The Anatomy of the Perineum
The perineum is the region between the thighs inferior to the pelvic diaphragm. The boundaries of this region are the same as that for the pelvic outlet, namely the pubic symphysis, ischiopubic rami, sacrotuberous ligaments, and coccyx. The perineum has a roof formed by the pelvic diaphragm and a floor of fascia and skin. It also contains the muscles and neurovasculature associated with urogenital structures and the anus.
When the legs are abducted, the perineum forms a diamond shape that can be divided into two triangles by drawing a line connecting the ischial tuberosities: the urogenital triangle and the anal triangle.
Urogenital triangle: The urogenital triangle makes up the anterior portion of the perineum. The female urogenital triangle is home to the opening of the vagina, the urethra, and the clitoris.
The perineal fascia of the urogenital triangle includes superficial and deep layers. The superficial perineal fascia has a fatty layer and a deeper membranous layer (Colles fascia). The fatty layer makes up the thickened areas of the labia majora and mons pubis. In males, the fatty layer is much thinner and is absent in the penis and scrotum.
Anal triangle: The anal triangle contains the anus and the ischioanal fossae, which are two wedge-shaped spaces between the skin around the anal canal and the pelvic diaphragm. They contain fat and loose connective tissue, which helps support the anal canal but is pliable enough to allow for expansion during bowel movements.
Hemorrhoids are painful, swollen veins in the anal canal or anus. Internal hemorrhoids occur in the anal canal, but they may not be painful because the rectum doesn’t have many nerves that sense pain. External hemorrhoids affect the anus and are easy to see and palpate by inspecting the anus. More sensory nerves are located around the anus, so external hemorrhoids may be quite painful. They may also result in itching and bleeding. Topical medications may help shrink hemorrhoids, and dietary changes may prevent their occurrence; however, surgery may be indicated when reoccurrences are frequent.
The anal region is innervated by the inferior hypogastric plexuses and the inferior rectal nerve. The blood supply to the anal area is provided by the superior and inferior rectal arteries. Blood is retuned by their accompanying veins. Lymph drains into the pararectal nodes and superficial inguinal nodes.
The male perineum
The male perineum includes the penis, scrotum, and the perineal muscles in the urogenital triangle, along with the anal triangle.
The scrotum is the fibromuscular sac that houses the testes. It’s located behind and below the penis. On the surface, you can see the scrotal raphe, which is a ridge that runs along the midline of the scrotum. It continues on the penis as the penile raphe. Internally, the scrotum is divided by a septum of the scrotum.
The female perineum
The female perineum includes the external genitalia, orifices of the urethra and vagina, and the perineal muscles. Pelvic examinations begin with the inspection of these areas.
The external genitalia are collectively referred to as the vulva. They include the mons pubis, the labia majora, the labia minora, and the clitoris:
Mons pubis: This rounded, fatty eminence is anterior to the pubic symphysis.
Labia majora: These prominent folds of fat and skin help to protect the orifices of the urethra and vagina. The labia majora are separated by the pudendal cleft.
Labia minora: Inside the pudendal cleft you find these two folds of skin, but they don’t contain fat. The anterior portions of the labia minora unite to form laminae that become the frenulum and prepuce of the clitoris.
Clitoris: This small erectile organ corresponds with the male penis. It’s located where the labia minor meet at the front of the vulva. The root of the clitoris is made up of the bulb of the vestibule and the left and right crura of the clitoris. The body of the clitoris contains two corpora cavernosa and ischiocavernosus muscles. The glans of the clitoris is a mass of erectile tissue that has many nerve endings. The blood supply is provided by the branches of the internal pudendal arteries and veins.
Vestibule: This feature is a space between the labia minora. You can find the external urethral orifice there, along with the vaginal orifice. Greater vestibular glands and lesser vestibular glands lie on either side of the vestibule posterior to the vaginal orifice. The vestibular glands secrete slippery fluids during sexual arousal.
The anterior vulva is innervated by anterior labial nerves (branches of the ilioguinal and genital branch of the genitofemoral nerves). Posterior (labial) nerves supply the labia minora, vagina, and clitoris (via a branch called the dorsal nerve of the clitoris). Blood flow to the vulva is provided by external and internal pudendal arteries. Blood is returned by the labial and internal pudendal veins. Lymph drains into the superficial inguinal lymph nodes, deep inguinal nodes, and internal iliac nodes.

