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Reorganization of mammalian body wall patterning with cloacal septation

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Septation of the cloaca is a unique mammalian adaptation that required a novel reorganization of the perineum-The caudal portion of the trunk body wall not associated with the hindlimb. Fish, the basal vertebrates, separate ventrolateral body wall musculature of the trunk into two discrete layers, while most tetrapods expand this pattern in the thorax and abdomen into four. Mammals, the only vertebrate group to divide the cloaca into urogenital and anorectal portions, exhibit complex muscle morphology in the perineum. Here we describe how perineal morphology in a broad sample of mammals fits into patterning of trunk musculature as an extension of the four-layer ventrolateral muscular patterning of the thorax and abdomen. We show that each perineal muscle layer has a specific function related to structures formed by cloacal septation. From superficial to deep, there is the subcutaneous layer, which regulates orifice closure, the external layer, which supplements both erectile and micturition function, the internal layer, which provides primary micturition and defecation regulation, and the transversus layer, which provides structural support for pelvic organs. We elucidate how the four-layer body wall pattern, restricted to the non-mammal tetrapod thorax and abdomen, is observed in the mammalian perineum to regulate function of unique perineal structures derived from cloacal septation.
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Scientific RepoRts | 7: 9182 | DOI:10.1038/s41598-017-09359-y
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Reorganization of mammalian
body wall patterning with cloacal
septation
Margaret I. Hall1,2, José R. Rodriguez-Sosa1,2 & Jerey H. Plochocki1
Septation of the cloaca is a unique mammalian adaptation that required a novel reorganization of the
perineum–the caudal portion of the trunk body wall not associated with the hindlimb. Fish, the basal
vertebrates, separate ventrolateral body wall musculature of the trunk into two discrete layers, while
most tetrapods expand this pattern in the thorax and abdomen into four. Mammals, the only vertebrate
group to divide the cloaca into urogenital and anorectal portions, exhibit complex muscle morphology
in the perineum. Here we describe how perineal morphology in a broad sample of mammals ts into
patterning of trunk musculature as an extension of the four-layer ventrolateral muscular patterning
of the thorax and abdomen. We show that each perineal muscle layer has a specic function related to
structures formed by cloacal septation. From supercial to deep, there is the subcutaneous layer, which
regulates orice closure, the external layer, which supplements both erectile and micturition function,
the internal layer, which provides primary micturition and defecation regulation, and the transversus
layer, which provides structural support for pelvic organs. We elucidate how the four-layer body wall
pattern, restricted to the non-mammal tetrapod thorax and abdomen, is observed in the mammalian
perineum to regulate function of unique perineal structures derived from cloacal septation.
Homologous body wall layers that support the vertebrate trunk follow generalized plans that are evolutionarily
conserved and broadly shared among related taxa1, 2. Basal vertebrates, such as teleost shes, have ventrolateral
wall musculature dierentiated into two layers (Figs1 and 2) that function to laterally ex the trunk during
undulatory swimming3. With the transition from water to land, morphological complexity of tetrapod ventro-
lateral body wall musculature in the thorax and abdomen increased as muscle function shied to include trunk
stabilization against torsion and movements of the limbs during terrestrial locomotion46. Some basal tetrapods,
such as certain salamanders and frogs, retain two layers throughout the trunk, while other amphibians developed
as many as four layers in the thorax and abdomen7, 8. With the rise of amniotes, which include lizards, crocodiles,
birds, and mammals, the ventrolateral body wall evolved to consistently maintain four layers in the thorax and
abdomen912.
Most tetrapods retain the original two vertebrate muscle layers present in shes to regulate opening of the
cloacal orice13, 14. Muscular patterning of the pelvic body wall in mammals, which completely separate the cloaca
to form the anatomical region of the trunk known as the perineum, has yet to be discussed within an evolutionary
context1517. Perineal muscles in mammals develop between the hindlimb bud and tail, receive innervation from
spinal levels caudal to the hindlimb, attach to axial and pelvic skeletal elements, and support erectile, defecatory,
and micturatory functions of the perineum18. Using a comparative approach, we investigate muscle patterning
in the perineal portion of the mammalian trunk body wall to gain insight into how muscular reconguration
in the perineum compares to the primitive vertebrate body plan. We suggest the muscular pattern for the body
wall present in the tetrapod thorax and abdomen is utilized again in mammals to regulate function of structures
derived from cloacal septation.
