Perineum

Perineum
Not to be confused with peritoneum.

Perineum

The muscles of the female perineum

The muscles of the male perineum

Latin Perineum, perinaeum

Gray's p.424 [1] System Musculoskeletal system Artery Perineal artery, dorsal artery of the penis and deep artery of the penis Nerve Perineal nerve, posterior scrotal nerves, dorsal nerve of the penis or dorsal nerve of clitoris

Lymph Primarily superficial inguinal lymph nodes

In human anatomy, the perineum (/prnim/;[2] Late Latin, from Greek - perineos[3]) is a region of the body including the perineal /prnil/ body and surrounding structures. There is some variability in how the boundaries are defined. According to some definitions, in females it is located between the vagina and anus and in

Perineum males between the scrotum and anus.

Terminology
It is generally defined as the surface region in both males and females between the pubic symphysis and the coccyx. The perineum is the region of the body inferior to the pelvic diaphragm and between the legs. It is a diamond-shaped area on the inferior surface of the trunk that includes the anus and, in females, the vagina.[4] Its definition varies: it can refer to only the superficial structures in this region, or it can be used to include both superficial and deep structures. The term lower rabbus is used colloquially in the UK to describe this structure.[citation needed] The perineum corresponds to the outlet of the pelvis. It is an erogenous zone for both males and females.[citation needed] Perineal tears and episiotomy often occur in childbirth with first-time deliveries, but the risk of these injuries can be reduced by preparing the perineum, often through massage. There are a number of American slang terms commonly used for this area of the human body, such as gooch, grundle, scrid, taint, tisney, and barse. The anogenital distance is a measure of the distance between the anus and the base of the penis or vagina. Studies show that the human perineum is twice as long in males as in females.[5] Measuring the anogenital distance in neonatal humans has been suggested as a noninvasive method to determine male feminisation and thereby predict neonatal and adult reproductive disorders.[6]

Boundaries
Its deep boundaries are as follows: in front: the pubic arch and the arcuate ligament of the pubis behind: the tip of the coccyx on either side: the inferior rami of the pubis and ischial tuberosity, and the sacrotuberous ligament superiorly: pelvic floor[7] inferiorly: skin and fascia

Triangles
A line drawn transversely across in front of the ischial tuberosities divides the space into two triangles:
Name Location Contents in females, contains the vagina

Urogenital triangle the anterior triangle Anal triangle

the posterior triangle contains the anus

Perineal fascia
The terminology of the perineal fascia can be confusing, and there is some controversy over the nomenclature. This stems from the fact that there are two parts to the fascia, the superficial and deep parts, and each of these can be subdivided into superficial and deep parts. The layers and contents are as follows, from superficial to deep: 1) Foreskin 2) superficial perineal fascia: Subcutaneous tissue divided into two layers: (a) A superficial fatty layer, and (b) Colles' fascia, a deeper, membranous layer. 3) deep perineal fascia and muscles:

Perineum

Superficial perineal pouch

Contains superficial perineal muscles: transversus perinei superficialis, bulbospongiosus, ischiocavernosus A membranous layer of the deep fascia.

Inferior fascia of urogenital diaphragm, or perineal membrane Deep perineal pouch

Contains the deep perineal muscles: transversus perinei profundus, sphincter urethrae membranaceae Considered hypothetical by some modern anatomists, but still commonly used to logically divide the contents of the region.

Superior fascia of the urogenital diaphragm

4) fascia and muscles of pelvic floor (levator ani, coccygeus)

Areas of the perineum

The region of the perineum can be considered a distinct area from pelvic cavity, with the two regions separated by the pelvic diaphragm. The following areas are thus classified as parts of the perineal region: Perineal pouches: superficial and deep (see above for details) Ischioanal fossa a fat-filled space at the lateral sides of anal canal. It is bounded laterally by obturator internus muscle, medially by pelvic diaphragm and anal canal. Its base is the skin. Anal canal Pudendal canal contains internal pudendal artery and the pudendal nerve.

Additional images

Diameters of inferior aperture of lesser pelvis (female)

The perineum. The integument and superficial layer of superficial fascia reflected

The superficial branches of the internal pudendal artery

The posterior aspect of the rectum exposed by removing the lower part of the sacrum and the coccyx

Perineum

Stages in the development of the external sexual organs in the male and female

References
[1] http:/ / archive. org/ stream/ anatomyofhumanbo1918gray#page/ 424/ mode/ 2up [2] OED 2nd edition, 1989 as and . [3] (http:/ / www. perseus. tufts. edu/ hopper/ text?doc=Perseus:text:1999. 04. 0057:entry=peri/ neos), Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus [4] Gray, Henry. Anatomy of the Human Body. Philadelphia: Lea & Febiger, 1918; Bartleby.com, 2000. [5] "Validity of anogenital distance as a marker of in utero phthalate exposure". PMID 16393642 [6] Michelle Welsh, et al.: "Identification in rats of a programming window for reproductive tract masculinization, disruption of which leads to hypospadias and cryptorchidism" (http:/ / www. jci. org/ articles/ view/ 34241). Journal of Clinical Investigation, 13 March 2008. [7] Daftary, Shirish; Chakravarti, Sudip (2011). Manual of Obstetrics, 3rd Edition. Elsevier. pp. 1-16. ISBN 9788131225561.

External links
perineum (http://mywebpages.comcast.net/wnor/perineum.htm) at The Anatomy Lesson (http://home. comcast.net/~wnor/homepage.htm) by Wesley Norman (Georgetown University) Slang words for the perineum (http://onlineslangdictionary.com/thesaurus/words+meaning+perineum.html)

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