Clinical Anatomy Glossary
abdomen
This region of the body starts along the bottom of the ribcage and extends to the hips. It’s visible from the front.

Clinical Anatomy Glossary
abdominopelvic splanchnic nerves
These sympathetic (fight-or-flight) nerves of the abdomen carry the presynaptic fibers to the abdomen and pelvis.

Clinical Anatomy Glossary
anastomose
To join together.

Clinical Anatomy Glossary
androgen hormones
Male sex hormones.

Clinical Anatomy Glossary
ankylosing spondylitis
An arthritic disease of the vertebral joints that results in hyperkyphosis and may restrict lung expansion if the disease spreads superiorly. It may lead to fusion of intervertebral joints and spinal column rigidity.

Clinical Anatomy Glossary
anterior
In clinical anatomy, closer to the front of the body. For instance, the abdominal muscles are anterior to the spine.

Clinical Anatomy Glossary
aponeurosis
The broad tendinous structure that attaches a muscle to another muscle.

Clinical Anatomy Glossary
articulate
In clinical anatomy, to form a joint.

Clinical Anatomy Glossary
ball-and-socket joint
A ball-shaped head that fits into a bony socket. The shoulder and hip are ball-and-socket joints. This type of joint allows for free movement in several directions, including flexion, extension, abduction, adduction, medial and lateral rotation, and circumduction.

Clinical Anatomy Glossary
bilateral
On both the left and right sides of the body, such as the eyes, the kidneys, and the arms and legs.

Clinical Anatomy Glossary
bladder
A thin-walled, bag-like organ that can hold up to two cups of urine.

Clinical Anatomy Glossary
bony process
A projection of bone that sticks out from the arch found in vertebrae.

Clinical Anatomy Glossary
brainstem
Connects the cerebrum with the spinal cord.

Clinical Anatomy Glossary
bursae
Fluid-filled sacs that help tendons glide over the bones and other tendons.

Clinical Anatomy Glossary
bursitis
An inflammation of a bursa, which is usually the result of repetitive motion injuries.

Clinical Anatomy Glossary
calcaneus
The part of the heel you stand on.

Clinical Anatomy Glossary
cardiovascular disease
Diseases of the heart and blood vessels.

Clinical Anatomy Glossary
cartilaginous joints
The joint surfaces in cartilaginous joints are covered with hyaline cartilage and have fibrocartilaginous discs between them. Like fibrous joints, cartilaginous joints can be immoveable.

Clinical Anatomy Glossary
cerebrum
The largest part of the brain; made up of the left and right cerebral hemispheres.

Clinical Anatomy Glossary
cervical
The neck region; starts below the head, ends at the thorax, and is visible from the front and rear from below the head to the shoulders.

Clinical Anatomy Glossary
circumduction
To move in a circular motion; doing arm circles, is circumduction.

Clinical Anatomy Glossary
condyloid joints
Joints with an oval surface on one bone that articulates with an oval-shaped depression in another bone. The metacarpophalangeal joints in the fingers are examples of condyloid joints.

Clinical Anatomy Glossary
contralateral
On opposite sides of the body. The right ear is contralateral to the left ear.

Clinical Anatomy Glossary
corpus callosum
A band of nerve fibers that allows the sides of the brain to communicate with the other.

Clinical Anatomy Glossary

Clinical Anatomy Glossary
dendrite
The receiving part of a neuron. The signal received at the dendrite is transmitted toward the cell body of the neuron in the form of an electrical impulse. The impulse is transmitted away from the cell body to another neuron, muscle, or gland by the axon.

Clinical Anatomy Glossary
dermis
The lower layer of the skin containing collagen and elastic fibers that give strength to the skin.

