The document summarizes the contents of the male and female perineal pouches. It describes that the perineum is divided into two triangles by an imaginary transverse line joining the anterior ends of the ischial tuberosities. The superficial perineal pouch in males contains various muscles like the bulbospongiosus and ischiocavernosus, while in females it contains the root of the clitoris and greater vestibular glands. The deep perineal pouch lies between the perineal membrane and levator ani fascia and contains the urethra and external urethral sphincter in both sexes.

1. Contents of male and female
perineal pouches
By
Dr. Abdul Waheed Ansari
(Prof. & chairperson of Anatomy, RAKCOMS)
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2. Perineum boundaries are
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3. An imaginary transverse line joining the anterior ends of the ischial
tuberosities divides the perineum into two triangles -
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4. The perineal body
Structurally perineal body is an irregular fibro muscular mass,
containing both collagenous and elastic fibers and both
skeletal and smooth muscles.
It is the site of convergence of several muscles:
1. Bulbospongiosus,
2. Superficial transverse perinea
3. Superficial part of external anal sphincter
4. Sphincter urethrae and
5. Deep transverse perinea,
6. Deep part of external anal sphincter and
7. Levator ani
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5. 12/18/2014 5

6. Perineal fascia
• There are two fascia in perineum.
• The superficial fascia from anterior
abdominal wall extends into the
perineum and get attached to the bony
landmarks and free border of perineal
membrane.
• The levator ani muscle is present at the
pelvic outlet and forms pelvic
diaphragm.
• The levator ani muscle is covered by
fascia, superior fascia of perineum. This
fascia closes to the free border of
perineal membrane. Between perineal
membrane and superior fascia of
perineum, the space is called as deep
perineal space/pouch.
• Between perineal membrane and fascia
descending from anterior abdominal
wall, is the superficial perineal
space/pouch.
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7. Male external genital organs
The penis:
a. root of the penis: the fixed dorsal segment within the urogenital perineum, consists of two crura
and the bulb
b. penile body: the pendulous, mobile ventral segment suspended from the pubis
• 1. consists of two corpora cavernosa and one corpus spongiosum
• 2. The two corpora cavernosa fuse lying side by side, and insert into the glans
• penis to form the superior (dorsal) surface.
• 3. The thinner corpus spongiosum, containing the urethra, lies below the fused
• corpora cavernosa and forms the inferior (ventral) surface.
c. Over lining these structures are the related muscles: the ishiocavernosus & bulbospongiosus
d. Vessels and nerves of the penis
• 1. superficial dorsal vein empties into the superficial external pudendal veins
• 2. deep dorsal veins drain into the prostatic venous plexus and also make connection
• with the vertebral venous flow
• 3. two dorsal penile arteries from the internal pudendal artery
• 4. paired dorsal nerves arise from the pudendal nerve
e. Suspensory Ligament
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8. Contents of superficial
perineal pouch in male
1. Bulbospongiosus
2. Ischiocavernosus
3. Anal sphincter
4. Deep Transverse Perineal
5. Superficial Transverse
Perineal
6. Pelvic diaphragm / Levator
Ani muscles
7. Obturator Internus
8. Perineal body
9. Ano-coccygeal body
10. Sacrum and coccyx
11. Ischial tuberosities
12. Sacrotuberous ligament
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9. External genitalia in both sexes
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10. Lymphatic drainage of male external
genitalia
• The lymph vessels from the scrotum drain
into the superficial inguinal lymph nodes.
• From most of the penis, lymph drains into the
superficial inguinal lymph nodes.
• Vessels from the glans penis drain into the
deep inguinal lymph nodes.
• Enlarged nodes are either due to disease in
drainage areas or systemic disease.
• Drainage areas
Horizontal group:-
• External genitalia (Cancer Penis, Vulva)
• Anal canal (cancer Rectum)
• Gluteal region
• Lower third of vagina
Vertical group:
• Leg
• Systemic disease
• Lymphoma
• Tuberculosis
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11. Contents of superficial perineal pouch in
female
1. Root (crura) of the clitoris and muscle
associated with it (ischiocavenous)
2. Bulbs of the vestibule and
surrounding muscle (bulbospongiosus)
3. Superficial transverse perineal
muscles
4. Branches of the internal pudendal
artery
5. Posterior labial branches of the
perieneal branch
6. Transverse perineal branches of the
perieneal branch
7. Posterior labial branch of Perineal
branch of the pudendal nerves
8. Perineal branch of posterior
cutaneous nerve of thigh
9. Greater vestibular glands
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12. The lymphatic drainage from female
external genitalia
• The vulva contains a very rich network of
lymphatic channels.
• Most lymph vessels pass to the superficial
inguinal lymph nodes and deep inguinal
nodes.
Grouping of inguinal lymph nodes
• Horizontal
• Vertical
Drainage area of inguinal lymph nodes
Horizontal
• Vulva
• Anus
Vertical
• Leg
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13. The deep perineal pouch/space
• It lies between the perineal
membrane and fascia over
inferior aspect of levator ani
muscle.
• It contains membranous
urethra passing through the
perineal membrane and
sphincter urethrae and deep
transverses perinei muscles.
• The urogenital diaphragm is a
fibromuscular layer between
the pelvic floor (levator ani
muscles) limited inferiorly by
the perineal membrane.
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14. Contents of deep perineal pouch in
female
1. Proximal part of urethra
2. External urethral sphincter muscle
3. Deep transverse perineal muscles
4. Related vessels and nerves
5. Deep artery of clitoris
6. Dorsal artery of clitoris
7. Artery to bulb of vestibule
8. Urethral artery
9. Dorsal nerve of clitoris
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15. Pelvic diaphragm
• The pelvic diaphragm is a muscular partition formed by the
levatores ani and coccygei, with which may be included the parietal
pelvic fascia on their upper and lower aspects.
• It separates the pelvic cavity above from the perineal region below.
• The right and left levatores ani lie almost horizontally in the floor of
the pelvis, separated by a narrow gap that transmits the urethra,
vagina, and anal canal.
• The levator ani is usually considered in three parts:
1. pubococcygeus,
2. puborectalis, and
3. iliococcygeus.
• The pubococcygeus, runs backward from the body of the pubis
toward the coccyx and may be damaged during parturition.
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16. 12/18/2014 16

