Pudendal Nerve Entrapment
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Pudendal Nerve Entrapment
Pudendal nerve entrapment (PNE), also known as Alcock canal syndrome, is an uncommon source of chronic pain in which the pudendal nerve (located in the pelvis) is entrapped or compressed in Alcock's canal. There are several different types of PNE based on the site of entrapment anatomically (see Anatomy). Pain is positional and is worsened by sitting. Other symptoms include genital numbness, fecal incontinence and urinary incontinence. The term pudendal neuralgia (PN) is often used interchangeably with "pudendal nerve entrapment". This condition can greatly affect a persons’ quality of life. Pudendal neuralgia can be caused by many factors including inflammation, extreme cycling, and can be a "secondary condition to childbirth". A 2009 review study found both that "prevalence of PN is unknown and it seems to be a rare event" and that "there is no evidence to support equating the presence of this syndrome with a diagnosis of pudendal nerve entrapment," meaning that it is poss ...
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Chronic Pain
Chronic pain is classified as pain that lasts longer than three to six months. In medicine, the distinction between acute and chronic pain is sometimes determined by the amount of time since onset. Two commonly used markers are pain that continues at three months and six months since onset, but some theorists and researchers have placed the transition from acute to chronic pain at twelve months. Others apply the term ''acute'' to pain that lasts less than 30 days, ''chronic'' to pain of more than six months duration, and ''subacute'' to pain that lasts from one to six months. A popular alternative definition of ''chronic pain'', involving no fixed duration, is "pain that extends beyond the expected period of healing". Chronic pain may originate in the body, or in the brain or spinal cord. It is often difficult to treat. Epidemiological studies have found that 8–11.2% of people in various countries have chronic widespread pain. Various non-opioid medicines are initially recommen ...
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Erectile Dysfunction
Erectile dysfunction (ED), also called impotence, is the type of sexual dysfunction in which the penis fails to become or stay erect during sexual activity. It is the most common sexual problem in men.Cunningham GR, Rosen RC. Overview of male sexual dysfunction. In: UpToDate, Martin KA (Ed), UpToDate, Waltham, MA, 2018. Through its connection to self-image and to problems in sexual relationships, erectile dysfunction can cause psychological harm. In about 80% of cases, physical causes can be identified. These include cardiovascular disease; diabetes mellitus; neurological problems, such as those following prostatectomy; hypogonadism; and drug side effects. About 10% of cases are psychological impotence, caused by thoughts or feelings; here, there is a strong response to placebo treatment. The term ''erectile dysfunction'' is not used for other disorders of erection, such as priapism. Treatment involves addressing the underlying causes, lifestyle modifications, and ...
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Dorsal Nerve Of The Clitoris
The dorsal nerve of the clitoris is a nerve in females that branches off the pudendal nerve to innervate the clitoris. The nerve is important for female sexual pleasure, and it may play a role in clitoral erections. It travels from below the inferior pubic ramus to the suspensory ligament of the clitoris. At its thickest, the DNC is in diameter, visible to the naked eye during dissection. The DNC splits into two nerve branches on either side of the midline, closely following the crura of the clitoris. Some surgeries—for example, sling surgeries to treat female urinary incontinence—can damage the DNC, causing a loss of sensation in the clitoris. Understanding the nerve is important for urologists and gynecologists who may operate on organs near the DNC. The dorsal nerve of the clitoris is analogous to the dorsal nerve of the penis in males. It is a terminal branch of the pudendal nerve The pudendal nerve is the main nerve of the perineum. It carries sensation from th ...
