PERINEUM

Berada pada outlet pelvis dan dipisahkan dari capvitas pelvis oleh diafragma pelvis(Levator ani and coccygeus muscles) Dibatasi oleh simphysis pubis pada anterior Anterolateral; inferior pubic rami and ischial rami Lateral: ischial tuberosity posterolateral: sacrotuberous ligament inferior sacrum and coccyx

Perineum

2 Triangles
Anal triangle (posterior) contains the anus Urogenital triangle (anterior) contains the root of the scrotum and penis in males or the external genitalia in females

Membran perineal membentang antara dua sisi arkus pubis dan meliputi bagian anterior outlet perineal body : mass fibromuscular irregular berlokasi antara anal canal dan perineal membrane

Perineum pria dan wanita

UG TRIANGLE
The subcutaneous tissue of the urogenital triangle includes a superficial fatty layer and a deeper membranous layer, the perineal fascia (Colles fascia), which are continuous with corresponding layers of the inferior anterior abdominal wall. In females, the fatty layer is thick within the mons pubis and labia majora, but in males it is replaced by smooth dartos muscle in the penis and scrotum. The perineal fascia is limited to the UG triangle, fusing with the deep fascia at the posterior border (base) of the triangle. In males, this layer extends into the penis and scrotum, where it is closely associated with the loose, mobile skin of those structures.

The planar perineal membrane divides the urogenital triangle of the perineum into superficial and deep perineal pouches.

Superficial perineal pouch

between the membranous layer of subcutaneous tissue of the perineum and the perineal membrane bounded laterally by the ischiopubic rami contains the erectile bodies of the external genitalia and associated muscles, the superficial transverse perineal muscle, deep perineal nerves and vessels, and in females the greater vestibular glands

Perineal Membrane

Perineum
Muscles Bulbospongiosus F O: tendon central perineum, M O: tendon central dan bulb of penis; F I: dorsum clitoris, diaphragma urogenital, M I: akar penis; A: kompressi orifisium vagina atau kompressi urethra, N: perineal nerve, pudenal nerve Ischiocavernosus O: ramus ischium, I: dekat symphysis pubic, menjaga ereksi penis atau klitoris

Muscles Male

Perineal Body

Superficial Transverse Perineal

O: Ischial tuberosity I: Perineal body A: Support perineal body N: Pudenal nerve

External Urethral Sphincter

O: Ischial tuberosity I: surround urethra A: compress urethra to maintain urine continence N: Pudenal (S2-S4)

Superficial Transverse Perineal Female

Superficial Transverse Perineal M

Deep Transverse Perineal

O:aspek medial ramus ischium I: Pineal Body A: stabilisasi posisi perineal body N: Pudenal N (S2-S4)

Deep Transverse Perineal - F

Deep Transverse Perineal -M

Deep perineal pouch

is between the perineal membrane and the inferior fascia of the pelvic diaphragm is bounded laterally by the obturator fascia includes the fat-filled anterior recesses of the ischioanal fossae (laterally), the deep perineal muscle and inferiormost part of the external urethral sphincter, the part of the urethra traversing the perineal membrane and inferiormost external urethral sphincter (the intermediate urethra of males), the dorsal nerves of the penis/clitoris, and in males the bulbourethral glands.

Anal Triangle

The ischioanal fossae are fascia-lined, wedgeshaped spaces occupied by ischioanal fat bodies. The fat bodies provide supportive packing that can be compressed or pushed aside to permit the temporary descent and expansion of the anal canal or vagina for passage of feces or a fetus. The fat bodies are traversed by inferior anal/rectal neurovasculature.

Canalis Alcock
The pudendal canal is an important passageway in the lateral wall of the fossa, between layers of the obturator fascia, for neurovasculature passing to and from the UG triangle

Branches

Superior gluteal Inferior gluteal Pudendal Posterior femoral cutaneou Sciatic Common

Pudendal nerve block