So what's the neurovasculature
of the perineum.
What's the neurovasculature of the
perineum? But we have looked at that
because we saw the internal pudendal
artery sweeping around in this direction,
a branch coming from
the internal iliac
artery it sweeping around. And this
as we saw gave rise to the inferior rectal
arteries supplies the anus and the rectum.
It goes on to give a whole of blood
vessels that supply the perineum.
Within it, we have the internal pudendal
artery. We also have the pudendal nerve.
I am not going to mention the veins. But the veins will
follow a similar course to that of the artery.
So the internal pudendal artery.
It's going to give rise to the inferior rectal
arteries that go and supply the anal canal.
It's going to give perineal branch that goes
to supply structures in the perineum.
And this will branch off to the
bulb of the penis or the
vestibule of the vagina.
The bulb of the vestibule.
It will also give rise to the deep arteries
of even the penis or the clitoris
and these supply the erectile tissues.
And it will give rise to an artery, dorsal
artery again of the penis or the clitoris.
That goes to the skin and
also the erectile tissues.
Within this pudenal canal we
also find the pudendal nerve.
Originating from spinal
cord segments S2, S3 and S4.
We saw the inferior rectal nerve passing
to the external anal sphincter
for the somatic control. We
have deep perineal nerves
that supply the muscles
within the perineal pouches.
And we also have a superficial
perineal nerve that supply the
skin of the scrotum and a dorsal nerve.
This supplies the skin of
the penis and the clitoris
The branching pattern of the pudendal
internal pudendal nerve and artery
in the perineum. It can be quite complicated.
It can be seen in this diagram.
We just try and follow some of these arteries
through in the male and the female and see where
we end up essentially. But we have
got the internal pudendal artery
which is running here. We
can see it giving rise to
the artery and the nerve
that goes to supply
the external anal sphincter, these are running
here. These running through ischioanal fossa
are going to be your inferior rectal and
inferior rectal arteries
and inferior rectal nerve.
The internal pudendal artery then
carries on and it carries on as the
perineal artery. And the perineal artery then
carries on running as it enters into the
perineum. It gives branches that
go to the bulb of the penis.
It gives branches that
go to the external anal sphincter.
And we can see the perineal
artery carry on in this direction.
We can see its giving rise to some
posterior scrotal arteries that run up here.
It's also giving rise to the dorsal nerve of
the penis we can see a branch coming up
in this direction here that's running
to supply the dorsal aspect of the artery.
It will also give rise to a deep artery
and that deep artery would run through
corpus cavernosum supplying the blood
that goes into this erectile tissue.
for engorgement. So we can see this
is a particularly complicated diagram
with the blood vessels passing into the
perineum. The nerves are going to follow
so we can pick out the
dorsal nerve of the penis.
That's going to run along the
dorsal surface of the penis.
If we look here at the female, then we have very
similar structures. Again we can see the internal
pudendal artery running around in here. Giving rise
to the inferior rectal artery running around.
This internal pudendal
artery would then carry on
it will give rise to some
posterior lubium arteries.
It will then give rise as we can see
here the dorsal artery of the clitoris.
This is going to supply the cliotris
just like the dorsal artery of the
penis supplied the penis.
We can see we have numerous veins that
are going to be taking the venous blood
in the opposite direction. And in
amongst here we have various nerve
like the dorsal nerve of the clitoris that
passes through. And we have the posterior
scrotal nerves that are running
through this region as well.
But you can see that it is very
complicated region, the neurovasculature
of the perineum with numerous
structures passing forwards into it.
It ultimately supply the erectile
tissues and to supply the skin
of the perineal pouches.