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Dorsal Nerve Of The Penis
The dorsal nerve of the penis is the deepest division of the pudendal nerve; it accompanies the internal pudendal artery along the ramus of the ischium; it then runs forward along the margin of the inferior ramus of the pubis, between the superior and inferior layers of the fascia of the urogenital diaphragm. Piercing the inferior layer it gives a branch to the corpus cavernosum penis, and passes forward, in company with the dorsal artery of the penis, between the layers of the suspensory ligament, on to the dorsum of the penis, and ends on the glans penis In male human anatomy, the glans penis, commonly referred to as the glans, is the bulbous structure at the distal end of the human penis that is the human male's most sensitive erogenous zone and their primary anatomical source of sexual pl .... It innervates the skin of the penis. Gallery File:Gray824.png, Deep and superficial dissection of the lumbar plexus File:Gray837.png , Sacral plexus of the right side (d ...
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Perineal Nerve
The perineal nerve is a nerve of the pelvis. It arises from the pudendal nerve in the pudendal canal. It gives superficial branches to the skin, and a deep branch to muscles. It supplies the skin and muscles of the perineum. Its latency is tested with electrodes. Structure The perineal nerve is a branch of the pudendal nerve. It lies below the internal pudendal artery. It accompanies the perineal artery. It passes through the pudendal canal for around 2 or 3 cm. Whilst still in the canal, it divides into superficial branches and a deep branch. The superficial branches of the perineal nerve become the posterior scrotal nerves in men,Essential Clinical Anatomy. K.L. Moore & A.M. Agur. Lippincott, 2 ed. 2002. Page 263 and the posterior labial nerves in women. The deep branch of the perineal nerve (also known as the "muscular" branch) travels to the muscles of the perineum. Both of these are superficial to the dorsal nerve of the penis or the dorsal nerve of the clitoris. ...
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Inferior Rectal Nerve
The Inferior rectal nerves (inferior anal nerves, inferior hemorrhoidal nerve) usually branch from the pudendal nerve but occasionally arises directly from the sacral plexus; they cross the ischiorectal fossa along with the inferior rectal artery and veins, toward the anal canal and the lower end of the rectum, and is distributed to the Sphincter ani externus (external anal sphincter, EAS) and to the integument (skin) around the anus. Branches of this nerve communicate with the perineal branch of the posterior femoral cutaneous and with the posterior scrotal nerves at the forepart of the perineum. Supplies Cutaneous innervation below the pectinate line and external anal sphincter. See also * Inferior rectal artery Additional images File:Gray405.png, The perineum. The integument and superficial layer of superficial fascia reflected. File:Gray837.png, Sacral plexus of the right side. (Hemorrhoidal branch of pudic labeled at bottom right.) References External links Details ...
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Lesser Sciatic Foramen
The lesser sciatic foramen is an opening (foramen) between the pelvis and the back of the thigh. The foramen is formed by the sacrotuberous ligament which runs between the sacrum and the ischial tuberosity and the sacrospinous ligament which runs between the sacrum and the ischial spine. Structure The lesser sciatic foramen has the following boundaries: * Anterior: the tuberosity of the ischium * Superior: the spine of the ischium and sacrospinous ligament * Posterior: the sacrotuberous ligament Alternatively, the foramen can be defined by the boundaries of the lesser sciatic notch and the two ligaments. Function The following pass through the foramen: * the tendon of the Obturator internus * internal pudendal vessels * pudendal nerve The pudendal nerve is the main nerve of the perineum. It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well as the motor supply to various pelvic muscles, including the male o ...
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Greater Sciatic Foramen
The greater sciatic foramen is an opening (foramen) in the posterior human pelvis. It is formed by the sacrotuberous and sacrospinous ligaments. The piriformis muscle passes through the foramen and occupies most of its volume. The greater sciatic foramen is wider in women than in men. Structure It is bounded as follows: * anterolaterally by the greater sciatic notch of the ilium. * posteromedially by the sacrotuberous ligament. * inferiorly by the sacrospinous ligament and the ischial spine. * superiorly by the anterior sacroiliac ligament. Function The piriformis The piriformis muscle () is a flat, pyramidally-shaped muscle in the gluteal region of the lower limbs. It is one of the six muscles in the lateral rotator group. The piriformis muscle has its origin upon the front surface of the sacrum, and in ..., which exits the pelvis through the foramen, occupies most of its volume. The following structures also exit the pelvis through the greater sciatic foramen: S ...
