Ischiorectal-fossa.ppt
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This document summarizes the anatomy of the ischio-rectal fossa. It describes the boundaries and contents of the ischio-rectal fossa, including the termination of the anal canal, perineal body, ischioanal fossa, and anococygeal ligament. It also outlines the structures that make up its boundaries, including muscles, ligaments, and fascia. Furthermore, it lists the neurovascular structures that pass through the ischio-rectal fossa and discusses some clinical applications such as ischio-rectal abscesses and pudendal nerve blocks.
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At the end of the presentation we should be able to:
Understand the perineum
Know the perineal pouches, Ischiorectal fossa and their contents
Identify the boundaries and recessess of ischiorectal fossa
Understand the Vasculature of the perineum
Diamond-shaped area between
Pubic symphysis (anteriorly)
Coccyx (posteriorly)
Ischial tuberosities (laterally)
Males contain
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Females contain
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Perineal region
boundaries of perianal region or perirecatal region, division of perineum, contents of the division, anal region, urogenital region and their contents, perineal body, ischioanal fossa or ischio rectal fossa,boundaries of ischio anal fossa, contents of ischio rectal fossa, dimension of ischio anal fossa, recessess, anterior recesses, posterior recesses, spaces and canals, perianal space, ischioanal spaces, pudendal canal, superficial fascia, deep fascia. cutaneous innervation of urogenital region,
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Ischiorectal-fossa.ppt
- 2. Faces posteroinferiorly Boundaries Laterally- sarcotuberous ligament Anteriorly – Horizontal line between two ischial tuberosities. Posteriorly – Coccyx.
- 4. Contains Termination of anal canal with external anal sphincter Perineal body Ischioanal fossa Anococygeal ligament
- 5. Wedged shaped gutter filled with fat on either sides of anal canal
- 6. Wedged shape Apex directed upwards Base Downwards
- 7. Lateral Medial Apex Base
- 8. Laterally- Obturator internus, Obturator fascia, Ischial tuberosity Medially – Levator ani covered by anal fascia In front – Transverse perinei muscles separated by perineal membrane Behind – sacrotuberous ligament covered by fibres of gluteus maximus Apex- fusion of anal fascia & obturator fascia Base – Skin & superficial fascia
- 9. Anterior Perineal membrane Posterior Gluteus maximus Sacrotuberous lig.
- 10. Along the pubic arch & above the deep perineal pouch. UD
- 15. Lunate Fascia
- 16. Supra- tegmental space Ischioanal space Perianal space
- 18. Ischioanal Pad of fat Pudendal canal with its contents Inferior rectal vessels and nerve Posterior scrotal Vessels & nerve Perineal branch of 4th sacral nerve Perforating cutaneous branches of S2 & S3
- 19. Fascial tunnel in lateral wall of ischiorectal fossa
- 20. Lesser Sciatic notch to deep perineal pouch
- 23. 1. Pudendal nerve (PN) 2. Inferior rectal N (IRN) 3. Posterior scrotal N 4. Perineal branch of 4th sacral nerve 5. Perforating cutaneous branches of S2 & S3
- 24. 1. Internal Pudendal Vessels 2. Inferior rectal Vessels 3. Posterior scrotal (Labial) Vessels IPA IRA PLA
- 25. Applied anatomy Allows distention of rectum & anal canal during defecation Ischiorectal fat acts as a cushion for rectum & anal canal Debilitating diseases like diarrhoea - Loss of fat – Prolapse of rectum Perianal & Ischiorectal fossa – Common site of abscesses Poor blood supply Coarse lobulated fat
- 27. Ischirectal abscess While performing I & D – Avoid injury to Inferior rectal nerve – To prevent paralysis of external anal sphincter Fournier's Gangrene – uncommon, lethal complication of ischiorectal abscess
- 28. Pudendal Nerve block The pudendal nerve is infiltrated with local anaesthetic solution where it crosses the ischial spine. The ischial spine is palpated through the vagina / rectum and the needle is inserted through the perineum, medial to the ischial tuberosity to anaesthetize the perineum.
- 29. Hiatus of Schwalbe Due to defective origin of Levator ani muscle from Obturator Fascia