Results and Discussion
Our dissections reveal that mammals dierentiate pelvic body wall muscles into four layers, mirroring the tet-
rapod thoracic and abdominal body wall (Figs2 and 3). ese layers include a subcutaneous, external, internal,
1Department of Anatomy, Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, 85308,
USA. 2Department of Anatomy, College of Veterinary Medicine, Midwestern University, Glendale, AZ, 85308, USA.
Margaret I. Hall and Jerey H. Plochocki jointly supervised this work. Correspondence and requests for materials
should be addressed to J.H.P. (email: jplochocki@midwestern.edu)
Received: 30 March 2017
Accepted: 25 July 2017
Published: xx xx xxxx
OPEN
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Scientific RepoRts | 7: 9182 | DOI:10.1038/s41598-017-09359-y
and transversus layer, with muscles in each layer demonstrating a dierent ber orientation (Fig.4). e per-
ineal muscle layers and associated fasciae are continuous with those of the abdomen and thorax. Subcutaneous
muscles of the perineum are present in the same fascial layer as M. cutaneous trunci in the thorax and abdomen.
Fibers of the external layer insert caudally onto an aponeurosis that is continuous with that of the external layer
of the abdomen, M. obliquus externus abdominis, which is continuous with M. intercostales externi in the thorax.
Neurovasculature in the pelvic body wall courses between the internal and transversus layers (e.g., within the
pudendal canal), a pattern observed in the thorax and abdomen where neurovasculature courses between M.
intercostales interni and M. intercostales intimi, and M. obliquus internus abdominis and M. transversus abdominis,
respectively. Endopelvic fascia covering the internal surface of the transversus layer of the pelvis is continuous
with transversalis fascia of the abdomen and endothoracic fascia of the thorax.
e perineal subcutaneous layer includes the M. sphincter ani externus pars subcutanea and M. constrictor
vulvae (variably present) in mammals we dissected (Fig.3). e external layer is comprised of the muscle sheet
associated with the phallus, which is traditionally divided into M. bulbospongiosus, M. ischiocavernosus and M.
transversus perinei supercialis. M. sphincter ani externus pars supercialis is comprised of bers of the M. bul-
bospongiosus portion of the muscle sheet that continues dorsally, continuous with M. sphincter ani externus pars
supercialis, to form a muscular ring. e internal muscle layer is formed by M. sphincter ani externus pars pro-
fundus and its continuity with M. levator ani. e M. transversus perinei profundus, only consistently present
in males, is also part of the internal layer and its bers intermingle with those of M. sphincter ani externus pars
profundus. is layer also includes the urethral sphincter muscles. e transversus layer is comprised of M. levator
ani and M. coccygeus. e portion of M. levator ani most closely associated with the anal canal, M. puborectalis, is
continuous with the deepest edge of M. sphincter ani externus pars profundus. ese ndings suggest M. sphincter
ani externus is not a single muscle, but rather a composite of several muscle layers19, 20. Because of the notable
continuities between M. levator ani and M. sphincter ani externus, these muscles have also been described as con-
tinuous with one another, and even as a single, multi-layered muscle2123.
Histological sections of the perinea of the adult dog and bovine fetus 15 weeks gestation age similarly demon-
strate four layers of the ventrolateral abdomen and perineal body wall (Fig.4). ese ndings agree with other
histological studies of perineal development that show embryological continuities among muscles in each of
the four trunk layers and separation of the muscle layers by fascial layers during fetal development24, 25. Human
fetuses at roughly 13 weeks of development show continuities between the external muscle layer containing M.
ischiocavernosus, M. bulbospongiosus, and the pars supercialis of the developing M. sphincter ani externus, just
inferior to M. levator ani of the transversus layer2628. is relationship arises shortly aer the cloacal membrane
obliterates during urogenital septation and remains in the adult29, 30. At this time, M. sphincter ani externus sur-
rounds the anal canal, forming a column extending to the ectoderm-derived epithelium30. Also around the same
time in development, the urinary sphincter muscles become well dened in the internal layer, positioned inferior
to the inferior margin of M. levator ani of the transversus layer but superior to M. bulbospongiosus of the external
layer31. Separations between muscles in each layer form later in development via apoptosis of muscle bers32.
us, the muscle layering found in dissection appears histologically subsequent to embryologic septation of the
cloaca.
e primitive vertebrate characteristic of two ventrolateral body wall muscle layers was expanded in number
and in distribution in the trunk multiple times in vertebrate evolution: at the tetrapod node to four layers in the
thorax and abdomen, and again at the mammal node to four layers throughout the trunk, including the perineum
(Fig.1). Mammalian perineal muscular patterning is associated with the complete septation of the cloaca, which
Figure 1. Cladogram of major vertebrate classes demonstrating the evolution of ventrolateral body wall muscle
layers. Primitively, vertebrates have two ventrolateral muscle layers, while most tetrapods have four layers in the
thorax and abdomen. Mammals exhibit four layers throughout the trunk, including the perineal portion of the
body wall.
