Perineum: perineal body, neurovascular & clinical

Question 1

what is the perineal body?

Answer 1

an irregular and fibromuscular mass

Question 2

where is the perineal body located?

Answer 2

at the junction of the urogenital and anal triangles – the central point of the perineum

Question 3

what does the perineal body contain?

Answer 3

skeletal muscle, smooth muscle and collagenous and elastic fibres

Question 4

Anatomically, where does the perineal body lie?

Answer 4

just deep to the skin

Question 5

function of perineal body?

Answer 5

as a point of attachment for muscle fibres from the pelvic floor and the perineum itself

Question 6

what are the muscle fibres from the pelvic floor which attach to the perineal body?

Answer 6

Levator ani (part of the pelvic floor)
Bulbospongiosus muscle
Superficial and deep transverse perineal muscles
External anal sphincter muscle
External urethral sphincter muscle fibres

Question 7

in women, what does the perineal body act as?

Answer 7

as a tear resistant body between the vagina and the external anal sphincter

Question 8

what does the perineal body support in women? against?

Answer 8

supporting the posterior part of the vaginal wall against prolapse

Question 9

in men, where does the perineal body lie?

Answer 9

between the bulb of penis and the anus

Question 10

where is the major neurovasculature supply to the perineum from? (include nerve roots)

Answer 10

from the pudendal nerve (S2 to S4) and the internal pudendal artery

Question 11

what is the perineal body a central attachment for?

Answer 11

perineal muscles

Question 12

function of perineal body?

Answer 12

support the pelvic floor

Question 13

what can lead to damage (stretching/tearing) of the perineal body?

Answer 13

Childbirth

Question 14

what can damage (stretching/tearing) of the perineal body lead to?

Answer 14

possible prolapse of pelvic viscera

pelvic viscera comes down into the vaginal orifice

Question 15

how can damage (stretching/tearing) of the perineal body during childbirth leading to prolapse of pelvic viscera be avoided?

Answer 15

by an episiotomy (a surgical cut in the perineum)

Question 16

what does an episiotomy cause?

Answer 16

damage to the vaginal mucosa, but prevents uncontrolled tearing of the perineal body

Question 17

name other causes of perineal body damage

Answer 17

inflammatory disease, infection or trauma

Question 18

where are the bartholin’s glands located?

Answer 18

within the superficial perineal pouch of the urogenital triangle

Question 19

role of bartholin’s glands?

Answer 19

to make a small amount of mucus-like fluid, which maintains a moist vagina

Question 20

when are the bartholin’s glands detected on examination?

Answer 20

Normally these are not detected on examination, however if the duct becomes blocked then these glands swell, forming fluid-filled cysts

Question 21

what is bartholinitis?

Answer 21

These (fluid-filled) cysts can become infected and inflamed (when blocked)

Question 22

most common cause of bartholinitis?

Answer 22

from the bacteria which cause skin and uterine infections, such as Staphylococcus spp. and Escherichia coli