of the perineal membrane in relation to the urogenital diaphragm?
What describes the urogenital triangle in relation to the anal triangle?
What describes the urogenital triangle in relation to the anal triangle?
What forms the deep compartment of the urogenital triangle?
What forms the deep compartment of the urogenital triangle?
Which ligament connects the anal canal to the coccyx?
Which ligament connects the anal canal to the coccyx?
What is another name for the deep penile fascia?
What is another name for the deep penile fascia?
Which fascia is found in the male perineum and lacks adipose tissue?
Which fascia is found in the male perineum and lacks adipose tissue?
How do the superficial and deep perineal fascia relate in terms of infections or fluid accumulation?
How do the superficial and deep perineal fascia relate in terms of infections or fluid accumulation?
What structure attaches the superficial perineal fascia to the inferior margins of the ischiopubic rami?
What structure attaches the superficial perineal fascia to the inferior margins of the ischiopubic rami?
What is the primary composition of Dartos fascia?
What is the primary composition of Dartos fascia?
What happens if there is a laceration of the anterior abdominal wall?
What happens if there is a laceration of the anterior abdominal wall?
What distinct feature do Colle's and Dartos fascia have in regards to their attachment?
What distinct feature do Colle's and Dartos fascia have in regards to their attachment?
Which fascia is responsible for investing the erectile tissues of the clitoris?
Which fascia is responsible for investing the erectile tissues of the clitoris?
What is the primary function of the cavernous nerves?
What is the primary function of the cavernous nerves?
Which arteries supply the deep structures of the perineum?
Which arteries supply the deep structures of the perineum?
What branch does the internal pudendal artery give off in the ischioanal fossa?
What branch does the internal pudendal artery give off in the ischioanal fossa?
Where does the deep artery of the penis/clitoris supply blood?
Where does the deep artery of the penis/clitoris supply blood?
What is the relationship between the names of branches of the internal pudendal veins and the corresponding arteries?
What is the relationship between the names of branches of the internal pudendal veins and the corresponding arteries?
Which of the following nerves pierces the pelvic diaphragm?
Which of the following nerves pierces the pelvic diaphragm?
How do the right and left internal pudendal arteries function after piercing the UG diaphragm?
How do the right and left internal pudendal arteries function after piercing the UG diaphragm?
What is the exception in venous return from the erectile tissues?
What is the exception in venous return from the erectile tissues?
What is the primary artery supplying blood to the clitoris?
What is the primary artery supplying blood to the clitoris?
Which structures are located in the anal triangle?
Which structures are located in the anal triangle?
What forms the roof of the ischioanal fossa?
What forms the roof of the ischioanal fossa?
In which direction does the deep dorsal vein of the clitoris travel after passing through the hiatus?
In which direction does the deep dorsal vein of the clitoris travel after passing through the hiatus?
What is the function of the ischioanal fat pad within the anal triangle?
What is the function of the ischioanal fat pad within the anal triangle?
Which nerve is responsible for innervating the structures associated with the perineum?
Which nerve is responsible for innervating the structures associated with the perineum?
How do the branches of the nerves supplying the clitoris terminate?
How do the branches of the nerves supplying the clitoris terminate?
Which of the following best describes the location of the anal triangle?
Which of the following best describes the location of the anal triangle?
Flashcards
Urogenital Diaphragm
Urogenital Diaphragm
A muscular diaphragm that lies within the urogenital triangle, forming the deep compartment and contributing to the support of the pelvic floor.
Perineal Membrane
Perineal Membrane
A fibrous sheet that lies inferior to the deep transverse perineal muscle and contributes to the integrity of the urogenital diaphragm.
Perineal Body
Perineal Body
A thickened midline tendon that anchors the posterior border of the urogenital diaphragm, connecting it to the anal canal and coccyx.
Deep Compartment (of the Urogenital Triangle)
Deep Compartment (of the Urogenital Triangle)
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Superficial Compartment (of the Urogenital Triangle)
Superficial Compartment (of the Urogenital Triangle)
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Anal Triangle
Anal Triangle
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Ischioanal Fat Pad
Ischioanal Fat Pad
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Ischioanal Fossa
Ischioanal Fossa
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Perineum
Perineum
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Urogenital Triangle
Urogenital Triangle
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Deep Perineal Pouch
Deep Perineal Pouch
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Superficial Perineal Pouch
Superficial Perineal Pouch
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Gallaudet's Fascia
Gallaudet's Fascia
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Deep Penile Fascia (Buck's Fascia)
Deep Penile Fascia (Buck's Fascia)
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Superficial Perineal Fascia (Colle's and Dartos)
Superficial Perineal Fascia (Colle's and Dartos)
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Dartos Fascia
Dartos Fascia
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Perineal Fluid Accumulation
Perineal Fluid Accumulation
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Fluid Flow Pathway in Perineum
Fluid Flow Pathway in Perineum
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Superficial Pouch Attachments
Superficial Pouch Attachments
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Dorsal Nerves of Penis/Clitoris
Dorsal Nerves of Penis/Clitoris
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Deep Clitoral Fascia
Deep Clitoral Fascia
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Pudendal Nerve
Pudendal Nerve
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Cavernous Nerves
Cavernous Nerves
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Pelvic Splanchnic Nerves
Pelvic Splanchnic Nerves
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Sacral Splanchnic Nerves
Sacral Splanchnic Nerves
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Inferior Hypogastric Plexus
Inferior Hypogastric Plexus
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Deep Artery of the Penis/Clitoris
Deep Artery of the Penis/Clitoris
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Dorsal Artery of the Penis/Clitoris
Dorsal Artery of the Penis/Clitoris
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Internal Pudendal Artery and its Branches
Internal Pudendal Artery and its Branches
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Internal Pudendal Artery and Pudendal Nerve Pathways
Internal Pudendal Artery and Pudendal Nerve Pathways
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Internal Pudendal Artery
Internal Pudendal Artery
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Cavernous Nerves and Muscle Piercing
Cavernous Nerves and Muscle Piercing
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Internal Pudendal Veins and Venous Return
Internal Pudendal Veins and Venous Return
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Internal Pudendal Artery and Compartments of the Urogenital Triangle
Internal Pudendal Artery and Compartments of the Urogenital Triangle
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What is the Anal Triangle?
