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Where is the perineum located?
between upper thighs, from pubic symphysis to the tip of the coccyx
What binds the perineum laterally?
ischial tuberosities
What binds the perineum posteriolaterally?
sacrotuberal ligament attaching the sacrum to the ischial tuberosites
What is the alternative definition of the perineum used by obsterticians?
space limited between the vagina and anus
What two non-parallel triangles is the perineum divided into?
urogenital and anal triangles
What separates the urogenital and anal triangles?
a transverse line between the ischial tuberosities
What is the supporting striated muscle and connective tissue membrane called that stretches between the bony elements of the urogenital triangle?
perineal membrane or inferior fascia of urogenital diaphragm
What is the CT membrane that attches laterally to the ischial tuberosities, ischial rami, and inferior pubic rami?
perineal membrane (inferior fascia of urogenital diaphragm)
Name the 2 spaces that the perineal membrane creates.
superficial and deep spaces
What is located superficial to the perineal membrane?
erectile tissue and muscles of the external genitalia
What is located deep to the perineal membrane?
striated muscle of urethra and deep transverse perineal muscle that supports the free edge of the perineal membrane
Where is the perineal body located?
lies in midline immediately behind the free edge of the perineal membrane
The integrity of the perineal body is essential for the integrity of _____.
anal sphincter
The superficial membranous fascia (Colle's fascia) attaches to what? What does this form?
free edge of the perineal membrane
superficial perineal space
What are the boundaries of the superficial perineal space?
laterally-fascia lata of thigh
anteriolaterally-inguinal ligament
superiorly-fuses w/ dep fascia of external oblique and rectus abdominis about 1/2 way between pubic symphysis and umbilicus
Where might a straddle injury bleed into?
superficial perineal space
Name the tissue layers of the urogenital triangle from superficial to deep.
skin, subcutaneous tissue, superficial membranous fascia, investing fascia, external genitalia erectile tissue and muscles, perineal membrane, external urethral sphincter muscles, fat, superficial fascia of pelvic diaphragm
What are the 3 parts of the superficial membranous fascia?
Scarpa's, Dartos and Colle's fascia
What does Scarpa's fascia cover?
anterior abdominal wall
What does Dartos fascia cover?
penis and scrotum
What is Colle's fascia located?
in males-posterior to scrotum
Name the erectile tissue in females? males?
f-vestibular bulbs
m-corpus spongiosum and bulb
What is present in the female external genitalia erectile tissue and muscle layer that is not in men?
Greater Vestibular (Bartholin's) glands
Name what is present in the external genitalia erectile tissue and muscle layer.
bulbospongiosus muscle, erectile tissue, ishiocavernosus muscles on crus of clitoris or penis, superficial transverse perineal muscles, branches of internal pudendal vessels
in females only Greater Vestibular (Bartholin's) glands
What tissue layers make up the superficial perineal space?
investing fascia and external genitalia erectile tissue and muscle
What tissue layers make up the deep perineal space?
external urethral sphincter muscles and fat
What muscles comprise the external urethral sphincter muscles?
urethral sphincter, compressor urethra and deep transverse perineal muscles
What forms the superficial fascia of the pelvic diaphragm?
levator ani and coccygeus muscles
What forms the roof of the deep perineal space?
inferior epimysium
What forms the anal triangle?
ischial tuberosities and tip of cocyx
What occurs w/ the rectum passing through the levator ani muscle?
causes change in muscle fiber direction creating the puborectalis portion of the levator ani muscle
What does the puborectalis muscle form? What is its function?
puborectal sling
helps keep fecal continence, relieves pressure on anal sphincters
What are the 3 parts of the external anal sphincter muscle? Which of these are skeletal muscle? smooth?
deep external, superficial external and subcutaneous external sphincters
all are skeletal muscle
What innervates the external anal sphincter? What does this nerve branch from?
S4, inferior rectal nerve a branch off the internal pudendal nerve
Is the internal anal sphincter above or below the pectinate line?
What inntervates the internal anal sphincter? What type of sensations can be felt here? What does that mean for hemrroids?
PSNS from the pelvic splanchnic nerves
stretch only, no temperature
internal hemrooids may be painless
Why do fluids normally not move from the superficial perineal space to the deep perineal space?
b/c of the attachment of the superficial membrane fascia to the free (posterior) edge of the perineal membrane

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