Perineum. Dept. of Human Anatomy Zhou Hong Ying

Transcription

1 Perineum Dept. of Human Anatomy Zhou Hong Ying

2 OUTLINE Subdivision The Layers Urogenital Diaphragm Main Structures inside Superficial & Deep Perineal Spaces Ischioanal Fossa

3 Perineum A narrow region Urogenital Triangle Anal Triangle

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5 Urogenital triangle 3 layers 2 spaces: Superficial perineal fascia superficial perineal space Inferior fascia of urogenital diaphragm deep perineal space superior fascia of urogenital diaphragm

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8 Superficial fascia of the urogenital triangle

9 CLINICAL NOTE Rupture of the Intermidate Part of the Urethra

10 Perineal membrane

11 the lateral margins of UG diaphragm are ischiopubic rami

12 The Perineal Body

13 Tear of Perineum & Pubococcygeus CLINICAL NOTE

14 Overview of the Structures inside the Urogenital Triangle urogenital canals & their sphincter muscles erectile tissues & their associated muscles accessory genital glands transverse perineal muscles terminal branches of internal pudendal a. & pudendal nerve

15 Structures of Superficial Perineal space Root (bulb and crura) of the penis and associated muscles (ischiocavernosus and bulbospongiosus). Proximal (bulbous) part of the spongy urethra. Superficial transverse perineal muscles. Deep perineal branches of the internal pudendal vessels and pudendal nerves Clitoris and ischiocavernosus. Bulbs of the vestibule and surrounding muscle (bulbospongiosus). Greater vestibular glands. Superficial transverse perineal muscles. Deep perineal branches of the internal pudendal vessels and pudendal nerves.

16 Structures of Deep Perineal space urethra and the inferior part of the external urethral sphincter muscle Anterior extensions of the ischioanal fat pads Intermediate part of the urethra Deep transverse perineal muscles Bulbourethral glands Dorsal neurovascular structures of the penis Proximal part of the urethra Deep transverse perineal muscles Dorsal neurovascular structures of the clitoris

17 Superficial features

18 Superficial features

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22 superficial perineal space

23 superficial perineal space

24 superficial perineal space

25 deep perineal space

26 deep perineal space

27 deep perineal space

28 Oblique Coronal Section through the Prostate

29 Superficial & Deep Perineal Spaces

30 Oblique Coronal Section through the Vagina

31 Anal triangle Anal canal Anal sphincter Ischioanal fossa Pudendal canal

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33 CLINICAL NOTE Abscess in the Ischioanal Fossae The anal mucosa can be easily injured, may be easily torn by hard feces. Patients develop inflammation and infection of the anal canal, which can spread into the ischio-anal fossae.

34 The Anterior Recess of Ischioanal Fossa & Deep Perineal Space

35 Pudendal Canal

36 Anal Sphincter

37 Pudendal nerve

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39 Arterial Supply of the Perineum internal pudendal artery (arises from anterior trunk of internal iliac artery) - dorsal neurovascular structures of penis or clitoris external pudendal artery (arises from femoral artery)

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42 Review of the Layers of the Perineum pelvic diaphragm (levator ani and coccygeus muscles), forming the floor of the pelvic cavity and the roof of the perineum. The urethra (and vagina in females) and rectum pass through the urogenital hiatus of the pelvic diaphragm

43 Review of the Layers of Perineum The external urethral sphincter and deep transverse perineal muscle span the region of the urogenital hiatus, which is closed inferiorly by the perineal membrane extending between the ischiopubic rami

44 Review of the Layers of Perineum Inferior to perineal membrane, the superficial perineal pouch or space contains the erectile bodies and the muscles associated with them

45 Review of the Layers of Perineum Subcutaneous Layer

46 Review of the Layers of Perineum Surface Anatomy in maternity department, to obstetrician, the perineum is restricted to the area between vagina and anus.

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