Perineal Anatomy and Degrees of Perineal Tear / TOACS and OSCE Station

Perineal Body / Perineal Central Tendon is a wedge shaped fibromuscular mass that is formed by the convergence of several muscles like Bulbospongiosus, Transverse Perineal Muscle (Superficial and deep), Levator Ani, External Anal Sphincter and Puborectalis. The perineal tendon lies between anal canal and lower end of Vagina. Perineal tendon gives support to the posterior wall of Vagina. Obstetric Perineal Lacerations are classified as first to fourth degree depending on their depth.
First degree perineal tear involves perineal skin and vaginal epithelium only. In second degree perineal tear, there is involvement of Fascia and Muscles. In third degree perineal tear there is transection of the anal sphincter. When Rectal Mucosa is also involved in the perineal tear, that is called fourth degree perineal tear.
In second degree perineal tear, there is involvement of Fascia and Muscles e.g., in case of Episiotomy Incision. (So, it's important to note that second degree lacerations do not extend into anal sphincters). Physicians usually uses stitches to repair second degree perineal tears.
This type of tear takes a bit longer to heal than first degree tears.
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This Channel is providing knowledge in the field of Obstetrics and Gynaecology. Obstetrics is related to medical and surgical care before, during, and after a woman gives birth. Obstetrics focuses on caring for and maintaining a woman’s overall health during maternity. This includes pregnancy, labor, childbirth, and the postpartum period. Gynaecology on the other hand focuses on women’s bodies and their reproductive health. It includes the diagnosis, treatment, and care of women’s reproductive system. This includes vagina, uterus, ovaries, and fallopian tubes. Gynaecology also includes screening for and treating issues associated with women’s breasts. Gynaecology is the overarching field of women’s health from puberty through adulthood. It represents most of the reproductive care you’ll receive during your lifetime. If you become pregnant, you’ll need to go to an obstetrician.
The channel will have videos on the topics of Obstetrics and Gynaecology which will include but not limited to:
 abnormal bleeding
 pelvic pain
 genital itching
 urinary incontinence
 urinary tract or vaginal infections
 endometriosis
 breast disorders
 hormonal disorders
 dilation and curettage
 biopsy
 tubal ligation for female sterilization
 laser surgery
 hysterectomy, or the removal of the uterus
 myomectomy, or the removal of fibroids
 in vitro fertilization
 vaginal delivery
 caesarean delivery
 amniocentesis to determine sex and detect any abnormalities
 forceps and vacuum deliveries
 pelvic exams
 pap smears
 clinical breast exams
 mammographies
 cancer screenings
 perimenopause
 menopause
 birth control, contraception, or sterilization
 advice on preventing or treating sexually transmitted infections or HIV
 vaccination against the human papilloma virus
 treatment and prevention of pain during sex
 abnormal vaginal discharge
 urinary tract infections
 prenatal care
 infertility treatment
 advice on diet
 labor and birthing options
 genetic testing and screenings
 advice on breast-feeding
 postpartum depression
 easing cramps
 irregular or abnormal bleeding
 mood swings
 advice about premenstrual syndrome
 cysts and fibroids
 pelvic support problems
 a low libido
 vaginal dryness
 hot flushes
 bone loss
 incontinence
 hormone replacement therapy