Perineum

Perineum
‫ﺍﻫﺩﺍﻑ ﺁﻣﻭﺯﺷﯽ‪:‬‬
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‫ﺁﺷﻧﺎﻳﻲ ﺑﺎ ﻓﺿﺎﻫﺎﻱ ﭘﺭﻳﻧﻪ‬
‫ﺷﻧﺎﺧﺕ ﻋﺿﻼﺕ ﺳﻁﺣﻲ ﻭ ﻋﻣﻘﻲ ﭘﺭﻳﻧﻪ‬
‫ﺁﺷﻧﺎﻳﻲ ﺑﺎ ﻋﺭﻭﻕ ﻭ ﺍﻋﺻﺎﺏ ﭘﺭﻳﻧﻪ‬
Superficial fascia:1- superficial 2- deep (Colles is continue with scarpa)
Deep fascia: anal T. (infraanal), urogenital T (inferior fascia of uroginital diaphragm or perineal ,
Superior fascia of uroginital diaphragm)
Superficial perineal pouch: between perineal fascia and colles fascia
Contents: root of penis or clitoris, superficialis perineal muscles, urethra, duct of copper glands,
bulb vestibule, int pudendal
Deep perineal pouch
Contents: muscles, urethra, copper glands, int pudendal, artery of bulb, dorsal penis nerve
Ischiorectal or ischioanal fossa:
Apex: between levator ani and obturator internus
Base: skin of anus
Lat: ischial tuberosity and obturator fascia
Med: inferior fascia of uroginital diaphragm and external anal sphincter
Ant: post border of uroginital diaphragm and perineal body
Post: sacrotuberus lig and gluteus maximums
Ant recess : above the uroginital diaphragm
Ischiorectal or ischioanal fossa
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Perianal space
Ischiorectal space
Pudendal canal or cal
of Alcock
Lunate facsia
Ant. & post. recess
Urogenital triangle:
Transverse perinei superficialis: ischial tuberosity  perineal body
Bulbospongiosus: in male; perineal body  urogenital diaphragm, corpus
spongiosus and cavernous. in female; perineal body  corpus cavernous
Ischiocavernosus: ischial tuberosity and rumus  crus of penis or clitoris
Deep perineal pouch
Transverse perinei deep: ischial rumus  perineal body
Urethral sphincter: inf rumus of pubis  perineal body
Perineal membrane or inferior fascia of uroginital diaphragm: attach
to pubic arch , perineal body ; ant part is transverse perinei lig
Superior fascia of uroginital diaphragm: parietal part of pelvic fascia,
attach to obturator fascia
Pudendal artery:
Inferior rectal
Perineal
Bulb artery
Urethral
Dorsal artery of penis
Deep artery of penis
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Pudendal nerve:
1- Inferior rectal
2- Perineal ( post
scrotal or labial)
3- Dorsal nerve of
penis or clitoris
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Lumbar plexus
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Iliohypogastric; lat. & ant.
Cutaneous branches
Ilioinguinal
Genitofemoral; genital &
femoral branches
Lat. Femoral cutaneous; ant. &
post. branches
Obturator; ant. Branch (in
subsartorial plexus) & pot.
Branch (for articular knee)
Accessory obturator
femoral
Femoral nerve
Sacral plexus
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Sciatic (L4-S3)
Post. Cutaneous n. of thigh (S1,2,3)
Nerve of the piriformis (S1,2)
Sup. Gluteal (L4-S1)
Inf. Gluteal (L5-S2)
Perforating cutaneous (S2,3)
Nerve to quadratus femoris & inf. Gemellus
(L4-S1)
Nerve to obturator internus & sup.
Gemellus (L5-S2)
Nerve to levator ani, coccygeus, & sphincter
ani externus (S4)
Pelvic splanchnic (S2-S4)
Pudendal nerve (S2-S4)
Anococcygeal nerve(S4,5,CO1)
Post. Cutaneous n. of thigh (S1,2,3)
Nerve of the piriformis (S1,2)
Perforating cutaneous (S2,3)