Perineum Flashcards
Pelvic Floor
Fromed by pelvic diaphragm
Consits of levator ani & coccygeus m. & fascia
Stretches between pubis ant & coccyx post & from lat pelvic wall to the other
Levator Ani
pubococcygeus, puborectalis & iliococcygeus
Innervated by n. to levator ani from S4 and inf rectal n. S2-S4 & coccygeal plexus
Helps support pelvic viscera
Act to raise pelvic floor & assist ab m. in forced expiration activities.
Male Pelvic Diaphragm
Levator ani & coccygeus
Support pelvic organs
counteracts increases in intra abdominal P
maintains urinary & faecal continence
PuboRectalis
Maintains anorectal angle (perineal flexure)
Boundaries of Pelvic Cavity
Perineum
Lies inf to pelvic outlet & is separated from pelvic cavity by pelvic diaphragm
Bounded by pubic symphysis ant
inf pubic rami & ischial rami anterolaterally
ischial tuberosity lat
sacrotuberous lig posterolat
inf by sacrum & coccyx
Perineum
Anal triangle- post contains anus
Urogenital triangle- ant contains scrotum & penis or external genitilia in females
perineal mem- streatches bt pubic arch & covers ant part
perineal body- irreg fibromuscular mass b/t anal canal & perineal mem
Perineal Mem
Perineal Body
fibromuscular mass in mid line of perineum
In females- in b/t vagina & anus
Perineal body ruptures during labor leads to widening gap b/t levator ani= prolapse of uterus, rectum & even urinary bladder
Perineum M.
Bulbospongiosus- compress vagina orfice or compress urethra. Perineal n. & pudendal n.
Ischiocavernosus- maintain erection of penis or clitoris
Superficial Transverse Perineal
O: ischial tuberosity
I: perineal body
A: support perineal body
N: pudendal n.
Deep Transverse Perineal
O: med aspect of ischial ramus
I: pineal body
A: stabilize position of perineal body
N. : pudendal n. S2-S4
External Urethral Sphincter
O: ischial tuberosity
I: surround urethra
A: compress urethra to maintain urine continence
N.: pudendal
Episiotomy
to avoid tearing, obtain more space for obstetric intervention, shortening 2nd phase of birth, midline episiotomy greater risk of rectal tear but recovers fast.
Fascia
Fascia 2
Fascia & Pouches of Urogenital Triangle
Fascia of Urogenital Triangle
Ischioanal Fossa
Ant- sphincter urethra, deep transverse perineal m.
post- gluteus max, sacrotuberous lig
superomed- external anal sphincter, levator ani m.
lateral- obturator fascia covering obturator internus
floor- skin over anal triangle
Ant recesses
Contents of ischioanal fossa
Ischioanal fat- allows distention of anal canal during defecation & accomodate fetus during childbirth
inf rectal n. & vessels
perineal branches of post femoral cutaneous n.
pudendal canal
