Rectum

Regina M. Celis-Talavera MD
Department of Anatomy
Emilio Aguinaldo College of Medicine
Rectum
• Part of the digestive tract, continuous
proximally with the sigmoid colon at the
level of the 3rd sacral vertebra
• Ends anteroinferiorly at the tip of the
coccyx as it perforates the pelvic
diaphragm to become the anal canal
• Ampulla of the rectum: dilated terminal
part of the rectum, receives and holds an
accumulating fecal mass until defecation
Relations of the rectum
• Posteriorly: sacrum, coccyx, piriformis,
coccygeus and levator ani muscles, sacral plexus
and sympathetic trunks
• Anteriorly:
• Male: upper 2/3 of the rectum which is covered by
peritoneum, sigmoid colon and coils of ileum that
occupy the rectovesicular pouch
• Lower 1/3 which is devoid of peritoneum,
posterior surface of the bladder, termination of
vas deferens and seminal vesicles and prostate
Relations of the rectum
• Female:
• Upper 2/3 of rectum which covered with
peritoneum, sigmoid colon and coils of
ileum the occupy the vesicouterine pouch
(pouch of Douglas)
• Lower 1/3 of the rectum, which is devoid
of peritoneum, posterior surface of the
vagina
Blood supply
• Superior rectal artery:
• Continuation of inferior mesenteric
artery
• supplies proximal part
• Middle rectal artery:
• Small branch of the internal iliac
artery
• Supplies middle and inferior part
Blood supply
• Inferior rectal artery:
• Branch of internal pudendal artery
• Supplies the anorectal junction
Veins
• Veins correspond to the arteries
• Superior rectal veins:
• Tributary of the portal circulation
• Drains into the inferior mesenteric
vein
• Middle and inferior rectal veins
• Drain into the internal iliac and
internal pudendal veins, respectively
Lymph drainage
• Lymph vessels drain into the pararectal
nodes
• Lymph vessels draining the upper and
middle nodes accompany the superior
rectal artery to the inferior mesenteric
nodes
• Lymph vessels from the lower part of the
rectum follow the mddle rectal artery to
the internal iliac nodes
Nerve supply
• Sympathetic and parasympathetic
nerves from the inferior hypogastric
plexuses.
• Rectum is only sensitive to stretch.
Perineum

Regina M. Celis-Talavera MD
Department of Anatomy
Emilio Aguinaldo College of Medicine
Perineum
• External surface area
• Shallow compartment of the body
Location:
• Inferior to the pelvic outlet
• Separated from the pelvic cavity by
the pelvic diaphragm ( levator ani +
coccygeus muscles)
Anatomical position
• Narrow region between the proximal part
of the thighs
• Diamond shaped (abducted lower limbs)
• Extends from:
• Anteriorly: mons pubis
• Laterally: medial surfaces of the thighs
• Posteriorly: gluteal folds and the upper
end of the intergluteal cleft (Fig. 3.32)
Boundaries of the perineum
(perineal compartment)
• Anterior: pubic synphysis
• Anterolateral: Inferior pubic rami and
ischial rami
• Lateral: Ischial tuberosities
• Posterolateral: Sacrotuberous
ligaments
• Inferior: sacrum and coccyx
Triangles
• A transverse line joining the anterior ends
of the ischial tuberosities divides the
perineum into two triangles:
• Anal triangle
• Containing the anus is posterior to this
line
• Urogenital triangle
• Contains the root of the scrotum and
penis in males or the external genitalia in
females is anterior to this line.
Triangles
• Midpoint of the lines joining the
ischial tuberosities is the central
point of the perinuem overlying the
perineal body
Perineal body
• Attachment for perineal muscles
• Irregular fibromuscular mass located
in the median plane between the anal
canal and the perineal membrane
• Contains collagenous and elastic
fibers
• Contains skeletal and smooth
muscle
Perineal body
• Site of convergence of several
muscles:
• Bulbospongiousus
• External anal sphincter
• Superficial and deep transverse
perineal muscles.
Perineal membrane
• Thin sheet of tough, deep fascia
• Stretches between the two sides of the
pubic arch.
• Covers the anterior part of the pelvic
outlet.
• Superior: deep transverse perineal
muscles runs transversely along the
posterior aspect of the perineal
membrane.
• Above the center of the membrane:
external urethral sphincter that surrounds
the urethra.