What is the Anal Triangle?
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What is the ischioanal fossa?
What is the ischioanal fossa?
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What is the ischioanal fat pad?
What is the ischioanal fat pad?
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What is the levator ani muscle?
What is the levator ani muscle?
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What is the pudendal canal?
What is the pudendal canal?
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What is the pelvic diaphragm?
What is the pelvic diaphragm?
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What does the pudendal nerve supply?
What does the pudendal nerve supply?
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What do the internal pudendal artery and vein supply?
What do the internal pudendal artery and vein supply?
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Study Notes
Perineum Course Learning Objectives
- Describe normal anatomy of the male and female perineum
- Describe the bones forming the skeleton
- Recall the muscles and coverings of the perineum
- Describe the nerves innervating structures
- Describe arterial supply and venous drainage
- Describe skin, joints, and tissues
- Detail compartments, spaces, and transition areas
- Describe glands and organs
- Outline anatomical relationships of all structures
Relating Anatomy to Function
- Relate bone anatomy to structural attachments and functions
- Describe muscle anatomy in terms of actions on structures
- Relate nerve anatomy to innervation of structures
- Correlate vessel anatomy to structures supplied or drained
- Relate connective tissue anatomy to attachment functions
- Explain compartment, space, and transition area functions related to connective tissue
- Describe gland and organ anatomy related to visceral functions
Applying Anatomical Knowledge to Problems
- Apply anatomy to evaluating deficits of nerve lesions
- Apply anatomy to evaluating effects of tissue damage/pathology
- Apply anatomy to evaluating clinical approaches and procedures
- Apply anatomy to evaluating radiological images
Perineum Session Outline
- Describe the boundaries and subdivisions of the perineum (urogenital and anal triangles)
- Compartmentalization of the urogenital triangle (deep and superficial compartments)
- Describe male external genitalia (scrotum and penis) including function, innervation, blood supply and venous return
- Describe female external genitalia (components of the pudendum) including innervation, blood supply and venous return
- Review the anal triangle, its boundaries, and contents (ischioanal fossa)
- Clinical relevance (pudendal nerve block, episiotomy, damage to male urethra)
The Perineum: Deep and Superficial Pouches/Compartments
- Deep pouch/compartment comprises the urogenital diaphragm
- This structure is attached laterally along the ischiopubic rami, bridges the urogenital triangle
- Contains the deep transverse perineal muscle and associated fibers contributing to the urethra in both male and female
- Perineal membrane is located inferior to the deep transverse perineal muscle
- It is a tough sheet maintaining the integrity of the urogenital diaphragm
Male and Female External Genitalia
- Identify male components and their functions (scrotum, penis, corpora cavernosa, corpus spongiosum)
- Identify female components and their functions (mons pubis, labia majora, labia minora, clitoris, vestibular bulbs, greater vestibular glands)
- Describe the innervation, blood supply, and venous return
The Anal Triangle
- Outline the boundaries of the anal triangle
- Detail the contents of the ischioanal fossa (pudendal canal, nerves, blood vessels, ischioanal fat pad)
Clinical Relevance
- Briefly describe pudendal nerve blocks, episiotomies, and damage to male urethra (anterior and posterior urethral injuries)
- Mention intercourse-related traumas (to the corpora cavernosa and distal penile urethra).
Fascia Layers Defining the Perineum
- Deep perineal fascia (Gallaudet's fascia)
- Invests the erectile muscle tissues, attaching to posterior perineal membrane and ischiopubic rami
- Superficial perineal fascia (Colle's fascia)
- Overlies scrotum (with Dartos fascia inside), anteriorly joins Scarpa's fascia
Blood Supply
- Internal pudendal artery branches provide blood to deep perineal structures
- Inferior rectal artery and branches supply structures within the anal triangle
- Dorsal arteries of the penis/clitoris supply erectile tissues
- Describe venous return paths, largely following the arterial routes and eventually draining into the pelvic plexus.
Venous Return
- Deep dorsal vein (male/female)
- External and internal pudendal veins empty into systemic venous system
Female External Genitalia
- Identify component parts (and briefly describe their roles) of the pudendum:
- Mons pubis, labia majora, labia minora, clitoris, vestibule, and bulbs of the vestibule
- Greater vestibular glands
The Anal Triangle (and Ischioanal Fossa)
- Describe the ischioanal fossa
- Its boundaries and contents (ischioanal fat pad): how this tissue maintains the structure of the anal canal
Clinical Relevance (cont'd)
- Mention intercourse-related traumas to the corpora cavernosa and distal penile urethra, and the potential for hematoma formation. Also reference trauma damage to the bulbar/penile urethra, including "Straddle injuries"
Innervation of the Perineum
- Note the pudendal nerve is mostly responsible for the perineum's innervation
- It arises from the sacral plexus (S2-S4) and travels via the greater/lesser sciatic foramina, emerging into the perineum
- Identify the pudendal canal's role
- Understand the distal branches of the Pudendal nerve; the perineal nerve, deep perineal nerve, and dorsal nerves of the penis/clitoris
- Note the sensory and motor functions of the different branches (e.g., sensory to skin, and/or motor to muscles).
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