Description: The perineum is a diamond-shaped region, folded
as a kite between the pubic symphysis
anteriorly, the ischial tuberosities
laterally, and the coccyx
posteriorly. The triangle anterior to an imaginary line drawn between
the tuberosities is the urogenital
triangle,and posterior to the line is the anal triangle.The
urogenital triangle is tilted superiorly parallel with the inferior rami
of the pubic bones, and the anal part is inclined superiorly to the coccyx.
Internal to the integument
and external structures (vulva and
anus), the pelvic diaphragm
is comprised of ligaments and muscles, through which the apertures for
the urethra, vagina, and anus
emerge. The perineal body is the central tendon of the perineum
between the vulva and anus. The major muscles of the pelvic diaphragm
are the levator ani, and the
coccygeous m. The
urogenital diaphragm, corresponding to the shape of, and lying
superior to the urogenital triangle, and inferior to the levator
sling, is comprised of two fascial leaves between which are the superficial transverse perineal m. Anteriorly,
the bulbospongiosus m., and
the internal urethral sphincter encircle the vagina and urethra, respectively,
and the external anal sphincter does so posteriorly. Antero-laterally,
an inverted-V shaped m., the ischiocavernosis,
extends along the ramus of the pubis. |