Perineum: Neurovasculature

by James Pickering, PhD

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    00:00 So what's the neurovasculature of the perineum.

    00:04 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.

    00:25 It goes on to give a whole of blood vessels that supply the perineum.

    00:31 Within it, we have the internal pudendal artery. We also have the pudendal nerve.

    00:37 I am not going to mention the veins. But the veins will follow a similar course to that of the artery.

    00:42 So the internal pudendal artery.

    00:44 It's going to give rise to the inferior rectal arteries that go and supply the anal canal.

    00:49 It's going to give perineal branch that goes to supply structures in the perineum.

    00:54 And this will branch off to the bulb of the penis or the vestibule of the vagina. The bulb of the vestibule.

    01:01 It will also give rise to the deep arteries of even the penis or the clitoris and these supply the erectile tissues.

    01:07 And it will give rise to an artery, dorsal artery again of the penis or the clitoris.

    01:13 That goes to the skin and also the erectile tissues.

    01:17 Within this pudenal canal we also find the pudendal nerve.

    01:20 Originating from spinal cord segments S2, S3 and S4.

    01:25 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.

    01:37 And we also have a superficial perineal nerve that supply the skin of the scrotum and a dorsal nerve.

    01:46 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.

    02:05 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.

    02:36 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.

    02:51 It gives branches that go to the external anal sphincter.

    02:54 And we can see the perineal artery carry on in this direction.

    02:58 We can see its giving rise to some posterior scrotal arteries that run up here.

    03:03 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.

    03:13 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.

    03:24 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.

    03:36 That's going to run along the dorsal surface of the penis.

    03:40 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.

    03:51 This internal pudendal artery would then carry on it will give rise to some posterior lubium arteries.

    03:57 It will then give rise as we can see here the dorsal artery of the clitoris.

    04:02 This is going to supply the cliotris just like the dorsal artery of the penis supplied the penis.

    04:08 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.

    04:27 But you can see that it is very complicated region, the neurovasculature of the perineum with numerous structures passing forwards into it.

    04:36 It ultimately supply the erectile tissues and to supply the skin of the perineal pouches.

    About the Lecture

    The lecture Perineum: Neurovasculature by James Pickering, PhD is from the course Pelvis.

    Included Quiz Questions

    1. External pudendal artery
    2. Internal pudendal artery
    3. External iliac artery
    4. Internal iliac artery
    5. Lateral sacral artery
    1. Posterior scrotal nerve
    2. Inferior rectal nerve
    3. Dorsal nerve of the penis
    4. Superior scrotal nerve
    5. Deep perineal nerve
    1. Dorsal artery of the clitoris
    2. Deep artery of the clitoris
    3. Artery of vestibule of the vagina
    4. Perineal artery
    5. External pudendal artery

    Author of lecture Perineum: Neurovasculature

     James Pickering, PhD

    James Pickering, PhD

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