Learning Objectives

Perineum 1 Lecture

Anal Triangle

1. Perineum and Pelvis- Define the boundaries of the anatomical regions known as the perineum and pelvis.

2. Anal Triangle

a. Define the boundaries of the ischio-anal fossae.

b. Describe the course of the pudendal nerve and internal pudendal vessels through the gluteal region and anal triangle.

c. Define the location and contents of the pudendal canal.

d. Describe the course and distribution of the inferior rectal nerve and vessels.

e. Describe the location of the internal and external anal sphincter muscles.

f. Define the location and importance of the perineal body.

g. Define the types of hemorrhoids and the vessels involved in each.

h. Describe the sensory nerve supply for the anal canal.

i. Describe the blood supply and lymphatic drainage for the anal canal and peri-anal skin.

j. Understand the importance of the fat in the ischio-anal fossae.

Netter 334

Ischial spine

Obturator foramen

Netter 334

Moore et al; Fig. 3.3

Netter 334

Netter 474

Netter 474

Netter 335

Netter 336

Netter 335

Netter 336

Netter 334

Diagonal conjugate

Moore et al, Fig B3.2

Anorectal hiatus

Urethral hiatus

Tendinous arch

Piriformis m.

(Ischio)coccygeus m.

Iliococcygeus m.

Puborectalis m.

Pubococcygeus m.

Obturator internus m.

Plate 340

Plate 341 Gluteus maximus m.

(Ischio)coccygeus m.

Iliococcygeus m.

Pubococcygeus m.

Puborectalis m.Urethra

Plate 338

Urethra

Vagina

Rectum

Piriformis m.

Tendinous arch

Pubococcygeus m.

Iliococcygeus m.

(Ischio)coccygeus m.

Urethra

Vagina

Plate 339

Sacrotuberous ligament

Obturator internus m.

Pubococcygeus m.

Puborectalis m.

Iliococcygeus m.

(Ischio)coccygeus m.

Plate 338

Rectum

VaginaUrethra

Piriformis m.

Obturator internus m.

Tendinous arch

(Ischio)coccygues m.

Iliococcygues m.

Pubococcygeus m.

Moore et al, Fig. 3.8

Backhouse & Hutchings, Plate 435

S3

S2

S3

S4

Netter 159

Snell, Fig. 4-3Snell, Fig 4-3

Snell, Fig 4-4Snell, Fig 4-4

Plate 360

Snell; Fig 23-2

Levator ani m.

Gluteus maximus m.

External anal sphincter m.

Perineal body

Plate 362

Plate 358Gluteus maximus m.

Levator ani m.

Perineal body

External anal sphincter m.

Plate 393

Inferior rectal nn.

Perineal n.

Dorsal n. of clitoris

Pudendal nerve

Plate 384

Inferior rectal a.

Internal pudendal a.

Perineal a.

Plate 391

Fascia of obturator internus m. forming pudendal canal

Inferior rectal nn.

Perineal n.

Posterior scrotal n

Inferior rectal a

Pudendal n.

Plate 385Inferior rectal a.

Inferior rectal v.

Perineal a. and v.

Pudendal canal

Plate 372

Fat in ischioanal fossa

Obturator internus m.

Levator ani m.

Pudenal canal with pudendal n, internal pudendal a. and v.

Rectum

Anal canal

Plate 373

RECTUM

Anal columns

Internal venous plexus

External venous plexus

Levator ani m.

External anal sphincter m.

Plate 374

External anal sphincter m.

Internal anal sphincter m.

Anal valves

Anal columns

Internal venous plexus

External venous plexus

Plate 378

Internal pudendal a.

Obturator internus m.

Inferior rectal a.

Superior rectal a.

Middle rectal a.

Plate 379

Inferior rectal v.

Internal pudendal v.

Obturator internus m.

Superior rectal v.

Middle rectal v.

External venous plexusInternal venous plexus

Levator ani m.

Anal Fissure

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Hemorrhoids

Anal Fistula

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