Perenium I and II Richard J

Total Page:16

File Type:pdf, Size:1020Kb

Perenium I and II Richard J Perenium I and II Richard J. Krieg, Jr., PhD OBJECTIVE: • To gain a fundamental knowledge of the male and female perineum with respect to their gross anatomical structure, function, and clinical correlates. READING REFERENCE: • Moore & Agur, Essential Clinical Anatomy ("ECA"), pp. 248­270. LEARNING RESOURCES: • Optional films, Tapes and CDs at the Computer Based Instruction Laboratory (CBIL). I. Perineum in General The perineum is a diamond­shaped area at the base of the trunk. Fig 1 The boundaries are (ECA, Fig. 3.24): 1. Anteriorly ­ the pubic arch and pubic symphysis 2. Laterally ­ the ischial tuberosities 3. Posteriorly ­ the sacrotuberous ligament and coccyx The perineum is bisected into an anteriorly placed urogenital triangle and a posteriorly placed anal triangle by a line which passes through the ischial tuberosities (ECA, Fig. 3.24). Fig 2 II. Anal Triangle The anal triangle includes the anal canal and the ischiorectal fossae which flank either side of the anal canal. The pelvic diaphragm separates the ischiorectal fossae from the pelvis above and the anal canal below ("Levator ani" ECA, Fig. B3.8, p. 257). The pelvic diaphragm also extends into the urogenital triangle, where it is located above the urogenital diaphragm (See Figure Below and Atlas, 12 th ed.: 3.21C, 11 th ed.: 3.14D). Fig 3 A. Ischiorectal fossa This is a fat­filled space on either side of the anal canal and rectum and serves the purpose of allowing these organs to expand and contract. 1. Borders of the fossa: a. Laterally ­ obturator internus The fascia covering the obturator internus is the obturator internus fascia, and it separates the muscle from the ischiorectal fossa (ECA, Fig. 3.27B, p. 255). b. Supero­medially ­ levator ani The "infraanal fascia" or "inferior fascia of the peIvic diaphragm" covers the inferior side of the levator ani muscle and separates it from the ischiorectal fossa (“Inferior fascia of levator ani”, ECA, Fig. 3.27, p. 255). c. Anteriorly ­ the "anterior recess of the ischiorectal fossa" extends superior to the urogenital diaphragm, between itand the inferior part of the pelvic diaphragm (See Figure Below). d. Posteriorly ­ sacrotuberous ligament and the overlying gluteus maximus muscle Fig 4 2. In the fascia of the obturator internus muscle, on the lateral boundary of the ischiorectal fossa, lies the pudendal canal. This is the region in which a pudendal block would be performed. 3. The inferior rectal nerves travel right across the ischiorectal fossa to reach the lower part of the rectum and the anal canal to innervate the external sphincter of the anal canal. Severance of these nerves in this region results in incontinence. Fig 5 B. Pelvic Diaphragm (see accompanying figure; Atlas, 12 th ed.: 3.9, 3.10, 11 th ed.: 3.4) The pelvic diaphragm is made up of two muscles: the levator ani and the coccygeus. 1. The levator ani arises in part from the pubis as the puboccygeus muscle. The puborectalis muscle is a bundle that passes around the rectum to form the puborectalis sling. This sling is important to the support of the rectum and anal canal, and assists the external anal sphincter muscle to control the passage of feces. In the male, part of the pubococcygeus also supports the prostate gland and can thus be termed the levator prostatae. In the female, the pubococcygeus contacts the vagina and can act as a vaginal sphincter. Part of the pubococcygeus is also thought to control the passage of urine, such that micturation requires the relaxation of this pubovesicalis muscle and the specific urethral sphincter (to be seen later in the deep perineal pouch). Fig 6 The other part of the levator ani is the iliococcygeus muscle which arises from the arcus tendineus and the spine of the ischium. The arcus tendineus is a thickening of the fascia of the obturator intemus which is located superior to the pudendal canal. 2. The coccygeus muscle (ischiococcygeus) is not part of the levator ani, but is part of the pelvic diaphragm. It extends from the ischial spine to the lower sacrum and coccyx. The muscle is covered externally by the sacrospinous ligament. 