PELVIC FLOOR
General medicine, aVLANII, spring 2017
Diaphragma pelvis
Perineal membrane (Deep perineal pouch (diaphragma urogenitale))
Superficial perineal pouch
Ischiorectal fossa
Fascias
m. obturatorius int.
MUSCLES OF THE PELVIC DIAPHRAGMA
Diaphragma pelvis
M. levator ani
1 pars iliaca
2 pars pubica
Hiatus urogenitalis
opening for rectum
3 M. coccygeus
Fascia diaphragmatis pelvis
sup. et inf.
Innervation: sacral plexus
1
2
3
Support the pelvic viscera, assist in the constriction of the rectum and vagina
M. levator ani
1 pars iliaca (iliococcygeus)
O: arcus tendineus m.levatoris ani
I: anoccoccygeal lig., coccyx
2 pars pubica (pubococcygeus PC)
O: ramus sup. ossis pubis
I: coccyx, ventral sacroccoccygeal lig.
Medial part of PC - M. levator prostatae, M. pubovaginalis
PERINEAL BODY – fibromuscular node between A and UG
Intermediate part of PC – M.puborectalis – blends with the
deep external anal sphincter
Innervation: sacral plexus
M. coccygeus
O: spina ischiadica
I: lateral parts of the coccyx and sacrum
(lies on the sacrospinal lig.)
Innervation: sacral plexus
PERINEUM Overlies the pelvic outlet, separated from the pelvic cavity with the pelvic diaphragm
2 triangular parts: anal region, urogenital region
Fascia diaphragmatis urogenitalis
sup. et inf. –pelvic membrane
M. transversus perinei prof.
Lig. transversum perinei in ♂ anteriorly
♀ small smooth muscles posteriorly
M. sphincter urethrae externus
(in ♀ m. sphincter urethrovaginalis)
M. compressor urethrae in ♀ only
Inn. N. pudendus
Muscles of the urogenital region:
Urogenitale diaphragma
= deep perineal pouch
Muscles of the anal region:
M. sphincter ani externus
Sacral plexus Lig. anococcygeum
m.compressor
urethrae
m. sphincter
urethrovaginalis
m. bulbospong.
m. ischiocavernosus
m. transversus
perinei profundus
sphincter ani ext.
m. transv. perinei
superfic.
M. ischiocavernosus
M. bulbospongiosus (M. constrictor cunni)
M. transversus perinei superf.
Superficial perineal pouch
Below the perineal membrane
n. pudendus
Fascia perinei
ISCHIORECTAL – ISCHIOANAL - FOSSA
FOSSA ISCHIORECTALIS – recessus pubicus
• et v. pudenda interna, n. pudendus – canalis pudendalis
Aa., vv. et nn. rectales inf.
m. obturatorius int.
Fascia obturatoria
Fossa
ischio
rectalis
Canalis
pudendalis
(Alcock´s canal)
Rectum
Recessus
pubicus
Spatium perinei
superficiale
N. pudendus
A. et v. pudenda interna
N. cutaneus femoris post. (rr. perineales)
A.dorsalis penis (clitoridis)
N. dorsalis penis (clitoridis)
V. dorsalis penis (clitoridis) profunda
A.,v. et n. perinealis
Gl. bulbourethralis
Fascia diaphragmatis urogenitalis sup. et inf.
Spatium perinei profundum
Fascia perinei spf.
Spatium perinei spf.
Recessus pubicus
fossae ischio-
rectalis
To review:
Any questions?
Thank you for your attention
Illustrations and photographs were copied from:
Atlas der Anatomie des Menschen/Sobotta.
Putz,R., und Pabst,R. 20. Auflage. München:
Urban & Schwarzenberg, 1993
Netter: Interactive Atlas of Human Anatomy.
Windows Version 2.0
Čihák R: Anatomie 2 (Splanchnologia). Avicenum,
zdravotnické nakladatelství, Praha, 1988.