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Scientific RepoRts | 7: 9182 | DOI:10.1038/s41598-017-09359-y
led to novel anatomical adaptations in mammals relative to other vertebrates. Specically, mammals alone among
vertebrates evolved the suite of characteristics from the anorectal and urogenital chambers formed by cloacal sep-
tation including the rectum, anal canal, urethra, and paired vascular erectile tissues. Other vertebrate intromis-
sion structures, such as those variably found in some sh, lizards, turtles, crocodilians, and waterfowl, arise from
the cloacal wall and have either a single vascular erectile body or one engorged with lymph, and are not homol-
ogous to mammalian genitalia3335. Lizards, crocodilians, birds, and even monotremes have muscular sphincters
that regulate opening of the cloaca9, 11, 36. ese cloacal muscles, as well as perineal muscles in mammals, were
proposed to evolve from abdominal trunk muscles in previous studies37, 38. However, anatomic, embryonic, and
molecular investigations indicate that, while cloacal muscle precursors temporarily reside in the limb, they later
Figure 2. Muscles of the ventrolateral body wall in the vertebrate abdomen derived from the embryonic
hypaxial and epaxial masses. (A) In shes, such as teleosts, hypaxial muscles of the ventrolateral wall are
organized into two layers (M. obliquus superioris and M. obliquus inferioris). (B) Amphibians, such as
salamanders, have two to four layers (M. obliquus externus, in some species divided into supercialis and
profundus portions, M. obliquus internus, and M. transversus abdominis, with scattered subcutaneous skeletal
muscle bers). (C) Mammals, like dogs, consistently have four layers (M. cutaneous trunci, a well-developed
subcutaneous muscle layer, M. obliquus externus abdominis, M. obliquus internus abdominis and M. transversus
abdominis). Development of the ventral musculature, such as M. rectus abdominis, is regulated by dierent
molecular signals and therefore follows a dierent organizational pattern and may not dierentiate into multiple
layers12.
Figure 3. Anatomical organization of the perineal portion of the mammalian trunk body wall into four layers,
drawn here aer our human dissections. e subcutaneous layer is formed by M. sphincter ani externus pars
subcutanea. e external layer includes M. bulbospongiosus, M. ischiocavernosus and M. transversus perinei
supercialis. e internal muscle layer is formed by M. sphincter ani externus pars profundus, M. transversus
perinei profundus, and the urethral sphincter muscles. e transversus layer includes M. levator ani and M.
coccygeus.
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migrate to the caudal trunk where they are subjected to the same developmental signaling that regulates trunk
muscular layering to form an extended myotomal sheet similar to that of developing trunk body wall muscles10,
25, 3942. is may explain why congenital malformations aecting ventrolateral abdominal body wall musculature
are commonly accompanied by perineal muscular defects43, 44.
