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Anatomy in detail.

PELVIC FLOOR MUSCLES

pelvic floor muscles male and female. front view.

The pelvic floor consists of several muscles within a web of connective tissues, attaching to the bones of the pelvis, sacrum and coccyx.

The anatomy of the pelvic floor (sometimes called the pelvic diaphragm) is complex and the terminology used varies between sources.

Take these lines from an academic paper:

The pelvic floor is comprised of a number of muscles ...

(No actual number given...)

... organized into superficial and deep muscle layers ...

(Described as 2 or 3 layers, depending on the source material.)

There is significant controversy with regards to the nomenclature ...

(Lots of complicated names that people can't agree on!)

PELVIC FLOOR ANATOMY AND APPLIED PHYSIOLOGY.
Varuna Raizada, Ravinder K. Mittal. 2008

For practical purposes, the exact details are not important.

What is important is learning to use your pelvic floor muscles. Being able to activate them and feel them as the base foundation for all movement.

Keep looking at the images. Picture your anatomy in your mind to increase your awareness of your body. Build the connection.

pelvic floor keeping it simpleBase-Line musclespelvis anatomy pictures

pelvic floor muscles in-situ female pelvic floor muscles in-situ male

Muscles of the pelvic floor.  

The pelvic floor consists of the levator ani muscle group and the coccygeus.

All are thin muscles that together span the pelvic canal at the base of the torso.

The female pelvis seen from above. Pelvic floor muscles, bones and connective tissues. Showing the ilium bones, the large wings of the pelvis and the smaller pubic bones at the front of the pelvis which are separated by the pubic symphyis on the body's midline. The sacrum and coccyx bones at at the back of the pelvis at the base of the spine. The levator ani muscles group is part of the pelvic floor, consisting of 3 muscles on either side of midline - the puborectalis, pubococcygeus and iliococcygeus muscles. The puborectalis muscles are small and located at the front of the pelvic floor, surrounding the anus, vagina and urethral openings and  are named for its proximity to the pubic bone and anus. The pubococcygeus muscles attach to the pubic bones and the coccyx. They are like ribbons forming an X-shape from front to back of the pelvic canal, either side of midline. The iliococcygeus muscles are the biggest of the levator ani muscles, wide and thin and most of the front half of the pelvic floor meeting . The coccygeus muscles make up the back half of the pelvic floor meeting with the bottom half of the X of the pubococcygeus. The coccygeus and iliococcygeu are similar in shape wide and flat. Several connective tissue structures are also labelled. The anterior sacroiliac ligament, a broad sheet of connective tissue attaching to the inside of the wings of the ilium and to the sacrum.  The iliolumbar ligament also attaches to the wings of the ilium but then extends higher to the lumbar vertebrae.  The obturator fascia covers the inside of the front portions of the pelvic canal. Also shown the part of the piriformis muscle that is within the pelvic canal. The piriformis goes through the greater sciatic foramen.  A lot of complex anatomy, layered and blending with the pelvic floor as the muscular base of the body.

Coccygeus

The coccygeus muscles (a.k.a. ischiococcygeus) form the posterior (back) part of the pelvic floor.

Coccygeus ~ near the coccyx.

Paired muscles that are triangular in shape.

Made up of muscular and connective tissue fibres.

The coccygeus muscles attach to:

  • The ischial spine. (The bony prominence of the medio-posterior part of the ischium bone of the pelvis.)
  • The anterior (front) surface of the sacrospinous ligament.
  • Lower sacrum.
  • Lateral margin of the coccyx.
  • The sacrotuberous ligament.

Levator ani muscle group

The levator ani muscles form the anterior (front) part of the pelvic floor.

The levator ani consists of three muscles on each side (left and right):

  • the iliococcygeus
  • the pubococcygeus
  • the puborectalis

1. Iliococcygeus.

The iliococcygeus muscles are the lateral parts of the levator ani.

Ilioccocygeus ~ ilio (covering term for ilium and ischium bones of pelvis) to coccyx.

Thin and triangular-shaped, consisting of muscle and fibrous tissue.

The iliococcygeus is the actual “levator” muscle of the levator ani muscle group, elevating the pelvic floor and the anorectal canal.

The iliococcygeus muscles attach to:

  • The tendinous arch (arcus tendineus) of the levator ani (part of the obturator fascia).
  • The ischial spine.
  • Posteriorly attaching to the last 2 segments of the coccyx.
  • The fibres from the left and right ilioccygeus fuse midline to form part of the anoccocygeal body (see below)
  • Anteriorly and medially the iliococcygeus muscles fuse with the pubococcygeus muscles.

