External Genitalia and Perineum

Prostate, Cowper’s glands, Penile urethral glands

These are common sites of gonococcal infection in males

Bulbar urethra

This is a common site of chronic infection and stricture formation in males

T

T/F: Females have a higher risk of having an ascending urethral infection

Low vaginal pH

This characteristic of the vagina helps it resist infection

Stratified squamous non-keratinizing

What epithelium lines the vagina

Chadwick’s sign

This is a non-specific, early sign of pregnancy when the vagina looks bluish due to venous congestion

8-12 weeks

When does the chadwick’s sign typically occur in pregnancy

Uterine prolapse

Long-term sequela of weakened pelvic floor secondary to multiple childbirths

Episiotomy

This is an incision made to prevent lacerations during childbirth

Size of perineal body

What is the basis of doing a midline incision vs a mediolateral incision in an episiotomy

Fecal incontinence and Anal prolapse

Long term sequela of unrepaired anal sphincter

Hymen

Structure that guides the vaginal orifice

Myrtiform caruncle

The remnants of the hymen are identified as what structure?

Imperforate hymen

This type of hymen could lead to primary amenorrhea

Anterior perineum

Sensation of which area remains when doing a pudendal nerve block

Puborectalis

Rectal prolapse can be treated by restoring the anorectal angle by tightening what structure?

Straddle injury

This type of injury is seen usually as a hematoma secondary to direct trauma to the labia majora

Lateral decubitus

What position are males put in when doing an anorectal exam

Dorsal lithotomy

What position are females put in when doing an anorectal exam

Superior rectal vein

Internal hemorrhoids involve what vein?

Inferior rectal vein

External hemorrhoids involve what vein?

T

T/F: Internal hemorrhoid can progress to an external hemorrhoid when not treated immediately

F; Opposite

T/F: Internal hemorrhoids are painful while external hemorrhoids are painless

11, 3, and 7 o’ clock positions

Common positions of internal hemorrhoids

Lower anal canal (Posterior and mid-line)

Common site of anal fissures

Submucous

What type of abscess is caused by fecal trauma to the mucosa

Subcutaneous

What type of abscess is caused by fecal trauma beneath the perianal skin

Ischioanal

What type of abscess is caused by fecal trauma occupying the ischioanal fossa

Horseshoe

What type of abscess is caused by a large ischioanal abscess that invades the contralateral side

Pelvirectal

What type of abscess is caused by fecal trauma between the ampulla of the rectum and upper surface of the levator ani

Inferior rectal and Perineal branch of S4

What nerves are blocked when doing an anal sphincter block

1st

What degree is the perineal laceration if it reaches up to the skin and fascia

2nd

What degree is the perineal laceration if it reaches up to the muscles

3rd

What degree is the perineal laceration if it reaches up to the anal sphincter

4th

What degree is the perineal laceration if it reaches up to the rectum