Pelvic Floor Flashcards
The pelvic floor is a part of the _______
Pelvic diaphragm
Superior surface of the pelvic diaphragm is covered with
Endopelvic fascia
Muscles in the pelvic floor
Levator ani
Coccygeus
Separates pelvis from perineum
Pelvic floor
Funnel shaped muscular ring
Pelvic floor
The _______ is superficial (inferior) to the pelvic diaphragm (pelvic floor)
Perineum
The perineum is Diamond shape from the __________ to the coccyx.
pubic symphysis to ischial
tuberosities
2 triangles of the perineum
Urogenital
Anal
The _________ is the inferior support of the abdominal cavity supporting all organs and abdominal pressure
Pelvic floor
Fundamentally same in males and females
Pelvic floor
Levator ani muscle group
Puborectalis
Pubococcygeus
Iliococcygeus
Body of the pubis
bilaterally as it wraps around the rectum (connecting at the anococcygeal ligament
Puborectalis
Pubis and obturator
foramen fascia bilaterally (connecting at the
anococcygeal ligament posteriorly).
• Lateral to puborectalis
Pubococcygeus
Pubis and obturator
foramen fascia bilaterally (connecting at the
anococcygeal ligament posteriorly).
• Lateral to puborectalis
Illiococcygeus
Innervation for Levator ani
S3-s4 ventral rami
–intra-abdominal pressure
resistance, fecal continence, prevent
prolapse, and occludes vagina.
• Supports the viscera, active during inspiration,
and can contract to aid intra-abdominal
stability.
Contraction Levator ani
urine excretion, fecal
defecation, and directs fetal head
during parturition.
Relaxation Levator ani
Attachment of coccygeus
Ischial spine to the coccyx
Innervation of coccygeus
Ventral rami of s3-s4
Small part of pelvic
support, elevates pelvic floor,
and flexes the coccyx (tail
wagger).
Action of the coccygeus
• Origin: Internal surface of obturator foramen
• Insertion: Greater trochanter of femur
• Innervation: N. to Obturator Internus
• Action: External (lateral) rotation, femoral
head stability.
Obturator internus
• Origin: Pelvic surface of S2-S4
• Insertion: Greater trochanter of femur
• Innervation: N. to Piriformis
• Action: External rotation, hip abduction,
femoral head stability.
Piriformis
Outlet of the pelvis
Perineum
Borders of the perineum
Anterior
Lateral
Anterior border of perineum
Pubic symphysis
Posterior borders of perineum
Coccyx
Perineum divided by line between
Ischial tuberosities
• Openings contained external genitalia and urethral orifice
• Contents: Muscles, fat, nerves, vessels, lymph, and external genitalia.
Anterior urogenital triangle
• Openings contained anus
• Contents: Mainly fat, nerves, vessels, lymph, and anus.
Posterior anal triangle
• Deep transverse perineal, urethral sphincter, and fibrous membrane
• Surrounds urogenital ducts and strengthens pelvic floor
Urogenital diaphragm
Borders of the urogenital triangle
Ischiocavernosus muscle (anteriorly) and
Superficial & Deep Transverse Perineal muscles (posteriorly,
is the location of multiple muscles interlacing
between anus and external genitilia (female-vagina, male-penis)
Perineal body
Deep fascia
Urogenital triangle
Subcutaneous tissue and skin
Urogenital triangle
Contents for males in the urogenital triangle
penis, mons pubis, scrotum, and
bulbospongiosum
Contents for females in the urogenital triangle
Vulva (vagina, urethra, glands, labia majora,
labia minora, mons pubis), and bulbospongiosum
• Origin: Ischial and pubic rami
• Insertion:
• Median raphe (male) • Vaginal wall (female)
• Innervation: Perineal branch of
pudendal nerve • Action: maintains continence;
helps expel last drops of urine
(both) and semen (male)
External urethral sphincter
Anal triangle contents are the SAME
For both genders
Borders of the anal triangle
Superficial & Deep Transverse Perineal muscles
anteriorly (attach to perineal body), and imaginary line from ischium to coccyx.
Superior (deep) anal triangle
Deep fascia
Inferior (superficial) anal triangle
Subcautaneous tissue and skin
• Anus: Internal and external Anal sphincter
• Anococcygeal ligament: Anus to coccyx
• Ischioanal fossae – area of fat to allow safe safe passage for:
• Nerves (pudendal nerve, cutaneous) and Vessels (artery,
vein, lymph).
Contents anal triangle
3 parts of your external anal sphincter
Deep, superficial, cutaneous
• Origin: Anococcygeal raphe
• Insertion: Central tendon
(perineal body)
• Innervation: Inferior rectal
branch of pudendal nerve and
S4
• Action: Keeps anal canal and
orifice closed
External anal sphincter
Innervation of external anal sphincter
Inferior rectal branch of pudendal nerve and s4
Perineum muscles are all Innervated by the __________
Pudendal nerve
External urethral sphincter branch
Perineal
• Ischiocavernosus
• Bulbospongiosus
• Superficial Transverse Perineal
• Deep Transverse Perineal
Deep branch of the perineal nerve of the pudendal
• Attachments: Internal surface of the ischiopubic ramus to
the crus and perineal membrane.
• Action: Supports erection of clitoris by compressing crus.
Ischiocavernous
• Attachments: Perineal body and surrounds the vagina
enclosing the greater vestibule gland and attaches to the pubic arch and fascia of the corpora cavernosa.
• Action: Supports and fixes perineal body, sphincter of the
vagina, assist in erection of clitoris, compresses the greater vestibule gland .
Bulbospongiosum
BOTH are innervated by the deep branch of the perineal
nerve of the pudendal nerve (S2-S4).
Ischiocavernosus, bulbospongiosum
Pudendal artery branches
-Deep and dorsal artery of
clitoris/penis
• Male not pictures but follows the
same path as clitoris
• Perineal • Inferior rectal
Pudendal nerve branches
• Inferior rectal – rectum/anus
• Deep Perineal – perineum
muscles
• Dorsal nerve of the
clitoris/penis – shaft and
glans penis (male); body and
glands clitoris (female)
• BOTH
• Innervation: Deep branch of perineal nerve of the pudendal nerve
(S2-S4) • Action: Supports and fixes perineal body, supports pelvic floor, and
resists intra-abdominal pressure
Moore and Dalley pg. 630-660; Netter plate 397
Perineum muscles
