PERINEUM-
Dr SUDAKSHINA C
PERINEUM-Boundaries-
Front- symphysis pubis
and arcuate pubic
ligament.
Behind- tip of coccyx.
Antero-laterally
ischio pubic rami and
ischial tuberosities.
Postero-laterally--
sacrotuberous
ligaments
PERINEUM
SUB DIVISIONS
• TWO- BY AN IMAGINARY LINE
JOINING THE ISCHIAL TUBEROSITIES .
• ANAL TRIANGLE BEHIND.
• UROGENITAL TRIANGLE IN FRONT.
• CENTRAL POINT OF PERINEUM IS THE
PERINEAL BODY.
Perineal body or the
gynecological perineum--
Pyramidal fibromuscular
node – apex , receives 10
muscles of perineum from
the pelvic diaphragm i.e.
levator ani anal canal i.e. ext
anal sphincter, longitudinal
muscle coat of anal canal,
deep and superficial perineal
muscles, bulbospongious.
UROGENITAL TRIANGLE
• TRIANGLE IS CLOSED BY---
Skin.
Superficial fascia.
Contents of superficial perineal pouch.
Perineal membrane.
Contents of deep perineal pouch.
Superior fascia of urogenital diaphragm.
Urogenital triangle
Urogenital triangle
SUPERFICIAL PERINEAL POUCH
BOUNDARIES
Above- perineal membrane.
Below- fascia of Colles.
Sides- ischio-pubic ramus.
Behind- closed by the fusion of perineal
membrane and fascia of Colles.
Front--- continuous with superficial inguinal
space.
CONTENTS
• MUSCLES—3 on each side.
1. Ischio-cavernosus.
2. Transversus perinei superficialis.
3. Bulbospongiosus.
• VESSELS--- 3 on each side.
1.Two posterior scrotal or labial vessels.
2.Transverse perineal vessels.
• NERVES----- 3 on each side.
1. Two posterior scrotal or labial nerves.
2. Perineal branch of post femoral cut N.
CONTENTS ---contd
• OTHER STRUCTURES---
1. crus of penis or clitoris.
2. bulb of penis and spongy urethra in
male.
3. urethra and vagina in female.
bulb of vestibule and greater vestibular
glands on each side of vagina
Superficial perineal pouch
Superficial perineal pouch
Superficial perenial muscles in
females.
PERINEAL MEMBRANE[inf fascia
of urogenital diaphragm]
• Extends across the pubic arch.
• Intervenes between sup and deep perineal
pouches.
• Triangular in shape with its apex directed
in front.
ATTACHMENTS OF PERINEAL
MEMBRANE.
• Sides- ischio -pubic rami.
• Front- forms transeverse perineal
ligament.
• Behind- fixed to the perineal body.
STRUCTURES PIERCING
PERINEAL MEMBRANE.
• Post scrotal or labial vessels and nerves.
• Deep artery of penis or clitoris.
• Dorsal artey of penis or clitoris.
• Urethra.
• Duct of bulbourethral glands and artery to
bulb in males.
• Vagina in females
Perineal membrane deep fascia
of perineum or the inf fascia of
uro genital diaphragm.
Superficial and deep perenial
pouches in females
Superficial and deep perenial
pouches in males
DEEP PERINEAL POUCH
• BOUNDARIES—
Above- sup fascia of urogenital
diaphragm.
Below- inf fascia of urogenital diaphragm
Sides- ischio pubic ramus.
Front- transverse perineal ligament.
Behind- fusion of sup and inf facia.
CONTENTS
1. MUSCLES
SPHINCTER URETHRAE
TRANSEVERSE PERINEI PROFUNDUS.
2. VESSELS – internal pudendal artery.
3. NERVES--- dorsal nerve of penis or clitoris.
4. OTHER STRUCTURES---
urethra.
in male bulbo urethral gland and its duct.
in females vagina.
Deep perineal pouch
UROGENITAL DIAPHRAGM
• Musculo fascial partition across the pubic
arch.
• Separates the pelvic cavity from ant aspect
of pelvic outlet.
• Cosists of – Two muscles .
1.sphincter urethra
2.transversus perinei profundus.
Two fasciae
1.sup fascia.
2. inf fascia.
UROGENITAL DIAPHRAGM
RELATIONS
• Above- apex of prostate in male.
neck of urinary bladder in females.
levator ani muscle.
• Below— sup perineal pouch.
• Behind- ischio-rectal fossae.
• Front– a triangular gap b/w arcuate pubic
and transverse perineal ligament.
ACTIONS
• Supports the prostate or bladder.
• Costricts the vagina.
• Voluntary control of micturition.
• Fixes the perineal body-
It is a pyramidal shaped fibro muscular
structure intervenes vaginal and anal orifices.
Receives the insertions of muscles.
Maintains the integrity of pelvic floor.
ANAL TRIANGLE
ISCHIOANAL FOSSA
ANAL TRIANGLE
• Presents-
perineal body
anal orifice.[ischio-rectal fossa
on each side]
ano-coccygeal raphe
