Anatomy, Abdomen and Pelvis, Pelvic Floor

Excerpt

The pelvic floor is a unique anatomical location where the balance of the different pressures, either visceral, muscular, or liquid play a fundamental role in the physiological functioning of all the structures contained therein. The pelvis is bounded superiorly by the imaginary line between the pubis and sacral promontory and inferiorly as the line between the ischial tuberosity and the apex of the coccyx, which separates the pelvis from the perineum below. From an anatomical standpoint, the pelvic floor can be divided into 4 compartments:

1. Anterior or urinary (bladder, bladder neck, and urethra)

2. Medium or genital (vagina and uterus in women, prostate in men)

3. Posterior or anterior (anus, anal canal, sigmoid, and rectum)

4. Peritoneal (endopelvic fascia and perineal membrane)

The functional classification of the pelvis is as follows:

1. Diaphragm or pelvic floor (ischiococcygial muscle and levator ani muscles), closed above by the endopelvic fascia.

2. The urogenital diaphragm (triangular ligament/fascia of Carcassonne) is located caudally between the ischium and the pubic symphysis and crossed by the urethra and the vagina.

3. The perineum or perineal membrane is the continuation of the Carcassonne fascia, connecting the deep layer of the pelvic floor musculature, the coccyx, and the anal sphincter.