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<opml version="2.0">
  <head>
    <title>079-03 Perineum, external genitalia, internal reproductive organs, and sexual anatomy</title>
    <ownerName>Integrated Medical Foundations</ownerName>
  </head>
  <body>
    <outline text="Perineum, genitalia, and reproductive organs">
      <outline text="Perineal triangles and pouches">
        <outline text="Diamond from symphysis to coccyx"/>
        <outline text="Intertuberous line divides two triangles"/>
        <outline text="Perineal membrane spans pubic arch"/>
        <outline text="Superficial pouch: genital roots, muscles">
          <outline text="Greater vestibular glands when present"/>
        </outline>
        <outline text="Deep pouch: external urethral sphincter">
          <outline text="Bulbourethral glands in male anatomy"/>
        </outline>
        <outline text="Ischioanal fossae: fat permits anal expansion">
          <outline text="Pudendal canal in obturator fascia"/>
          <outline text="Infection crosses behind anal canal"/>
        </outline>
      </outline>
      <outline text="Perineal fascia and spread">
        <outline text="Membranous fascia continues with Scarpa, dartos">
          <outline text="Attachment below inguinal ligament spares thigh"/>
        </outline>
        <outline text="Spongy urethral rupture">
          <outline text="Urine to scrotum, penis, abdominal wall"/>
          <outline text="Not freely into thighs or anal triangle"/>
        </outline>
        <outline text="Membranous or bladder injury: deep planes"/>
        <outline text="Necrotising infection spreads along planes"/>
      </outline>
      <outline text="Erectile tissue and control">
        <outline text="Vascular spaces within tunica"/>
        <outline text="Cavernosa form crura on ischiopubic rami"/>
        <outline text="Spongiosum surrounds spongy urethra"/>
        <outline text="Clitoral corpora, vestibular bulbs"/>
        <outline text="Ischiocavernosus reduces venous outflow"/>
        <outline text="Bulbospongiosus: ejaculation, vaginal constriction"/>
        <outline text="Parasympathetic cavernous nerves">
          <outline text="Nitric oxide dilates arteries, erection"/>
        </outline>
        <outline text="Sympathetic: emission, detumescence"/>
        <outline text="Dorsal nerve somatic, autonomic nerves deeper"/>
      </outline>
      <outline text="Testes, cord, and ducts">
        <outline text="Descent through inguinal canal">
          <outline text="Coverings from abdominal wall layers"/>
          <outline text="Tunica vaginalis from processus vaginalis"/>
        </outline>
        <outline text="Tubules to rete, epididymis, ductus"/>
        <outline text="Cord contents">
          <outline text="Ilioinguinal nerve outside coverings"/>
        </outline>
        <outline text="Arteries from aorta">
          <outline text="Left vein to left renal vein"/>
          <outline text="Lymph to para-aortic nodes"/>
        </outline>
        <outline text="Ductus crosses ureter, joins seminal duct"/>
      </outline>
      <outline text="Prostate and accessory glands">
        <outline text="Surrounds proximal urethra below bladder"/>
        <outline text="Peripheral, central, transitional, anterior zones">
          <outline text="Carcinoma mostly peripheral"/>
          <outline text="Benign enlargement transitional"/>
        </outline>
        <outline text="Ejaculatory ducts open near colliculus"/>
        <outline text="Venous plexus to vertebral plexus"/>
        <outline text="Seminal glands: fructose, no sperm storage"/>
      </outline>
      <outline text="Ovaries, tubes, uterus, vagina">
        <outline text="Ovary in ovarian fossa, position varies">
          <outline text="Suspensory ligament carries ovarian vessels"/>
          <outline text="Ovarian vessels and lymph to aorta"/>
        </outline>
        <outline text="Tube: fimbriae, ampulla, isthmus">
          <outline text="Fertilisation commonly in ampulla"/>
          <outline text="Impaired transport: ectopic pregnancy"/>
        </outline>
        <outline text="Uterus commonly anteverted, anteflexed"/>
        <outline text="Broad ligament not main support">
          <outline text="Cardinal, uterosacral, floor support"/>
        </outline>
        <outline text="Uterine artery crosses above ureter"/>
        <outline text="Posterior fornix deepest"/>
        <outline text="Lower vagina somatic, upper autonomic"/>
      </outline>
      <outline text="External genitalia and glands">
        <outline text="Vulva: labia, clitoris, vestibule, glands">
          <outline text="Size and pigmentation vary widely"/>
        </outline>
        <outline text="Penis: paired cavernosa, ventral spongiosum">
          <outline text="Deep dorsal vein to prostatic plexus"/>
        </outline>
        <outline text="Cremaster via genitofemoral motor fibres"/>
        <outline text="Temperature: skin, dartos, pampiniform exchange"/>
      </outline>
      <outline text="Childbirth, surgery, and pain">
        <outline text="Birth stretches floor and perineal body">
          <outline text="Nerves, levator, sphincter may tear"/>
          <outline text="Repair identifies sphincter, rectal injury"/>
        </outline>
        <outline text="Hysterectomy risks ureter"/>
        <outline text="Prostate, rectal surgery risk cavernous nerves"/>
        <outline text="Node dissection risks obturator nerve"/>
        <outline text="Perineal pain has many sources">
          <outline text="Localise by organ, not gender"/>
        </outline>
      </outline>
    </outline>
  </body>
</opml>
