SUPERFICIAL AND DEEP PERINEAL FASCLZE. 



1039 



the whole perinseum, is subdivided into two equal parts. To one of these 

 smaller spaces the operations usually performed for gaining access to the 

 urinary bladder are for the most part restricted. The skin of the perinseuiu 

 is provided with numerous sebaceous follicles. 



From the muscles of the peringeum the skin is separated by areolar tissue 

 and fat, except in the neighbourhood of the anus, where the sphincter of 

 the bowel is immediately in contact with the integument. The deeper part 

 of the fatty subcutaneous membrane, the superficial fascia (p. 259), 

 taking on a fibrous appearance, has, in a great measure, the same arrange- 

 ment and characters as the corresponding structure of the groin. With that 

 membrane the layer is continuous in front through the scrotum, but at 

 other points it is confined to the perinseum, being fixed laterally to the 

 sides of the pubic arch, while it is continued posteriorly, beneath the 

 sphincter ani and in front of the rectum, into the deep perineal fascia. 

 It is in consequence of these connections of the superficial fascia, that 

 abscesses do not attain a large size in the perineum, and that urine effused 

 in consequence of rupture of the urethra does not extend backwards to the 

 rectum or outwards to the thigh, but continues forwards, and, if an outlet 

 for its escape should not be afforded by the surgeon, reaches successively 

 the scrotum, the penis, and the groin above Poupart's ligament. In extreme 

 cases the extravasated fluid would spread from the position last mentioned 

 over the anterior part of the abdomen and even to the thorax, its extension 

 downwards to the thigh being restrained by the attachment of the super- 

 ficial fascia along the fold of the groin. 



Fig. 714. 



Fig. 714. DEEPER DISSECTION OF THE PERINJSUM. 



The perineal muscles have been removed and also the fat in the ischio-rectal fossa ; a, 

 superficial fascia ; b, accelerator urinse ; c, crus penis ; d, the bulb ; e, triangular liga- 

 ment of the urethra ; /, levator ani ; g, sphincter ; h, tuberosity of the ischium ; Jc, gluteus 

 maximus ; *, Cowper's gland of the left side ; 1, pudic artery ; 2, superficial perineal 

 artery and nerve. The inferior hacmorrhoidal arteries and the artery of the bulb are 

 likewise shown. 