3. As the lower part of the large intestine passes through the pelvic diaphragm it abruptly changes course from an infero­anterior direction to a downward or even infero­posterior direction. This perineal flexure marks the transition from rectum to anal canal. C. Anal sphincters The external anal sphincter (Atlas, 12 th ed.: 3.51, 11 th ed.: 3.44) is classically considered to have three parts: subcutaneus, superficial, and deep. The deep part of the external anal sphincter is the most important sphincter of the three, and acts with the puborectalis muscle to maintain anal continence. The superficial part of the external anal sphincter attaches posteriorly to the coccyx and anteriorly to the perineal body to anchor the anus. Just posterior to the rectum, the ischiorectal fossae from either side are continuous with each other such that an infection of the fossae can assume a horseshoe shape. The area through which the fossae connect posteriorly is between the superficial and deep parts of the external anal sphincter. The external anal sphincter is supplied mainly by the inferior rectal nerve, but the anterior part of the muscle may be innervated by the perineal branch of the pudendal nerve. Fig 7 The internal anal sphincter is simply the circular muscular coat of the wall of the large intestine. D. Internal structure of the anal canal The anal columns are located at the upper end of the anal canal. The bases of the anal columns are connected by anal valves (See Figure Below). The line formed by the anal valves (and the bases of the anal columns) is called the pectinate or dentate line. This is an important landmark which will separate internal from external hemorrhoids. The pectinate line is located approximately 1­5 centimeters from the anal opening. Below the pectinate line is the "pecten”. At this "mucocutaneous line" a transition takes place involving epithelium, innervation, and venous and lymphatic drainage. Fig 8 E. Blood supply of the rectum and anal canal (Atlas, 12 th ed.: 3.17A, 11 th ed.: 3.10) 1. Superior rectal artery and vein from the inferior mesenteric artery and vein 2. Middle rectal artery and vein from the internal iliac artery and vein 3. Inferior rectal artery and vein from the internal pudendal artery and vein Since the middle rectal vein drains the muscular coat of the rectum, it is usually not involved in the development of hemorrhoids. The superior rectal vein drains the mucosa superior to the pecten and the inferior rectal vein drains the mucosa inferior to this area. Due to the lack of muscular tissue support for these very superficial veins, the superior and inferior rectal veins are commonly involved in hemorrhoids. Fig 9 In general, internal hemorrhoids are located superior to the pectinate line and involve the superior rectal vein, and external hemorrhoids are inferior to the pectinate line and involve the inferior rectal vein. Internal hemorrhoids are the most common due to the number of factors that make the superior rectal vein more prone to varicosities. Since the superior rectal vein drains into the inferior mesenteric vein and subsequently into the hepatic portal system, and since the inferior rectal vein drains into the internal pudendal vein, then the internal iliac vein and eventually into the inferior vena cava, the abundant anastomoses between these vessels in the mucosa of the anal canal act as one of the more significant sites of porta­ caval anastomoses. III. The Male Urogenital Region A. Fascia 1. Superficial fascia The membranous layer of the superficial fascia of the abdomen (Scarpa’s fascia) forms the superficial fascia of the perineum ­ Colles' fascia (See Figure Below). It also forms the dartos tunic of the scrotum (See Figure Below). It attaches to the fascia lata laterally, to the ischiopubic rami, and to the posterior edge of the perineal membrane to enclose the superficial perineal pouch. Fig 10 2. Deep fascia a. The perineal membrane is one of two membranes which enclose the deep perineal pouch. The two layers are also more simply termed the inferior and superior fascias of the urogenital diaphragm (perineal membrane & pelvic fascia, respectively ­ See Figure Below Fig 11 b. Deep fascia of the penis (ECA, figure 3.25A) ­ Buck's fascia This fascia is closely applied to the penis, deep to the superficial fascia. It covers the shaft and root of the penis. B. Superficial perineal pouch 1. As mentioned above, the superficial perineal pouch is formed by the superficial perineal fascia (Colles' fascia) as a continuation of Scarpa's fascia, and finally attaches at the posterior edge of the urogenital diaphragm. 2. The contents of the pouch in the male are: a. Bulb of the penis with bulbospongiosus muscle b. Crura of the penis with ischiocavernosus muscles c. Superficial transverse perinei muscles (ECA, Fig. 3.31A, Atlas, 12 th ed.: 3.51, 11 th ed.: 3.44) d. Perineal branch of the pudendal nerve e. Posterior scrotal and muscular branches of the perineal nerve (ECA, Fig. 3.31A, Atlas, 12 th ed.: 3.51, 11 th ed.: 3.44) f. Perineal and posterior scrotal arteries (Atlas, 12 th ed.: 3.51, 11 th ed.: 3.44) Fig 12 Fig 13 Fig 14 C. Deep perineal pouch 1. The deep perineal pouch is formed by the inferior and superior fascias of the urogenital diaphram. 2. The contents of the deep perineal pouch of the male include: a. Deep transverse perinei muscles b. Sphincter urethrae muscle c. Membranous urethra d. Dorsal nerve of the penis (ECA, Fig.
