Understanding the Perineum: Boundaries, Divisions, and Fossae
Discover the anatomy of the perineum, from its superficial and deep boundaries to the divisions into urogenital and anal triangles. Explore the ischiorectal fossa, its measurements, boundaries, and significance in body mechanics.
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Presentation Transcript
Perineum (part 1) Perineum (part 1) Dr Stuti Tandon Assistant professor Department of anatomy Cims&h
Introduction Introduction Perineum is the lowest region of trunk below pelvic diaphragm. It is traversed by urethra and anal canal in males. It is traversed by urethra,vagina and anal canal in females. Surface features in males: penis, scrotum and anal orifice. Surface features in females: female external genitalia and anal orifice.
Superficial boundaries Superficial boundaries Male perineum Female perineum
Deep boundaries Deep boundaries
Divisions Divisions The perineum is divided into two triangles by a horizontal plane passing through the anterior end of ischial tuberosities. 1. Anterior urogenital triangle 2. Posterior anal triangle
Anal triangle/posterior perineum Anal triangle/posterior perineum
Ischiorectal fossa (ischioanal fossa) Ischiorectal fossa (ischioanal fossa) Wedge shaped Fat filled space Situated on either side of anal canal Lies below the pelvic diaphragm The two fossae communicate with each other behind the anal canal They help in dilatation of Anal canal during defecation Base of fossa skin over the anal region of perineum Apex directed upwards
Measurement of fossa Length 5cm Width 5cm Depth 5cm or slightly more
Boundaries Boundaries
Recesses of ischiorectal fossa Recesses of ischiorectal fossa
Contents Contents
Clinical correlation Clinical correlation Ischiorectal abscess- infection in ischiorectal fossa can occur from boils and abrasions of perianal skin,from lesions within the anal canal, pelvic infection or rarely via blood forming ischiorectal abscess. Infection may pass from one fossa to another behind the anal canal forming horse shoe shaped abscess. Abscess may burst into anal canal leading to anorectal fistula. Abscess may burst on the surface of perineum leading to fistula in ano. Loss of fat in ischiorectal fossa leads to rectal prolapse Pelvic organs may herniate into ischiorectal fossa through a gap between tendinous origin of levator ani and obturator fascia ( hiatus of Schwalbe) Ischiorectal abscess and anorectal fistula
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