Sphincter urethrae membranaceae muscle | |
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Details | |
Origin | Junction of the inferior rami of the pubis and ischium to the extent of 1.25 to 2 cm. |
Insertion | Ischiopubic rami |
Nerve | Somatic fibers from S2-S4 through pudendal nerve |
Actions | Constricts urethra, maintains urinary continence |
Identifiers | |
Latin | musculus sphincter urethrae externus urethrae masculinae, musculus sphincter urethrae membranaceae |
TA98 | A09.4.02.016M |
TA2 | 2421 |
FMA | 19733 |
Anatomical terms of muscle |
The external sphincter muscle of the male urethra, also sphincter urethrae membranaceae, sphincter urethrae externus, surrounds the whole length of the membranous urethra, and is enclosed in the fascia of the urogenital diaphragm.
Its external fibers arise from the junction of the inferior pubic ramus and ischium to the extent of 1.25 to 2 cm., and from the neighboring fascia.
They arch across the front of the urethra and bulbourethral glands, pass around the urethra, and behind it unite with the muscle of the opposite side, by means of a tendinous raphe.
Its innermost fibers form a continuous circular investment for the membranous urethra.
The muscle helps maintain continence of urine along with the internal urethral sphincter which is under control of the autonomic nervous system. The external sphincter muscle prevents urine leakage as the muscle is tonically contracted via somatic fibers that originate in Onuf's nucleus and pass through sacral spinal nerves S2-S4 then the pudendal nerve to synapse on the muscle. [1] [2]
Voiding urine begins with voluntary relaxation of the external urethral sphincter. This is facilitated by inhibition of the somatic neurons in Onuf's nucleus via signals arising in the pontine micturition center and traveling through the descending reticulospinal tracts. During ejaculation, the external sphincter opens and the internal sphincter closes. [3]
The urethra is the tube that connects the mammalian urinary bladder to the urinary meatus. In placental mammals, the urethra transports urine through the penis or vulva during urination and semen through the penis during ejaculation.
The bladder is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In placental mammals, urine enters the bladder via the ureters and exits via the urethra. In humans, the bladder is a distensible organ that sits on the pelvic floor. The typical adult human bladder will hold between 300 and 500 ml before the urge to empty occurs, but can hold considerably more.
The pudendal nerve is the main nerve of the perineum. It is a mixed nerve and also conveys sympathetic autonomic fibers. 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 or female external urethral sphincter and the external anal sphincter.
Urination is the release of urine from the bladder to the outside of the body. Urine is released from the urethra through the penis or vulva in placental mammals and through the cloaca in other vertebrates. It is the urinary system's form of excretion. It is also known medically as micturition, voiding, uresis, or, rarely, emiction, and known colloquially by various names including peeing, weeing, pissing, and euphemistically going number one. The process of urination is under voluntary control in healthy humans and other animals, but may occur as a reflex in infants, some elderly individuals, and those with neurological injury. It is normal for adult humans to urinate up to seven times during the day.
The bulbourethral glands or Cowper's glands are two small exocrine and accessory glands in the reproductive system of many male mammals. They are homologous to Bartholin's glands in females. The bulbourethral glands are responsible for producing a pre-ejaculate fluid called Cowper's fluid, which is secreted during sexual arousal, neutralizing the acidity of the urethra in preparation for the passage of sperm cells. The paired glands are found adjacent to the urethra just below the prostate, seen best by screening (medicine) MRI as a tool in preventative healthcare in males. Screening MRI may be performed when there is a positive prostate-specific antigen on basic laboratory tests. Prostate cancer is the second-most common cause of cancer-related mortality in males in the USA.
The levator ani is a broad, thin muscle group, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis.
The bulbospongiosus muscles are a subgroup of the superficial muscles of the perineum. They have a slightly different origin, insertion and function in males and females. In males, these muscles cover the bulb of the penis, while in females, they cover the vestibular bulbs.
