Neurovasculature of the Perineum

00:01 Now, let's turn our attention to the neurovascular structures within the perineum.

00:05 And this can be quite complicated.

00:07 There's lots of blood vessels going on here.

00:09 So it may be important to take this quite slowly and go through it, methodically.

00:13 So here we have a look at really the neurovasculature of the region, which is predominantly supplied by the internal pudendal artery and vein and the pudendal nerve.

00:23 Let's have a look here at the internal pudendal artery.

00:26 So we can see the internal pudendal artery is coming away from the internal iliac artery.

00:32 And we can see the internal pudendal artery here.

00:35 It's leaving the pelvis as we've mentioned previously, via the greater sciatic foramen.

00:40 And it passes over the sacrospinous ligament.

00:44 So it passes posterior to the sacrospinous ligament as it exits the pelvis. And then passes into the perineum by going through the lesser sciatic foramen, which then runs alongside side the ischiopubic ramus As it runs through the ischiopubic ramus the internal pudendal artery and vein, and the pudendal nerve run in that canal, which is the pudendal canal.

01:09 So it's running alongside the ischiopubic ramus.

01:12 As it does this, it passes the anus.

01:15 As it passes the anus in the ischio-anal fossa.

01:18 It gives rise to the inferior rectal arteries.

01:21 They go on to supply the rectum and the anus.

01:24 As the internal pudendal artery is given off the inferior rectal artery, it continues into the perineum as the perineal artery.

01:31 And here we can see in the male, it then goes on to supply arteries of the penis.

01:36 Both the deep dorsal and the artery of the bulb of the penis.

01:39 Here we can see it gives rise to a branch that goes to the scrotum.

01:42 So we have the scrotal artery.

01:45 So the internal pudendal artery we can see in this position here.

01:49 It's running alongside the pudendal nerve.

01:52 And this will take an identical course as the internal pudendal artery and gives rise to nerves very similar name to that of branches coming from the internal pudendal artery.

02:02 It's found alongside this artery within the pudendal canal.