14.perineal pouches & ur diaphragm.ppt

7/18/2019 14.Perineal Pouches & Ur Diaphragm.ppt

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By. Dr. Mujahid Khan



It is a triangular musculofascial diaphragm

Situated in the anterior part of the perineum

Filling in the gap of the pubic arch

It is formed by the sphincter urethrae and the

deep transverse perineal muscles, hich areenclosed beteen a superior and an inferiorlayer of fascia of the urogenital diaphragm

!he inferior layer of fascia is often referred to

as the perineal membrane



"nteriorly the to layers of fascia fuse, leavinga small gap beneath the symphysis pubis

#osteriorly, the to layers of fascia fuse itheach other and ith the membranous layer ofthe super$cial fascia and the perineal body

%aterally the layers of fascia are attached to

the pubic arch

!he closed space that is contained beteenthe super$cial and deep layers of fascia is

&non as the deep perineal pouch



Superficial perineal pouch is bounded below by themembranous layer of superficial fascia

above it is bounded by the urogenitaldiaphragm

Is closed behind by the fusion of its upperand loer alls



%aterally, it is closed by the attachmentof the membranous layer of super$cialfascia and the urogenital diaphragm to

the margins of the pubic arch

"nteriorly, the space communicates

freely ith the potential space lyingbeteen the super$cial fascia of theanterior abdominal all and the anteriorabdominal muscles



!he super$cial perineal pouch containsstructures forming the root of the penis

!he muscles that cover them, thebulbospongiosus and the ischiocavernosusmuscles

!he bulbospongiosus muscles, situatedone on each side of the midline

!hey cover the bulb of the penis and the

posterior portion of the corpus spongiosum



!hese muscles compress the penile partof the urethra and empty the residualurine or semen

!he anterior $bers also compress thedeep dorsal vein of the penis

!hus impeding the venous drainage ofthe erectile tissue and thereby assistingin the process of erection of the penis



!he ischiocavernosus muscles cover thecrus penis on each side

!he action of each muscle is to compressthe crus penis and assist in the process oferection of the penis



!he super$cial transverse perineal muscles liein the posterior part of the super$cial perinealpouch

'ach muscle arises from the ischial ramus andis inserted into the perineal body

!he function of these muscles is to $( theperineal body in the center of the perineum

"ll the muscles of the super$cial perinealpouch are supplied by the perineal branch ofthe pudendal nerve



!his small mass of $brous tissue isattached to the center of the posterior

margin of the urogenital diaphragm

It serves as a point of attachment for thee(ternal anal sphincter, bulbospongiosus

muscle, and super$cial transverseperineal muscles



!he perineal branch of the pudendalnerve on each side terminates in the

super$cial perineal pouch by supplyingthe muscles and s&in



!he deep perineal pouch contains )

!he membranous part of the urethra

!he sphincter urethrae muscle

!he bulbourethral glands

!he deep transverse perineal muscles

!he internal pudendal vessels and their branches

!he dorsal nerves of the penis



!he membranous part of the urethra is about *.+cm long and lies ithin the urogenital diaphragm

It is surrounded by the sphincter urethrae muscle

It is continuous above ith the prostatic urethraand belo ith the penile urethra

It is the shortest and least dilatable part of theurethra



!he sphincter urethrae muscle surrounds theurethra in the deep perineal pouch

It arises from the pubic arch on the to sidesand passes medially to encircle the urethra

!he perineal branch of the pudendal nervesupplies the sphincter

!he muscle compresses the membranous part ofthe urethra and rela(es during micturition

It is the means by hich micturition can be

voluntarily stopped



!he bulbourethral glands are to smallglands that lie beneath the sphincterurethrae muscle

!heir ducts pierce the perinealmembrane and enter the penile portion

of the urethra

!he secretion is poured into the urethraas a result of erotic stimulation



!he deep transverse perineal muscles lieposterior to the sphincter urethraemuscle

'ach muscle arises from the ischialramus and passes medially to be inserted

into the perineal body

!hese muscles are clinically unimportant



!he internal pudenal artery on each sideenters the deep perineal pouch and passesforard, giving rise to)

!he artery to the bulb of the penis

!he arteries to the crura of the penis

!he dorsal artery of the penis, hichsupplies the s&in and fascia of the penis

!he dorsal nerve of the penis on each sidepasses forard through the deep perinealpouch and supplies the s&in of the penis



!he super$cial perineal pouch containsstructures forming the root of the clitorisand the muscles that cover them

!he bulbospongiosus muscles

!he ischiocavernosus muscles



!he bulbospongiosus muscle surrounds theori$ce of the vagina and covers thevestibular bulbs

Its $bers e(tend forard to gain attachmentto the corpora cavernosa of the clitoris

!he bulbospongiosus muscle reduces thesie of the vaginal ori$ce and compressesthe deep dorsal vein of the clitoris, therebyassisting in the mechanism of erection in

the clitoris



!he ischiocavernosus muscle on eachside covers the crus of the clitoris

-ontraction of this muscle assists incausing the erection of the clitoris



!he super$cial transverse perinealmuscles are identical in structure andfunction to those of the male

"ll the muscles of the super$cial perinealpouch are supplied by the perineal

branch of the pudendal nerve



!he perineal body is larger than that of themale and is clinically important

It is a edgeshaped mass of $brous tissue

Situated beteen the loer end of thevagina and the anal canal

It is the point of attachment of manyperineal muscles /as in the male0, includingthe levatores ani muscles

%evatores ani assist the perineal body insupporting the posterior all of the vagina



!he perineal branch of the pudendalnerve on each side terminates in the

super$cial perineal pouch by supplyingthe muscles and s&in



!he deep perineal pouch contains part of theurethra

#art of the vagina

!he sphincter urethrae, hich is pierced by theurethra and the vagina

!he deep transverse perineal muscles

!he internal pudendal vessels and theirbranches

!he dorsal nerves of the clitoris



Se(ual e(citement producesengorgement of the erectile tissue ithin

the clitoris in e(actly the same manner asin the male



!he female urethra is about +.1 cm long

It e(tends from the nec& of the bladder to thee(ternal meatus

It opens into the vestibule about 2.3 cm belo theclitoris

It traverses the sphincter urethrae and liesimmediately in front of the vagina

"t the sides of the e(ternal urethral meatus are thesmall openings of the ducts of the paraurethralglands

!he urethra can be dilated relatively easily



!he paraurethral glands correspond tothe prostate in the male

4pen into the vestibule by small ducts oneither side of the urethral ori$ce



!he greater vestibular glands are a pairof small mucussecreting glands that lieunder cover of the posterior parts of thebulb of the vestibule and the labia majora

'ach drains its secretion into thevestibule by a small duct hich opensinto the groove beteen the hymen andthe posterior part of the labium minus

!hese glands secrete a lubricating mucus

d i l i

14.perineal pouches & ur diaphragm.ppt

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