Clinical Anatomy Glossary
diencephalon
The central part of the brain, underneath the cerebrum.

Clinical Anatomy Glossary
distal
Farther from the trunk or from the point of origin. The elbow is distal to the shoulder.

Clinical Anatomy Glossary
dorsal
An anatomical region that runs from immediately below the neck down to the area below the waist. It doesn’t include the shoulders. It’s visible from the rear.

Clinical Anatomy Glossary
dorsiflex
To move your foot and toes up.

Clinical Anatomy Glossary
duodenum
The first segment of the small intestine.

Clinical Anatomy Glossary
dural venous sinuses
The spaces between the two layers of the dura matter that collect blood from veins on the surface of the brain.

Clinical Anatomy Glossary
elastic cartilage
Cartilage that contains elastic fibers in the matrix, so it’s more flexible than either hyaline or fibrocartilage; your ear has elastic cartilage.

Clinical Anatomy Glossary
endoneurium
The delicate layer that surrounds each individual nerve fiber in the peripheral nervous system.

Clinical Anatomy Glossary
epidermis
The tough layer outermost layer of skin. It gets its toughness from a protein called keratin.

Clinical Anatomy Glossary
epineurium
The thick layer of connective tissue that surrounds a bundle of fascicles in the peripheral nervous system.

Clinical Anatomy Glossary
esophagus
A muscular tube that extends from the pharynx to the stomach.

Clinical Anatomy Glossary
eversion
To move the bottom of your foot away from the midline of the body.

Clinical Anatomy Glossary
facet
In clinical anatomy, a smooth joint-forming surface.

Clinical Anatomy Glossary
fascia
A layer of fibrous connective tissue that covers muscle.

Clinical Anatomy Glossary
fibrocartilage
This cartilage has a larger number of collagen fibers and less matrix. It’s found in the discs in joint spaces including the temporomandibular joint, knee joint, and joints between the bodies of the vertebrae.

Clinical Anatomy Glossary
fibrous joints
The bones of a fibrous joint are connected by fibrous tissue. They range from being immovable (like joints between the bones of the skull) to being slightly moveable (joints between the tibia and fibula in the legs).

Clinical Anatomy Glossary

Clinical Anatomy Glossary
frontal planes
Imaginary vertical planes that clinical anatomy uses to define regions of the body. They pass through the body at right angles to the midsagittal plane, so they divide the body into front and back. Frontal (coronal) planes can divide the body at any point, so you need to use a reference point to know where exactly the plane passes.

Clinical Anatomy Glossary
ganglion
A collection of nerve-cell bodies similar to the nuclei of the central nervous system, except that these ganglia are only found in the peripheral nervous system.

Clinical Anatomy Glossary

Clinical Anatomy Glossary
hila
The plural of hilum, and the hilum is the part of the lung where the bronchus and pulmonary artery enter and the pulmonary vein exits the lungs.

Clinical Anatomy Glossary
hinge joint
A joint that allows flexion and extension (bending and straightening) of joints like the elbow and the knee.

Clinical Anatomy Glossary
hyaline cartilage
This durable type of cartilage covers most of the bone surfaces in synovial joints. It’s also found in the nasal septum, rings of the trachea, and costal cartilages of the ribs, and it forms the epiphyseal plates of growing bones.

Clinical Anatomy Glossary
hyperkyphosis
An abnormal increase in the thoracic curvature.

Clinical Anatomy Glossary
hypertension
A condition in which blood pressure remains elevated over time. Having high blood pressure increases the risk of heart disease, stroke, and kidney disease.

Clinical Anatomy Glossary
inferior
Closer to the feet. The chin is inferior to the nose.

Clinical Anatomy Glossary

Clinical Anatomy Glossary
intermuscular septa
The septa divide muscles into various groups.

Clinical Anatomy Glossary
inversion
To move the bottom of your foot toward the midline of your body.

Clinical Anatomy Glossary
investing fascia
This part of the fascia covers deeper structures, such as muscles and ligaments.

