Perineum

Question 1

What is the perineum?

Answer 1

Region beneath pelvic diaphragm (levator ani and coccygeus)

Question 2

How is the perineum divided?

Answer 2

Anal triangle and urogenital triangle

Question 3

What are the layers of the anal triangle?

Answer 3

1. Fatty superficial fascia
2. Pudendal nerve and internal pudendal vessels
3. Deep fascia

Question 4

What is the fatty superfical fascia comprised of?

Answer 4

Thick subcutaneous fat

Question 5

What does the fatty superficial fascia thicken to form?

Answer 5

Ischiorectal/Ischioanal fossae on either side of the anal opening

Question 6

What is the ischiorectal fossa?

Answer 6

Deep fat filled indentation on either side of the anal opening.

Question 7

What does the ischiorectal fossa contain?

Answer 7

Contains pudendal vessels and nerves which enter it through the lesser sciatic foramen and run in pudendal canal in lateral wall of the fossa. q

Question 8

What level does the pudendal nerve arise?

Answer 8

(Ventral rami S2-4)

Question 9

What does the pudendal nerve supply?

Answer 9

Supplies levator ani, lower anal canal and sphincter.

Question 10

What does the pudendal nerves become?

Answer 10

Becomes dorsal nerve of penis/clitoris.

Question 11

Where is the artery of the internal pudendal vessels?

Answer 11

Anterior trunk of internal line

Question 12

What does the pudendal vein drain? Where does it drain into?

Answer 12

Drain prostatic venous plexus which drain penis and inferior rectal vessels.
Internal iliac vein.

Question 13

Where do the branches of the pudendal nerve, artery and veins leave?

Answer 13

Medial wall of pedendal canal

Question 14

What is the deep fascia shared with?

Answer 14

Shared with fascia of pelvic diaphragm

Question 15

What does the anal traingle include?

Answer 15

External anal sphincter

Question 16

How many fascia layers and spaces (poches) does the urogential triangle contain?

Answer 16

3 fascia layers and 2 spaces

Question 17

What is the fascia shared between?

Answer 17

Pelvic diaphragm and urogential diaphragm

Question 18

What does the deep perineal space or urogenital diaphragm contain?

Answer 18

Containing urethral sphincter and deep transverse perineal muscle

Question 19

What does the superficial perineal space contain?

Answer 19

Contains bulbospongiosis, ischiocavernous and superficial transverse perineal muscles (partly overlie deep perineal space - muscles have to be reflected to see entire deep perineal space)

Question 20

What are the layers from deep (superior) to superficial (inferior) of the urogential triangle?

Answer 20

1. Fascia shared between pelvic diaphragm and urogenital diaphragm
2. Deep perineal space or Urogential diaphragm
3. Fascia (Inferior fascia of urogenital diaphragm or perineal membrane)
4. Superficial perineal space
5. Fascia (superficial fascia)

Question 21

Where is the perineal body?

Answer 21

In the midline where fibres from transverse perineal muscles interlace - added support for pelvic viscera