Perineal body

Synonyms: Pubovisceral muscle, Musculus pubovisceralis The pelvic floor is primarily made up of thick ligaments and their investing fascia. It is a basin-shaped muscular diaphragm that helps to support the visceral contents of the pelvis. The main focus of this article will be the pelvic floor muscles. On that topic, there are several important questions that need to be answered: • Which muscles make up the pelvic floor? • What arteries and nerves supply the muscles of the pelvic floor? • What causes pelvic floor dysfunction? • What is the best exercise for the pelvic floor? Key facts about the muscles of the pelvic floor Gross anatomy A variably thick muscular membrane called a diaphragm Coccygeus and levator ani muscles ( iliococcygeus, puborectalis, pubococcygeus) Pubococcygeus can be further separated into – puboperinealis, puboprostaticus (male), pubovaginalis (female), puboanalis Mnemonic: Could I Please Peek? Attachments Laterally – attached to the tendinous arch of levator ani Posterolaterally – attached to the ischial spine Posteriorly – attached to the caudal sacrum and coccyx Anteriorly – attached to the posterior surface of the Midline – fibers form a midline levator raphe Blood supply Branches of the anterior division of the internal iliac artery: inferior vesical, pudendal, inferior gluteal Innervation Pudendal nerve (S2, S3) Direct branches from S4 (nerve to levator ani) Embryology Hypaxial division of the sacrococcygeal myotome Function Prevent...

Article: • • • • • • Images: • Gross anatomy The perineum is bounded by the The urogenital triangle is the anterior part of the perineum and it contains the The anal triangle contains the The central tendon of the perineum is the midpoint of the joining line between the ischial tuberosities and is called the perineal body. The Arterial supply The Innervation The Radiographic features Imaging is required to assess pelvic floor laxity in women with urinary and bowel continence issues. CT Provides limited visualization of the pelvic muscles. MRI Muscles of the pelvic floor can be imaged with MRI and pelvic floor movements can be assessed with MRI is the modality of choice in assessing the complex perineal lesions and their relations to the adjacent structures. It provides guidance for surgical planning due to its greater sensitivity and specificity than the other non-invasive imaging techniques. • 1. Chummy S. Sinnatamby. Last's Anatomy. (2020) • 2. Stephanie Ryan, Michelle McNicholas, Stephen J. Eustace. Anatomy for Diagnostic Imaging. (2020) • 3. Paul Butler, Adam Mitchell, Jeremiah C. Healy. Applied Radiological Anatomy. (2012) • 4. Ssi-Yan-Kai G, Thubert T, Rivain AL, Prevot S, Deffieux X, De Laveaucoupet J. Female perineal diseases: spectrum of imaging findings. (2015) Abdominal imaging. 40 (7): 2690-709. • skeleton of the abdomen and pelvis • • • • • • • • • • • • • • • • • • • muscles of the abdomen and pelvis • • • • • muscles • • • • • • • • • • • • • • • • • • • • •...

The perineal body (or central tendon of perineum) is a pyramidal fibromuscular mass in the middle line of the perineum at the junction between the urogenital triangle and the anal triangle. It is found in both males and females. In males, it is found between the bulb of penis and the anus; in females, is found between the vagina and anus, and about 1.25 cm in front of the latter. The perineal body is essential for the integrity of the pelvic floor, particularly in females. Its rupture during vaginal birth leads to widening of the gap between the anterior free borders of levator ani muscle of both sides, thus predisposing the woman to prolapse of the uterus, rectum, or even the urinary bladder. At this point, the following muscles converge and are attached: • External anal sphincter • Bulbospongiosus muscle • Superficial transverse perineal muscle • Anterior fibers of the levator ani • Fibers from external urinary sphincter • Deep transverse perineal muscle IMAIOS and selected third parties, use cookies or similar technologies, in particular for audience measurement. Cookies allow us to analyze and store information such as the characteristics of your device as well as certain personal data (e.g., IP addresses, navigation, usage or geolocation data, unique identifiers). This data is processed for the following purposes: analysis and improvement of the user experience and/or our content offering, products and services, audience measurement and analysis, interaction with soci...