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Coccygeus Muscle
The coccygeus muscle or ischiococcygeus is a muscle of the pelvic floor, located posterior to levator ani and anterior to the sacrospinous ligament. Structure The coccygeus muscle is posterior to levator ani and anterior to the sacrospinous ligament in the pelvic floor. It is a triangular plane of muscular and tendinous fibers. It arises by its apex from the spine of the ischium and sacrospinous ligament. It is inserted by its base into the margin of the coccyx and into the side of the lowest piece of the sacrum. In combination with the levator ani, it forms the pelvic diaphragm. The pudendal nerve runs between the coccygeus muscle and the piriformis muscle, superficial to the coccygeus muscle. Nerve supply The coccygeus muscle is innervated by the pudendal nerve, which runs between it and the piriformis muscle. Function The coccygeus muscle assists the levator ani and piriformis muscle in closing in the back part of the outlet of the pelvis. This helps to ...
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Piriformis Muscle
The piriformis muscle () is a flat, pyramidally-shaped muscle in the gluteal region of the lower limbs. It is one of the six muscles in the lateral rotator group. The piriformis muscle has its origin upon the front surface of the sacrum, and inserts onto the greater trochanter of the femur. Depending upon the given position of the leg, it acts either as external (lateral) rotator of the thigh or as abductor of the thigh. It is innervated by the piriformis nerve. Structure The piriformis is a flat muscle, and is pyramidal in shape. Origin The piriformis muscle originates from the anterior (front) surface of the sacrum by three fleshy digitations attached to the second, third, and fourth sacral vertebra. It also arises from the superior margin of the greater sciatic notch, the gluteal surface of the ilium (near the posterior inferior iliac spine), the sacroiliac joint capsule, and (sometimes) the sacrotuberous ligament (more specifically, the superior part of the pelvic s ...
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Sacral Plexus
In human anatomy, the sacral plexus is a nerve plexus which provides motor and sensory nerves for the posterior thigh, most of the lower leg and foot, and part of the pelvis. It is part of the lumbosacral plexus and emerges from the lumbar vertebrae and sacral vertebrae (L4-S4).''Thieme Atlas of Anatomy'' (2006), pp 470-471 A sacral plexopathy is a disorder affecting the nerves of the sacral plexus, usually caused by trauma, nerve compression, vascular disease, or infection. Symptoms may include pain, loss of motor control, and sensory deficits. Structure The sacral plexus is formed by: * the lumbosacral trunk * the anterior division of the first sacral nerve * portions of the anterior divisions of the second and third sacral nerves The nerves forming the sacral plexus converge toward the lower part of the greater sciatic foramen, and unite to form a flattened band, from the anterior and posterior surfaces of which several branches arise. The band itself is continued as th ...
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Spinal Nerve
A spinal nerve is a mixed nerve, which carries motor, sensory, and autonomic signals between the spinal cord and the body. In the human body there are 31 pairs of spinal nerves, one on each side of the vertebral column. These are grouped into the corresponding cervical, thoracic, lumbar, sacral and coccygeal regions of the spine. There are eight pairs of cervical nerves, twelve pairs of thoracic nerves, five pairs of lumbar nerves, five pairs of sacral nerves, and one pair of coccygeal nerves. The spinal nerves are part of the peripheral nervous system. Structure Each spinal nerve is a mixed nerve, formed from the combination of nerve fibers from its dorsal and ventral roots. The dorsal root is the afferent sensory root and carries sensory information to the brain. The ventral root is the efferent motor root and carries motor information from the brain. The spinal nerve emerges from the spinal column through an opening ( intervertebral foramen) between adjacent verteb ...
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