Recommended publications
  • The Anatomy of the Rectum and Anal Canal
    BASIC SCIENCE identify the rectosigmoid junction with confidence at operation. The anatomy of the rectum The rectosigmoid junction usually lies approximately 6 cm below the level of the sacral promontory. Approached from the distal and anal canal end, however, as when performing a rigid or flexible sigmoid- oscopy, the rectosigmoid junction is seen to be 14e18 cm from Vishy Mahadevan the anal verge, and 18 cm is usually taken as the measurement for audit purposes. The rectum in the adult measures 10e14 cm in length. Abstract Diseases of the rectum and anal canal, both benign and malignant, Relationship of the peritoneum to the rectum account for a very large part of colorectal surgical practice in the UK. Unlike the transverse colon and sigmoid colon, the rectum lacks This article emphasizes the surgically-relevant aspects of the anatomy a mesentery (Figure 1). The posterior aspect of the rectum is thus of the rectum and anal canal. entirely free of a peritoneal covering. In this respect the rectum resembles the ascending and descending segments of the colon, Keywords Anal cushions; inferior hypogastric plexus; internal and and all of these segments may be therefore be spoken of as external anal sphincters; lymphatic drainage of rectum and anal canal; retroperitoneal. The precise relationship of the peritoneum to the mesorectum; perineum; rectal blood supply rectum is as follows: the upper third of the rectum is covered by peritoneum on its anterior and lateral surfaces; the middle third of the rectum is covered by peritoneum only on its anterior 1 The rectum is the direct continuation of the sigmoid colon and surface while the lower third of the rectum is below the level of commences in front of the body of the third sacral vertebra.
    [Show full text]
  • Anatomical Planes in Rectal Cancer Surgery
    DOI: 10.4274/tjcd.galenos.2019.2019-10-2 Turk J Colorectal Dis 2019;29:165-170 REVIEW Anatomical Planes in Rectal Cancer Surgery Rektum Kanser Cerrahisinde Anatomik Planlar Halil İbrahim Açar, Mehmet Ayhan Kuzu Ankara University Faculty of Medicine, Department of General Surgery, Ankara, Turkey ABSTRACT This review outlines important anatomical landmarks not only for rectal cancer surgery but also for pelvic exentration. Keywords: Anorectal anatomy, pelvic anatomy, surgical anatomy of rectum ÖZ Pelvis anatomisini derleme halinde özetleyen bu makale rektum kanser cerrahisi ve pelvik ezantrasyon için önemli topografik noktaları gözden geçirmektedir. Anahtar Kelimeler: Anorektal anatomi, pelvik anatomi, rektumun cerrahi anatomisi Introduction Surgical Anatomy of the Rectum The rectum extends from the promontory to the anal canal Pelvic Anatomy and is approximately 12-15 cm long. It fills the sacral It is essential to know the pelvic anatomy because of the concavity and ends with an anal canal 2-3 cm anteroinferior intestinal and urogenital complications that may develop to the tip of the coccyx. The rectum contains three folds in after the surgical procedures applied to the pelvic region. the coronal plane laterally. The upper and lower are convex The pelvis, encircled by bone tissue, is surrounded by the to the right, and the middle is convex to the left. The middle main vessels, ureters, and autonomic nerves. Success in the fold is aligned with the peritoneal reflection. Intraluminal surgical treatment of pelvic organs is only possible with a projections of the lower boundaries of these folds are known as Houston’s valves. Unlike the sigmoid colon, taenia, good knowledge of the embryological development of the epiploic appendices, and haustra are absent in the rectum.
