1. Urogenital triangle in female + Perineal pouches
Dr Rania Gabr

2. OBJECTIVES
1. Describe the boundaries & contents of urogenital triangle in female.
2. Recite the parts of the female external genital organs.
3. Identify its parts and openings present in it.
4. Discuss the features of each part
5. Discuss the contents of the perineal pouches in female and male.
6. Enumerate the structures piercing the perineal membrane.

3. Urogenital Triangle in female
BOUNDARIES :
Anteriorly : Symphysis pubis
Posteriorly : Transverse line passing through the 2 ischial tuberosities.
Laterally : Ischiopubic rami & ischial tuberosities.
CONTENTS :
Lower part of urethra & vagina.
External genitalia (vulva).
Urethra
Vagina
Vulva

4. Female External Genitalia (Vulva)
Mons pubis : a collection of fat overlying the pubis.
Labia majora.: Two folds of skin containing fatty tissue and covered with hair
Located on either side of the vaginal opening, extending from the mons pubis to the perineum

5. Short, elongated organ composed of erectile tissue
Labia minora.:
Two thin folds of tissue located within the folds of the labia majora
Extends from the clitoris downward toward the perineum
Clitoris.:
Short, elongated organ composed of erectile tissue
Located just behind the upper junction of the labia minora
Homologous to the penis

6. Vestibule of vagina: The interval between the two labia minora.
Vagina & urethra open into it through urethral orifice anteriorly and vaginal orifice (Also known as the vaginal introitus), posteriorly.
Bartholin’s glands
Located on either side of the vaginal orifice
Secrete a mucous substance that lubricates the vagina

7. Indifferent
Male
Female
Gonad
Testis
Ovary
Paramesonephric duct (Mullerian duct)
Appendix testis
Fallopian tubes
Paramesonephric duct
Prostatic utricle
Uterus, upper vagina
Mesonephric tubules
Efferent ducts, Paradidymis
Epoophoron, Paroöphoron
Mesonephric duct (Wolffian duct)
Rete testis
Rete ovarii
Mesonephric duct
Epididymis
Gartner's duct
Vas deferens
Seminal vesicle
Urogenital sinus
Prostate
Skene's glands
Bladder, urethra
Bladder, urethra, lower vagina

8. Urogenital sinus
Cowper's or Bulbourethral gland
Bartholin's gland
Labioscrotal folds
Scrotum
Labia majora
Urogenital folds
Spongy urethra
Labia minora
Genital tubercle
Penis
Clitoris
Bulb of penis
Vestibular bulbs
Glans penis
Clitoral glans
Crus of penis
Clitoral crura
Prepuce
Foreskin
Clitoral hood
Peritoneum
Processus vaginalis
Canal of Nuck
Gubernaculum
Gubernaculum testis
Round ligament of uterus

9. Superficial Perineal Pouch
It is the space between the deep membranous layer of superficial fascia and the perineal membrane.
BOUNDARIES:
Inferiorly: membranous layer of superficial fascia (Colle`s fascia).
Superiorly: perineal membrane.
Laterally: ischiopubic rami

11. Contents of Superficial Perineal Pouch in the female
1- Bulbs of vestibule: on each side of vaginal orifice.
2- Crura of clitoris.
3- Superficial perineal muscles:
A-Bulbospongiosus muscle, surrounds orifice of vagina and covers vestibular bulb.
B- Ischiocavernosus muscle, covers crus of clitoris on each side.

12. C- Superficial transverse perineal muscles.
4- Greater vestibular glands: on each side of vaginal orifice.
5- Perineal body
6- Perineal branch of pudendal nerve suppling muscles & skin.
Ischiocavernosus
Bulbospongiosus

13. Contents of Superficial Perineal Pouch in the male
1- Root (bulb and crura) of the penis and associated muscles (ischiocavernosus and bulbospongiosus).
2- Proximal (bulbous) part of the spongy urethra.
3- Superficial transverse perineal muscles.
4- Deep perineal branches of the internal pudendal vessels and pudendal nerves.

14. Bulbospongiosus
Ischiocavernosus

15. Deep Perineal Pouch
It is a completely closed space deep to the perineal membrane.
BOUNDARIES:
Inferiorly: Inferior fascia of the urogenital diaphragm (Perineal membrane)
Superiorly: Superior fascia of the urogenital diaphragm
Laterally: Inferior portion of obturator internus fascia

16. Contents of Deep Perineal Pouch in female
1- Part of urethra .
2- Part of vagina.
3- Sphincter urethrae muscle, which is pierced by urethra & vagina.
4- Deep transverse perineal muscles
5- Internal pudendal vessels.
6- Dosal nerve of clitoris.

17. Contents of Deep Perineal Pouch in male
1- membranous part of the urethra,
2- the sphincter urethrae,
3- the bulbourethral glands,
4- the deep transverse perineal muscles, the internal pudendal vessels and their branches, and
5- the dorsal nerves of the penis.

18. Structures piercing the perineal membrane:
1- In the centre:
a- Membranous urethra in male
b- urethra and vagina in female
2- On both sides of the urethra:
a- ducts of bulbourethral glands of male
b- artery to bulb
3- Anteriorly
a-Deep and dorsal arteries of penis or clitoris
b- Dorsal nerve of penis or clitoris
4- Posteriorly:
Scrotal or labial vessels and nerves

20. Anal Triangle BOUNDARIES:
Anteriorly: Transverse line passing through the 2 ischial tuberosities.
Posteriorly : coccyx.
Laterally : ischial tuberosity & sacrotuberous lig. overlapped by gluteus maximus.

21. CONTENTS:
Lower part of Anal canal (upper part lies in pelvis).
Ano-coccygeal body (or raphe) :
a fibrofatty mass that extends from anus to tip of coccyx.
Ischiorectal fossa on each side.

22. Ischiorectal Fossa
A fascial lined wedge-shaped space on each side of the anal canal.
Boundaries:
Base: Skin of the perineum.
Medial wall: Levator ani & anal canal.
Lateral wall: Obturator internus, covered with pelvic fascia.

24. Pudendal Canal: Contents: Dense fat.
Pudendal nerve & internal pudendal vessels within the pudendal canal
Inferior rectal nerve & vessels crossing the fossa to reach anal canal.
Pudendal Canal:
A fascial canal formed by obturator fascia, located on the lateral wall of the ischiorectal fossa,
on the medial side of the ischial tuberosity.
Contains pudendal nerve and internal pudendal vessels

25. Anococcygeal Body
The anococcygeal body is a complex musculotendinous structure situated between the anterior aspect of the coccyx and the posterior wall of the anorectal canal
Receives insertion of fibers of levator ani muscle

26. Thank You
&
Good Luck