The iliococygeus may fail entirely, or be largely replaced by fibrous tissue.(need ref.)

An accessory slip at the posterior part of the iliococcygeus is sometimes named the iliosacralis.

2. Pubococcygeus.

The most medial (near midline) muscles of the levator ani group, like a hammock from front to back of the pelvic floor.

Pubococcygeus ~ pubis (pubic bone of pelvis) to coccyx.

The pubococcygeus muscles attach to:

  • Posterior (back) surface of the pubis.
  • The anterior (front) portion of the tendinous arch of the levator ani (a.k.a. arcus tendineus of obturator internus fascia), a dense connective tissue structure that runs from the pubic ramus of the pubis to the ischial spine of the ischium.
  • Anteriorly the pubococcygeus muscles fuse with the iliococcygeus muscles.
  • Coccyx via the anococcygeal body (see below).
  • Lower sacrum.

3. Puborectalis.

Puborectalis ~ pubis (pubic bone of pelvis) + rectum.

The puborectalis muscles are relatively thick muscles, forming a U-shaped sling past the urogenital hiatus and around the anus.

These muscles maintain faecal continence and relax during defecation.

The puborectalis muscles attach to:

  • Posterior surface of the pubis just lateral to pubic symphysis.
  • Superior fascia of the urogenital diaphragm - continuous with the obturator fascia.
  • Left and right fuse midline posterior to the rectum.
  • Fibres fusing medially at the perineal body and musculature of the prostate/vagina.

The puborectalis muscles encircles the rectum (anorectal junction) some fibres are interwoven with the external anal sphincter.

Some fibres of the puborectalis muscles (pre-rectal fibres) form another U-shaped sling that flank the urethra (and vagina in the female) pubovaginalis or sphincter urethrae / vaginae). These fibres are very important in preserving urinary continence.

The pubococcygeus and puborectalis muscles have intervening and inseparable muscle fibres as they originate on the pubis.

The puborectalis muscle is located in between the superficial and deep muscle layers and some sources classify it as the middle muscle layer of the pelvic floor.

Anococcygeal body.

The anococcygeal body (a.k.a. anococcygeal ligament a.k.a anococcygeal raphe) is a midline musculo-tendinous structure between the coccyx and the anus.

It consists of three layers:

  • The superior layer formed for the presacral fascia.
  • The middle layer formed by:
    • The median tendinous raphe of the pubococcygeus.
    • The muscular raphe of the iliococcygeus.
    • The posterior muscular attachments of the puborectalis.
  • The inferior layer formed from the deep fibres of the external anal sphincter.
- along with the posterior fibres of the pubococcygeus. This raphe between the anus and the coccyx also known as the levator plate and is the shelf on which the pelvic organs rest. When the body is in a standing position, the levator plate should be horizontal.

The inner border of the pubococcygeus muscles forms the margin of the levator (urogenital) hiatus, the hole through which passes the urethra, anorectum and in females the vagina.

The levator plate is formed by an overlap of the puborectalis, iliococcygeus, and pubococcygeus muscle fibres

More information:

pelvic floor keeping it simpleBase-Line musclespelvis anatomy pictures

outline of human figures seen from behind male and female. The pelvis and pelvic floor muscles are show demonstrating the different shapes of the muscles and bones of the pelvic region.
the bones, muscles and connective tissues of the female pelvis. View from behind.

Perineal muscles.

The pelvic floor (pelvic diaphragm) muscles lie deep (more internal) to the superfical perineal muscle layer of the pelvis.

The urogenital diaphragm (a.k.a. perineal membrane) is a musculofascial structure present over the anterior pelvic outlet that closes the urogenital (levator) hiatus. The structure of the urogential diaphragm is subject to discussion/controversy.

The ischiocavernosus and bulbocavernosus muscles, and thin slips of the superficial transverse perinei, complete the inferior aspect of the urogenital diaphragm. The structure bridges the gap between the inferior pubic rami bilaterally and the perineal body.

Male and female perineal muscles. A group of muscles that form the outer/most superficial layer of the pelvic muscles.

The external anal sphincter, perineal body and possibly the puboperineal (or transverse perinei) muscles are the muscles relevant to anal canal function.

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 OPTIMISING THE USE OF YOUR MUSCLES = BETTER HEALTH.

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