    [Show full text]
  • Rectum & Anal Canal
    Rectum & Anal canal Dr Brijendra Singh Prof & Head Anatomy AIIMS Rishikesh 27/04/2019 EMBRYOLOGICAL basis – Nerve Supply of GUT •Origin: Foregut (endoderm) •Nerve supply: (Autonomic): Sympathetic Greater Splanchnic T5-T9 + Vagus – Coeliac trunk T12 •Origin: Midgut (endoderm) •Nerve supply: (Autonomic): Sympathetic Lesser Splanchnic T10 T11 + Vagus – Sup Mesenteric artery L1 •Origin: Hindgut (endoderm) •Nerve supply: (Autonomic): Sympathetic Least Splanchnic T12 L1 + Hypogastric S2S3S4 – Inferior Mesenteric Artery L3 •Origin :lower 1/3 of anal canal – ectoderm •Nerve Supply: Somatic (inferior rectal Nerves) Rectum •Straight – quadrupeds •Curved anteriorly – puborectalis levator ani •Part of large intestine – continuation of sigmoid colon , but lacks Mesentery , taeniae coli , sacculations & haustrations & appendices epiploicae. •Starts – S3 anorectal junction – ant to tip of coccyx – apex of prostate •12 cms – 5 inches - transverse slit •Ampulla – lower part Development •Mucosa above Houstons 3rd valve endoderm pre allantoic part of hind gut. •Mucosa below Houstons 3rd valve upto anal valves – endoderm from dorsal part of endodermal cloaca. •Musculature of rectum is derived from splanchnic mesoderm surrounding cloaca. •Proctodeum the surface ectoderm – muco- cutaneous junction. •Anal membrane disappears – and rectum communicates outside through anal canal. Location & peritoneal relations of Rectum S3 1 inch infront of coccyx Rectum • Beginning: continuation of sigmoid colon at S3. • Termination: continues as anal canal, • one inch below
    [Show full text]
  • Gross Anatomical Studies on the Arterial Supply of the Intestinal Tract of the Goat
    IOSR Journal of Agriculture and Veterinary Science (IOSR-JAVS) e-ISSN: 2319-2380, p-ISSN: 2319-2372. Volume 10, Issue 1 Ver. I (January. 2017), PP 46-53 www.iosrjournals.org Gross Anatomical Studies on the Arterial Supply of the Intestinal Tract of the Goat Reda Mohamed1, 2*, ZeinAdam2 and Mohamed Gad2 1Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, University of the West Indies, Trinidad and Tobago. 2Anatomy and Embryology Department, Faculty of Veterinary Medicine, Beni Suef University Egypt. Abstract: The main purpose of this study was to convey a more precise explanation of the arterial supply of the intestinal tract of the goat. Fifteen adult healthy goats were used. Immediately after slaughtering of the goat, the thoracic part of the aorta (just prior to its passage through the hiatus aorticus of the diaphragm) was injected with gum milk latex (colored red) with carmine. The results showed that the duodenum was supplied by the cranial pancreaticoduodenal and caudal duodenal arteries. The jejunum was supplied by the jejunal arteries. The ileum was supplied by the ileal; mesenteric ileal and antimesenteric ileal arteries. The cecum was supplied by the cecal artery. The ascending colon was supplied by the colic branches and right colic arteries. The transverse colon was supplied by the middle colic artery. The descending colon was supplied by the middle and left colic arteries. The sigmoid colon was supplied by the sigmoid arteries. The rectum was supplied by the cranial; middle and caudal rectal arteries. Keywords: Anatomy,Arteries, Goat, Intestine I. Introduction Goats characterized by their high fertility rate and are of great economic value; being a cheap meat, milk and some industrial substances.
