What is the shape of the perineum
Diamond shaped
What are the superior of inferior borders of the perineum
Superior:
- Pelvic diaphragm
- Superficial Fascia
Inferior:
-Skin
What traverses the perineum
Anal canal
Urethra
Vagina
What are the two sections that the perineum is divided into
Anterior - Urogenital triangle
Posterior - Anal triangle
What are the boundaries of the perineum
Anterior
-pubic symphysis
Posterior
- inferior sacrum
- coccyx
Anterolateral
-ischiopubic rami
Lateral
-Ischial tuberosities
Posterolaterally
-sacrotuberous ligaments
What are the contents of the anal canal
Anal canal and anus
External and internal anal sphincters
Ischiorectal fossa
SAME IN BOTH MALE AND FEMALE
What are the contents of the urogenital triangle
Female:
- Membranous and distal urethra
- vagina
- vulva
- erectile bodies of vulva
Male:
- Membranous and spongy urethra
- Proximal erectile bodies of the penis
- attachment of the scrotum
What is the conposition of the Central Perineal Tendon
Fibrocatilageous
What is the other name for the central perineal tendon
perineal body
What are the relations of the central perineal tendon
Anterior to anal canal
Posterior to bulb of penis / vestibule (depending on male or female)
What attaches to the perineal body
Bulbospongiosus Superficial transverse perineal muscles deep transverse perineal muscles External anal sphincter Fascicles of muscle from External Urethral Sphincter Fascicles of muscle from Levator Ani
What type of connective tissue is the perineal membrane
Thin sheet of deep fascia
What is the extent of the Perineal Membrane
Runs between the two ischiopubic rami
Spans anterior pelvic outlet
Attached to perineal body at midpoint of posterior margin
What pierces the perineal membrane
Urethra
Ducts of bulbourethral glands
What are the layers of fascia in the urogenital triangle
Superficial Fascia
- Superficial fatty layer (replaced by Dartos Fascia in males)
- Deep membranous layer (Colle’s fascia)
Deep perineal Fascia (Galludet’s Fascia)
What are the attachments of the Deep Membranous Layer of Superficial Fascia (Colle’s Fascia)
Poteriorly attached to:
-Posterior margin of perineal body
Laterally attached to:
-Deep fascia of superior medial thigh (Fascia Lata)
Anteriorly attached to:
-Membranous layer of superficial Fascia of Abdomen (Scarpa’s Layer)
Where is the Superficial Perineal Pouch found?
Between:
- Membranous layer of superficial fascia
- Perineal membrane
What are the contents of the Superficial Perineal Pouch
Males:
- Bulb and Crura of penis
- Proximal Spongy urethra
- Superficial Transverse Perineal Muscles
- Branches of Internal pudendal Vessels
- Branches of Pudendal Nerves
Females:
- Crura of Clitoris and associated structures
- Bulbs of vestibule and associated muscles
- Superficial transverse perineal muscles
- Branches of Internal pudendal vessels
- Branches of Pudendal Nerves
- Greater Vesibular Glands
What, essentially, is the urogenital diaphragm
Deep perineal pouch
What are the boundaries of the Deep Perineal Pouch
Historical: Best in males
- Superior:
- –Superior fascia of Urogenital diaphragm
- Inferior:
- –Perineal membrane
Current: Best in females
- Superior
- –Inferior fascia of pelvic diaphragm, laterally
- –Obturator fascie, laterally
What are the contents of the Deep Perineal Pouch
Male:
- Deep transverse perineal muscles
- Bulbouretheral glands
- External urethral sphincter
- Membranous urethra
- Dorsal neurovasculature of penis
Female:
- Proximal urethra
- Smooth muscle (NB. there is no deep transverse perineal muscles)
- Dorsal neurovasculature of clitoris
- Ischioanal fat pads
- Sphincter urethra
What are the clinical implications of the perineium
Extravasated urine (collection of urine in the wrong place
