Perineum Dept. of Human Anatomy Zhou Hong Ying
OUTLINE Subdivision The Layers Urogenital Diaphragm Main Structures inside Superficial & Deep Perineal Spaces Ischioanal Fossa
Perineum A narrow region Urogenital Triangle Anal Triangle
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
Superficial fascia of the urogenital triangle
CLINICAL NOTE Rupture of the Intermidate Part of the Urethra
Perineal membrane
the lateral margins of UG diaphragm are ischiopubic rami
The Perineal Body
Tear of Perineum & Pubococcygeus CLINICAL NOTE
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
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.
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
Superficial features
Superficial features
superficial perineal space
superficial perineal space
superficial perineal space
deep perineal space
deep perineal space
deep perineal space
Oblique Coronal Section through the Prostate
Superficial & Deep Perineal Spaces
Oblique Coronal Section through the Vagina
Anal triangle Anal canal Anal sphincter Ischioanal fossa Pudendal canal
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.
The Anterior Recess of Ischioanal Fossa & Deep Perineal Space
Pudendal Canal
Anal Sphincter
Pudendal nerve
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)
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
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
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
Review of the Layers of Perineum Subcutaneous Layer
Review of the Layers of Perineum Surface Anatomy in maternity department, to obstetrician, the perineum is restricted to the area between vagina and anus.