    [Show full text]
  • MALE REPRODUCTIVE SYSTEM Male ReproducVe System
    Human Anatomy Unit 3 MALE REPRODUCTIVE SYSTEM Male Reproducve System • Gonads = testes – primary organ responsible for sperm producon – development/ maintenance of secondary sex characteriscs • Gametes = sperm Male Reproducve System Anatomy of the Testes • Tunica albuginea • Seminiferous tubules – highly coiled – sealed by the blood tess barrier – Site of sperm producon • located in tescular lobules Anatomy of the Testes Histology of the Testes • Intersal cells of Leydig – Intersal endocrinocytes – Located between seminiferous tubules – testosterone • Sertoli cells – Nursing cells or sustentacular cells – form the blood tess barrier – support sperm development Development of Sperm • Sperm formed by two processes – meiosis • Cell division resulng in cells with genecally varied cells with only one complete set of DNA (remember…our cells have two complete sets!) – spermatogenesis • morphological changes as sperm develop in tubule system • 64 days in humans – Can survive 3 days in female reproducve tract Development of Sperm The Long and Winding Road… • Seminiferous tubules • Rete tess • Epididymis • Vas deferens • Ejaculatory duct • Prostac urethra • Membranous urethra • Penile urethra The Epididymis • Sperm “swim school” • Comma shaped organ that arches over the posterior and lateral side of the tess • Stores spermatozoa unl ejaculaon or absorpon • Sperm stored for up to 2 weeks Vas Deferens • Extends from the epididymis • Passes posterior to the urinary bladder • Meets the spermac blood vessels to become the spermac cord • Enters
    [Show full text]
  • 1 Male Checklist Male Reproductive System Components of the Male
    Male Checklist Male Reproductive System Components of the male Testes; accessory glands and ducts; the penis; and reproductive system the scrotum. Functions of the male The male reproductive system produces sperm cells that reproductive system can be transferred to the female, resulting in fertilization and the formation of a new individual. It also produces sex hormones responsible for the normal development of the adult male body and sexual behavior. Penis The penis functions as the common outlet for semen (sperm cells and glandular secretions) and urine. The penis is also the male copulatory organ, containing tissue that can fill with blood resulting in erection of the penis. Prepuce A fold of skin over the distal end of the penis. Circumcision is the surgical removal of the prepuce. Corpus spongiosum A spongy body consisting of erectile tissue. It surrounds the urethra. Sexual excitement can cause erectile tissue to fill with blood. As a result, the penis becomes erect. Glans penis The expanded, distal end of the corpus spongiosum. It is also called the head of the penis. Bulb of the penis The proximal end of the corpus spongiosum. Bulbospongiosus muscle One of two skeletal muscles surrounding the bulb of the penis. At the end of urination, contraction of the bulbospongiosus muscles forces any remaining urine out of the urethra. During ejaculation, contractions of the bulbospongiosus muscles ejects semen from the penis. Contraction of the bulbospongiosus muscles compresses the corpus spongiosum, helping to maintain an erection. Corpus cavernosum One of two spongy bodies consisting of erectile tissue that (pl., corpora cavernosa) form the sides and front of the penis.
    [Show full text]
  • Pelvic Anatomyanatomy
    PelvicPelvic AnatomyAnatomy RobertRobert E.E. Gutman,Gutman, MDMD ObjectivesObjectives UnderstandUnderstand pelvicpelvic anatomyanatomy Organs and structures of the female pelvis Vascular Supply Neurologic supply Pelvic and retroperitoneal contents and spaces Bony structures Connective tissue (fascia, ligaments) Pelvic floor and abdominal musculature DescribeDescribe functionalfunctional anatomyanatomy andand relevantrelevant pathophysiologypathophysiology Pelvic support Urinary continence Fecal continence AbdominalAbdominal WallWall RectusRectus FasciaFascia LayersLayers WhatWhat areare thethe layerslayers ofof thethe rectusrectus fasciafascia AboveAbove thethe arcuatearcuate line?line? BelowBelow thethe arcuatearcuate line?line? MedianMedial umbilicalumbilical fold Lateralligaments umbilical & folds folds BonyBony