17. The Puborectalis
• The right and left
Puborectalis unite behind
the anorectal junction to
form a muscular sling.
• The Puborectalis fibers
interdigitates with the
sphincter ani externus.
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18. The coccygeus
• The iliococcygeus, the most posterior part of the
levator ani.
• The coccygeus extends from the ischial spine to
the lateral margin of the sacrum and coccyx.
• The pelvic diaphragm is supplied chiefly by the
ventral rami of S3,S4.
• The diaphragm helps to support the pelvic
viscera, resists increases in intra-abdominal
pressure, and aids in micturition.
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19. References
• http://teachinganatomy.blogs
pot.ae/2013/06/perineum25_
268.html
• http://anatomytopics.wordpre
ss.com/2009/01/08/38-the-
perineum-the-formation-of-
the-placenta-the-structure-of-
the-matured-placenta/
• http://download.videohelp.co
m/vitualis/med/male_ext_gen
italia.htm
• http://www.meddean.luc.edu/
lumen/meded/medicine/pulm
onar/pd/pstep43.htm
• http://web.uni-
plovdiv.bg/stu1104541018/do
cs/res/skandalakis'%20surgical
%20anatomy%20-
%202004/Chapter%2028_%20
Pelvis%20and%20Perineum.ht
m
• http://unanipathy.com/videos
/pelvic-floor-part-1-the-pelvic-
diaphragm-3d-anatomy-
tutorial/
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