Surgical anatomy : a treatise on human anatomy in its application to the practice of medicine and surgery / by John B. Deaver.

Deaver, John B. (John Blair), 1855-1931.

Date:: 1899-1903

Credit: Surgical anatomy : a treatise on human anatomy in its application to the practice of medicine and surgery / by John B. Deaver. Source: Wellcome Collection.

670/718 (page 668)

$1 668 SURGICAL ANATOMY. urina?, it consists of three sets of fibers—anterior, middle, and })osterior. The anterior fibers join those of the opposite side upon the dorsum of the clitoris in an ^ aponeurosis, a few fibers being inserted into the suspensory ligament of the clitoris ; the middle fil)ers join those of the opposite side beneath the clitoris in an a})oneu- rosis, which extends across the vestibule above the urethra ; the posterior fibers are attached to the triangular ligament. Some of the most posterior fibers are inserted into the middle of the ischio-pubic ramus between the crus clitoridis and the triangular ligament. Action.—To approximate the labia niajora, thus closing the pudendal cleft, and assist in erection of the clitoris. The Transverse Perineal Muscle arises from the ramus of the ischium immediatel}^ in advance of the tuberosity and passes inward and slightly back- ward, to be inserted into the perineal body, blending with the other transverse perineal, the external sphincter ani, the sphincter yaginjB, the deep transversus perinei, and the levator ani mu.scles. Action.—To steady the perineal body. The Erector Clitoridis Muscle (isHrio-cavernosus), the homologue of the erector penis muscle, is in relation with the crus clitoridis, and its origin and insertion are similar to those of the erector penis muscle. Action,—Similar to that of the erector penis muscle. Blood and Nerve Supplies.—The blood and nerve supplies of the sphincter vaginae, erector clitoridis, and transverse perineal muscles are derived from the same sources as that of their homologues in the male. Dissection.—By separating the contiguous borders of the sphincter vaginse . and erector clitoridis muscles, and displacing the superficial i')erineal vessels and nerves and the inferior pudendal nerves, a portion of the inferior layer of the tri- angular ligament can be seen. The 8])liincter vaginae, erector clitoridis, and trans- verse jK'rineal muscles are now to V)e removed ; the sphincter vagin;c and the erector clitoridis are refiected forward, and the transversus jjcrinei is reflected inward. This dissection exposes the triangnlar ligament and the bulbs of the vagina and small elevations in the ligament produced by Bartholin's glands. The Bulbs of the Vagina {l)iiI/>>< of the vcMibvlc, sewibvlh:^ of the clitoris), tlie homologues of the l)nll) of the ]K'nis, are two small pyrifonn erectile bodies situated one upon each side of the vestibule, beliind the lal)in minora, Ix'iieath the sphincter vagina' muscles, anil on tlie superficial surface of the inferior la^'cr of the triangular ligament. They are about one inch, or two and one-half centimeters, in length, and are compo.sed of a plexus of veins communicating with the veins of the clitoris. Each bulb is surrounded by a fibrous ca])sule derived from the infe- rior layer of the triangular ligament. The narrow anterior extremities of the two$