AnatomyAnatomy andand LigamentsLigaments BonyBony PelvisPelvis TheThe bonybony pelvispelvis isis comprisedcomprised ofof 22 innominateinnominate bones,bones, thethe sacrum,sacrum, andand thethe coccyx.coccyx. WhatWhat 33 piecespieces fusefuse toto makemake thethe InnominateInnominate bone?bone? PubisPubis IschiumIschium IliumIlium ClinicalClinical PelvimetryPelvimetry WhichWhich measurementsmeasurements thatthat cancan bebe mademade onon exam?exam? InletInlet DiagonalDiagonal ConjugateConjugate MidplaneMidplane InterspinousInterspinous diameterdiameter OutletOutlet TransverseTransverse diameterdiameter ((intertuberousintertuberous)) andand APAP diameterdiameter ((symphysissymphysis toto coccyx)coccyx)
    [Show full text]
  • Female Perineum Doctors Notes Notes/Extra Explanation Please View Our Editing File Before Studying This Lecture to Check for Any Changes
    Color Code Important Female Perineum Doctors Notes Notes/Extra explanation Please view our Editing File before studying this lecture to check for any changes. Objectives At the end of the lecture, the student should be able to describe the: ✓ Boundaries of the perineum. ✓ Division of perineum into two triangles. ✓ Boundaries & Contents of anal & urogenital triangles. ✓ Lower part of Anal canal. ✓ Boundaries & contents of Ischiorectal fossa. ✓ Innervation, Blood supply and lymphatic drainage of perineum. Lecture Outline ‰ Introduction: • The trunk is divided into 4 main cavities: thoracic, abdominal, pelvic, and perineal. (see image 1) • The pelvis has an inlet and an outlet. (see image 2) The lowest part of the pelvic outlet is the perineum. • The perineum is separated from the pelvic cavity superiorly by the pelvic floor. • The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus muscle, and associated connective tissue. (see image 3) We will talk about them more in the next lecture. Image (1) Image (2) Image (3) Note: this image is seen from ABOVE Perineum (In this lecture the boundaries and relations are important) o Perineum is the region of the body below the pelvic diaphragm (The outlet of the pelvis) o It is a diamond shaped area between the thighs. Boundaries: (these are the external or surface boundaries) Anteriorly Laterally Posteriorly Medial surfaces of Intergluteal folds Mons pubis the thighs or cleft Contents: 1. Lower ends of urethra, vagina & anal canal 2. External genitalia 3. Perineal body & Anococcygeal body Extra (we will now talk about these in the next slides) Perineum Extra explanation: The perineal body is an irregular Perineal body fibromuscular mass.
    [Show full text]
  • 48 Anal Canal
    Anal Canal The rectum is a relatively straight continuation of the colon about 12 cm in length. Three internal transverse rectal valves (of Houston) occur in the distal rectum. Infoldings of the submucosa and the inner circular layer of the muscularis externa form these permanent sickle- shaped structures. The valves function in the separation of flatus from the developing fecal mass. The mucosa of the first part of the rectum is similar to that of the colon except that the intestinal glands are slightly longer and the lining epithelium is composed primarily of goblet cells. The distal 2 to 3 cm of the rectum forms the anal canal, which ends at the anus. Immediately proximal to the pectinate line, the intestinal glands become shorter and then disappear. At the pectinate line, the simple columnar intestinal epithelium makes an abrupt transition to noncornified stratified squamous epithelium. After a short transition, the noncornified stratified squamous epithelium becomes continuous with the keratinized stratified squamous epithelium of the skin at the level of the external anal sphincter. Beneath the epithelium of this region are simple tubular apocrine sweat glands, the circumanal glands. Proximal to the pectinate line, the mucosa of the anal canal forms large longitudinal folds called rectal columns (of Morgagni). The distal ends of the rectal columns are united by transverse mucosal folds, the anal valves. The recess above each valve forms a small anal sinus. It is at the level of the anal valves that the muscularis mucosae becomes discontinuous and then disappears. The submucosa of the anal canal contains numerous veins that form a large hemorrhoidal plexus.
