Anatomy Male and Female Perineum

pelvic outlet and skin between the thighs

perineum is between the

Male Perineum

the area between the anus and scrotum

Female Perineum

the area between the anus and the vagina

-pubic symphysis and body of pubic bone

-ischiopubic ramus to ischial tuberosities

-sacrotuberous ligaments

-coccyx

Pelvic Outlet is bounded by:

Sacrotuberous ligament

connects sacrum to ischial tuberosity

pelvic and urogenital diaphragms

Perineum is separated from the true pelvic cavity by the

perineum

space between the diaphragms and skin

Sacrospinous Ligament

connects sacrum to ischial spine

urogenital triangle and anal triangle

what are the two parts of the perineum?

ischial tuberosity

what divides the two trianges of the perineum

between sacrospinous and sacrotuberous ligaments

Where is the lesser sciatic foramen located?

Lesser sciatic foramen

passageway for structures entering or leaving the perineum

Pudendal nerve

innervates muscles of the perineum

Internal Pudendal Artery

supplies perineum and external genitalia

piriformis

The pudendal nerve and internal pudendal artery are located inferior to what muscle?

greater sciatic foramen

The pudendal nerve and artery pass out of

lesser sciatic foramen

The pudendal nerve and artery pass into

ischioanal fossa

after the pudendal nerve and internal pudental artery pass through the lesser sciate foramen where do they go

pubic symphysis

ischiopubic rami

ischial tuberosities

Urogenital triangle borders

Urogenital triangle

Coccyx

Sacrotuberous ligament

Ischial tuberosities

Anal triangle borders

Anal Triangle

Obturator Internis Fascia

Ischioanal Fossa

deep to anal triangle

The ischioanal fossa is located deep to what structure?

levator ani

obturator internus

The ischioanal fossa is located between what two muscles?

skin of anal triangle

floor of ischioanal fossa

junction where iliococcygeus muscle takes origin from the obturator internus muscle

which is the deeper located apex of the ischioanal fossa

obturator internus

What is the lateral side of the ischioanal fossa

levator ani

What is the medial side of the ischioanal fossa

Pudendal canal

Inferior rectal nerve, arteries and veins

Contents of ischioanal fossa

Pudendal nerve

Internal pudendal artery and vein

Contents of pudendal canal

Pudendal canal

Alcock's cana

the pudendal canal is also known as

external anal sphincter

inferior rectal nerves and arteries supply

pudendal nerve

inferior rectal nerve is a branch of the

internal pudendal artery

inferior rectal arteries and veins are branches of

Pectinate Line

line separates soma (i.e., the body wall) from viscera

Pectinate Line

coincides with anal valves

painful

ex. external hemorrhoids

Describe lesions below the pectinate line

silent unless they cause stretching of GI wall

ex. internal hemorrhoids

Describe lesions above the pectinate line

Anal columns

small longitudinal folds in the anal canal

Anal valves

circular folds inferior to anal columns

Internal anal sphincter

involuntary smooth muscle

External anal sphincter

voluntary skeletal muscle

inferior rectal nerve

What nerve supplies the external anal sphincter?

perineal nerves and arteries

Pudendal nerve and Internal Pudendal artery change names to

in the urogenital triangle

Where do Pudendal nerve and Internal Pudendal artery change names to perineal nerves and arteries ?

Perineum

Perineal Membrane

deep and superficial perineal spaces

The perineal membrane separates what?

Urogenital Diaphragm

Middle layer of pelvic floor

Superficial Perineal Pouch

potential space inferior to the perineal membrane

Colles Fascia

continuous with scarpa's fascia

Glans Penis

bulging structure at the distal end of the penis (glans = acorn)

Corona of Glans

rim of glans

Frenulum of Prepuce

a fold of skin

deep surface of prepuce with the glans

Frenulum of Prepuce connects what two structures?

immediately ventral to external urethral orifice

Where is the Frenulum of Prepuce located?

Penile Raphe

line on penis at fusion of urethral folds

Scrotal Raphe

division of the 2 scrotal chambers

Body of Penis

Root of Penis

Corpus Cavernosum

becomes engorged with blood during erection

Corpus Spongiosum

surrounds the urethra

Crus of the Penis

Bulb of the Penis

corpus spongiosum

The bulb of the penis is to the root, as the ______ __________ is to the body of the penis

Bulbospongious muscle

covers bulb of penis

expel contents of spongy urethra

What is the function of the bulbospongious muscle?

Ischiocavernosus muscle

covers crus of penis

stops drainage of blood during erection

What is the function of the ischiocavernosus muscle?

Superficial Transverse Perineal Muscle

stabilizes and strengthens central tendon of perineum

What is the function of the Superficial Transverse Perineal Muscle?

Prostatic Urethra

Membranous Urethra

Spongy Urethra

3 Male Urethras

Prostatic Urethra

surrounded by prostate

Membranous Urethra

passes through urogenital diaphragm

Spongy Urethra

runs through penis; opens at external urethral orifice

External Urethral Sphincter

voluntary skeletal muscle

urogenital diaphragm

Where is the external urethral sphincter located?

controls urination

external urethral sphincter function

Internal Urethral Sphincter

involuntary muscle

in neck of urinary bladder

Where is the internal urethral sphincter located?

prevents semen from entering the urinary bladder

What is the function of the internal urethral sphincter?

Internal Urethral Sphincter

What urethral sphincter is found only in males?

Superficial Dorsal Vein of the Penis

within the skin

Deep Dorsal Vein of the Penis

unpaired

lies along dorsal midline

Dorsal Artery of the Penis

paired arteries on the dorsum of the penis

deep to Buck's fascia

lateral to the deep dorsal vein

Source of blood that engorges Corpus Cavernosum to form erection

Deep Artery of the Penis

Buck's Fascia

deep fascia of penis

Tunica Albuginea

white fibrous capsule on testes

vein, artery, nerve

order of Deep Dorsal Vein of the Penis, Dorsal Artery of the Penis, Dorsal Nerve of the Penis

Peyronie's Disease

Idiopathic formation of fibrous plaques within the Tunica Albuginea, usually on the dorsal surface.

Presents with palpable subcutaneous mass and often abnormal curvature of the penis.

how does Peyronie's Disease present

pain during intercourse

erectile dysfunction

stenosis of spongy urethra

Peyronie's Disease (Penile Fibrosis) is associated with

cutaneous to femoral triangle, anterior scrotum/labia majora

Genitofemoral nerve innervates

anterior surface of psoas major muscle

Genitofemoral nerve descends on

Lateral cutaneous nerve of thigh

cutaneous to lateral side of the thigh

(passes medial to ASIS)

Cremaster muscle

Muscle that pulls the scrotum closer to the body in cold temperatures and relaxes to let the testicles be farther away from the body in warmer weather

Cremasteric Reflex

stroking superior part of medial thigh causes contraction of cremaster muscle which leads to retraction of spermatic cord and elevation of the testes