Perineal fascia
• Consists of superficial and deep
layers.
• Superficial (Subcutaneous) consist
of:
• Fatty superficial layer
• Membranous or deep (Colles’ fascia)
Perineal fascia
• Membranous (deep) layer of the superficial
perineal fascia is attached:
• Posterior : posterior margin of the perineal
membrane and perineal body
• Lateral : fascia lata (Deep fascia) of the
uppermost medial aspect of the thigh
• Anterior: continuous with the Dartos fascia in the
scrotum
• On each side and anterior to scrotum: continuous
with the membranous layer of the abdomen
(Scarpa’s fascia)
Perineal fascia
• Females:
• Fatty superficial fascia continues
anteriorly into the labia majora and
then into the mons pubis and the
fatty superficial layer of the abdomen
(Camper’s fascia)
Perineal Fascia
• Females
• Membranous (Deep) layer of
superficial fascia
• Passes superior to the fatty layer
forming the labia majora
• Becomes continuous with the
membranous layer of the
subcutaneous layer of the abdomen
Perineal fascia
• Males:
• Fatty superficial layer is greatly
diminished in the urogenital triangle
replaced in the penis and scrotum with
smooth (dartos muscle)
• Continuous between the scrotum and
thighs with the subcutaneous tissue of the
abdomen
• Posteriorly with a similar layer in the anal
region (Ischioanal fat pad)
Deep perineal Fascia
• Investing or Gaullaudet’s fascia
• Invests the;
• A) ischiocavernous
• B) bulbospongiosus
• C) superficial transverse perineal muscles
• Attached laterally to the ischiopubic ramus
superior to the attachment of the membranous
layer of the superficial perineal fascia.
• Anteriorly: fused to the suspensory ligament of
the penis (male)
Deep perineal fascia
• Continuous with the deep fascia
covering the external oblique muscle
of the abdomen and the rectus
sheath.
• Fused with the suspensory ligament
of the clitoris (female)
• Deep fascia of the abdomen (male)
Superficial Perineal pouch
(compartment)
• Potential space between the
membranous layer of the subcutaneous
tissue and the perineal membrane.
• Male: contains
• Root (bulb and crura) of the penis and
muscles associated with it.
(ischiocavernous and bulbospongiosus)
• Proximal part of the spongy urethra
Superficial perineal pouch
(compartment)
• Superficial transverse perineal
muscles
• Branches of the internal pudendal
vessels
• Branches of the pudendal nerves
(perineal nerves)
Superficial perineal pouch
(compartment)
• Female: contains
• Root (crura) of the clitoris and the muscle
associated with it (ischiocavernous)
• Bulbs of the vestibule and surrounding
muscle
• ( bulbospongiosus)
• Superficial transverse perineal muscles
• Related vessels and nerves ( branches of
internal pudendal vessels, perineal
nerves)
• Greater vestibular glands
Deep perineal pouch (space)
• Not an enclosed compartment
• Open superiorly
• Boundaries ( with deep urogeniatl
muscles)
• Below: Perineal membrane
• Extends superiorly: as the anterior
recesses of the ischioanal fossa
Deep perineal pouch (space)
• Male: contains
• Intermediate (membranous) part of
the urethra
• External urethral sphincter muscle
• Bulbourethral glands
• Deep transverse perineal muscles
• Related vessels and nerves
Deep perineal pouch (space)
• Females: contains
• Proximal part of the urethra
• External urethral sphincter muscle
• Deep transverse perineal muscle
• Related vessels and nerves
Pelvic diaphragm
• Consist of:
• levator ani muscle
• Coccygeus muscle
• Fascia above and elow
• Important: separates the pelvic cavity
from the perineum
• Forms the funnel-shaped,hammock like
floor of the pelvic cavity
• Forms the medial slope of the inverted V-
shaped roof of each ischioanal fossa.
Ischianal fossae
• Ischiorectal fossae
• Located: around the wall of the anal
canal
• Large fascia lined
• Wedge shaped space
• Between the skin of the anal region
and the pelvic diaphragm
Ischioanal fossae
• Apex: lies superiorly where the levator ani
muscle arises from the obturator fascia.
• Wide inferiorly, narrow superiorly
• Contents: fat and loose connective tissue.
• Communicate : deep postanal space over
the anococcygeal ligament (body)
• Anococcygeal ligament (body) is a
fiborius mass located between the anal
canal and the tip of the cocyx.
