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ANAT 1625 Lecture Notes - Perineum

ANAT 1625 Lecture Notes - Perineum - 1 Perineum Perineum...

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Perineum Perineum lies inferior to the pelvic outlet and is separated from the pelvic cavity by the pelvic diaphragm Pelvic diaphragam 1. levator ani 2. coccygeus Boundaries of the perineum anterior – pubic symphysis anterolateral – a) inferior ramus of pubis b) ramus of ischium posterolateral – sacrotuberous ligament inferior – a) sacrum b) coccyx It is divided into two triangles by an imaginary line joining the anterior ends of the two ischial tuberosities 1. urogenital triangle lies anterior to this line, contains two spaces – superficial and deep perineal pouches Contents of the urogenital triangle a) root of the scrotum in male b) penis in male c) external genitalia in female 2. anal triangle lies posterior to this line, contains the anus Perineal body Lies in the central point of the perineum, midpoint of the line joining the ischial tuberosities It is an irregular fibromuscular mass located in the median plane between the anal canal and the perineal membranegivers attachment of perineal muscles It lies deep to the skin and subcutaneous tissue, posterior to the vestibule of the vagina in female or bulb of the penis in male and anterior to the anus and anal canal It is the central tendon of perineum, gives attachment to the perineal muscles It contains 1 1
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1. collagenous fibers 2. elastic fibers 3. skeletal muscle 4. smooth muscle Muscles attached to the perineal body 1. bulbospongiosus 2. external anal sphincter 3. superficial transverse perineal 4. deep transverse perineal Perineal membrane is a thin sheet of tough deep fascia, ,stretches between the two sides of pubic arch and covers the anterior part of the pelvic outlet Immediately superior to the perineal membrane is the deep transverse perineal muscle Above the center of the perineal membrane is the external urethral sphincter muscle Perineal fascia consists of superficial and deep layers 1. superficial is the subcutaneous tissue of the perineum a) fatty layer b) membranous layer 2. deep invests the ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles Superficial perineal pouch is a potential space between the membranous layer of the subcutaneous tissue and the perineal membrane Contents in male 1. root of the penis with the bulb and the two crura 2. two muscles, bulbospongiosus and ischiocavernosus 3. proximal part of the spongy urethra 4. superficial transverse perineal muscle 5. branches of internal pudendal vessels 6. branches of pudendal nerve In female 1. root / crura of the clitoris 2. ischiocavernosus 3. bulb of the vestibule 4. bulbospongiosus 5. superficial transverse perineal muscle 6. branches of internal pudendal vessels 7. branches of pudendal nerve 8. greater vestibular glands 2 2
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Deep perineal pouch Is open superiorly, bounded below by the perineal membrane Contents of the deep perineal pouch In male 1. membranous part of the urethra 2. external urethral sphincter muscle 3. bulbourethral glands 4. deep transverse perineal muscle 5. related vessles and nerves In female 1.
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