Clinical Anatomy Glossary
ipsilateral
On the same side of the body. For example, the right ear and the right eye are ipsilateral.

Clinical Anatomy Glossary
keratin
A major structural component of the outer layers of skin.

Clinical Anatomy Glossary
keratinocytes
These cells are constantly shed and replaced by cells from the lower layers of the epidermis. These cells have lost most of their internal structures and organelles.

Clinical Anatomy Glossary
kidneys
Organs that filter the blood and produce urine.

Clinical Anatomy Glossary
lateral
In clinical anatomy, away from the body’s midline. For example, the little toe is lateral to the big toe.

Clinical Anatomy Glossary
lateral epicondyle
A bony prominence located proximal to the lateral condyle.

Clinical Anatomy Glossary
lateral rotation
To move a body part around its long axis with the anterior surface moving away from the midline, like turning your whole lower extremity so your foot points out toward the side.

Clinical Anatomy Glossary

Clinical Anatomy Glossary
manubrium
The superior part of the sternum.

Clinical Anatomy Glossary

Clinical Anatomy Glossary
matrix
A structural component made of water, collagen fibers, and crystallized calcium salts.

Clinical Anatomy Glossary
medullary cavity
Open space inside the bone.

Clinical Anatomy Glossary
meninges
Coverings of the brain. They protect the brain by housing a fluid-filled space, and they function as a framework for blood vessels.

Clinical Anatomy Glossary
midsagittal plane
An imaginary vertical plane that clinical anatomy uses to divide the body into left and right halves.

Clinical Anatomy Glossary
multinucleated
Containing more than one nucleus.

Clinical Anatomy Glossary
myoblasts
Embryonic muscle cells.

Clinical Anatomy Glossary
myocardium
Muscle of the heart.

Clinical Anatomy Glossary
nasal mucosa
Membranous lining of the nasal cavity that secretes mucus.

Clinical Anatomy Glossary
neurocranium
The part of the cranium that holds the brain.

Clinical Anatomy Glossary
osteoblasts
Cells that build up bone.

Clinical Anatomy Glossary
osteoclasts
Cells that break down bone.

Clinical Anatomy Glossary
osteocytes
Cells that maintain bone and collagen fibers.

Clinical Anatomy Glossary
papillae
Small, rounded protuberances.

Clinical Anatomy Glossary
parasympathetic stimulation
Constricts the bronchi, dilates blood vessels, and increases glandular secretions.

Clinical Anatomy Glossary

Clinical Anatomy Glossary
perineurium
Dense connective tissue surrounding a bundle of nerve fibers called a fascicle in the peripheral nervous system.

Clinical Anatomy Glossary
periorbita
A covering of fibrous connective tissue.

Clinical Anatomy Glossary
pharyngotympanic tube
The eustachian tube.

Clinical Anatomy Glossary
pivot joints
Joints that include a bone shaped like a pivot and a ring made of bone or ligament. Pivot joints, such as the atlantoaxial joint of the cervical spine, have rotational movements.

Clinical Anatomy Glossary
plane joints
Joints with flat articular surfaces that allow for a sliding motion, such as the acromioclavicular joint of the shoulder.

Clinical Anatomy Glossary
plantarflex
To point your toes down.

Clinical Anatomy Glossary
popliteal fossa
A diamond-shaped space posterior to the knee joint, bordered by several muscles, skin, the popliteal fascia, the femur, and the joint capsule.

Clinical Anatomy Glossary
posterior
Closer to the rear. The spine is posterior to the abdominal muscles.

Clinical Anatomy Glossary
pronation
A medial rotation of the forearm so that the palm faces posteriorly (toward the rear).

Clinical Anatomy Glossary
proximal
Closer to the trunk or closer to the point of origin. The shoulder is proximal to the elbow.

Clinical Anatomy Glossary
retinacula
Band-like structures that hold tendons in place while joints move.

Clinical Anatomy Glossary
retrusion
To move backward.

Clinical Anatomy Glossary
rugae
Gastric folds that appear when the stomach muscle tissue is contracted.

