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Download Perineum ( Division of Perineum and Perineal Body
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Division of perineum and cutaneous nerves. Perineal body. Learning Objectives At the end of the lecture the student should be able to know the • • • • Borders and relation of the perineum Divisions of the perineum Cutaneous nerves of the perineum Perineal body Perineum Boundaries Anterior Symphysis pubis - Posterior Tip of coccyx - Lateral Ischial tuberosities Perineum • Region of the body inferior to the pelvic diaphragm and between the legs. • Diamond shaped • Divided into - Urogenital Triangle - Anal triangle Male Perineum Female Perineum Triangles • A line drawn transversely across in front of the ischial tuberosities divides the space into two triangles Name Urogenital triangle Anal triangle Location The anterior triangle The posterior triangle Urogenital Triangle Relations Posteriorly Anococcygeal body Laterally Ischiorectal fossae Anteriorly Perineal body, urogenital diaphragm Bulb of penis,Membranour part of urethra(Male) Lower part of vagina (Female) Anal Triangle Nerve supply Skin around the anus is supplied by the inferior rectal (hemorrhoidal) nerve Urogenital Triangle Boundaries - Front Pubic arch Laterally Ischial tuberosities Urogenital Triangle Nerve supply Pudendal nerve Pelvic plexuses Pudendal Nerve • • • • • - Pudendal Nerve Branch of sacral plexus Leaves main pelvic cavity through greater sciatic foramen Enters perineum through lesser sciatic foramen Pudendal Nerve Passes forward in pudendal canal By it branches it supplies External anal sphincter Muscles of perineum Skin of perineum Pudendal Nerve - Branches in Perineum 1. Inferior rectal nerve External anal sphincter Mucous membrane of lower half of the anal canal Perianal skin Pudendal Nerve Branches in Perineum 2. Perineal nerve - Muscles in urogenital triangle - Skin on the posterior surface of scrotum (or labia majora) 3. Dorsal nerve of the penis(or clitoris) Perineal nerve • • Inferior and larger of the two terminal branches of the Pudendal nerve Accompanies the Perineal artery Perineal nerve Divides into two branches 1. Superficial perineal nerves, becoming posterior scrotal nerves in men and Posterior labial nerves in women 2. Deep branch of the perineal nerve (also known as "muscular") • - Posterior scrotal (labial) branches Two in number Medial Lateral Branches of the perineal nerve Distributed to the skin of the scrotum or labia Communicate with the perineal branch of the posterior femoral cutaneous nerve • • • • Dorsal nerve of the penis Deepest division of the pudendal nerve Accompanies the internal pudendal artery Gives a branch to the corpus cavernosum penis Dorsal nerve of the clitoris is analogous to the dorsal nerve of the penis in males Perineal body • Pyramidal fibromuscular mass • Junction between the urogenital triangle and the anal triangle • Essential for the integrity of the pelvic floor, particularly in females Attachments • External anal sphincter muscle • Bulbospongiosus muscle • Superficial transverse perineal muscle Attachments • Anterior fibers of the levator ani • Fibers from external urinary sphincter • Deep transverse perineal musc =========================================================
