PRACTICAL CONSIDERATIONS : MALE PERINEUM. 



1917 



and the ligament to the pubo-ischiatic rami, and behind by the union of the fascia 

 with the base of the ligament. 



This space or pouch contains the bulb and the crura of the penis and the 

 muscles covering them, the superficial transverse perineal muscles, the superficial 

 perineal nerves and vessels, and the long pudendal nerves ; in its anterior part the 

 internal pudic artery divides into its terminal branches, the dorsal artery of the penis 

 and the artery to the corpus cavernosum. It is very important in its relations to 

 wounds and ruptures of the urethra (q.v.). 



In the uro-genital triangle, half-way between the centre of the anus and the 

 perineo-scrotal junction, is the so-called "perineal centre," where the bulbo-caver- 

 nosus, the sphincter ani, and the superficial transverse perineal muscles meet, and 

 which corresponds to the middle of the posterior edge of the fibrous shelf formed 

 by the union of the two layers of the triangular ligament. These structures are 

 exposed when CoUes's fascia is turned back, and on either side a triangular space is 



Bulbo-cavernosus muscle 



Ischio-cavernosus muscle 



Crus penis 



Colles's fascia, reflected 

 Triangular lig., inf. layer 

 Ischio-cavernosus, stump 



Transver. perinei muscle 



Tuber ischii' 



Sphincter ani externus 



Levator ani 



Pudic nerve 



Internal pudic artery 



Greater sacrosciatic lig. 



Gluteus maximus 



Colles's fascia, reflected 

 Ischio-cavernosus muscle 



Internal perineal nerve 

 External perineal nerve 

 Superficial perineal artery 



Transversus perinei mus. 



Anal fascia 



Greater sacro-sciatic lig. 

 Inf. hemorrhoidal nerve 

 Inf. hemorrhoidal artery 



Branch of fourth sacral 

 nerve 



Branch of fourth sacral 

 nerve 



• itrBT- 



Dissection of perineum ; Colles's fascia has been cut and reflected to expose crura and bulb of 

 penis covered by muscles ; on right side ischio-rectal fossa is partly cleaned out. 



seen, the floor of which is constituted by the inferior layer of the triangular ligament. 

 At the lateral, median, and posterior sides of the triangle lie the bulbo-cavernosus, 

 ischio-cavernosus, and superficial transverse perineal muscles respectively (Fig. 1627). 

 When the inferior layer of the triangular ligament is divided, the space (deep 

 perineal interspace') between that and the superior layer (as this portion of the parie- 

 tal layer of the pelvic fascia is called) is opened and is found to be broader in- 

 feriorly and behind, the two layers fusing anteriorly with a dense band {ligamentiini 

 transversiim pelvis) stretching from one pubic bone to the other, and leaving only 

 sufficient space above it, beneath the subpubic ligament, to permit the passage of 

 the dorsal vein of the penis. The space between the two layers (Fig. 1629) is 

 occupied by (a) the compressor urethrae muscle ; ((5) the membranous urethra, 

 about half an inch in length; (r) Cowper's glands {glandules bjilbo-jwetlirales); 

 (d) the beginning of the artery of the bulb ; (<?) the continuation of the internal 

 pudic artery, which, while between the two layers of the triangular ligament and 



