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SERIES OF COURSES

ANATOMY OF PERINEUM
 Anatomy of Perineum

- General View of Perineum

- Anal Triangle

- Urogenital Triangle
General View of Perineum Anatomy of Perineum
Perineum is of which shape ---
It is diamond-shaped

Perineum is divided into which parts

perineum is divided into
Anal Triangle and
Urogenital Triangles by ------
A transverse line between the ischial tuberosities
General View of Perineum Anatomy of Perineum
Nerve supply of Perineum is ---
Pudendal nerve, which is a branch of ---
Sacral plexus
General View of Perineum Anatomy of Perineum
Blood supply of Perineum is ---
Internal Pudendal artery, which is a branch of ---
Internal Iliac artery
General View of Perineum Anatomy of Perineum
The Pudendal nerves and vessels enter the perineum after
crossing which structure ---
Pudendal nerves and vessels enter the Perineum after
crossing the Ischial spine posteriorly
 Anatomy of Perineum

- General View of Perineum

- Anal Triangle

- Urogenital Triangle
Anal triangle Anatomy of Perineum
The anal triangle contains---
Anal canal, which is surrounded by ---
Ischioanal (Ischiorectal fossa)
Anal triangle Anatomy of Perineum
The anal canal has two sphincters ---
Internal anal sphincter, which is innervated by ---
Autonomic nervous system
External anal sphincter, which is innervated by ---
Pudendal nerve
Anal triangle Anatomy of Perineum

Pudendal nerve and vessels travel in the Ischiorectal

fossa in---
Pudendal canal, which is found on the ---
Lateral aspect of Ischiorectal fossa
Anal triangle Anatomy of Perineum
Ischioanal (Ischiorectal) fossa is of which shape--
It is wedge-shaped situated on each side of the anal canal
Its base is directed ----
Downwards towards the surface
The apex is directed ----
Upwards
Anal triangle Anatomy of Perineum
Ischioanal (Ischiorectal) fossa base is formed by -
Skin
Its apex is formed by ----
Line corresponding to the origin of levator ani from lateral
pelvic wall
Anal triangle Anatomy of Perineum
Ischioanal (Ischiorectal) fossa is bounded anteriorly by ---
Posterior border of the perineal membrane (The recess of the fossa
extends forwards laterally on both sides of middle perineal structures)
The fossa is bounded posteriorly by ----
Lower border of gluteus maximus and Sacrotuberous ligament
Anal triangle Anatomy of Perineum
Ischioanal (Ischiorectal) fossa lateral wall is formed by ---
Obturator internus with the obturator fascia, and the medial surface of the
ischial tuberosity, below the attachment of obturator fascia
The medial wall is formed by ----
The external anal sphincter, with the fascia covering it in the lower part,
and the levator ani with the anal fascia in the upper part
Anal triangle Anatomy of Perineum
Perianal space
Perianal space is separated by the Ischiorectal fossa by---
Perianal fascia, which is a septum passing laterally from ---
lower end of the longitudinal coat of the anal canal
The perianal fascia extends medially from ---
White line of Hilton, and laterally upto the ---
Pudendal canal
The Contents of the Perianal space is ----
Fat, tightly arranged in small loculi
(Infection of this closed
space is therefore painful)
Anal triangle Anatomy of Perineum
Ischiorectal (Ischioanal) space
Ischioanal space infections are painful or not ?
They are least painful, why ? ----
Because the fat in this space is loosely arranged in large loculi
formed by incomplete delicate septa
 Anatomy of Perineum

- General View of Perineum

- Anal Triangle

- Urogenital Triangle
Urogenital Triangle Anatomy of Perineum
Urogenital Triangle
Urogenital triangle is present in the anterior portion of the perineum
The urogenital triangle is divided into ---
-Superficial perineal pouch (Space)
-Deep perineal pouch (Space)

It also contains the superficial and root structures of the external

genitalia
Urogenital Triangle Anatomy of Perineum
Superficial perineal pouch/Space
Superficial perineal pouch is bounded inferiorly(Towards skin) by ---
Superficial perineal (Colles’) fascia---
It is bounded superiorly by ---
Perineal membrane of the urogenital diaphragm

Female
Urogenital Triangle Anatomy of Perineum
Superficial perineal pouch/Space
Superficial perineal pouch is bounded inferiorly(Towards skin) by ---
Superficial perineal (Colles’) fascia---
It is bounded superiorly by ---
Perineal membrane of the urogenital diaphragm

Male
Urogenital Triangle Anatomy of Perineum
Superficial perineal pouch/Space
Superficial perineal pouch is bounded inferiorly(Towards skin) by ---
Superficial perineal (Colles’) fascia---
It is bounded superiorly by ---
Perineal membrane of the urogenital diaphragm
Urogenital Triangle Anatomy of Perineum
Superficial perineal pouch/Space
It is bounded in the sides by the -------
Ischiopubic rami--
It is closed posteriorly by the fusion of ---
Perineal membrane with Colles’ fascia
Urogenital Triangle Anatomy of Perineum
Superficial perineal pouch/Space
Anteriorly ---
The space communicates freely with the potential space
lying between the superficial fascia of the anterior
abdominal wall and the anterior abdominal muscles
Urogenital Triangle Anatomy of Perineum
Superficial perineal pouch/Space
Contents of the superficial perineal pouch are-------
Root (Crura) of penis or Clitoris erectile tissue (Two corpora cavernosa
and one corpus spongiosum)
In males Bulb of penis (Erectile tissue containing urethra)
It is traversed by urethra
In female the corpus spongiosum is absent, two bulbs of vestibule are
present on each side of vaginal orifice
The two bulbs of vestibule unite and get attached to the ---
Glans Clitoris

