The Perineum

The Perineum

The perineum is a main area of the pelvis located between the thighs which acts as the inferior outlet of the pelvis. It is formed by its anatomical borders: the pubic symphysis, the coccyx, and the bones and ligaments of the pelvis. The skin of the perineum is supplied by the pudendal nerve, with nerve roots S2-S4, and the internal pudendal artery, which originates from the internal iliac artery.

The anatomy of the perineum covers various aspects, including the pelvis, ligaments, arteries, and nerves. It is important to understand the anatomy and functions of the perineal area in order to provide a more holistic approach when dealing with pelvic health.

The primary structures of the perineum include:

• Pelvis: The pelvis is made up of four bones, namely the sacrum, the coccyx, the ilium, and the ischium. It forms the base of the spine and supports the body.
• Ligaments: These are tough, fibrous bands of tissue that connect bones together. They provide stability to the pelvis and perineal area, and include the sacrotuberous ligament, the sacrospinous ligament, the puboperineal ligament, and the pubococcygeal ligament.
• Arteries: The primary artery of the perineal area is the internal iliac artery, which supplies the pudendal artery. This artery is responsible for supplying the skin of the perineum with fresh oxygenated blood.
• Nerves: The main nerve of the perineum is the pudendal nerve. It is a branch of the sacral plexus and provides sensation to the perineum and external genitals.

The Sciatic Foramina

The sciatic foramina are two openings located on either side of the pelvis. They are formed by the anterior sacral and the masocaudal parts of the ischial spine. These openings allow the sciatic nerve to pass through the pelvis and innervate the muscles of the lower limb.

The sciatic foramina are also the points of connection between the lumbar and sacral plexuses, allowing for communication between the two spinal nerve plexuses. Through these openings, the pudendal nerve also passes into the perineum, providing sensory innervation to the area.

The sciatic foramina also have several other functions. These include providing passage for lymph flow, housing the pudendal vessels, and connecting the rectal and pudendal vessels to the pelvic cavity.

Understanding the anatomy and functions of the perineal area can lead to a better understanding of pelvic health, as well as a more holistic approach in caring for this important region of the body.