File:Operative surgery, for students and practitioners (1906) (14585185710).jpg

Identifier: operativesurgery00mcgr (find matches)
Title: Operative surgery, for students and practitioners
Year: 1906 (1900s)
Authors: McGrath, John J. (John Joseph), b. 1866
Subjects: Surgery, Operative
Publisher: Philadelphia, Davis
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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vis. This analfascia is attached in front to the transverse fibrous raphe and iscontinuous there with the deep layer of the superficial perineal fascia. The ischio-rectal space is thus walled off from the perineal spaceproper and from the rectum. It is the seat of the so-called ischio-rectal abscess, and when this breaks through into the rectum it formsthe fistula in ano. Some small vessels and nerve branches cross this space trans-versely just beneath the skin, passing from the tuberosity of theischium toward the anus, and these are cut when incisions are madeinto the space. PERINEUM AND ISCHIORECTAL REGION. 489 The Perineum.—Upon removing the deep layer of superficial peri-neal fascia we open into the proper perineal space. Occupying the middle of the space is a thin muscle, the bulbo-cavernosus; it arises from the middle tendinous point of the peri-neum, and, passing forward, covers the bulb of the urethra, which isthe posterior enlarged portion of the corpus spongiosum, joining,
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Fig. 215.—The Perineum and Ischio-rectal Region. The superficial anddeep layers of the superficial perineal fascia have been removed. The spacein front of the transversus perinei (TP) corresponds to the perineum; thatbehind the transversus perinei to the ischio-rectal region. The floor of thespace (TL) corresponds to the anterior layer of the triangular ligament. BO,bulbo-cavernosus muscle; C, tip of coccyx; CC, corpus cavernosum (cruspenis); CS, corpus spongiosum (the posterior part of the corpus spongiosumis called the bulb of the urethra); G, edge of gluteus maximus muscle; IG,ischio-cavernosus muscle; LA, levator ani muscle; R, ramus of the pubesand ischium; 8 A, sphincter ani; 8L, edge of great sacro-sciatic ligament;lI, tuberosity of the ischium; TL, superficial or anterior layer of the tri-angular ligament; TP, transversus perinei muscle. with fibers from the muscle of the opposite side upon its upper sur-face, in a strong aponeurosis. The most anterior fibers of the bulbo-ca

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