    [Show full text]
  • The Reproductive System
    27 The Reproductive System PowerPoint® Lecture Presentations prepared by Steven Bassett Southeast Community College Lincoln, Nebraska © 2012 Pearson Education, Inc. Introduction • The reproductive system is designed to perpetuate the species • The male produces gametes called sperm cells • The female produces gametes called ova • The joining of a sperm cell and an ovum is fertilization • Fertilization results in the formation of a zygote © 2012 Pearson Education, Inc. Anatomy of the Male Reproductive System • Overview of the Male Reproductive System • Testis • Epididymis • Ductus deferens • Ejaculatory duct • Spongy urethra (penile urethra) • Seminal gland • Prostate gland • Bulbo-urethral gland © 2012 Pearson Education, Inc. Figure 27.1 The Male Reproductive System, Part I Pubic symphysis Ureter Urinary bladder Prostatic urethra Seminal gland Membranous urethra Rectum Corpus cavernosum Prostate gland Corpus spongiosum Spongy urethra Ejaculatory duct Ductus deferens Penis Bulbo-urethral gland Epididymis Anus Testis External urethral orifice Scrotum Sigmoid colon (cut) Rectum Internal urethral orifice Rectus abdominis Prostatic urethra Urinary bladder Prostate gland Pubic symphysis Bristle within ejaculatory duct Membranous urethra Penis Spongy urethra Spongy urethra within corpus spongiosum Bulbospongiosus muscle Corpus cavernosum Ductus deferens Epididymis Scrotum Testis © 2012 Pearson Education, Inc. Anatomy of the Male Reproductive System • The Testes • Testes hang inside a pouch called the scrotum, which is on the outside of the body
    [Show full text]
  • Anatomy of the Large Blood Vessels-Veins
    Anatomy of the large blood vessels-Veins Cardiovascular Block - Lecture 4 Color index: !"#$%&'(& !( "')*+, ,)-.*, $()/ Don’t forget to check the Editing File !( 0*"')*+, ,)-.*, $()/ 1$ ($&*, 23&%' -(0$%"'&-$(4 *3#)'('&-$( Objectives: ● Define veins, and understand the general principles of venous system. ● Describe the superior & inferior Vena Cava and their tributaries. ● List major veins and their tributaries in the body. ● Describe the Portal Vein. ● Describe the Portocaval Anastomosis Veins ◇ Veins are blood vessels that bring blood back to the heart. ◇ All veins carry deoxygenated blood. with the exception of the pulmonary veins(to the left atrium) and umbilical vein(umbilical vein during fetal development). Vein can be classified in two ways based on Location Circulation ◇ Superficial veins: close to the surface of the body ◇ Veins of the systemic circulation: NO corresponding arteries Superior and Inferior vena cava with their tributaries ◇ Deep veins: found deeper in the body ◇ Veins of the portal circulation: With corresponding arteries Portal vein Superior Vena Cava ◇Formed by the union of the right and left Brachiocephalic veins. ◇Brachiocephalic veins are formed by the union of internal jugular and subclavian veins. Drains venous blood from : ◇ Head & neck ◇ Thoracic wall ◇ Upper limbs It Passes downward and enter the right atrium. Receives azygos vein on its posterior aspect just before it enters the heart. Veins of Head & Neck Superficial veins Deep vein External jugular vein Anterior Jugular Vein Internal Jugular Vein Begins just behind the angle of mandible It begins in the upper part of the neck by - It descends in the neck along with the by union of posterior auricular vein the union of the submental veins.
    [Show full text]
  • By Dr.Ahmed Salman Assistant Professorofanatomy &Embryology My Advice to You Is to Focus on the Diagrams That I Drew
    The University Of Jordan Faculty Of Medicine REPRODUCTIVE SYSTEM By Dr.Ahmed Salman Assistant ProfessorofAnatomy &embryology My advice to you is to focus on the diagrams that I drew. These diagrams cover the Edited by Dana Hamo doctor’s ENTIRE EXPLANATION AND WHAT HE HAS MENTIONED Quick Recall : Pelvic brim Pelvic diaphragm that separates the true pelvis above and perineum BELOW Perineum It is the diamond-shaped lower end of the trunk Glossary : peri : around, ineo - discharge, evacuate Location : it lies below the pelvic diaphragm, between the upper parts of the thighs. Boundaries : Anteriorly : Inferior margin of symphysis pubis. Posteriorly : Tip of coccyx. Anterolateral : Fused rami of pubis and ischium and ischial tuberosity. Posterolateral : Sacrotuberous ligaments. Dr.Ahmed Salman • Same boundaries as the pelvic Anteriorly: outlet. inferior part of • If we drew a line between the 2 symphysis pubis ischial tuberosities, the diamond shape will be divided into 2 triangles. Anterior and Anterior and Lateral : Lateral : •The ANTERIOR triangle is called ischiopubic ischiopubic urogenital triangle ramus The perineum ramus •The POSTERIOR triangle is called has a diamond anal triangle shape. ischial tuberosity Posterior and Posterior and Lateral : Lateral : Urogenital sacrotuberous sacrotuberous tri. ligament ligament Anal tri. Posteriorly : tip of coccyx UROGENITAL TRI. ANAL TRI. Divisions of the Perineum : By a line joining the anterior parts of the ischial tuberosities, the perineum is divided into two triangles : Anteriorly :Urogenital
    [Show full text]