Glossary of 4-Perineum
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- Where is the perineum located?
- between upper thighs, from pubic symphysis to the tip of the coccyx
- What binds the perineum laterally?
- ischial tuberosities
- What binds the perineum posteriolaterally?
- sacrotuberal ligament attaching the sacrum to the ischial tuberosites
- What is the alternative definition of the perineum used by obsterticians?
- space limited between the vagina and anus
- What two non-parallel triangles is the perineum divided into?
- urogenital and anal triangles
- What separates the urogenital and anal triangles?
- a transverse line between the ischial tuberosities
- What is the supporting striated muscle and connective tissue membrane called that stretches between the bony elements of the urogenital triangle?
- perineal membrane or inferior fascia of urogenital diaphragm
- What is the CT membrane that attches laterally to the ischial tuberosities, ischial rami, and inferior pubic rami?
- perineal membrane (inferior fascia of urogenital diaphragm)
- Name the 2 spaces that the perineal membrane creates.
- superficial and deep spaces
- What is located superficial to the perineal membrane?
- erectile tissue and muscles of the external genitalia
- What is located deep to the perineal membrane?
- striated muscle of urethra and deep transverse perineal muscle that supports the free edge of the perineal membrane
- Where is the perineal body located?
- lies in midline immediately behind the free edge of the perineal membrane
- The integrity of the perineal body is essential for the integrity of _____.
- anal sphincter
- The superficial membranous fascia (Colle's fascia) attaches to what? What does this form?
- free edge of the perineal membrane
superficial perineal space
- What are the boundaries of the superficial perineal space?
- laterally-fascia lata of thigh
superiorly-fuses w/ dep fascia of external oblique and rectus abdominis about 1/2 way between pubic symphysis and umbilicus
- Where might a straddle injury bleed into?
- superficial perineal space
- Name the tissue layers of the urogenital triangle from superficial to deep.
- skin, subcutaneous tissue, superficial membranous fascia, investing fascia, external genitalia erectile tissue and muscles, perineal membrane, external urethral sphincter muscles, fat, superficial fascia of pelvic diaphragm
- What are the 3 parts of the superficial membranous fascia?
- Scarpa's, Dartos and Colle's fascia
- What does Scarpa's fascia cover?
- anterior abdominal wall
- What does Dartos fascia cover?
- penis and scrotum
- What is Colle's fascia located?
- in males-posterior to scrotum
- Name the erectile tissue in females? males?
- f-vestibular bulbs
m-corpus spongiosum and bulb
- What is present in the female external genitalia erectile tissue and muscle layer that is not in men?
- Greater Vestibular (Bartholin's) glands
- Name what is present in the external genitalia erectile tissue and muscle layer.
- bulbospongiosus muscle, erectile tissue, ishiocavernosus muscles on crus of clitoris or penis, superficial transverse perineal muscles, branches of internal pudendal vessels
in females only Greater Vestibular (Bartholin's) glands
- What tissue layers make up the superficial perineal space?
- investing fascia and external genitalia erectile tissue and muscle
- What tissue layers make up the deep perineal space?
- external urethral sphincter muscles and fat
- What muscles comprise the external urethral sphincter muscles?
- urethral sphincter, compressor urethra and deep transverse perineal muscles
- What forms the superficial fascia of the pelvic diaphragm?
- levator ani and coccygeus muscles
- What forms the roof of the deep perineal space?
- inferior epimysium
- What forms the anal triangle?
- ischial tuberosities and tip of cocyx
- What occurs w/ the rectum passing through the levator ani muscle?
- causes change in muscle fiber direction creating the puborectalis portion of the levator ani muscle
- What does the puborectalis muscle form? What is its function?
- puborectal sling
helps keep fecal continence, relieves pressure on anal sphincters
- What are the 3 parts of the external anal sphincter muscle? Which of these are skeletal muscle? smooth?
- deep external, superficial external and subcutaneous external sphincters
all are skeletal muscle
- What innervates the external anal sphincter? What does this nerve branch from?
- S4, inferior rectal nerve a branch off the internal pudendal nerve
- Is the internal anal sphincter above or below the pectinate line?
- What inntervates the internal anal sphincter? What type of sensations can be felt here? What does that mean for hemrroids?
- PSNS from the pelvic splanchnic nerves
stretch only, no temperature
internal hemrooids may be painless
- Why do fluids normally not move from the superficial perineal space to the deep perineal space?
- b/c of the attachment of the superficial membrane fascia to the free (posterior) edge of the perineal membrane
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