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The pelvic floor or pelvic diaphragm is an anatomical location in the human body, [1] which has an important role in urinary and anal continence, sexual function and support of the pelvic organs. [2] The pelvic floor includes muscles, both skeletal and smooth, ligaments and fascia.
It is a remnant of part of biceps femoris muscle. The sacrotuberous ligament is attached by its broad base to the posterior superior iliac spine, the posterior sacroiliac ligaments (with which it is partly blended), to the lower transverse sacral tubercles and the lateral margins of the lower sacrum and upper coccyx.
The coccygeus muscle completes the pelvic floor, which is also called the pelvic diaphragm. It supports the viscera in the pelvic cavity, and surrounds the various structures that pass through it. The levator ani is the main pelvic floor muscle and contracts rhythmically during female orgasm, and painfully during vaginismus. [4]
The vagina is attached to the pelvic walls by endopelvic fascia. The peritoneum is the external layer of skin that covers the fascia. This tissue provides additional support to the pelvic floor. The endopelvic fascia is one continuous sheet of tissue and varies in thickness. It permits some shifting of the pelvic structures.
Pelvic fascia extends to cover the organs within the pelvis. It is attached to the fascia that runs along the pelvic floor along the tendinous arch. The fascia which covers pelvic organs can be divided according to the organs that are covered: The front is known as the "vesical layer". It forms the anterior and lateral ligaments of the bladder.
The coccygeus muscle is posterior to levator ani and anterior to the sacrospinous ligament in the pelvic floor.It is a triangular plane of muscular and tendinous fibers. It arises by its apex from the spine of the ischium and sacrospinous ligament.
The muscle helps maintain continence of urine along with the internal urethral sphincter which is under control of the autonomic nervous system.The external sphincter muscle prevents urine leakage as the muscle is tonically contracted via somatic fibers that originate in Onuf's nucleus and pass through sacral spinal nerves S2-S4 then the pudendal nerve to synapse on the muscle.
The function of the muscle is fixation of the perineal body (central tendon of perineum), support of the pelvic floor, expulsion of semen in males and last drops of urine in both sexes. [2] The deep transverse perineal muscle lies in the same plane as the urethral sphincter and formerly the two muscles were described together as the constrictor ...