perineum 2014

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PERINEUM

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Berada pada outlet pelvis dan dipisahkan dari

capvitas pelvis oleh diafragma pelvis(Levator

ani and coccygeus muscles)

Dibatasi oleh simphysis pubis pada anterior Anterolateral; inferior pubic rami and ischial rami

Lateral: ischial tuberosity

posterolateral: sacrotuberous ligamentinferior sacrum and coccyx

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Perineum

2 Triangles

Anal triangle (posterior) contains the anus

Urogenital triangle (anterior) contains the root of thescrotum and penis in males or the external genitalia infemales

Membran perineal membentang antara dua sisiarkus pubis dan meliputi bagian anterior outlet

perineal body : mass fibromuscular irregularberlokasi antara anal canal dan perinealmembrane

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Perineum pria dan wanita

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The subcutaneous tissue of the urogenital triangle includes a

superficial fatty layer and a deeper membranous layer, theperineal fascia (Colles fascia), which are continuous withcorresponding layers of the inferior anterior abdominal wall. ♦

In females, the fatty layer is thick within the mons pubis andlabia majora, but in males it is replaced by smooth dartosmuscle in the penis and scrotum. ♦

The perineal fascia is limited to the UG triangle, fusing withthe deep fascia at the posterior border (base) of the triangle.♦

In males, this layer extends into the penis and scrotum,where it is closely associated with the loose, mobile skin ofthose structures.

UG TRIANGLE

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The planar perineal membrane divides the

urogenital triangle of the perineum into

superficial and deep perineal pouches.

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Superficial perineal pouch

between the membranous layer of

subcutaneous tissue of the perineum and the

perineal membrane

bounded laterally by the ischiopubic rami

contains the erectile bodies of the external

genitalia and associated muscles, the

superficial transverse perineal muscle, deepperineal nerves and vessels, and in females

the greater vestibular glands

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Perineal Membrane

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Perineum

Muscles

Bulbospongiosus –

F O: tendon central perineum,

M O: tendon central dan bulb of penis;

F I: dorsum clitoris, diaphragma urogenital, M I: akar penis;

A: kompressi orifisium vagina atau kompressi urethra,

N: perineal nerve, pudenal nerve

IschiocavernosusO: ramus ischium,

I: dekat symphysis pubic, menjaga ereksi penis atauklitoris

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Muscles – Male

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Perineal Body

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Superficial Transverse Perineal

O: Ischial tuberosity

I: Perineal body

A: Support perineal body

N: Pudenal nerve

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External Urethral Sphincter

O: Ischial tuberosity

I: surround urethra

A: compress urethra to maintain urine

continence

N: Pudenal (S2-S4)

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Superficial Transverse Perineal

Female

S fi i l T

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Superficial Transverse

Perineal M

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Deep Transverse Perineal

O:aspek medial ramus ischium

I: Pineal Body

A: stabilisasi posisi perineal body

N: Pudenal N (S2-S4)

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Deep Transverse Perineal - F

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Deep Transverse Perineal -M

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Deep perineal pouch

is between the perineal membrane and the inferior

fascia of the pelvic diaphragm

is bounded laterally by the obturator fascia

includes the fat-filled anterior recesses of theischioanal fossae (laterally), the deep perineal

muscle and inferiormost part of the external

urethral sphincter, the part of the urethra

traversing the perineal membrane andinferiormost external urethral sphincter (the

intermediate urethra of males), the dorsal nerves

of the penis/clitoris, and in males the bulbourethral

glands.

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Anal Triangle

The ischioanal fossae are fascia-lined, wedge-

shaped spaces occupied by ischioanal fat

bodies.

The fat bodies provide supportive packing thatcan be compressed or pushed aside to permit

the temporary descent and expansion of the

anal canal or vagina for passage of feces or a

fetus. ♦

The fat bodies are traversed by inferior

anal/rectal neurovasculature. ♦

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Canalis Alcock

The pudendal canal is an important

passageway in the lateral wall of the fossa,between layers of the obturator fascia, forneurovasculature passing to and from theUG triangle

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Branches

Superior gluteal Inferior gluteal

Pudendal

Posterior femoral

cutaneou

Sciatic Common

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Pudendal nerve block

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perineum 2014

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