844 



SURGICAL ANATOMY OF THE PERINEUM. 



The muscles of the perineum in the female are, the 



Sphincter Vaginae. Compressor Urethrae. 



Erector Clitoridis. Sphincter Ani. 



Transversus Perinei. Levator Ani. 



Coccygeus. 



The Sphincter Vaginse surrounds the orifice of the vagina, and is analogous 

 to the Accelerator Urinae in the male. It is attached, posteriorly, to the central 

 tendon of the perineum, where it blends with the Sphincter Ani. Its fibres pass 

 forwards on each side of the vagina, to be inserted into the corpora cavernosa 

 and body of the clitoris. 



The Erector Clitoridis resembles the Erector Penis in the male, but is smaller 

 than it. 



The Transversus Perinsei is inserted into the side of the Sphincter Vaginae, and 

 the Levator. Ani into the side of the vagina. The other muscles are precisely 

 similar to those in the male. 



The Accelerator Urinae and Erector Penis muscles should now be removed, when the deep 

 perineal fascia will be exposed, stretching across the front part of the outlet of the pelvis. The 

 urethra is seen perforating its centre, just behind the bulb ; and on either side is the crus penis, 

 connecting the corpus cavernosa with the ramus of the ischium and pubes. 



Fig. 458. Deep Perineal Fascia. On the left side, the anterior layer has been removed. 



Anterior Layer cf 

 Drrp Perinca.1 F/iteia remcvtd 



COMPRESSOR URETHRA 



Jnirmal PuJic Arty. 

 ArtV of the Bu.ll, 

 - 'Mr'* Gland 



The Deep Perineal Fascia (triangular ligament), is a dense membranous 

 lamina, which closes the front part of the outlet of the pelvis. It is triangular 

 in shape, about an inch and a half in depth, attached, above, by its apex to 

 the under surface of the symphysis pubis and subpubic ligament ; and, on each 

 side, to the rami of the ischium and pubes, beneath the crura penis. Its inferior 

 margin, or base, is directed towards the rectum, and connected to the central 

 tendinous point of the perineum. It is continuous with the deep layer of the 

 superficial fascia behind the Transversus Perinaei muscle, and with a thin fascia 

 which covers the cutaneous surface of the Levator Ani^muscle. 



The deep perineal fascia is perforated by the urethra, about an inch below the 

 symphysis pubis. The aperture is circular in form, and -about three or four 

 lines in diameter. Above this is the aperture for the dorsal vein of the penis ; 

 and, outside the latter, the pudic nerve and artery pierce it. 