Boundaries of the ischioanal fossae
• Lateral: ischium and inferior part of the
obturator, covered by obturator fascia
• Medial: anal canal to which the levator ani
descends and the external sphincter
surrounds
• Posterior: sacrotuberous ligament and
gluteus maximus
• Anterior: external urethral sphincter and
deep transverse perineal and their fasciae.
Ischioanal fossae
• Parts of the fossae superior to the
perineal membrane are known as:
• Anterior recesses of the ischioanal fossae.
• Traversed by tough fibrous bands filled
with fat: fat bodies of the ischioanal
fossae.
• Fat bodies support the anal canal .
• Readily displaced to permit expansion of
the anal canal during the passage of
feces.
Ischioanal fossae
• Lateral walls contain:
• Internal pudendal vessels and nerves
• Posteriorly: vessels and nerve give rise to
the inferior rectal vessels and nerves
which cross the fossae and become the
superficial and supply the external anal
sphincter and the anal skin.
• Other nerves: perforating branch of S2
and S3 and perineal branch of S4 nerve.
 Pudendal canal
• Space within the obturator fascia
• Covers the medial aspect of the
obturator internus and lines the
lateral wall of the ischioanal fossae
• Vessels: enter the canal at the
lesser sciatic notch, inferior to the
ischial spine.
• Pudendal artery, vein and nerve
• Nerve to the obturator internus
Pudendal nerve
• Supplies most of the innervation to the
perineum.
• End of the pudendal canal, nerve splits,
giving rise to the perineal nerves and
continuing as the dorsal nerve of the
penis or clitoris.
• These nerves run anteriorly on each side
of the continuation of the internal
pudendal artery.
Nerves
• Superficial perineal nerves:
• Scrotal or labial branches
• Deep perineal nerves:
• Muscles of the deep and superficial
perineal pouches.
• Skin of the vestibule of the vagina
• Mucosa of the inferior most part of
the vagina
Nerves
• Inferior rectal nerve:
• Arises from the pudendal nerve at the
entrance of the pudendal canal and
crosses each ischioanal fossae to reach
the anus.
• Supplies: external anal sphincter
• Perianal skin
• Communicates with the posterior scrotal
or labial nerves
• Perineal nerves
Nerves
• Dorsal nerve of the penis or clitoris
• Sensory branch of the pudendal
nerve
• runs through the deep perineal
pouch.
Anal canal
• Terminal part of the large intestines.
• Extends from the upper part of the
pelvic diaphragm to the anus
• Begins where the rectal ampulla
narrows at the level of the U-shaped
sling formed by the puborectalis
muscle.
• Ends as the anus
Anal sphincters
• External anal sphincter
• Large voluntary sphincter that forms
a broad band on each side of the
inferior 2/3 of the anal canal
• Blends superiorly with puborectalis
muscle.
• Supplied by S4 through the inferior
rectal nerve.
Anal sphincters
• Internal anal sphincter
• Involuntary sphincter surrounding the superior
2/3 of the anal canal.
• Thickening of the circular muscle layer
• Innervated by parasympathetic fibers that pass
through the pelvic splanchnic nerves.
• Contracted most of the time to prevent leakage of
fluid or flatus.
• Relaxes in the response of the pressure of the
feces or gas distending the rectal ampulla
Anal canal
• Anal columns
• a series of longitudinal ridges.
• Located in the superior half of the
mucous membrane of the interior of
the anal canal
• Columns contain terminal branches
of the superior rectal artery and vein
Anal canal
• Anorectal junction
• Indicated by the superior ends of the anal
columns
• Rectum joins the anal canal
• Inferior end of the anal columns are joined by the
anal valves
• Superior to the valves are small recesses : anal
sinuses
• Pectinate line: indicates the junction of the
superior part of the anal canal and the inferior
part
Arterial supply of the anal canal
• Superior rectal artery:
• Supplies the anal canal superior to the
pectinate line.
• 2 inferior rectal arteries supply the inferior
part of the anal canal and surrounding
muscle and perianal skin.
• Middle rectal arteries
• Assist with the blood supply to the anal
canal by forming anatomosis with the
superior and inferior rectal arteries.
Venous drainage
• Internal rectal venous plexus drains in
both directions from the level of the
pectinate line.
• Superior to the pectinate line
• The internal rectal venous plexus drains
chiefly into the superior rectal vein.
