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<\/a>Description<\/h4>\n<\/span>\n\n\nThe pelvic diaphragm extends between the anterior, lateral, and posterior walls of the lesser pelvis. <\/p>\n\n\n\n
- The pelvic diaphragm forms the pelvic floor in combination with the perineal membrane and the muscles of the deep perineal bursa in the anterior midline. <\/li>
- It separates the pelvic cavity from the perineum.<\/li><\/ul>\n\n\n<\/span>\n
Parts<\/h4>\n<\/span>\n\n\nThe pelvic diaphragm consists of the following structures:<\/p>\n\n\n\n
- The levator ani muscle group<\/li>
- The coccygeus muscle<\/li>
- The fascias (L. fasciae)<\/li><\/ul>\n\n\n\n
The pelvic diaphragm relates to the greater and the lesser foramen when its circular line of attachment to the cylindrical pelvic wall passes through them bilaterally. <\/p>\n\n\n\n
By attaching to the obturator fascia, the pelvic diaphragm divides the obturator internus into two: a superior pelvic section<\/strong> and an inferior perineal section<\/strong>, respectively. <\/p>\n\n\n\n- The obturator vessels and nerves, along with other branches of the internal iliac vessels pass through the pelvic diaphragm medially to the pelvic sections of the obturator internus muscles.<\/li>
- The urethra, and the vagina (in females), pass through the urogenital hiatus, an aperture located between the medial borders of both levator ani muscles.<\/li><\/ul>\n\n\n<\/span>\n
Pelvic muscles<\/h2>\n<\/span>\n\n<\/span>\nLevator ani<\/h3>\n<\/span>\n\n\nThe levator ani is the larger muscle of the pelvic diaphragm, generally divided into the pubococcygeous, puborectalis, <\/strong>and iliococcygeus<\/strong> muscles<\/strong>. <\/p>\n\n\n\nIt remains actively contracted most of the time to support the abdominopelvic viscera in this cavity (especially during periods of increased intra-abdominal pressure), and surrounds various structures that pass through it. Its relaxation allows urination and defecation.<\/p>\n\n\n\n
- The levator ani originates bilaterally from each side of the pelvic wall.
- Anteriorly: attaches to the pubic bones.<\/li>
- Posteriorly: attaches to the ischial spines.<\/li>
- Laterally: attaches to the tendinous arch of the levator ani.<\/li><\/ul><\/li>
- Each levator ani muscle goes forward medially and inferiorly to rejoin in the midline.<\/li>
- Both muscles find each other in the midline where they blend around the anal aperture until becoming the anococcygeal ligament<\/strong> that adheres to the side of the last two segments of the coccyx.<\/li>
- The urogenital hiatus separated both levators ani muscles anteriorly. This u-shaped gap is responsible that the urethra and vagina pass through the pelvic diaphragm.<\/li>
- The levator ani muscles are innervated by a branch from the S4 nerve and by a branch derived from the pudendal nerve (inferior hemorrhoidal division).<\/li><\/ul>\n\n\n<\/span>\n
Pubococcygeus<\/h4>\n<\/span>\n\n\nThe thinner and wider part of the levator ani. <\/p>\n\n\n\n
- Arises from the posterior section of the pubis and from the anterior part of the obturator fascia (anterior tendinous arch). <\/li>
- Follows its way backward and nearly horizontally next to the anal canal, until it reaches and finally attaches to the coccyx and sacrum.<\/li>
- The levator plate forms when the two pubococcygeus muscles find each other and form a thick fibrous raphe (ligament) between the anus and the coccyx.<\/li>
- The pubococcygeus is further subdivided into the following muscles, named for the structure near their termination: the puboprostaticus<\/strong> (males), the pubovaginalis <\/strong>(females), and the puboanalis muscles<\/strong>.<\/li><\/ul>\n\n\n<\/span>\n
Puborectalis<\/h4>\n<\/span>\n\n\nThe medial and thicker portion of the levator ani. The puborectalis originates along with the pubococcygeus, from the posterior section of the pubic bones.<\/p>\n\n\n\n