Clinical Anatomy Glossary
saddle joints
Joints that have the appearance of a saddle. The carpometacarpal joint at the base of the thumb is an example of a saddle joint.

Clinical Anatomy Glossary
sagittal planes
Imaginary vertical planes that are parallel to the midsagittal plane and divide the body into unequal left and right portions. There are many possible sagittal planes, so you should always give a reference point where the plane passes through.

Clinical Anatomy Glossary
scapula
The shoulder blade.

Clinical Anatomy Glossary
sciatic foramen
The opening in the posterior portion of the pelvis formed by the sciatic notch of the ischium and the sacrospinous and sacrotuberous ligament.

Clinical Anatomy Glossary
scoliosis
A rotation and lateral flexion of the spine that may twist and turn the thoracic cage.

Clinical Anatomy Glossary
sebaceous glands
Glands connected to the hair follicles. They produce sebum, which is an oily substance that helps keeps the hair flexible.

Clinical Anatomy Glossary
skeletal muscles
The muscles responsible for making the skeleton move. They’re voluntary muscles because you can control whether the muscles move.

Clinical Anatomy Glossary
stratum basale
Forms the deepest layer of the skin. The cells of this layer continuously divide and form new keratinocytes to replace the ones that are constantly shed. This layer also contains melanocytes, which are the cells that produce skin coloring.

Clinical Anatomy Glossary
stratum corneum
Dead, mature skin cells called keratinocytes. These cells are constantly shed and replaced by cells from the lower layers of the epidermis. These cells have lost most of their internal structures and organelles.

Clinical Anatomy Glossary
stratum granulosum
The area of the skin where keratin is formed. The cells in this layer also produce materials that prevent evaporation, which helps waterproof the skin.

Clinical Anatomy Glossary
stratum lucidum
Found in thicker skin; helps reduce friction between the stratum corneum and the stratum granulosum. It’s composed of dead, flattened cells.

Clinical Anatomy Glossary
stratum spinosum
Contains keratin-producing cells that were formed in the stratum basale.

Clinical Anatomy Glossary
subcutaneous layer
Area below the skin; underneath the cutaneous layer and is sometimes called the hypodermis or superficial fascia.

Clinical Anatomy Glossary
subserous fascia
The part of the fascia that lies between the body walls such as the thoracic wall and the membranes that line corresponding body cavities.

Clinical Anatomy Glossary
superficial
Closer to the surface. For instance, the skin is superficial to the muscles.

Clinical Anatomy Glossary
superior
Closer to the top of the head. For example, the nose is superior to the chin.

Clinical Anatomy Glossary
superior oblique muscle
The muscle that turns the eyeball inferiorly and laterally.

Clinical Anatomy Glossary
supination
Lateral rotation of the forearm so the palm faces anteriorly.

Clinical Anatomy Glossary
sympathetic stimulation
Causes bronchodilation and constricts the blood vessels.

Clinical Anatomy Glossary
synapse
The junction in the brain where nerve impulses pass.

Clinical Anatomy Glossary
synovial joints
A typical synovial joint includes bones covered in hyaline cartilage and a joint cavity lined with a synovial membrane and filled with synovial fluid. A durable fibrous joint capsule surrounds the joint. Some synovial joints also have fibrocartilaginous discs between the bones.

Clinical Anatomy Glossary
thorax
The section of the body that starts immediately below the neck, at the clavicles, and ends along the bottom of the ribcage. It’s visible from the front.

Clinical Anatomy Glossary
transverse planes
Imaginary horizontal planes that pass through the body at right angles to the midsagittal and the frontal planes. They divide the body into upper and lower portions. You need to have a reference point to know exactly where a transverse plane lies.

Clinical Anatomy Glossary

Clinical Anatomy Glossary
tympanic membrane
The eardrum.

Clinical Anatomy Glossary

Clinical Anatomy Glossary
ureters
Two long tubes that lead to the urinary bladder.

Clinical Anatomy Glossary
ventral
Toward the abdomen.