Regional and surgical anatomy of the human body / A. Velpeau.

  • Alfred-Armand-Louis-Marie Velpeau
Date:
[1829?]
Catalogue details

Licence: Public Domain Mark

Credit: Regional and surgical anatomy of the human body / A. Velpeau. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    i .ANO-l'EIUNifcAL KJKGION. below upwards, but from within outwards: or, perhaps, more correctly, these laminaj are two continuous parts of* the one identical deep layer of the pelvic aponeurosis: the one (tthfe obturator fascia) passes down to the ischium and sacro-sciatic ligament; the other (the levator ani portion) downwards to the verge of the anus. Posteriorly, this space ends in a cul de sac, bounded externally by the obturator fascia, which we have just spoken of; internally, by a continuation of the levator ani layer, which is here attached to the coccygeus muscle; and inferiorly, by the glutajus maximus. The obturator and levator ani layers send down a fibrous production, which passes over the inferior edge of the glutseus maximus, to continue itself on its external surface. Anteriorly, there is another cul de sac, bounded upon its two sides by the two layers (the obturator and levator fasciae) just described; inferiorly, by the superior surface of the transversalis perinsei. These two cavities are lined by aponeurosis, and full of adipose substance. Considering it as a single cavity, we may .call it the ischio-rectal space. Inferiorly, it measures twelve or fifteen lines from one side to the other: it is an inch and a half or two inches from the apex of one cul de sac to the other, in passing along the bottom of the space. The obturator fascia is strong; its fibres fall vertically on the edge of the ligament: the inferior hemorrhoidal artery and a branch of the intei'nal pudic nerve perforate it obliquely inwards and somewhat forwards; twelve or fifteen lines behind the transversus perinsei muscle the internal pudic artery proceeds, bound down by the obturator fascia. The levator fascia is thinner, interwoven, and more cellular than fibrous : its external surface appears to be broken up, so as to form an adipose cellular bed, which completely fills this cavity. Inferiorly, the levator fascia has no very defined edge, but becomes thinner and continuous with that of the thigh and buttock, and it is also incorporated with the superficial fascia. In considering this aponeurosis, in the anterior cul de sac of the ischio-rectal cavity, we find two layers placed horizon- tally : the one passing with an abrupt curvature downwards, on i the posterior edge of the transversus perinsei, and then covering its inferior surface, also that of the erectores penis and acccle- ratorcs urinse, and the deep part of that space which separates them; it even extends to, and is lost on, the fibrous layer of the corpora cavernosa and urethra. Thus we find this thin layer or web spread upon the under surface of the muscles of the perinseum, the bulb of the urethra, and crura penis. It is- attached externally to the rami of the ischium and pubis; ante- riorly, is lost imperceptibly on the body of the penis: and pos- teriorly, is incorporated with the two layers of the false peri- nseum. This aponeurosis then continues as the deep layer above these parts, to the vertex of the pubic arch, wlierc it becomes ideuli-