- Compose the puborectal sling, a u-shaped muscular sling that goes through posteriorly until reaches the anorectal junction and delimits the urogenital hiatus.<\/li>
- This sling is responsible for creating, an angle at the anorectal junction referred to as the perineal flexure. When this muscle actively contracts, collaborates in maintaining fecal continence.<\/li><\/ul>\n\n\n<\/span>\n
Iliococcygeus<\/h4>\n<\/span>\n\n\nIt originates from the tendinous arch of the pelvic fascia and the ischial spine. Attaches the to the coccyx and anococcygeal ligament.<\/p>\n\n\n\n
- The posterolateral and final segment of the levator ani muscle.<\/li>
- It is the thin part of the levator ani muscle, and most of the time appears more aponeurotic than muscular tissue.<\/li>
- Blends with the anococcygeal muscle posteriorly.<\/li><\/ul>\n\n\n<\/span>\n
Coccygeus<\/h3>\n<\/span>\n\n\nThe coccygeus muscle (also known as the ischiococcygeus) is a triangular-shaped muscle located posterior to the levator ani.<\/p>\n\n\n\n
- Originates from the spine of the ischium and sacrospinous ligament<\/li>
- Inserts onto the lateral sections of the sacrum and the margin of the coccyx.<\/li>
- Supports the Levator ani and the Piriformis muscles in the formation of the posterior segment of the pelvic floor.<\/li>
- Both coccygeus muscles have innervation from the anterior rami of S3 and S4.<\/li>
- Its main function is to pull forward the coccyx after defecation or parturition.<\/li><\/ul>\n\n\n\n
Muscle<\/td> Origin<\/td> Insertion<\/td> Innervation<\/td> Function<\/td><\/tr><\/thead> Levator ani <\/strong>(puborectalis, pubococcygeus, and iliococcygeus)<\/td>Body of pubis, obturator fascia, and ischial spine<\/td> Perineal body, coccyx, anococcygeal ligament, walls of prostate or vagina, rectum, and anal canal<\/td> Nerve to levator ani (from S4 spinal nerve), inferior anal (rectal) nerve, and coccygeal plexus<\/td> Forms most of the pelvic diaphragm<\/td><\/tr> Coccygeous <\/strong>(ischiococcygeus)<\/td>Ischial spine and sacrospinous ligament<\/td> Inferior sacrum and coccyx<\/td> Branches of S3 and S4 spinal nerves<\/td> Forms small part of the pelvic diaphrag<\/td><\/tr><\/tbody><\/table>Table 1. The muscles of the pelvic diaphragm<\/strong><\/figcaption><\/figure>\n<\/span>
Parts<\/h4>\n<\/span>\n\n\nThe pelvic diaphragm consists of the following structures:<\/p>\n\n\n\n
- The levator ani muscle group<\/li>
- The coccygeus muscle<\/li>
- The fascias (L. fasciae)<\/li><\/ul>\n\n\n\n
The pelvic diaphragm relates to the greater and the lesser foramen when its circular line of attachment to the cylindrical pelvic wall passes through them bilaterally. <\/p>\n\n\n\n
By attaching to the obturator fascia, the pelvic diaphragm divides the obturator internus into two: a superior pelvic section<\/strong> and an inferior perineal section<\/strong>, respectively. <\/p>\n\n\n\n- The obturator vessels and nerves, along with other branches of the internal iliac vessels pass through the pelvic diaphragm medially to the pelvic sections of the obturator internus muscles.<\/li>
- The urethra, and the vagina (in females), pass through the urogenital hiatus, an aperture located between the medial borders of both levator ani muscles.<\/li><\/ul>\n\n\n<\/span>\n
Pelvic muscles<\/h2>\n<\/span>\n\n<\/span>\nLevator ani<\/h3>\n<\/span>\n\n\nThe levator ani is the larger muscle of the pelvic diaphragm, generally divided into the pubococcygeous, puborectalis, <\/strong>and iliococcygeus<\/strong> muscles<\/strong>. <\/p>\n\n\n\nIt remains actively contracted most of the time to support the abdominopelvic viscera in this cavity (especially during periods of increased intra-abdominal pressure), and surrounds various structures that pass through it. Its relaxation allows urination and defecation.<\/p>\n\n\n\n
- The levator ani originates bilaterally from each side of the pelvic wall.