Evolutionary restructuring of mammalian perineal musculature may be a consequence of interactions
between muscle precursors and connective tissue during musculoskeletal patterning. Skeletal muscles originate
from undierentiated tissue known as the epaxial and hypaxial masses, which give rise to dorsal and ventral body
wall muscles, respectively. Hypaxial muscle cell precursors from the ventrolateral lip of somitic myotomes migrate
through the lateral somitic frontier, i.e., from the primaxial mesodermal domain into the abaxial mesodermal
domain, to populate the ventral body wall, where they are inuenced by connective tissue derived from the lateral
plate45, 46. Developmental signals expressed in lateral plate mesoderm that result in layering of the abdominal
wall also control muscle layering in the perineum, discrete from hindlimb signaling, and are further directed by
local signals that ne-tune muscle development25, 42, 47. Variations in these interactions, along with the modular
property of mesodermal domains, have been used to explain regional dierences in anatomic musculoskeletal
structure across related taxa48, 49. Such anatomic restructuring may also explain similarities of perineal muscle
layering with that of the abdomen and thorax, as cloacal sphincter muscles adapted to specialized reproductive
and excretory functions in mammals. With the evolutionary establishment of the mammalian perineum, somatic
musculature associated with the derived perineal structures was recongured into four layers16. From supercial
to deep, these four muscle layers are (1) the subcutaneous layer, which regulates orice closure, (2) the external
layer, which supplements both erectile and micturition function, (3) the internal layer, which provides primary
Figure 4. Perineum of an adult dog in (A) gross dissection (le lateral view, scale bar 5 mm) and (B)
histological section (le lateral view, scale bar 5 mm). Histological sections of a fetal bovine aged 15 weeks
of the (C) ventrolateral abdominal wall (le anterior view, scale bar 50 µm) and (D) perineum (le lateral
view, scale bar 2 mm). Structures labeled 1–4 are 1, subcutaneous layer; 2, external layer; 3, internal layer;
and 4, transversus layer. Perineal muscle bers (B and D) of the subcutaneous layer (1) are shown in cross-
section, ber orientation in the internal and external layers (2 and 3) is oblique, and ber orientation in the
transversus layer (4) is longitudinal in the taxa that have an anus that is shied to protrude posteriorly, such as
the bovine, dog, and horse, but is transverse in other taxa. e fetal muscle layers (D) are closely associated with
smooth muscle of the internal anal sphincter and rectum (*) and developing sacral vertebrae (). a, artifact; i,
integument; SCV, M. sacrocaudalis ventralis, a muscle that acts on the tail.
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micturition and defecation regulation, and (4) the transversus layer, which provides structural support for pelvic
organs (Fig.3)50.
Our research denes for the rst time the four serially homologous trunk ventrolateral body wall layers in the
perineum. Our sample consists of primates and domestic mammals that represent a broad distribution of placen-
tal mammalian groups that are not closely related phylogenetically, including perissodactyls (horse), artiodactyls
(cow, goat, pig), carnivorans (cat, dog) and primates (human, monkey, prosimian) and form a robust sample from
which to draw conclusions about perineal morphology14. We suggest the primitive anatomical building blocks
and developmental signaling used to construct the thoracic and abdominal trunk body wall were repurposed
in the perineum. Mammalian perineal structure derived from cloacal septation is an evolutionary innovation
that allows for myriad anatomical congurations, diverse reproductive strategies, and precise excretory control
available only to mammals.
Methods
We dissected pelvic and perineal musculature in a subset of adult mammals (Table1). is sample was obtained
from Midwestern University teaching collections, the Arizona Research Collection for Integrative Vertebrate
Education and Study (ARCIVES) housed at Midwestern University (Glendale, AZ, USA), and donated human
cadavers from the National Body Donor Program (St. Louis, MO, USA). All animals in the study were treated in
accordance with the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health with
approval from the Institutional Animal Care and Use Committee at Midwestern University. All human cadavers
were obtained and studied with informed consent and treated in accordance with local and national laws and
regulations with approval from Midwestern University. All muscles of the perineum were dissected according
to methods described in Hall and Walters51. We identied the following perineal muscles during dissection: M.
coccygeus, M. levator ani, M. bulbospongiosus, M. ischiocavernosus, M. transversus perinei supercialis and profun-
dus, M. sphincter ani externus and its subdivisions, and urinary sphincters. During dissection, we observed the
layering, attachment and innervation of each muscle. Histological sections 5 µm thick were taken from the peri-
neum and abdomen of an adult dog and a fetal cow aged 15 weeks of an approximately 40-week gestation period.
Sections were stained with hematoxylin and eosin and imaged under light microscopy.
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Indriidae Propithecus verreauxi Verreaux’s sifaka 2
Lemuridae Lemur catta Ring-tailed lemur 1
Lorisidae Perodicticus potto Potto 1
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Suidae Sus domesticus Pig 9
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Felidae Felis catus Cat 6
Gallidae Gallus domesticus Chicken 1
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Acknowledgements
We thank Drs K. Baab, S. Dobson, A. Grossman, W. Grow, C.P. Heesy, K. Muldoon, H. Smith, and J.
VandenBrooks for discussions about the anatomy, S. Ruiz who assisted with dissection preparation, A. Bergeron
for access to specimens, and M. Neumann for assistance with Figure 4. is is Midwestern University Arizona
Research Collection for Integrated Vertebrate Education and Study (ARCIVES) Publication #2. Lastly, we thank
the human cadaveric donors and their families.
Author Contributions
J.H.P., J.R.R-S., and M.I.H. formulated the study design, performed the dissections, and conducted the analyses.