(tributary of the inferior mesenteric vein
and the portal system)
Venous drainage
• Inferior to the pectinate line
• Internal rectus plexus drains into the
inferior rectal veins ( tributaries of the
caval venous system)--- around the
margin of the external anal sphincter
• Middle rectal veins ( tributaries of the
internal iliac veins)--- mainly drain the
muscularis externa of the ampulla and
form anastomosis with the superior and
inferior rectal veins
Lymphatic drainage of the anal
canal
• Superior to the pectinate line
• Lymphatic vessels drain into the
internal iliac lymph nodes
• Into the common iliac and lumbar
lymph nodes
• Inferior to the pectinate line
• Lymphatic vessels drain into the
superficial inguinal lymph nodes
Innervation of the anal canal
• Superior to the pectinate line
• Visceral innervation: in from the inferior
hypogastric plexus (sympathetic and
parasympathetic fibers)
• Superior part of the anal canal I sensitive
to stretching
• Inferior to the pectinate line:
• somatic Innervation: derived from the
inferior rectal nerves
• Sensitive to pain, touch and temperature
Male perineum
• Includes:
• Anal canal
• Intermediate and spongy parts of the
urethra
• Roots of the penis and the scrotum
Urethra
• 3 parts
• Prostatic
• Membranous
• Spongy
Urethra
• Intermediate (membranous) part of
the urethra
• Shortest and narrowest part of the
urethra, except for the external
uretheral orifice
• Begins at the apex of the prostate
and ends at the bulb of the penis
Urethra
• Traverses the deep perineal pouch
• Surrounded by the external urethral
sphincter and perineal membrane
• Posterolateral: bulbourethral gland
(Cowper’s gland)
Urethra
• Spongy urethra:
• Longest part
• Passes through the bulb and corpus
spongiosum of the penis
• Begins at the distal end of the
intermediate part of the urethra and
ends at the external urethral orifice
(narrowest part of the urethra)
Urethra
• Lumen of the spongy urethra is 5 mm
in diameter .
• Lumen expands in the bulb of the
penis to form the intrabulbar fossa
• In the glans penis the lumen expands
to for the Navicular fossa
Arterial supply of the Distal parts of
the Urethra
• Intermediate and spongy parts
• From the branches of the internal
pudendal artery
Venous and Lymphatic drainage
• Intermediate and spongy urethra
• Veins accompany arteries with similar
names
• Lymphatic vessels (intermediate urethra)
drain mainly into the internal iliac lymph
nodes
• Lymphatic vessels (spongy urethra) drain
to the deep inguinal lymph nodes, some
passes to the external iliac nodes
Innervation of Intermediate and
Spongy parts
• Nerves are branches of the pudendal
nerve
• Afferent fibers from the urethra run
in the pelvic splanchnic nerves
• Nerves from the prostatic nerve
plexus that arise from the inferior
hypogastric plexus are distributed to
the urethra.
Scrotum
• Cutaneous fibromuscular sac for the
testes and associated structures.
• Location:
• Posteroinferior to the penis
• Inferior to the pubic symphysis
• Scrotal raphe- bilateral embryonic
formation (midline)
• Penile raphe- ventral surface of the penis
• Perineal raphe – midline of perineum
Scrotum
• Contents:
• Testes
• Epididymis
Arterial supply of the scrotum
• Anterior: external pudendal arteries
• Posterior: internal pudendal arteries
• Receives branches from the
testicular and cremasteric arteries.
Venous and lymphatic drainage
• Scrotal veins accompany the
arteries and join the external
pudendal veins.
• Lymphaticvessles carry lymph to the
superficial inguinal lymph nodes
Innervation of the Scrotum
• Anterior:
• anterior scrotal nerves derived from the
inguinal nerves
• Genital branch of the genitofemoral nerve.
• Posterior:
• posterior scrotal nerves
• Branches of the superficial perineal
nerves
• Perineal branch of the posterior femoral
cutaneous nerve
Penis
• Male copulatory organ
• Common outlet for the urine and
semen
• Consist of:
• Root
• Body
• Glans penis
Penis
• Composed of 3 cylindrical bodies of
erectile cavernous tissue.
