The perineal anatomy includes a part of the body, which on different sides is limited by the pubis, coccygeal apex and tubercles of the seat with hump-sacral ligaments. If the legs are retracted or bent, it has a rhombic shape, which is formed due to the bone apparatus of the pubis and sciatica, as well as the spinous-sacral ligaments, covered with large sciatic muscles.
Differences in perineal anatomy of men and women
A tendon suture is located in the middle of the perineum in the anteroposterior side. In men, he goes into the scrotal seam. Crotch - the lower wall of the body. Thus, she covers the small pelvis from below. Through it go the channel of urination, the vagina and rectum in women.
Crotch function
Crotch helps keep the pelvic organs in place. Prevents uncontrolled elimination of human waste, regulates the withdrawal of urine and feces.
It is important to know the topographic anatomy of the pelvis and perineum. Particular attention should be paid to this when it comes to a female patient. Structural features are always taken into account by surgeons during an intervention during the elimination of perineal tears of the 1st degree during childbirth.
Structure
The obstetric crotch is the muscle segment between the labia majora and the exudate opening. The term is used exclusively in the narrow sense of the word.
In a broad sense, anatomy defines the perineum as the connection of the anterior and posterior triangle.
The front triangle is the area related to the genitourinary system. Filled with frontal muscular-fascial plate. She is the urogenital diaphragm. Contains deep transverse fibers and two fascia leaves. The latter covers the muscle fibers up and down. In front of the urethra, the muscle-fascial plate does not reach the connection of the pubis and forms a transverse ligament of the perineum. The area between the transverse and annular ligaments of the pubic fusion enter the arterial structures of either the penis or the clitoral region.
The posterior triangle is the area of the rectum that passes into the anus. Fills the bottom of the pelvis with a diaphragm horizontally. It is formed by the plexus of both muscles that lift the anus, as well as both fibrous structures of the coccyx with fascia. Through the diaphragm of the pelvis, the intestine ends in the anus. Through the diaphragm of the urogenital structure in men there is a channel of urination, scrotum sac and root of the penis, in women - parts of the external reproductive system.
Perineal muscle anatomy
Muscle fibers form deep and superficial layers.
Diaphragm layers next to the genitourinary system:
1. Superficial: spongy-bulbous, cavernous-sciatic, transverse superficial.
2. Deep: transversely deep, urinary canal closure.
The spongy-onion layers have a paired structure, close the lower lateral part and the spongy area. Spliced with the same layers on the back. Together form a longitudinal seam. Main function: compressing the urination channel to remove urine or seminal fluid. In women, they are divided into two parts, which narrow the vagina.
Cavernous-sciatic fibers come from both tubercles of the sciatica. Attached to the cavernous body. Main function: compression of the venous passages of the clitoris or penis; thickening of the penis and its rise during filling with blood of the corpus cavernosum.
Cross-surface layers are paired structures that lie between two diaphragms. Begin from the hillocks of the seat on both sides. Directed to the center of the tendons in order to strengthen.
The transverse-deep muscle is a flat fibrous structure enveloping the membranes of the urination channel. It goes from the tubercles of the sciatica and the bottom of the bone apparatus of the sciatica to the middle to form a tendon suture. Fastens the diaphragm of the genitourinary system. It contains a channel for emitting urine, as well as a vagina. In the place of passage of the urination channel, muscle fibers ring it, forming a kind of contactor. It serves as a urethra valve.
Muscles descending to the perineum
The tissues responsible for lifting the anus, as well as the coccygeal muscles, form a deep layer.
The muscle that lifts the anus looks like a flat triangle that goes to the descending part of the pubic bones, the lictor bundles inside the closure muscle, and also the bottom of the pelvis at the spine. Part of the muscles goes in the opposite direction to limit the mobility of the direct section of the intestine. Spliced with beams on the back. The other half of the muscles goes along the sides of the prostate and the bladder (in the female, the vagina). At this point, they grow together with the fibers surrounding the bladder and vagina, then move in the opposite direction, where they are attached to the lower third of the spine and coccygeal-anal ligaments.
The tailbone muscle lies behind the diaphragm of the pelvis. It starts from the bone apparatus of the sciatica and the spinosacral ligaments. Mounted on the sides of the lower spine.
The muscle of the diaphragm of the pelvis forms a layer on the surface.
It includes the anal fiber closure. According to the anatomy of the perineum, it is located in the anal circle above the main muscle responsible for lifting the anus. It works as an external arbitrary rectal exit closure. Together with muscle bundles forms a semicircle. The bundles lying on the surface go into the subcutaneous tissue, the bundles of which, in turn, begin from the lower third of the spinal column, and end in the center of the tendons. The deepest sections cover the anus, as well as the muscle responsible for its rise.
Pelvic and perineal tufts
The walls of the pelvic space, as well as the pelvic organs are framed by lictor beams.
In the crotch of women and men, the following liquor bundles are distinguished:
- actually pelvic;
- parietal pelvic bundles;
- visceral;
- bundles of peritoneal and perineal regions;
- upper bundles of the diaphragm of the pelvis;
- lower beams of the diaphragm of the pelvis;
- upper bundles of the diaphragm of the genitourinary system;
- lower bundles of the diaphragm of the genitourinary system;
- bundles lying on the surface of the perineum.
According to the perineum anatomy, the liquor bundles have a limiting and strengthening function.