3 Perineum and perineal body videos: Perineum and Perineal body • Perineum. • Perineal body. Perineum Perineum definition: the area between vaginal orifice & anus. Perineum divisions: it is divided into 2 triangles by a line between 2 ischial spines: i. Anterior triangle (urogenital triangle). ii. Posterior triangle (anal triangle). Perineum classification: i. Anatomical perineum (true perineum): • Diamond- shaped, pelvic outlet & soft structures cover it. ii. Gynecological perineum: • Area between posterior commisure & anus. Perineum and Perineal body Perineal body Perineal body development: mesodermal (lower part of anorectal septum). Description: Def.: central tendon of the perineum. Position:pyramidal fibromuscular mass that: • Lies in midline between anal canal posteriorly & lower vagina anteriorly. • Its base extends from fourchette to the anus & covered by skin. Size: each side of the triangle = 3.5 cm. Muscles attached to it: 1. Bulbocavernosus. 2. Superficial transverse perineii. 3. Deep transverse perineii. 4. External anal sphincter. 5. Some fibers of levator ani. Perineal body blood supply: A. Arterial: pudendal arteries (arise from internal iliac artery). B. Venous: pudendal veins (drain into internal iliac vein). Perineal bodynerve supply: perineal branch of pudendal nerve. Perineal bodylymph drainage: Inguinal & external iliac L.Ns. Perineal bodyfunctions: 1. Support pelvic viscera. 2. Support urethra& urethra-vesical junction. 3. Assists in defecation & chi...

Perineal descent is a condition in which the perineum prolapses (bulges down) or descends below the bony outlet of the pelvis. Perineal descent is often associated with chronic straining in patients with chronic constipation. Other conditions that weaken the pelvic floor musculature can also lead to symptomatic perineal descent. Some amount of perineal descent is often present in conjunction with pelvic organ prolapse. Common symptoms of perineal descent include the need to press up on the perineum to aid with bowel movements and the feeling of the pelvis “dropping” with weight bearing activity. Treatment begins with identifying and addressing the underlying cause. As mentioned above, constipation and the need to chronically strain is often identified and treated. Pelvic floor physical therapy to strengthen the floor of the pelvis can sometimes be utilized to help symptoms. If surgery is performed, the focus is on elevation of the perineum and pelvic floor with either a Chronic constipation and perineal descent may co-exist with rectal prolapse. If rectal prolapse is present, rectopexy is performed with sacrocolpoperineopexy. Bowel and fecal incontinence also may be associated with perineal descent if the perineal body is weak and is treated by anal sphincteroplasty. If you think you may be dealing with issues related to perineal descent, we encourage you to

About 1 in 10 women require surgery for vaginal prolapse. A prolapse of the back (posterior) wall of the vagina is usually due to a weakness in the strong tissue layer (fascia) that divides the vagina from the lower part of the bowel (rectum). This weakness may cause difficulty when passing a bowel movement, a feeling of fullness or dragging in the vagina or an uncomfortable bulge that may extend beyond the vaginal opening. Other names for the weakness of the back wall of the vagina include rectocele and enterocele. A posterior repair, also known as a posterior colporrhaphy, is a surgical procedure to repair or reinforce the fascial support layer between the rectum and the vagina. A perineorrhaphy is the term used for the operation that repairs the perineal body. The perineal body (the supporting tissue between vaginal and anal openings) also helps to support the back wall of the vagina. The perineum is the area that is often damaged when tears or episiotomies occur during childbirth. This area may need to be repaired along with the back wall of the vagina to give perineal support and in some cases reduce the vaginal opening. The surgery can be performed under general, regional or even local anesthetic; your doctor will discuss which is best for you. There are many ways to perform a posterior repair. Below is a general description of a common repair method. • An incision is made along the center of the back wall of the vagina starting at the entrance and finishing near the...