• Corpora cavernosa (2)
• Corpus spongiosum
• Tunica albuginea: fibrous capsule
that covers the erectile tissue
• Buck’s Fascia- deep fascia of the
penis ( superficial to t. albuginea)
Penis
• Corpus spongiosum- contains the spongy urethra
• 2 Corpora cavernosum are fused together in the
median plane except posteriorly where they
separate to form the crura of the penis
• Root of the penis, attached part consist of:
• Crura
• Bulb
• Ischiocavernosus and bulbospongiosus muscles
Penis
• Root is located in the superficial perineal
pouch
• Between perineal membrane, superiorly
• Deep perineal fascia, inferiorly
• Crura and bulb: contain erectile tissue
• Each crus is attached to the inferior part
of the internal surface of the
corresponding ischial ramus anterior to
the ischial tuberosity.
Penis
• Body of the penis
• Free part that is pendulous in the
flaccid condition.
• No muscles except:
• few fibers of the bulbospongiosus
near the root of the penis
• Ischiocavernous that embrace the
crura.
Penis
• Consists of:
• thin skin
• Connective tissue
• Blood and lymphatic vessels
• Fascia
• Corpora cavernosum and
spongiosum containing the spongy
urethra
Penis
• Distally, copus spongiosum expands to
form the conical glans penis
• ( head of the penis)
• Margins of the glans projects beyond the
ends of the corpora cavernosa to form the
corona of the glans.
• Neck of the glans: obliquely grooved
constriction, separates the glans from the
body of the penis
Penis
• External urethral orifice: (meatus)
• Slit like opening of the spongy
urethra
• Located near the tip of the glans
• Skin of the penis:
• Thin, dark
• Connected to the tunica albuginea by
loose connective tissue.
Penis
• At the neck of the glans, skin and
fascia are prolonged as a double
layer of skin, prepuce (foreskin)
• Frenulum of the prepuce:
• Median fold that passes from the
deep layer of the prepuce to the
urethral surface of the glans
Penis
• Suspensory ligament of the penis
• Condensation of deep fascia that arises
from the anterior surface of the pubic
symphysis.
• Fundiform ligament of the penis:
• Band of elastic fibers of the subcutaneous
tissue that extends from the linea alba
superior to the pubic symphysis and splits
to surround the penis
Superficial perineal muscles
• Superficial transverse perineal
• Bulbospongiosus
• Ischiocavernous
• These muscles are in the superficial
perineal pouch and are supplied by
the perineal nerves.
Superficial perineal muscles
• Superficial transverse perineal muscle
• Slender strips of muscle that pass
transversly, anterior to the anus
• Bulbospongiosus muscle:
• Lie in the median plane of the perineum,
anterior to the anus
• Forms a sphincter that compresses the
bulb of the penis and the corpus
spongiosum.
Superficial perineal muscles
• Ischiocavernous muscle
• Surround the crura in the root of the
penis.
• Forces blood from the cavernous
spaces in the crura into the distal
parts of the corpora cavernosa.
Arterial supply of the penis
• Supplied mainlpplying the ey by branches
of the internal pudendal arteries
• Dorsal arteries: run in the interval between
the corpora cavernosa on each side of the
deep dorsal vein, supplying the fibrous
tissue around the corpora and penile skin.
• Deep arteries: peirce the crura and run
within the corpora cavernosa, supplying
the erectile tissue in these structures.
(helicine arteries)
Arterial supply of the penis
• Artery of the bulb of the penis
• Supplies the posterior part of the
corpus spongiosum and the
bulbourethral gland
Venous and lymphatic drainage of
the penis
• Blood from the cavernous spaces is
drained by a venous plexus that joins
the deep dorsal vein of the penis in
the deep fascia
• Superficial inguinal lymph nodes
receive most of the lymph from the
penis
Innervation of the penis
• Nerves derived from S2 through S4 segments of
the spinal cords
• Passes through the pudendal nerve and plexuses
• Dorsal nerve of the penis ( br. of pudendal nerve)
• Supplies both skin and glans penis
• Penis is richly provided with a variety of sensory
nerve endings.
• Especially the glans penis
• Branches of the ilioinguinal nerves supply the
skin at the root of the penis.
