QuestionSBA
QuestionChoice
This is a stabiliser of the sacroiliac joint and connects the bony pelvis to the vertebral column. It forms part of the base of the ischioanal fossa posteriorly.
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d
Sacrotuberous ligament
QuestionChoice
The gluteus maximus is the most superficial and largest of the muscles which make up the bulk of the shape and form of the buttock and hip area. It is the main extensor muscle of the hip. It forms part of the base of the ischioanal fossa posteriorly.
10014254
b
Gluteus maximus
QuestionChoice
This is a muscle that originates within the pelvis and inserts into the greater trochanter of the femur. It forms part of the lateral wall of the ischioanal fossa.
10014255
c
Obturator internus muscle
QuestionChoice
The levator ani is the main pelvic floor muscle. It is a broad, thin structure formed by 3 muscle components – the pubococcygeus, iliococcygeus and puborectalis.
10014253
a
Levator ani
QuestionChoice
This is the fascia of the obturator internus muscle. It covers its internal surface and is attached to the bony margin of the obturator foramen. It forms part of the lateral wall of the ischioanal fossa.
10014257
e
Obturator fascia
Concept
Chapter
## Summary

The pelvic floor is formed by **levator ani** and **coccygeus muscles**, and associated connective tissue. It supports the abdominal and pelvic viscera including the rectum, vagina, urethra and bladder.

## Muscles

The **transverse perineal muscles** attach to the inferior ischial ramus. There are superficial and deep transverse perineal muscles, both innervated by the **pudendal nerve**. They play an important role in maintaining urinary continence.

**Coccygeus muscle** runs from the ischial spines to the lateral sacrum and coccyx.

**Levator ani** comprises three parts:

* **Puborectalis**: a U-shaped sling (the puborectal sling) that wraps around the anal canal with the main function of maintaining faecal continence.
* **Pubococcygeus**: runs from the body of the pubic bone to the coccyx and anococcygeal ligament
* **Iliococcygeus**: important for maintaining the integrity of the pelvic floor by keeping it in a raised position.

All three parts are innervated by the **anterior ramus of S4** and the **inferior rectal branch of the pudendal nerve (S2,S3,S4)**


## Hiatuses

The pelvic floor has two hiatuses:

* The urogenital hiatus allows the urethra (and vagina) to pass through the pelvic floor.
* The rectal hiatus allows the anal canal to pass through the pelvic floor.

## Clinical points

- Weakness of the lavator ani muscles may lead to faecal incontinence.
- General weakness of the pelvic floor muscles can lead to visceral prolapse through the hiatuses - i.e. uterine or rectal prolapse.
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Pelvic floor
Topic
237
Pelvic Anatomy
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Topic
237
Pelvic Anatomy
Name the annotated structure.

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a