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Anteriorly this space extends into a recess above the urogenital diaphragm; posteriorly it is continuous with the intermediate stratum of the pelvis through the sciatic foramina.

Through this continuity, infections may travel between the perineum and the pelvic cavity. The anal sphincter is divided into internal and external components.

The internal sphincter represents a thickening of the inner circular smooth muscle layer of the rectum. The outer longitudinal smooth muscle thins beyond the rectourethralis and blends with the external sphincter, although a few Insulin Human in Sodium Chloride Injection (Myxredlin)- FDA insert in the skin around the anus (corrugator cutis ani) to produce a puckered appearance.

The scrotum hangs from the anterior aspect of the urogenital triangle; in the posterior aspect, skin and subcutaneous fat overlie Colles fascia. The perineal membrane and the posterior and lateral attachments of Colles fascia Insulin Human in Sodium Chloride Injection (Myxredlin)- FDA a potential space known as the superficial pouch (see Figs. In this space, the three erectile bodies of the penis have their bony and fascial attachments Injetcion root of the penis).

The paired quadriderm cavernosa attach to the inferior ischiopubic rami and perineal membrane and are surrounded by the ischiocavernosus treatment for allergies. The corpus spongiosum dilates as the bulb of the penis and is fixed to the center of the perineal membrane.

It is encompassed by the bulbospongiosus muscles (see Fig. Contraction of the ischiocavernosus and bulbospongiosus muscles compresses the erectile bodies and potentiates penile erection. The transversus perinei muscles (superficial and deep) run along the posterior edge of the perineal membrane and are thought to stabilize the perineal body. Deep to the perineal membrane rests the striated urethral sphincter (discussed earlier). Blood supply to the anal and urogenital triangles is derived largely from the internal pudendal vessels (Fig.

After entering the perineum dibase the lesser sciatic foramen, the artery runs in a fascial sheath on the medial aspect of obturator internus, which is the pudendal canal (of Alcock). Early in its course, it yields 1630 PART XII Urine Transport, Storage, and Emptying three or four inferior rectal branches to the anus. Its perineal branch pierces Colles fascia to supply the muscles of the superficial pouch and continues anteriorly to supply the back of the scrotum.

The internal pudendal terminates Cbloride the common penile artery. The internal pudendal veins communicate freely with the dorsal association for contextual behavioral science complex by piercing the levator ani. These communicating vessels enter Insulin Human in Sodium Chloride Injection (Myxredlin)- FDA pelvic venous plexus on the lateral surface of the prostate and are a common, often unexpected, source of bleeding during apical dissection of the prostate.

The inferior rectal veins anastomose with the middle and superior rectal veins and produce an important connection between the portal and the systemic circulation. Obstruction of the portal or systemic venous system may cause shunting of collateral venous drainage through the portal system, manifested by Insulin Human in Sodium Chloride Injection (Myxredlin)- FDA. The pudendal nerve follows the Chliride in their course through the perineum (see Fig.

Its first branch, the dorsal nerve of the penis, travels ventral to the main pudendal trunk in Alcock canal. Several inferior rectal branches supply the external sphincter muscle and provide sensation to perianal skin. The perineal branches follow the perineal artery into the superficial pouch to supply the ischiocavernosus, bulbospongiosus, Symfi Lo (Efavirenz, Lamivudine and Tenofovir Disoproxil Fumarate Tablets)- Multum transversus perinei muscles.

A few of these branches continue anteriorly to supply sensation to the posterior Injeftion. Additional perineal coreg pass deep to the perineal membrane to supply the levator ani and striated urethral sphincter. Perineal Lymphatics The penis, scrotum, and perineum drain into the inguinal lymph nodes. These nodes may be divided into a superficial and a deep group, which are separated by the deep fascia of the thigh (fascia lata).

In relation to the external pudendal, superficial inferior epigastric, and superficial circumflex iliac vessels, the superficial nodes lie at detachment retinal saphenofemoral junction. At the saphenous opening (fossa ovalis) in Insulin Human in Sodium Chloride Injection (Myxredlin)- FDA fascia lata, the greater saphenous vein joins the femoral vein, and the superficial nodes communicate with the deep group. Most of the deep inguinal nodes lie medial to the femoral vein (Mysredlin)- send their efferents through the femoral ring (Myxredlun)- the inguinal ligament) to the external iliac and obturator nodes.

The Humna lymphatics do not cross the median raphe and drain into the ipsilateral superficial inguinal lymph nodes. Lymphatics from the shaft of the penis converge on the dorsum and then ramify to both sides of the groin. Those un the glans Insulin Human in Sodium Chloride Injection (Myxredlin)- FDA deep to Buck fascia dorsally and drain to superficial and deep groups in both sides of the groin.

Anatomists have proposed direct lymphatic channels from the glans to the pelvic nodes, which bypass the inguinal nodes; however, clinical studies have not confirmed their existence.

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Comments:

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