Anatomy of the female perineum
and perineal pouches
Collectively called the Vulva which includes:
• Mons Pubis
• Labia Majora and Minora
• Clitoris
• Urethra
• Vaginal Orifice
• Vestibular Glands
• Mons Pubis fatty, rounded area over the pubic symphysis
• Labia Majora 2 fatty skin folds that are homologous with the
male scrotum
• Labia Minora smaller folds covered with mucosa and richly
supplied with sebaceous glands enclose the region called the
vestibule, which contains the clitoris, urethra and vaginal
orifices
Greater Vestibular Glands (Batholin's Glands)
• equivalent to bulbourethral glands in males
• secrete mucus containing liquid for lubrication
• during sexual intercourse
Lesser Vestibular Glands
• also secrete mucus for lubrication
Clitoris
erectile tissue equivalent to glans penis
housed in a hood of tissue (prepuce) formed by the junction
of labia minora
richly supplied by nerves and engorges with blood upon
sexual arousal
Part of the adult female external
genitalia
Mons pubis
clitoris
Urethral
orifice
Labia majora
Labia
minora
introitus
anus
The perineum
• Overlies the inferior pelvic aperture
• The urogenital triangle s anterior to a line
in front of the ischial tuberosities
• The muscles are grouped as
• Superficial –
bulbospogiosus,ischiocarvenosus and
superficial transverse perinei occupying
the superficial perineal pouch
Superficial perineal pouch
• Boundaries
• Below-membranous layer of superficial
fascia (Colle’s fascia)
• Above-urogenital diaphragm
• Laterally attached to margins of pubic arch
• Anteriorly communicates with space btw
sup. Fascia of ant abd. Wall & its muscles
The superficial perineal pouch
• Contains structures forming the root of
clitoris
• Bulbospongiosus- sorrounds orifice of
vagina & covers vestibular bulbs
• Ischiocarvenosus-covers the crus of
clitoris
• Superficial transverse perinei
• Perineal body-wedge shaped mass of
ffibrous tissue situated btw lower end of
vagina & anal canal
• Giives attachment to perinei muscles,
levatores ani & support posterior wall of
vagina
• Perineal branch of pudendal nerve
supplies skin & muscles
Deep perineal pouch
• Lies between the superior & inferior
(perineal membrane) fascia of the
urogenital diaphragm
Contents of the dep perineal pouch
• Deep perinei muscles-deep transverse
pernei
• Part of the urethra
• Part of the vagina
• The sphincter urethrae (pierced by urethra
and vagina)
• Internal pudendal vessels & their branches
• Dorsal nerves of clitoris
Female urethra
• 4cm long
• Opens into vestibule 2.5cm below clitoris
Episiotomy
• At childbirth the introitus may be enlarged
by making an incision in the perineum
• Starts at the fourchette and extends
mediolateraaly to the right side for 3cm.
• Structures encountered in an episiotomy
include- skin, vaginal epithelium,
subcutaneous fat, perineal body and
superficial transverse perineal muscle
Episiotomy and perineal nerve block