Henry Gray (18251861). Anatomy of the Human Body. 1918.
fossa, being contained in a sheath of the obturator fascia termed Alcocks canal, and divides into two terminal branches, viz., the perineal nerve, and the dorsal nerve of the penis or clitoris. Before its division it gives off the inferior hemorrhoidal nerve.
The inferior hemorrhoidal nerve (n. hæmorrhoidalis inferior) occasionally arises directly from the sacral plexus; it crosses the ischiorectal fossa, with the inferior hemorrhoidal vessels, toward the anal canal and the lower end of the rectum, and is distributed to the Sphincter ani externus and to the integument 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.
The perineal nerve (n. perinei), the inferior and larger of the two terminal branches of the pudendal, is situated below the internal pudendal artery. It accompanies the perineal artery and divides into posterior scrotal (or labial) and muscular branches.
The posterior scrotal (or labial) branches (nn. scrotales (or labiales) posteriores; superficial peroneal nerves) are two in number, medial and lateral. They pierce the fascia of the urogenital diaphragm, and run forward along the lateral part of the urethral triangle in company with the posterior scrotal branches of the perineal artery; they are distributed to the skin of the scrotum and communicate with the perineal branch of the posterior femoral cutaneous nerve. These nerves supply the labium majus in the female.
The muscular branches are distributed to the Transversus perinæi superficialis, Bulbocavernous, Ischiocavernosus, and Constrictor urethræ. A branch, the nerve to the bulb, given off from the nerve to the Bulbocavernosus, pierces this muscle, and supplies the corpus cavernosum urethræ, ending in the mucous membrane of the urethra.
The dorsal nerve of the penis (n. dorsalis 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 the female this nerve is very small, and supplies the clitoris (n. dorsalis clitoridis).
The Visceral Branchesarise from the third and fourth, and sometimes from the second, sacral nerves, and are distributed to the bladder and rectum and, in the female, to the vagina; they communicate with the pelvic plexuses of the sympathetic.
The Muscular Branches are derived from the fourth sacral, and supply the Levator ani, Coccygeus, and Sphincter ani externus. The branches to the Levator ani and Coccygeus enter their pelvic surfaces; that to the Sphincter ani externus (perineal branch) reaches the ischiorectal fossa by piercing the Coccygeus or by passing between it and the Levator ani. Cutaneous filaments from this branch supply the skin between the anus and the coccyx.
Anococcygeal Nerves (nn. anococcygei).The fifth sacral nerve receives a communicating filament from the fourth, and unites with the coccygeal nerve to form the coccygeal plexus. From this plexus the anococcygeal nerves take origin; they consist of a few fine filaments which pierce the sacrotuberous ligament to supply the skin in the region of the coccyx.
7. The Sympathetic Nerves
The sympathetic nervous system(Fig. 838) innervates all the smooth muscles and the various glands of the body, and the striated muscle of the heart. The efferent sympathetic fibers which leave the central nervous system in connection with