J.H.P. wrote the original dra of the manuscript and J.R.R-S. and M.I.H. contributed to revisions. All authors
approved the nal version and may be held accountable for the work.
Additional Information
Competing Interests: e authors declare that they have no competing interests.
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... In this study the lateral and ventral abdominal anatomy of female capybaras has been described to promote better surgical procedures for sterilization surgeries. The anatomy of the capybaras' abdominal wall followed the general stratigraphy described for mammals [21], with variations concerning the thickness of the skin and cutaneous muscle as well as the distribution of muscular aponeurosis and facility of linea alba identification with a ventral approach, when compared to dogs and horses [22,23]. In agreement with our findings, the abdominal muscles of guinea pigs (Cavia porcellus), hystricomorph ...
... In this study the lateral and ventral abdominal anatomy of female capybaras has been described to promote better surgical procedures for sterilization surgeries. The anatomy of the capybaras' abdominal wall followed the general stratigraphy described for mammals [21], with variations concerning the thickness of the skin and cutaneous muscle as well as the distribution of muscular aponeurosis and facility of linea alba identification ...
... In this study the lateral and ventral abdominal anatomy of female capybaras has been described to promote better surgical procedures for sterilization surgeries. The anatomy of the capybaras' abdominal wall followed the general stratigraphy described for mammals [21], with variations concerning the thickness of the skin and cutaneous muscle as well as the distribution of muscular aponeurosis and facility of linea alba identification with a ventral approach, when compared to dogs and horses [22,23]. In agreement with our findings, the abdominal muscles of guinea pigs (Cavia porcellus), hystricomorph rodents closely related to capybaras, also encompass the external abdominal oblique muscle as the outermost layer, followed by the internal abdominal oblique muscle, transversus abdominis, and rectus abdominis [24], although we failed to find a detailed description of aponeurosis distribution and linea alba visibility in this species. ...
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... The thoracic, abdominal, and pelvic wall muscles have three layers (Nishi, 1938;Hall et al., 2017). The traditional view of the homology of muscles between the thoracic and abdominal walls is that the external intercostal muscles correspond to the external oblique abdominis, the inner intercostal muscles to the internal oblique abdominis, and the innermost intercostal muscles to the transverse abdominis (Figures 14A, C). ...
... The thoracolumbar fascia invests the intrinsic back muscles and quadratus lumborum, and the external oblique abdominis muscle is located entirely external to the thoracolumbar fascia ( Figure 14D; Willard et al., 2012;Standring, 2015). Hall et al. (2017) previously documented a homology of the muscular organization between the pelvic and abdominal regions in the body wall. We here provide a different view of muscle homology between the pelvic and thoracic regions, based on the innervation patterns of the different classes of nerve branches. ...
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... By the eighth week, the anal membrane breaks down, establishing the anal canal. The urorectal septum also divides the cloacal musculature into anterior and posterior components and thus explains why the nerve supply of the whole musculature is supplied by one nerve, the pudendal nerve [5]. ...
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Female perineum is the tissue complex between the peritoneum and the skin that closes the pelvis inferiorly and its functionality depends on the interplay between organs, tissues, septae and spaces in it. It is a diamond-shaped region below the pelvic floor and extends between the pelvic diaphragm and the perineal skin. It is a surprisingly dynamic field with new insights, discoveries, and controversies and carries differences in viewpoint among anatomists and surgeons. This book chapter will provide an overview regarding perineal anatomy in the female and will focus on embryology, anatomy of the perineal region with modern proponents. It includes detailed anatomy of Urogenital and Anal triangles, their muscles with blood supply and innervation, anatomy and functions of the perineum, its role in Pelvic Organ Prolapse and clinical significance in urinary and fecal incontinence and contribution towards common obstetric and gynecological pathologies.
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... M. obliquus externus profundus) and a superficial layer (e.g. M. obliquus externus superficialis) [24,39]. ...
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... The tetrapods comprise four-limbed animals and is the superclass containing the four subclasses of mammals, amphibians, birds and reptiles [9]. As these animals further evolved, differentiating themselves from fish and the other animal classes, the anatomy of their abdominal walls began to follow a similar framework [10]. Such that, within mammals, the general structure of the abdominal wall is largely conserved [11]. ...
... M. obliquus externus profundus) and a superficial layer (e.g. M. obliquus externus superficialis) [10,[18][19][20]. ...