- Anteriorly: attaches to the pubic bones.<\/li>
- Posteriorly: attaches to the ischial spines.<\/li>
- Laterally: attaches to the tendinous arch of the levator ani.<\/li><\/ul><\/li>
- Each levator ani muscle goes forward medially and inferiorly to rejoin in the midline.<\/li>
- Both muscles find each other in the midline where they blend around the anal aperture until becoming the anococcygeal ligament<\/strong> that adheres to the side of the last two segments of the coccyx.<\/li>
- The urogenital hiatus separated both levators ani muscles anteriorly. This u-shaped gap is responsible that the urethra and vagina pass through the pelvic diaphragm.<\/li>
- The levator ani muscles are innervated by a branch from the S4 nerve and by a branch derived from the pudendal nerve (inferior hemorrhoidal division).<\/li><\/ul>\n\n\n<\/span>\n
Pubococcygeus<\/h4>\n<\/span>\n\n\nThe thinner and wider part of the levator ani. <\/p>\n\n\n\n
- Arises from the posterior section of the pubis and from the anterior part of the obturator fascia (anterior tendinous arch). <\/li>
- Follows its way backward and nearly horizontally next to the anal canal, until it reaches and finally attaches to the coccyx and sacrum.<\/li>
- The levator plate forms when the two pubococcygeus muscles find each other and form a thick fibrous raphe (ligament) between the anus and the coccyx.<\/li>
- The pubococcygeus is further subdivided into the following muscles, named for the structure near their termination: the puboprostaticus<\/strong> (males), the pubovaginalis <\/strong>(females), and the puboanalis muscles<\/strong>.<\/li><\/ul>\n\n\n<\/span>\n
Puborectalis<\/h4>\n<\/span>\n\n\nThe medial and thicker portion of the levator ani. The puborectalis originates along with the pubococcygeus, from the posterior section of the pubic bones.<\/p>\n\n\n\n
- Compose the puborectal sling, a u-shaped muscular sling that goes through posteriorly until reaches the anorectal junction and delimits the urogenital hiatus.<\/li>
- This sling is responsible for creating, an angle at the anorectal junction referred to as the perineal flexure. When this muscle actively contracts, collaborates in maintaining fecal continence.<\/li><\/ul>\n\n\n<\/span>\n
Iliococcygeus<\/h4>\n<\/span>\n\n\nIt originates from the tendinous arch of the pelvic fascia and the ischial spine. Attaches the to the coccyx and anococcygeal ligament.<\/p>\n\n\n\n
- The posterolateral and final segment of the levator ani muscle.<\/li>
- It is the thin part of the levator ani muscle, and most of the time appears more aponeurotic than muscular tissue.<\/li>
- Blends with the anococcygeal muscle posteriorly.<\/li><\/ul>\n\n\n<\/span>\n
Coccygeus<\/h3>\n<\/span>\n\n\nThe coccygeus muscle (also known as the ischiococcygeus) is a triangular-shaped muscle located posterior to the levator ani.<\/p>\n\n\n\n
- Originates from the spine of the ischium and sacrospinous ligament<\/li>
- Inserts onto the lateral sections of the sacrum and the margin of the coccyx.<\/li>
- Supports the Levator ani and the Piriformis muscles in the formation of the posterior segment of the pelvic floor.<\/li>
- Both coccygeus muscles have innervation from the anterior rami of S3 and S4.<\/li>