Onuf's nucleus is a distinct group of neurons located in the ventral part of the anterior horn of the sacral region of the human spinal cord involved in the maintenance of micturition and defecatory continence, as well as muscular contraction during orgasm. It contains motor neurons, and is the origin of the pudendal nerve. The sacral region of the spinal cord is the fourth segment of vertebrae in the spinal cord which consists of the vertebrae 26-30. While working in New York City in 1899, Bronislaw Onuf-Onufrowicz discovered this group of unique cells and originally identified it as “Group X.” “Group X” was considered distinct by Onufrowicz because the cells were different in size from the surrounding neurons in the anterolateral group, suggesting that they were independent.
Older texts have asserted the existence of a urogenital diaphragm, also called the triangular ligament, which was described as a layer of the pelvis that separates the deep perineal sac from the upper pelvis, lying between the inferior fascia of the urogenital diaphragm and superior fascia of the urogenital diaphragm.
The perineal membrane is an anatomical term for a fibrous membrane in the perineum. The term "inferior fascia of urogenital diaphragm", used in older texts, is considered equivalent to the perineal membrane.
The deep perineal pouch is the anatomic space enclosed in part by the perineum and located superior to the perineal membrane.
The spongy urethra is the longest part of the male urethra, and is contained in the corpus spongiosum of the penis.
The membranous urethra or intermediate part of male urethra is the shortest, least dilatable, and, with the exception of the urinary meatus, the narrowest part of the urethra. It extends from the apex of the prostate proximally to the bulb of urethra distally. It measures some 12 mm in length. It traverses the pelvic floor. It is surrounded by the external urethral sphincter, which is in turn envelopped by the superior fascia of the urogenital diaphragm.
The superior fascia of the urogenital diaphragm is continuous with the obturator fascia and stretches across the pubic arch.
The detrusor muscle, also detrusor urinae muscle, muscularis propria of the urinary bladder and muscularis propria, is smooth muscle found in the wall of the bladder. The detrusor muscle remains relaxed to allow the bladder to store urine, and contracts during urination to release urine. Related are the urethral sphincter muscles which envelop the urethra to control the flow of urine when they contract.
The urethral sphincters are two muscles used to control the exit of urine in the urinary bladder through the urethra. The two muscles are either the male or female external urethral sphincter and the internal urethral sphincter. When either of these muscles contracts, the urethra is sealed shut.
The internal urethral sphincter is a urethral sphincter muscle which constricts the internal urethral orifice. It is located at the junction of the urethra with the urinary bladder and is continuous with the detrusor muscle, but anatomically and functionally fully independent from it. It is composed of smooth muscle, so it is under the control of the autonomic nervous system, specifically the sympathetic nervous system.
In human male anatomy, the radix or root of the penis is the internal and most proximal portion of the human penis that lies in the perineum. Unlike the pendulous body of the penis, which is suspended from the pubic symphysis, the root is attached to the pubic arch of the pelvis and is not visible externally. It is triradiate in form, consisting of three masses of erectile tissue; the two diverging crura, one on either side, and the median bulb of the penis or urethral bulb. Approximately one third to one half of the penis is embedded in the pelvis and can be felt through the scrotum and in the perineum.
The external sphincter muscle of the female urethra is a muscle which controls urination in females. The muscle fibers arise on either side from the margin of the inferior ramus of the pubis. They are directed across the pubic arch in front of the urethra, and pass around it to blend with the muscular fibers of the opposite side, between the urethra and vagina.
The vaginal support structures are those muscles, bones, ligaments, tendons, membranes and fascia, of the pelvic floor that maintain the position of the vagina within the pelvic cavity and allow the normal functioning of the vagina and other reproductive structures in the female. Defects or injuries to these support structures in the pelvic floor leads to pelvic organ prolapse. Anatomical and congenital variations of vaginal support structures can predispose a woman to further dysfunction and prolapse later in life. The urethra is part of the anterior wall of the vagina and damage to the support structures there can lead to incontinence and urinary retention.
This article incorporates text in the public domain from page 429 of the 20th edition of Gray's Anatomy (1918)