Male Female
Urogenital Triangle Anatomy of Perineum
Superficial perineal pouch/Space
Contents of the superficial perineal pouch are-------
Muscles –
Ischiocavernosus, covering ---
Crura (Corpus cavernosa) of penis or clitoris
Bulbospongiosus, covering ---
Bulb of penis or bulb of vestibule
Superficial transverse perinei

Male Female
Urogenital Triangle Anatomy of Perineum
Superficial perineal pouch/Space
Contents of the superficial perineal pouch are-------
Muscles –
Function of Bulbospongiosus in males is ---
These muscles compress the penile part of the urethra and empty the residual
urine or semen

The anterior fibers also compress the deep dorsal vein of the penis

Thus impeding the venous drainage of the erectile tissue and thereby assisting in

Male Female
Urogenital Triangle Anatomy of Perineum
Superficial perineal pouch/Space
Contents of the superficial perineal pouch are-------
Muscles –
Function of Ischiocavernosus in males is ---
The Ischiocavernosus muscles cover the crus penis on each side

The action of each muscle is to compress the crus penis and

assist in the process of erection of the penis

Male Female
Urogenital Triangle Anatomy of Perineum
Superficial perineal pouch/Space
Contents of the superficial perineal pouch are-------
Glands–
Greater vestibular (Bartholin) gland (Female only), which are
homologous to ----
Cowper gland in males

Male Female
Urogenital Triangle Anatomy of Perineum
Superficial perineal pouch/Space
Contents of the superficial perineal pouch are-------
Vessels and Nerves
Nerves:
Three sets of branches from perineal nerve (Posterior scrotal N., branch to bulb
and muscular branches)
Long perineal nerve from posterior cutaneous nerve of thigh

Vessels:
Two branches of perineal artery (Posterior scrotal and transverse perineal
Four branches from the artery of penis (Artery to bulb, urethral artery, deep and
dorsal arteries of penis

Male Female
Urogenital Triangle Anatomy of Perineum
Deep perineal pouch/Space
Deep perineal pouch lies between ---
Superficial fascia of urogenital diaphragm and perineal
membrane ---

Female
Urogenital Triangle Anatomy of Perineum
Deep perineal pouch/Space
Deep perineal pouch lies between ---
Superficial fascia of urogenital diaphragm and perineal membrane ---

Female
Urogenital Triangle Anatomy of Perineum
Deep perineal pouch/Space
Contents ---
Sphincter urethrae muscle, whose function is ---
Voluntary external sphincter of the urethra
Deep transverse perineal muscle
Bulbourethral (Cowper) gland (in the male only)
Urogenital Triangle Anatomy of Perineum
Deep perineal pouch/Space

Nerves and vessels ---

Internal pudendal nerve and vessels
Dorsal vessels and nerve of the Penis
Posterior scrotal vessels and nerves
Urogenital Triangle Anatomy of Perineum
Deep perineal pouch/Space

Nerves and vessels ---

Internal pudendal nerve and vessels
Dorsal vessels and nerve of the Penis
Posterior scrotal vessels and nerves
Urogenital Triangle Anatomy of Perineum
Clinical correlates
In case of rupture of spongy urethra the urine will extravaste
where ---
It will go into the superficial perineal space and then in the
subcutaneous perianal compartment, all around scrotum, penis
and it will ascend along anterior abdominal wall
Urogenital Triangle Anatomy of Perineum
Clinical correlates
Rupture of the intermediate part of the urethra results in
extravasation of urine and blood into----
The deep perineal compartment.
The fluid reach upto where ---
It may pass superiorly through the urogenital hiatus and
distribute extraperitoneally around the prostate and bladder.
Urogenital Triangle Anatomy of Perineum
Clinical correlates
The cutaneous supply of skin of Penis or clitoris is by ---
Dorsal nerve of penis or clitoris, except at its root

Skin of anterior 1/3rd of scrotum or labium majus and the root of penis is
supplied by ---
Ilioinguinal nerve and genital branch of the genitofemoral nerve

Skin of the lateral part of the Posterior 2/3rd of scrotum or the labium majus,
and the lateral part of the urogenital region is supplied by ---
Perineal branch of posterior cutaneous nerve of thigh

Skin of the medial part of the urogenital region including the labium minus in
females and the medial part of the posterior 2/3rd of the scrotum or labium
majus is supplied by ----
Posterior Scrotal or labial nerves

Mucous membrane of urethra is supplied by ---

Perineal branch of the pudendal nerve