Female perineum
• Boundaries:
• Mons pubis
• Medial aspects of the thighs
• Gluteal folds
• Intergluteal cleft
• Female perineum includes:
• Pudendum or vulva (external genitalia)
• Anus
• Clinically: region between the and vaginal orifice
Female external genitalia
• External genital organs include:
• Mons pubis
• Labia majora
• Labia minora
• Clitoris
• Vestibule of the vagina
• Bulbs of vestibule
• Greater vestibular glands
Female external genitalia
• Synonymous terms vulva and
pudendum include all the parts
mentioned
• Vulva serves:
• As sensory erectile tissue for sexual
arousal and intercourse
• To direct the flow of urine
• Prevent entry into the urogenital tract
Female external genitalia
• Mons Pubis
• Rounded, fatty prominence anterior to the
pubic symphysis, pubic tubercle and
superior pubic rami
• The eminence is formed by a mass of fatty
subcutaneous tissue
• After puberty it is covered with coarse
pubic hair
• The amount of fat increases at puberty
and decreases after menopause.
Female external genitalia
• Labia majora
• Prominent folds of skin
• Bounds the pudendal cleft
• Indirectly provide protection for the
urethral and vaginal orifices.
• Filled with finger like digital process of
loose subcutaneous tissue containing
smooth muscle, termination of the round
ligament of the uterus and fat
Female external genitalia
• Lies at the side of the pudendal cleft
(slit between the labia major)
• Labia is thicker anteriorly: anterior
commissure
• Posteriorly: posterior commissure
(nulliparous)
Female external genitalia
• Labia minora:
• Folds of fat free hairless skin
• Enclosed in the pudendal cleft within the
labia majora
• Immediately surrounds the vestibule of
the vagina
• They have a core of spongy connective
tissue containing erectile tissue and many
blood vessels
Female external genitalia
• Extends from the clitoris
posterolaterally around the external
urethral orifice and vaginal orifice
• L.minor is connected by a small fold
called Frenulum of the labia minora
• ( virgin)fourchette
• Mucus membrane and sebaceous
gland and sensory nerve endings
Female external genitalia
• Clitoris:
• Erectile organ located where the
labia minora meet anteriorly
• Consist of a root and body which are
composed of two crura, two corpora
cavernosa and a glans clitoris that is
covered by a prepuce.
Female external genitalia
• Vestibule
• Space between the l. minora that
contain the openings of:
• Urethra
• Vagina and ducts of greater and
lesser vestibular glands
Female external genitalia
• External urethral orifice is located posteroinferior
to the glans of the clitoris
• Anterior to the vaginal orifice
• On each side of the external urthral orifice is the
parauretheral glands
• Hymen: thin fold of mucous membrane
surrounding the vaginal orifice
• Remnants of hymen: hymenal caruncles (tags)
• These remnants demarcate the vulva from the
vagina
Female external genitalia
• Bulbs of the vestibule:
• Paired masses of elongated erectile
tissue.
• Lie alongside the vaginal orifice
under cover of the bulbospongiosus
muscles.
• Homologous with the bulbs of the
penis and the corpus spongiosum
Female external genitalia
• Vestibular glands
• Greater vestiular glands are on each side
of the vestibule, posterolateral to the
vaginal orifice
• Round or oval and partly overlapped
posteriorly by the bulbs of the vestibule
• Secrete mucus into the vestibule during
sexual arousal.
Female external genitalia
• Lesser vestibular gland
• Small glands on each side of the
vestibule
• Opens between the urethral and
vaginal orifice
• Secrete mucus into the vestibule
which moistens the labia and
vestibule
Perineal fascia and muscles
• Superficial perineal fascia consists
of:
• Fatty and membranous layer of
subctaneous connective tissue.
• Superficial perineal muscles:
• Superficial transvers perineal
• Ischiocavernous
• Bulbospongiosus
Arterial supply of the vulva
• External pudendal arteries
• One internal pudendal artery on each side
• Int. pudendal artery supplies the skin, sex
organs and perineal muscles
• Labial arteries are branches of the internal
pudendal are as those of the clitoris
Venous and lymphatic drainageof
the vulva
• Labial veins are tributaries of the
internal pudendal veins
• Venous engorgement during sexual
excitement increases the size and
consistency of the clitoris
• Vulva contains lymph vessels that
drain into the superficial inguinal
lymph nodes
Innervation of the vulva
• Anterior labial nerves ( branch of the
ilioinguinal nerve)
• Genital branch of the genitofemoral
nerve ( perineal branch of the
cutaneous nerve of the thigh)
• Posterior labial nerves ( branch of
the perineal nerve)
Female external genitalia
• Parasympathetic stimulation
produces:
• Increasedvaginal secretion
• Erection of the clitoris
• Engorgement of erectile tissue in the
bulbs of the vestibule