·
In Extravasated urine by rupture of BULBOUS Part, The urine cannot spread
laterally into the thigh because the inferior fascia of the urogenital diaphragm
(the perineal membrane) and the superficial fascia of the perineum are firmly
attached to the ischiopubic rami and are connected with the deep fascia of the
thigh (fascia lata). It cannot spread posteriorly into the anal region because
the perineal membrane and Colles' fascia are continuous with each other around
the superficial transverse perineal muscles.
If the membranous part of the urethra is ruptured,
urine escapes into the deep perineal space and can extravasate upward around
the prostate and bladder or downward into the superficial perineal space.
·
Ischiorectal Fossa has the following boundaries:
1.
Anterior: the sphincter urethrae and deep
transverse perineal muscle.
2.
Posterior: the gluteus maximus muscle and the
sacrotuberous ligament
3.
Superomedial: the sphincter ani externus and
levator ani muscles
4.
Lateral: the obturator fascia covering the
obturator internus muscle
5.
Floor: the skin over the anal triangle
·
Deep fascia of the penis (Buck's fascia) is a
continuation of the deep perineal fascia.Is continuous with the fascia covering
the external oblique muscle and the rectus sheath.
·
Internal Pudendal Artery from IIA, But External is from
FA.
·
Lymph vessels
from the glans penis (or clitoris) and labium minus pass to the deep inguinal
and external iliac nodes.
·
Urethral crest is located on the posterior wall
of the prostatic urethra and has numerous openings for the prostatic ducts on
either side.
Has an
ovoid-shaped enlargement called the seminal colliculus (verumontanum), on which the
two ejaculatory ducts and the prostatic utricle open. At the summit of the
colliculus is the prostatic utricle, which is an invagination (a blind pouch)
about 5 mm deep; it is analogous to the uterus and vagina in the female.
·
The internal anal sphincter (a thickening of the
circular smooth muscle in the lower part of the rectum) is separated from the
external anal sphincter (skeletal muscle that has three parts: subcutaneous,
superficial, and deep) by the intermuscular (intersphincteric) groove called Hilton's white
line.
·
Anal Canal has a point of demarcation between
visceral and somatic portions called the pectinate (dentate) line, which is a serrated
line following the anal valves and crossing the bases of the anal columns.
·
Pelvic splanchnic nerves (nervi erigentes)
Arise from the
sacral segment of the spinal cord (S2-S4) and are the only splanchnic nerves that carry
parasympathetic fibers. (All other splanchnic nerves are sympathetic.)Contribute
to the formation of the pelvic (or inferior hypogastric) plexus, and supply the
descending colon, sigmoid colon, and other viscera in the pelvis and perineum.
·
Contents of
Deep Perineal Pouch
1. Part of urethra and vagina.
2. Sphincter Urethrae.
3. Bulbourethral glands of Cowper.
4. Deep Transverse Perenei muscles.
5. Internal pudendal vessels and their branches.
6. Dorsal nerve of Penis or Clitoris
·
The anterior
third of the scrotum is supplied mainly from the L1 (by way of the ilioinguinal and
genitofemoral nerves), while the posterior
two-thirds are innervated principally from the S3 (via the perineal and posterior femoral
cutaneous nerves). The ventral axial line of the lower limb passes between
these areas. A spinal anaesthetic, therefore, must be injected much higher to
anaesthetize the anterior region.
·
In the midline behind the pubis, the
preperitoneal space is known as the space of
Retzius, while laterally it is referred to as the space of Bogros.
·
The pubococcygeus
muscle is the most
frequently torn muscle that results in female incontinence. The puborectalis, pubococcygeus, and iliococcygeus
comprise the levator ani, the main muscular component of the pelvic floor. The
pubococcygeus is the part of the levator ani most frequently damaged during
parturition. Because the
pubococcygeus surrounds and supports the neck of the bladder and the proximal
urethra, urinary leakage is a common result, particularly during increased
abdominopelvic pressure, as occurs, during coughing. Damage to the
puborectalis results in fecal incontinence under similar situations.
·
The perineal body
(central tendon of the perineum) is a fibromuscular node at the center of the
perineum. It provides attachment for the bulbospongiosus, the superficial and
deep transverse perineal muscles, and the sphincter ani externus muscles. Other
muscles (ischiocavernosus, sphincter urethrae, and obturator internus) are not
attached to the perineal body.
·
The deep dorsal vein
of the penis lies medial to the dorsal artery of the penis on the dorsum of the
penis and deep to Buck's fascia, drains into the prostatic plexus of veins, and
is compressed against the underlying deep fascia of the penis during erection.
·
The lymphatic
vessels from the ovary ascend with the ovarian vessels in the suspensory
ligament and terminate in the lumbar (aortic) nodes. Lymphatic vessels from the
perineum, external genitalia, and lower part of the anterior abdominal wall
drain into the superficial inguinal nodes.
·
The iliohypogastric
nerve innervates the skin above the pubis. The skin of the urogenital triangle
is innervated by the pudendal nerve, perineal branches of the posterior femoral
cutaneous nerve, anterior scrotal or labial branches of the ilioinguinal nerve,
and the genital branch of the genitofemoral nerve.
·
The deep dorsal vein
of the penis enters the pelvic cavity by passing under the symphysis pubis
between the arcuate and transverse perineal ligaments.
·
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