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Trunk Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Rowan Sherwood
The deep transverse perineal muscle frequently varies among individuals (Bergman et al. 1988). This muscle may be absent, particularly in females (Knott 1883b; Bergman et al. 1988; Tubbs and Watanabe 2016). An accessory muscle named transversus perinei alter may be present in front of this muscle (Tubbs and Watanabe 2016).
Pelvis and perineum
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Structures in deep perineal pouch in females– external urethral sphincter– compressor urethrae– deep transverse perineal muscle
Anatomy of the vulva
Published in Miranda A. Farage, Howard I. Maibach, The Vulva, 2017
Aikaterini Deliveliotou, George Creatsas
Three types of muscle exist in the vulva: The ischiocavernosus muscle compresses the crura and lowers the clitoris. It originates from the ischial tuberosity and inserts at the ischiopubic bone.The bulbocavernosus muscle compresses the vestibular bulb and dorsal vein of the clitoris. It originates from the perineal body and inserts into the posterior aspect of the clitoris; some fibers pass above the dorsal vein of the clitoris in a sling-like fashion.The superficial transverse perineal muscle holds the perineal body fixed. It originates from the ischial tuberosity and inserts at the central perineal tendon.
Ten-Step Surgical Approach to Management of Pathology of the Ischiorectal Fossa—A Review of the Literature and Application in a Rare Pelvic Schwannoma
Published in Journal of Investigative Surgery, 2022
Sarah Louise Smyth, Sunanda Dhar, Miss Lucy Cogswell, Hooman Soleymani majd
The transichiorectal approach provides direct access to Alcock’s canal with minimal pelvic muscle and ligament disruption [5, 7]. The procedure requires an in-depth knowledge of the pelvic anatomical spaces [4]. The pudendal nerve arises from the S2-4 sacral nerve and travels forward laterally in the pelvis within the obturator internus fascial sheath [8]. It has both motor and sensory functions. The ischiorectal fossa is a pyramidal space lateral to the anal canal and below the pelvic diaphragm with the apex at the anal canal and obturator fascia boundary, and the base at the perineal surface. It is bound medially by the levator ani, external anal sphincter and anal fascia, laterally by the ischial tuberosity and obturator internus muscle, anteriorly by the urogenital diaphragm fascia and Colles’ transverse perineal muscle fascia and posteriorly by the gluteus maximus and sacrotuberous ligament [2, 9]. It contains the internal pudendal, posterior labial and inferior rectal vessels and nerve, the perineal S4 branch, the perforating cutaneous nerve and lymphatic tissue [1, 3].
Maintaining sexual function after pelvic floor surgery
Published in Climacteric, 2019
The female external genitalia consist of the labia (majora and minora), vestibule (interlabial space), and female erectile organs including the clitoris and vestibular bulbs. The clitoris comprises an outer glans, a middle corpus, and an inner crura, and the vestibular bulbs are erectile tissue located on either side of the female urethra. During sexual stimulation, the clitoris, labia minora, and vestibular bulbs become engorged. This results in increased lubrication, vaginal wall engorgement, and an increase in clitoral length and diameter. At the neurogenic level, nitric oxide, phosphodiesterase-V, and vasoactive intestinal peptide are believed to play a role in addition to the effect of the hormones estrogen and testosterone. The pelvic floor, on the other hand, forms the outlet of the bony pelvis and supports the abdominal and pelvic organs, maintains continence of urine and stool, and allows intercourse and parturition. It is formed by the levator ani muscle, urogenital diaphragm, and perineal membrane. The perineal membrane, consisting of the ischiocavernous, bulbocavernous, and superficial transverse perineal muscles, has a crucial role in sexual response.
Female genito-pelvic reflexes: an overview
Published in Sexual and Relationship Therapy, 2019
Symen K. Spoelstra, Esther R. Nijhuis, Willibrord C. M. Weijmar Schultz, Janniko R. Georgiadis
The main somatic nerve of the perineum is the pudendal nerve, which has somatosensory and somatomotor tributaries, and which divides into three main branches (inferior rectal, perineal, dorsal penile/clitoral) at the level of the levator ani muscle. The muscles that embryonically derive from the cloacal sphincter (external anal and urethral sphincter, superficial transverse perineal muscle, bulbocavernosus muscle and ischiocavernosus muscle) are all innervated by pudendal nerve fibres originating in a specialized sacral motor neuronal pool called Onuf's nucleus (Iwata, Inoue, & Mannen, 1993; Onuf, 1899). As Onuf motoneurons innervate striated muscles but also are known to be relatively unaffected by somatic motoneuron diseases like amyotrophic lateral sclerosis (Mannen, Iwata, Toyokura, & Nagashima, 1977), they have been proposed to be of a mixed somatic/autonomic type (Kihira, Yoshida, Yoshimasu, Wakayama, & Yase, 1997). Interestingly, the pudendal nerve seems less involved in the innervation of the levator ani muscle. A separate nerve, the “levator ani nerve” (Wallner, Maas, Dabhoiwala, Lamers, & De Ruiter, 2010), arising from the ventral ramus of the third and fourth sacral nerves, is held to innervate the pelvic diaphragm. In at least 50% of cadavers studied, the pudendal nerve also contributed to innervation of the levator ani muscle, especially in regards to the medial portions (puborectal and pubococcygeal muscles) (Rock JA, 2003).