Transactions of the American Association of Obstetricians and Gynecologists for the year ... . parts must be made, to construct a bridge 5 to 6 cm. wide,directly over the bowel, to hold it down properly, and not merely toform a bar across the introitus internally. Operating at a depthless than 5 to 6 cm. inward from the hymen, can, therefore, not usu-ally fulfill the correct anatomical requirements. The anatomy of the female perineum becomes clearer when grosslydivided into three strata, as is done by several French and Germananatomists, the first embracing the subcutaneous tissues and super-f
Transactions of the American Association of Obstetricians and Gynecologists for the year ... . parts must be made, to construct a bridge 5 to 6 cm. wide,directly over the bowel, to hold it down properly, and not merely toform a bar across the introitus internally. Operating at a depthless than 5 to 6 cm. inward from the hymen, can, therefore, not usu-ally fulfill the correct anatomical requirements. The anatomy of the female perineum becomes clearer when grosslydivided into three strata, as is done by several French and Germananatomists, the first embracing the subcutaneous tissues and super-ficial muscles, the bulbo-cavernosus, ischio-cavernosus and super-ficial transversus perinei. The second layer is called by several LACERATIONS OF THE PERINEUM. 129 anatomists the urogenital diaphragm, or trigone. By others it iserroneously called the triangular ligament, a name that suggestsnothing of its composite structure consisting of two layers of fasciawith a muscle, transversus perinei profundus, between them. Thisdense, strong, and more inelastic formation fills in the angle formed. Fig. 2.—(Plate XII of Edward Martins Atlas.) Labia, skin, subcutaneousfat, superficial perineal fascia, and contents of the ischiorectal fossa; are ischiocavernosus (a) bulbocavernosus (b) and superficial transversus peroneimuscles (e) (belonging to the superficial stratum) are intact on the left side;but the latter two muscles are cut away (d) on the right side to expose the uro-genital diaphragm (c) Uhe middle stratum) on that side The bulbi (f), Bartholingland (k), vulva (g), and the anus (/;), with the external sphincter (i) are levator ani muscle (?) constituting the innermost stratum, is divested of itsouter fascia. by the descending pubic and ascending ischial rami, back to theanterior border of the anus. It closely surrounds the vaginal in-troitus near the hymen, and forms a firmer and narrower boundaryaround that passage than the levator ani does. Its inner
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Keywords: ., bo, bookcentury1900, booksubjectgynecology, booksubjectobstetrics