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With the increased use of simulation based training using animal models for the education of surgical and anaesthetic techniques, an increased understanding of the anatomy of such models and how they compare to humans is required. The transversus abdominis plane block is a regional anaesthetic technique that requires an understanding of the abdominal wall anatomy along with proficient ultrasound use. The current review aims to compare the anatomy of the abdominal wall across species, particularly focussing on the pertinent differences within the class of mammals, and secondarily, it aims to address the implications of these differences for simulation based training of the transversus abdominis plane block. To achieve this, the PubMed, Web of Science and Google Scholar databases were searched for relevant literature. The mammalian abdominal wall differs in its musculature, vasculature or innervation from that of amphibians, birds or reptiles, however, among species of mammals, the structure of the abdominal wall follows a similar framework. Particular differences among mammals include the additional muscular layer of the panniculus carnosus found in most mammals other than humans, the variable arterial origins and dominant vascular supply of the abdominal wall and the number of thoracolumbar nerves innervating the abdominal wall. When using animal models for simulation based training, the pig is recommended for the transversus abdominis plane block given its closely homologous abdominal wall structure, availability and larger comparative size.
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How do males become male and females become female? And what are the consequences if the decision is not incisive? Drawing upon interests in animal genetics and molecular biology, the author endeavours to answer these difficult yet fascinating questions. Originally published in 1995, this book describes the genetic determination of sex and examines how sexual organs are differentiated. Using examples of intersexuality, chimaeras and asymmetries, the book describes the underlying molecular basis of sex determination and sexual differentiation, and focuses on the critical role of the rate of embryonic development in these vital processes. Male precocity is a recurrent theme, as is the involvement of Sertoli cells and their secretion of anti-Müllerian hormone. An invaluable book for reproductive physiologists, geneticists and developmental biologists whose interests may extend from animal science through veterinary medicine to human clinical medicine.
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Introduction: Modern anatomical and surgical references illustrate perineal muscles all innervated by branches of the pudendal nerve but still organized into anatomically distinct urogenital and anal triangles with muscles inserting onto a central perineal body. However, this conflicts with the anatomy commonly encountered during dissection. Materials and Methods: We use dissections of 43 human cadavers to characterize the anatomical organization of the human perineum and compare our findings to standard references. Results: We found bulbospongiosus and the superficial portion of the external anal sphincter (EAS) were continuous anatomically with a common innervation in 92.3% of specimens. The superficial transverse perineal muscle inserted anterior and lateral to the midline, interdigitating with bulbospongiosus. The three EAS subdivisions were anatomically discontinuous. Additionally, in 89.2% of our sample the inferior rectal nerve emerged as a branch of S3 and S4 distinct from the pudendal nerve and innervated only the subcutaneous EAS. Branches of the perineal nerve innervated bulbospongiosus and the superficial EAS and nerve to levator ani innervated the deep EAS. Conclusions: We empirically demonstrate important and clinically relevant differences with perineal anatomy commonly described in standard texts. First, independent innervation to the three portions of EAS suggests the potential for functional independence. Second, neuromuscular continuity between bulbospongiosus and superficial EAS suggests the possibility of shared or overlapping function of the urogenital and anal triangles. This article is protected by copyright. All rights reserved.
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Hypaxial muscle is the anatomical term commonly used when referring to all the ventrally located musculature in the body of vertebrates, including muscles of the body wall and the limbs. Yet these muscles had very humble beginnings when vertebrates evolved from their chordate ancestors, and complex anatomical changes and changes in underlying gene regulatory networks occurred. This review summarises the current knowledge and controversies regarding the development and evolution of hypaxial muscles.
Article
Traditional dissections of the female urogenital (UG) triangle can lead to early destruction of the erectile tissues, associated musculature, and neurovascular structures. Here, we present an alternate dissection of the female UG triangle. Rather than begin the female UG triangle dissection with the fatty tissue of the labia majora, we utilize an early identification of the suspensory ligament of the clitoris to organize the dissection. The suspensory ligament leads to the body of the clitoris, which can be palpated from distal to proximal to find the crura of the clitoris with overlying ischiocavernosus muscles. Once the crura have been defined, the bulbs of the vestibule with overlying bulbospongiosus muscles can be palpated medially and posteriorly. This dissection approach results in a clean dissection that well demonstrates homologies between male and female external genitalia. Through the use of this method, most student dissection attempts are able to demonstrate the erectile tissues and associated musculature that comprise the female UG triangle. This technique can also be used for male UG triangle dissections, encouraging identification of male and female homologies. Clin. Anat., 2013. © 2013 Wiley Periodicals, Inc.