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Perineum
N/A
12
Anatomy
Undergraduate 1
12/11/2010

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Term

Superficial Boundaries of Perineum:

 

Definition

Anteriorly:        Scrotum in Males, Mons Pubis in Females

Posteriorly:      Buttocks

Laterally:           Upper part of Medial Side of the thighs

Term
Deep Boundaries of Perineum
Definition
Anteriorly : Upper part of Pubic Arch, Inferior / Arcuate Pubic Ligament
Posteriorly : Tip of the Coccyx
Laterally : Ischiopubic Rami, Ischial Tuberosity, Sacarotuberous ligament
Term
Posterior Anal Triangle
Definition
Contains termination of Anal Canal in Median Plane, and Ischiorectal Fossa on each side
Term
Anterior Urogenital Region
Definition
External Urogenital Organs, Superficial Perineal Space/Pouch, Deep Perineal Space/Pouch
Term
Pudendal Canal
Definition
It is a Fascial Tunnel that lies in the lateral wall of Ischiorectal Fossa. It contains the cheif neurovascular bundle of perineum i.e. The pudendal nerve and the internal Pudendal Vessels

Attachments
Above : Fused with lunate Fascia
Below : Fused with Falciform Fascia
Laerally : Fused with Obturator Fascia
Medially : Fused with Perineal Fascia
Term
Gynaecological Perineum
Definition
Interval between the Posterior Commissure and the Anus, of 2.5 of 3 cm in length
Term
Cutaneous Innervation of Anal Region
Definition
Inferior Rectal Nerve (S2, S3, S4) supplies the skin around the anus and the ischiorectal fossa.
Perineal Branch of Fourth Sacral Nerve - supplies the skin posterior to the anus

Mnemonic-
I Rest on Pillow.
I Rest = Inferior Rectal Nerve for Ischio Rectal fosa

Pillow : Perineal Branch of fourth Sacral Nerve - supplies skin Posterior to the anus
Term
Anococcygeal Ligament
Definition
A fibrofatty mass that extends from Anus to the Tip of the Coccyx. It supports the Rectum. It is permeated with Muscle Fibres derived from LEVATOR ANI and External Anal Sphincter
Term
Perineal Body
Definition
-Central point in Perineum
-Fibromuscular node
- 1.25 cm infront of Anal Margin, close to the Bulb of the penis

Recieves convergence of 10 important muscles.
2 are unpaired : External Anal Sphincter and Unstriped Muscular fibres of longitudinal muscle coat of Rectal Ampulla and Anal Canal

4 paired : Bulbospongiousus, Superficial Transverse Perenei, Deep Transverse Perenei , and Levator Ani

Importance : Supports Pelvic Organs. May be damaged in Parturition. Results in prolapse of Urinary Bladder, uterus, and ovaries and even the rectum
Term
Ischiorectal Fossa : Definition, Location, Boundaries
Definition
It is a Wedge Shaped Space on either side of the Anal Canal below the pelvic Diaphraghm. It has a base directed downwards, towards the surface. And an Apex directed upwards.

Anteroposterior Length : 2 inches - 5 cm
Widge (side to side) : 1 inch - 2.5 cm
Depth (Vertically) 2-2.5 inches = 5 cm - 6.2 cm

Boundaries :
Base is formed by the skin.
Apex is formed by the line where Obturator Fascia meets with the inferior Fascia of the pelvic Diaphragm or Anal Fascia. The line corresponds to the Origin of Levator Ani from the lateral pelvic wall.

Anteriorly : Posterior Border of Perineal Membrane
Posteriorly : Gluteus Maximus, Sacrotuberous Ligament

Lateral Wall : Obturator Internus, Obturator Fascia, Ischial Tuberosity
Medial Wall : External Anal Sphincter with Fascia in lower part , and Levator Ani with Anal Fascia in upper part
Term
Recesses of Ischiorectal Fossa
Definition
1- Anterior Recess : Extends forward above Urogenital Diaphragm reaching almost upto the Posterior Surface of body of pubis. It is related to Prostate or Vagina.

2. Posterior Recess is smaller than Anterior. Extends deep to Sacrotuberous ligament.

3. Horseshoe Recess : Connects the two ischioretal fossae behind the anal canal
Term
Pudendum or Vulva
Definition
Contains : Mons Pubis. Labia Majora. Labia Minora. Clitoris. Vestibule of Vagina and Bulb of Vestibule. Greater Vestibular glands (of Bartholin)
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