- Its main function is to pull forward the coccyx after defecation or parturition.<\/li><\/ul>\n\n\n\n
Muscle<\/td> Origin<\/td> Insertion<\/td> Innervation<\/td> Function<\/td><\/tr><\/thead> Levator ani <\/strong>(puborectalis, pubococcygeus, and iliococcygeus)<\/td>Body of pubis, obturator fascia, and ischial spine<\/td> Perineal body, coccyx, anococcygeal ligament, walls of prostate or vagina, rectum, and anal canal<\/td> Nerve to levator ani (from S4 spinal nerve), inferior anal (rectal) nerve, and coccygeal plexus<\/td> Forms most of the pelvic diaphragm<\/td><\/tr> Coccygeous <\/strong>(ischiococcygeus)<\/td>Ischial spine and sacrospinous ligament<\/td> Inferior sacrum and coccyx<\/td> Branches of S3 and S4 spinal nerves<\/td> Forms small part of the pelvic diaphrag<\/td><\/tr><\/tbody><\/table>Table 1. The muscles of the pelvic diaphragm<\/strong><\/figcaption><\/figure>\n<\/span>
The pelvic diaphragm relates to the greater and the lesser foramen when its circular line of attachment to the cylindrical pelvic wall passes through them bilaterally. <\/p>\n\n\n\n
By attaching to the obturator fascia, the pelvic diaphragm divides the obturator internus into two: a superior pelvic section<\/strong> and an inferior perineal section<\/strong>, respectively. <\/p>\n\n\n\n The levator ani is the larger muscle of the pelvic diaphragm, generally divided into the pubococcygeous, puborectalis, <\/strong>and iliococcygeus<\/strong> muscles<\/strong>. <\/p>\n\n\n\n It remains actively contracted most of the time to support the abdominopelvic viscera in this cavity (especially during periods of increased intra-abdominal pressure), and surrounds various structures that pass through it. Its relaxation allows urination and defecation.<\/p>\n\n\n\n The thinner and wider part of the levator ani. <\/p>\n\n\n\n The medial and thicker portion of the levator ani. The puborectalis originates along with the pubococcygeus, from the posterior section of the pubic bones.<\/p>\n\n\n\n It originates from the tendinous arch of the pelvic fascia and the ischial spine. Attaches the to the coccyx and anococcygeal ligament.<\/p>\n\n\n\n The coccygeus muscle (also known as the ischiococcygeus) is a triangular-shaped muscle located posterior to the levator ani.<\/p>\n\n\n\nPelvic muscles<\/h2>\n<\/span>\n\n<\/span>\n
Levator ani<\/h3>\n<\/span>\n\n\n
Pubococcygeus<\/h4>\n<\/span>\n\n\n
Puborectalis<\/h4>\n<\/span>\n\n\n
Iliococcygeus<\/h4>\n<\/span>\n\n\n
Coccygeus<\/h3>\n<\/span>\n\n\n
Muscle<\/td> Origin<\/td> Insertion<\/td> Innervation<\/td> Function<\/td><\/tr><\/thead> Levator ani <\/strong>(puborectalis, pubococcygeus, and iliococcygeus)<\/td> Body of pubis, obturator fascia, and ischial spine<\/td> Perineal body, coccyx, anococcygeal ligament, walls of prostate or vagina, rectum, and anal canal<\/td> Nerve to levator ani (from S4 spinal nerve), inferior anal (rectal) nerve, and coccygeal plexus<\/td> Forms most of the pelvic diaphragm<\/td><\/tr> Coccygeous <\/strong>(ischiococcygeus)<\/td> Ischial spine and sacrospinous ligament<\/td> Inferior sacrum and coccyx<\/td> Branches of S3 and S4 spinal nerves<\/td> Forms small part of the pelvic diaphrag<\/td><\/tr><\/tbody><\/table>