PELVIC FLOOR

MUSCLE & THE

PERINEAL BOBY
 INTRODUCTION
HUMAN BEINGS ARE CREATED AS
ARTISTIC CREATURE IN THIS WORLD
BY THE GOD. HUMAN BODIES ARE
MADE UP OF SKIN, MUSCLES,
SKELETONS,NERVES,BLOOD VESSELS,
LYMPH VESSELS, APPROPRIATE TO
THEIR VARIOUS SYSTEMS.
 Overview
• Terminologies
• Pelvic floor muscles
• Layers of the muscles
• Nerve supply
• Functions
• Blood supply
• Perineal body
 Learning objectives
• At the end of the class, the students are able to,
• Explain about pelvic floor muscles
• List out the functions of pelvic floor muscles
• Discuss about the perineal body
 TERMINOLOGIES
• PELVIS
• PELVIC FLOOR
• MUSCLES
• PERINEAL BODY
• LEVATOR ANI
• FASCIA
• LIGAMENTS
 Pelvic floor
THE PELVIC FLOOR IS FORMED BY THE
SOFT TISSUES THAT FILLS THE OUTLET OF
THE PELVIS.IT MAKES STRONG FROM THE
WALL OF THE PELVIS AND PASS THE
URETHRA,VAGINA AND THE ANAL CANAL.

PELVIC DIAPHRAGM
THE MUSCLES WITH THE COVERING
FASCIA.
 ORIGIN
• EACH LEVATOR ANI ARISES FROM THE
BACK OF THE PUBIC RAMI,FROM THE
CONDENSED FASCIA COVERING THE
OBTURATOR INTERNUS(WHITE LINE)
AND FROM THE INNER SURFACE OF
THE ISCHIAL SPINE
 INSERTION

• INCLINED DOWNWARDS,BACKWARDS
AND MEDIALLY FROM BEFORE
BACKWARDS TO THE VAGINA(LATERAL
AND POSTERIOR WALLS),
ANOCOCCYGEAL BODY, LATERAL
BORDERS OF THE COCCYX AND LOWER
PART OF THE SACRUM.
 GAPS OF PELVIC FLOOR
• 2 GAPS ARE PRESENT

ANTERIOR –HIATUS UROGENITALIS,WHICH IS

BRIDGED BY THE MUSCLES AND FASCIA OF
UROGENITAL TRIANGLE AND PIERCED BY THE
URETHRA AND VAGINA.

POSTERIOR – HIATUS RECTALIS WHHICH

TRANSMITTING THE RECTUM.
 LAYERS OF THE MUSCLES
• SUPERFICIAL LAYERS

 THE EXTERNAL ANAL SPHINCTER

 THE TRANSVERSE PERINEAL MUSCLES

 THE BULBOCAVERNOSUS MUSCLES

 THE ISCHIOCAVERNOSUS MUSCLES

 THE MEMBRANOUS MUSCLE

 THE MEMBRANOUS SPHINCTER OF THE URETHRA

 CONT..,
• DEEP LAYERS
THE PUBOCOCCYGEOUS MUSCLE

THE ISCHICOCCYGEOUS MUSCLE

THE ILIOCOCCYGEOUS MUSCLES

STRUCTURES RELATED TO THE
PELVIC FLOOR

• SUPERIOR SURFACE
PELVIC ORGANS
PELVIC CELLULAR TISSUES
URETER
PELVIS NERVES

• INFERIOR SURFACE
 NERVE SUPPLY
• SUPPLIED BY 4TH SACRAL
NERVE,INFERIOR RECTAL NERVE AND
PERINEAL BRANCH OF PUDENDAL
NERVE S2.

BLOOD SUPPLY
 FUNCTIONS
• TO SUPPORT THE PELVIC ORGANS
• TO MAINTAIN THE INTRA ABDOMINAL
PRESSURE BY REFLEXLY RESPONDING
TOMITS CHANGES.
• FACILITATES THE ANTERIOR ROTATION
OF THE PRESENTING PART WHEN
TOUCHES PELVIC FLOOR.
• ISCHIOCOCCYGEOUS HELPS TO
STABILISE THE SACRO-ILIAC AND
SACRO-COCCYGEAL JOINTS.
• TO STABILISE THE PERINEAL BODY.
PERINEAL BODY
 CONT..,
• PYRAMID OF MUSCLES AND FIBROUS TISSUE SITUATED
BETWEEN THE VAGINA AND THE RECTUM.

• APEX-DEEPEST PART FORMED OF PUBOCOCCYGEOUS

MUSCLE.

• BASE-FORMED FROM THE TRANSVERSE PERINEAL

MUSCLES WHICH MEETS IN THE PERINEU TOGETHER
WITH THE BULBOCAVERNOUS INFRONT AND SHINCTER
BEHIND.
 PELVIC FLOOR EXERCISES
• PELVIC FLOOR CONTRACTION

• VARIATION A(ELEVATOR)

• VARIATION B(PELVIC FLOOR BULGING)

• SQUATTING
 Summary
• Pelvic floor muscles and perineal body has the
major role in supporting the uterus and its
structures in position. Once its gets damaged
or stretched due to obesity or pregnancy, it will
land up will prolapse. So pelvic floor muscles
exercises helps to regain atleast to its normal
position.
 Evaluation
• What is perineal body and pelvic floor
muscles?
• Mention any two functions of perineal body
• Discuss the role of pelvic floor muscle
• Explain about the pelvic floor exercises
• Which sacral nerve supplies the pelvic floor
muscle.
 Assignments
• Write in detail about the pelvic floor, pelvic
tilting exercises and their advantages
 References
• D C Dutta, “Textbook of obstetrics”, 6th
edition(2004), published by new central book
agency (P) ltd, calcutta
• Myles, “Textbook for midwives”, 14th edition
(2006), published by churchill livingstone,
philadelphia.
• T.S.Ranganathan, “ A textbook of human
anatomy”, 1st edition jaypee brothers, New
delhi.