Anatomy Notes - Pelvis and Perineum

Anatomy Notes - Pelvis and Perineum - Anatomy Pelvis and...

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Anatomy – Pelvis and Perineum Ischioanal fossa – triangular space on each side of anal canal Side view: skin [_] – internal obturator m.[|] – levator ani m.[\] Ant. recess – ant. continuation of fossa L and R ischioanal fossa communicate via anococcygeal ligament Contents: pudendal vessels, pudendal nerve, fat Borders Superior: levator ani Inferior: skin [_] Anterior: Fascia of Colles covering Transversus perinei superficialis Inferior fascia of urogenital diaphragm Posterior: Gluteus maximus Sacrotuberous ligament Lateral Ischial tuberosity Obturator internus muscle [|] - laterally rotates the thigh Obturator fascia Medial Levator ani muscle [\] - supports and raises pelvic floor Sphincter ani externus – closes the anus Anal fascia Contents Pudendal (Alcock's) canal [lateral wall]: Internal pudendal artery + vein, pudendal nerve Outside pudendal canal: inferior rectal artery + vein, inferior anal nerves Pudendal nerve – originates in sacral plexus (ventral rami of S2-S4) Passes through greater sciatic forament b/w piriformis and coccygeus muscles Crosses ischial spine and renters pelvis through lesser sciatic foramen Accompanies internal pudendal vessels along lateral wall of ischioanal fossa in pudendal canal (contained by obturator fascia) Gives off inferior rectal nerves Splits into: Perineal nerve – deep and superficial perineal spaces Dorsal nerve of penis or clitoris Inferior rectal nerves Arise from pudendal nerve Cross ischiorectal fossa to anus; innervates sphincter ani externus and skin around anus Inferior rectal artery (<--internal pudendal artery <-- internal iliac) Pierce wall of pudendal canal, breaks into several branches which ross ischioanal fossa Distributed to muscles and skin around anal canal Sends offshoots around lower edge of gluteus maximus and skin of buttock Anastomose w/ vessels of other side, sup. + mid. rectal arteries, and perineal artery.
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