Urogenital triangle in female + Perineal pouches

Dr Rania Gabr

OBJECTIVES 1. Describe the boundaries &

contents of urogenital triangle in female.

2. Recite the parts of the female external genital organs.

3. Identify its parts and openings present in it.

4. Discuss the features of each part 5. Discuss the contents of the

perineal pouches in female and male. 6. Enumerate the structures piercing

the perineal membrane.

Urogenital Triangle in femaleBOUNDARIES :• Anteriorly : Symphysis

pubis• Posteriorly : Transverse

line passing through the 2 ischial tuberosities.

• Laterally : Ischiopubic rami & ischial tuberosities.

CONTENTS : • Lower part of

urethra & vagina.• External genitalia

(vulva).

Ure

thra

Vagi

na

Vulva

Female External Genitalia (Vulva)

Mons pubis : a collection of fat overlying the pubis.

Labia majora.: Two folds of skin containing fatty tissue and covered with hair

Located on either side of the vaginal opening, extending from the mons pubis to the perineum

Labia minora.:› Two thin folds of tissue located within

the folds of the labia majora Extends from the clitoris downward toward the perineum

Clitoris.:› Short, elongated organ composed of

erectile tissue› Located just behind the upper

junction of the labia minora› Homologous to the penis

Vestibule of vagina: The interval between the two labia minora.

Vagina & urethra open into it through urethral orifice anteriorly and vaginal orifice (Also known as the vaginal introitus), posteriorly.

Bartholin’s glands› Located on either side of the vaginal

orifice Secrete a mucous substance that lubricates the vagina

Indifferent Male Female

Gonad Testis Ovary

Paramesonephric duct(Mullerian duct)

Appendix testis Fallopian tubes

Paramesonephric duct Prostatic utricle Uterus, upper vagina

Mesonephric tubules Efferent ducts, Paradidymis

Epoophoron, Paroöphoron

Mesonephric duct(Wolffian duct) Rete testis Rete ovarii

Mesonephric duct Epididymis Gartner's duct

Mesonephric duct Vas deferens

Mesonephric duct Seminal vesicle

Urogenital sinus Prostate Skene's glands

Urogenital sinus Bladder, urethra Bladder, urethra, lower vagina

Urogenital sinus Cowper's or Bulbourethral gland Bartholin's gland

Labioscrotal folds Scrotum Labia majora

Urogenital folds Spongy urethra Labia minora

Genital tubercle Penis Clitoris

Genital tubercle Bulb of penis Vestibular bulbs

Genital tubercle Glans penis Clitoral glans

Genital tubercle Crus of penis Clitoral crura

Prepuce Foreskin Clitoral hood

Peritoneum Processus vaginalis Canal of Nuck

Gubernaculum Gubernaculum testis

Round ligament of uterus

It is the space between the deep membranous layer of superficial fascia and the perineal membrane.

BOUNDARIES: Inferiorly: membranous

layer of superficial fascia (Colle`s fascia).

Superiorly: perineal membrane.

Laterally: ischiopubic rami

Superficial Perineal Pouch

Contents of Superficial Perineal Pouch in the female• 1- Bulbs of

vestibule: on each side of vaginal orifice.

• 2- Crura of clitoris. • 3- Superficial

perineal muscles: • A-

Bulbospongiosus muscle, surrounds orifice of vagina and covers vestibular bulb.

• B- Ischiocavernosus muscle, covers crus of clitoris on each side.

• C- Superficial transverse perineal muscles.

• 4- Greater vestibular glands: on each side of vaginal orifice.

• 5- Perineal body• 6- Perineal branch of pudendal

nerve suppling muscles & skin.

BulbospongiosusIschiocavernosus

Contents of Superficial Perineal Pouch in the male

1- Root (bulb and crura) of the penis and associated muscles (ischiocavernosus and bulbospongiosus).

2- Proximal (bulbous) part of the spongy urethra.

3- Superficial transverse perineal muscles.

4- Deep perineal branches of the internal pudendal vessels and pudendal nerves.

Bulbospongiosus Ischiocavernosus

Deep Perineal Pouch It is a completely

closed space deep to the perineal membrane.

BOUNDARIES: Inferiorly: Inferior

fascia of the urogenital diaphragm (Perineal membrane)

Superiorly: Superior fascia of the urogenital diaphragm

Laterally: Inferior portion of obturator internus fascia

• 1- Part of urethra .

• 2- Part of vagina.

• 3- Sphincter urethrae muscle, which is pierced by urethra & vagina.

• 4- Deep transverse perineal muscles

• 5- Internal pudendal vessels.

• 6- Dosal nerve of clitoris.

Contents of Deep Perineal Pouch in female

Contents of Deep Perineal Pouch in male

1- membranous part of the urethra,

2- the sphincter urethrae,

3- the bulbourethral glands,

4- the deep transverse perineal muscles, the internal pudendal vessels and their branches, and

5- the dorsal nerves of the penis.

Structures piercing the perineal membrane:

1- In the centre: a- Membranous urethra in male b- urethra and vagina in female

2- On both sides of the urethra: a- ducts of bulbourethral glands of male b- artery to bulb

3- Anteriorly a-Deep and dorsal arteries of penis or clitoris b- Dorsal nerve of penis or clitoris 4- Posteriorly:Scrotal or labial vessels and nerves

Anal TriangleBOUNDARIES:• Anteriorly:

Transverse line passing through the 2 ischial tuberosities.

• Posteriorly : coccyx.

• Laterally : ischial tuberosity & sacrotuberous lig. overlapped by gluteus maximus.

CONTENTS:

• Lower part of Anal canal (upper part lies in pelvis).

• Ano-coccygeal body (or raphe) : a fibrofatty mass that extends from anus to tip of coccyx.

• Ischiorectal fossa on each side.

Ischiorectal Fossa • A fascial lined

wedge-shaped space on each side of the anal canal.

Boundaries:

• Base: Skin of the perineum.

• Medial wall: Levator ani & anal canal.

• Lateral wall: Obturator internus, covered with pelvic fascia.

• Contents: • Dense fat. • Pudendal nerve & internal pudendal

vessels within the pudendal canal• Inferior rectal nerve & vessels

crossing the fossa to reach anal canal.

• Pudendal Canal:• A fascial canal formed by obturator

fascia, located on the lateral wall of the ischiorectal fossa,

• on the medial side of the ischial tuberosity.

• Contains pudendal nerve and internal pudendal vessels

The anococcygeal body is a complex musculotendinous structure situated between the anterior aspect of the coccyx and the posterior wall of the anorectal canal

Receives insertion of fibers of levator ani muscle

Anococcygeal Body

Thank You &Good Luck