Lies at the front of the anal canal. It is composed of: - interdigitating fibers of puboprostaticus (pubovaginalis) - superficial external anal sphincter - transversus perinei m.

Perineum Flashcards by Kamaal Jones

Boundaries of the Perineum

ANTERIOR: Pubic arch
LATERAL BOUNDARY: Pubic/Ischial rami, ischial tuberosity, sacrotuberous ligament
POSTERIOR BOUNDARY: sacrum and coccyx
ROOF: Pelvic diaphragm

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Where is the anal triangle

Posterior to a line connecting the ischial tuberosities

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The 2 general components of the Anal Triangle

Anal Canal

Anal Sphincters

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Anal Canal

Continuation of rectum beyond the puborectalism

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Arterial supply/Venous drainage of the Anal Canal

Above pectinate line: Superior Rectal Artery/vein

Below pectinate line: Inferior Rectal Artery/vein

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Innervation of the Anal Canal

Autonomic: inferior hypogastric plexus

Somatic: inferior rectal nerve

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How many Anal Sphincters?

2 (Internal and External)

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Internal Anal Sphincter

Thickened lower end of the inner circular muscle of the rectum.

SMOOTH MUSCLE
A weak sphincter which is not competent acting alone
INNERVATION: inferior hypogastric plexus

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External Anal Sphincter (components and innervation)

(1) Subcutaneous: complete circle just deep to skin
(2) Superficial: attached posteriorly to coccyx, anteriorly to the perineal body
(3) Deep: encircles the anal canal and is fused with the puborectalis muscle

SKELETAL MUSCLE
Innervation: Inferior rectal branch of the pudendal nerve.

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Ischiorectoral Fossa

A fat filled space lateral to the anal triangle. USED AS DEAD SPACE FOR ANUS TO EXPAND.

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Pudendal Canal

Formed by the fascia of obturator internus which splits to enclose the pudendal neurovascular bundle and connect the lesser sciatic foramen to the posterior perineal membrane.

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Perineal Body:

Lies at the front of the anal canal.

It is composed of:

interdigitating fibers of puboprostaticus (pubovaginalis)
superficial external anal sphincter
transversus perinei m.

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Nerves of the anal canal

Pudenal N.
Inferior Rectal N.

Pudenal nerve divides at the anterior end of the angle triangle to form:

Dorsal nerve of the penis/clitoris
Perineal n.

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Blood vessels of the Anal Canal

Internal Pudenal Artery and Vein

main branch of pudenal= Inferior Artery and Vein
Internal Pudenal gives perineal branch to superficial pouch and continues to deep pouch.

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Arteries to the Uterus/ Vagina/ Ovaries

Uterus: Uterine Artery
Vagina: Vaginal Artery
Ovaries: Ovarian Artery

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Main sections and attachments of uterus

Fundus
Body
Cervix
Uterine Tube (Fallopian tube)
Fimbria

Scarpa’s fascia turns into….?

Where does this happen?

Turns into Colle’s fascia

Occurs in the perineum

Two proper bends for the positioning of the uterus

Anteflexion

- Anteversion

Urogenital (UG) Triangle

Anterior part of the perineum which holds all of the components of the Penis or Vagina

Perineal Membrane

Forms the base for the penile (clitoral) musculature and the penis (clitoris)

Spaces deep and superficial to the perineal membrane

Deep: Deep pouch
Superficial: Superficial pouch

Contents of the Superficial Perineal Pouch

ROOTS OF PENIS OR CLITORIS:

Bulb -FOR FEMALES (posterior part of corpus spongiosum)
Crura (posterior part of corpora cavernosa)
Blood supply (deep penile A. to crura and artery to the bulb)

MUSCLES:

Ischiocavernosus m.
Bulbospongiosus m.
Superfical Transverse Perinei m.

Ischiocavernosus M.

Contracts to compress venous outflow of the penis

Bulbospongiosus M.

Surrounds the bulb, it acts to expel any remaining urine or semen in the urethra

Main differences between Male and Female UG Triangle

- Female bulb and bulbospongiosus m. are split by the vagina. - Greater vestibular gland of female found in superficial pouch - Bulb FOUND IN DEEP POUCH for male

Nerve of the Superficial Perineal Pouch

Perineal Nerve (branch of the PUDENDAL n.) Perineal Branches into: - muscular branches - scrotal/labial branches

Arteries of Superficial Perineal Pouch

Perineal a. (branch of INTERNAL PUDENDAL) Perineal branches into: - muscular branches - scrotal/labial branches

Contents of the Deep Perineal Pouch

- membranous urethra - Bulbourethral glands (of MALES) - Sphincter Urethra m. - Deep transverse perinei m.

Innervation of Deep Perineal Pouch

All muscles receive innervation from the muscular branch of perineal n. from superficial pouch.

Main Arteries of the Deep Perineal Pouch

All branches of the INTERNAL PUDENDAL A. - Muscular branch - Artery to the bulb (pierces the perineal membrane to enter the bulb of the penis or clitoris) - Deep A: Pierces the perineal membrane to reach the corpora cavernosa - Dorsal A.: pierces the perineal membrane to reach the dorsum of the penis or clitoris

Veins of the Deep Perineal Pouch

Correspond to the arteries exept the dorsal vein is divided into a deep and superficial dorsal vein SUPERFICIAL: Drains into the superficial external pudendal veins DEEP: Enter the pelvic cavity and drain into the prostatic plexus of veins

3 main divisions of the Uterus

Fundus, Body, Cervix

Borders of UG Triangle

- Ischial tuberosity/ Ischiopubic ramus - Perineal membrane - Pubic Symphsis

Borders of the Anal Triangle

- Sacrotuberous ligament - Perineal membrane - Sacrum

In a cross section of the penis, what structures would be viewed superiorly to inferiorly?

- Skin - Veins/Arteries (Deep artery of penis) - 2 tubes of Corpora Cavernosa - 1 Corpus Spongiosum (surrounding the urethra)

Crus

Extensions of the CORPORA CAVERNOSA which are attached to the perineal membrane