pelvic floor

Structure of

vagina

Wikipedia • Public domain

Left Levator

ani from within.

Wikipedia • Public domain

Levator ani

muscle • Levator ani (Gray's illustration) - Ganzer Fall bei Radiopaedia

Hacking C, Levator ani (Gray's illustration). Case study, Radiopaedia.org (Accessed on 07 Apr 2024) https://doi.org/10.53347/rID-94298 • CC by-nc-sa 3.0 (modified)

Levator ani

muscle • Normal MRI pelvis (fistula protocol) - Ganzer Fall bei Radiopaedia

Gerstenmaier J, Normal MRI pelvis (fistula protocol). Case study, Radiopaedia.org (Accessed on 07 Apr 2024) https://doi.org/10.53347/rID-38290 • CC by-nc-sa 3.0 (modified)

Levator ani

muscle • Female perineal muscles (Gray's illustration) - Ganzer Fall bei Radiopaedia

Hacking C, Female perineal muscles (Gray's illustration). Case study, Radiopaedia.org (Accessed on 07 Apr 2024) https://doi.org/10.53347/rID-94303 • CC by-nc-sa 3.0 (modified)

Levator ani

muscle • Male perineal muscles (Gray's illustration) - Ganzer Fall bei Radiopaedia

Hacking C, Male perineal muscles (Gray's illustration). Case study, Radiopaedia.org (Accessed on 07 Apr 2024) https://radiopaedia.org/cases/94302 • CC by-nc-sa 3.0 (modified)

Levator ani

muscle • Levator ani imaging (3D transperineal ultrasound) - Ganzer Fall bei Radiopaedia

Fares G, Levator ani imaging (3D transperineal ultrasound). Case study, Radiopaedia.org (Accessed on 07 Apr 2024) https://doi.org/10.53347/rID-98034 • CC by-nc-sa 3.0 (modified)

Dynamic

magnetic resonance imaging of the female pelvic floor—a pictorial review. Normal female pelvic anatomy. Sagittal midline T2-TSE image demonstrating the perineal body (*) and the levator plate (white arrow). B, bladder; U, uterus; V, vagina; R, rectum

insightsimaging.springeropen.com • CC-by-4.0

Dynamic

magnetic resonance imaging of the female pelvic floor—a pictorial review. Pelvic compartments. Sagittal midline T2-TSE image representing the three pelvic compartments in different colors

insightsimaging.springeropen.com • CC-by-4.0

Dynamic

magnetic resonance imaging of the female pelvic floor—a pictorial review. Representative image of the pelvic floor ligaments and their relative anatomical positions in a female model

insightsimaging.springeropen.com • CC-by-4.0

Radiopaedia • CC-by-nc-sa 3.0 • de

The levator ani muscle, also known as the muscular pelvic diaphragm, is the musculotendinous sheet that forms the majority of the pelvic floor, supports the pelvic viscera, and aids in urinary and fecal evacuation as well as maintaining continence.

Gross anatomy

The levator ani has three main components, each of which is paired :

pubococcygeus (pubovisceral) muscle
- subparts: puboperineal, pubovaginal, puboanal muscles
iliococcygeus muscle
puborectalis muscle

The pubococcygeus muscle runs from the inner surface of the pubis and obturator fascia with fibers fusing medially at the perineal body and musculature of the prostate/vagina.

The iliococcygeus muscle attaches to the inner tip of the coccyx posteriorly. Posterolaterally, it attaches to the ischial spine and along the tendinous arch of the obturator fascia (a.k.a. the tendinous arch of the levator ani), which is a thickened band of the fascia covering the inner aspect of the obturator internus muscle. Anteriorly and medially, it fuses with the pubococcygeus.

Puborectalis takes attachment from the pelvic surfaces of both ischiopubic rami, anterolaterally. It passes posterior to the rectum to form a muscular sling.

The coccygeus muscle (also known as ischiococcygeus) is not formally a part of the levator ani muscle . It is a triangular muscle with its base attaching to the lateral aspect of the inferior sacrum and coccyx and apex attached to the ischial spine. It flexes the coccyx anteriorly and partially fuses with the sacrospinous ligament.