Perineum: perineal body, neurovascular & clinical Flashcards
what is the perineal body?
an irregular and fibromuscular mass
where is the perineal body located?
at the junction of the urogenital and anal triangles – the central point of the perineum
what does the perineal body contain?
skeletal muscle, smooth muscle and collagenous and elastic fibres
Anatomically, where does the perineal body lie?
just deep to the skin
function of perineal body?
as a point of attachment for muscle fibres from the pelvic floor and the perineum itself
what are the muscle fibres from the pelvic floor which attach to the perineal body?
Levator ani (part of the pelvic floor)
Bulbospongiosus muscle
Superficial and deep transverse perineal muscles
External anal sphincter muscle
External urethral sphincter muscle fibres
in women, what does the perineal body act as?
as a tear resistant body between the vagina and the external anal sphincter
what does the perineal body support in women? against?
supporting the posterior part of the vaginal wall against prolapse
in men, where does the perineal body lie?
between the bulb of penis and the anus
where is the major neurovasculature supply to the perineum from? (include nerve roots)
from the pudendal nerve (S2 to S4) and the internal pudendal artery
what is the perineal body a central attachment for?
perineal muscles
function of perineal body?
support the pelvic floor
what can lead to damage (stretching/tearing) of the perineal body?
Childbirth
what can damage (stretching/tearing) of the perineal body lead to?
possible prolapse of pelvic viscera
pelvic viscera comes down into the vaginal orifice
how can damage (stretching/tearing) of the perineal body during childbirth leading to prolapse of pelvic viscera be avoided?
by an episiotomy (a surgical cut in the perineum)
what does an episiotomy cause?
damage to the vaginal mucosa, but prevents uncontrolled tearing of the perineal body
name other causes of perineal body damage
inflammatory disease, infection or trauma
where are the bartholin’s glands located?
within the superficial perineal pouch of the urogenital triangle
role of bartholin’s glands?
to make a small amount of mucus-like fluid, which maintains a moist vagina
when are the bartholin’s glands detected on examination?
Normally these are not detected on examination, however if the duct becomes blocked then these glands swell, forming fluid-filled cysts
what is bartholinitis?
These (fluid-filled) cysts can become infected and inflamed (when blocked)
most common cause of bartholinitis?
from the bacteria which cause skin and uterine infections, such as Staphylococcus spp. and Escherichia coli
