Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

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Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy

Transcript of Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Page 1: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Pelvic diaphragm,

urogenital diaphragm and

perineum

Sanjaya AdikariDepartment of Anatomy

Page 2: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Describe/draw

• Pelvic diaphragm/floor

• Urogenital and anal triangles

• Urogenital diaphragm

• Deep perineal pouch & contents

• Superficial perineal pouch &

contents

Page 3: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Pelvic diaphragm/Floor

• Consists of

– Levator ani

– Coccygeus

– Superior and inferior pelvic fascia

Page 4: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Pelvic diaphragm

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Obturator fascia

IschiococcygeusIliococcygeusPubococcygeus

Pelvic diaphragm…

Levator ani Coccygeus

White line(tendinous arch)

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Puborectalis

Pubovaginalis

Urogenital hiatus

Page 8: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

PubovaginalisLevator prostatae

Anococcygeal raphe

Anorectal junction

Puborectalis

Puborectalis, pubovaginalis, levator prostatae

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Levator prostatae

Puboprostatic ligaments

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Urogenital triangle

Anal triangle

Coccyx

subpubic angle

Ischiopubic ramus

Sacrotuberous ligament

Anterior end of ischial tuberosity

Perineum

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Perineal triangles

Page 14: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Sacrotuberous ligament

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Perineal body

Perineal body/central perineal tendon

Pubis

Fibromuscular mass to which pelvic diaphragm and perineal muscles are attached

Page 16: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Deep perineal pouch

Perineal membrane/inferior fascia UD

Perineal body/central perineal tendon

External Sphincter

Prostate

Urogenital diaphragm

Page 17: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Urogenital diaphragm

• Consists of

– Superior fascia (blends with inferior pelvic

fascia)

– Inferior fascia (perineal membrane)

– Sphincter urethrae muscle

– Deep transverse perineal muscles

Page 18: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Deep perineal pouch• Space between the superior and inferior

fasciae of the urogenital diaphragm

• Contents– Membranous urethra

– Internal pudendal vessels

– Dorsal nerve of penis

– Perineal nerve

– Bulbourethral glands (Bartholin glands in superficial

pouch)

– Sphincter urethrae and deep transverse perineal muscles

Page 19: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Deep transverse perineal muscles

Bulbourethral glands

Deep perineal pouch

Sphincter urethrae

Vessels and nerves

Page 20: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Membranous layer of superficial fascia of abdomen/ fascia Scarpa

Superficial perineal pouch

Superficial perineal fascia/Colles

Superficial perineal pouchCorona of glans penis

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Page 22: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Attachment of superficial perineal fascia

Perineal membrane

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Superficial perineal pouch…. Cont.

superficial perineal fascia

superficial transverseperineal muscle

bulbospongiosus

ischioanalfossa

ischiocavernosus

Page 24: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Superficial perineal pouch

• Space between the superficial

perineal fascia and the perineal

membrane

• Contents– Bulbospongiosus muscle

– Ischiocavernosus muscle

– superficial transverse perineal muscles

– Root and the body of the penis

– testicles

Page 25: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Root

Body

Glans

Bulb

Crus

Corpus spongiosum

Corpus cavernosum

Bulbospongiosus

Ischiocavernosus

Parts of the penis & muscle attachments

Page 26: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Anal canal

Levator ani

External anal sphincter

Tube within a funnel

External anal sphincter

skeletal muscle

Internal anal sphincter

smooth muscle

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Ischioanal (ischiorectal) fossa

Ischial tuberosity

Obturator internus and fascia

Skin

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External anal sphincter

Deep

Superficial

Subcutaneous

Anococcygeal body

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Nerve to obturator internus

Internal pudendal artery

Pudendal nerve

Sacrospinous ligament

Ischial spine

Page 30: Pelvic diaphragm, urogenital diaphragm and perineum Sanjaya Adikari Department of Anatomy.

Penis

Deep p. pouch

Pudendal canal

Nerve to obturator internus

Internal pudendal artery

Pudendal nerve Inferior rectal nerve & artery

Dorsal nerve of penis

Perineal nerve

Dorsal artery of penis

Perineal artery

Deep artery of penis