Levator Ani and coccygeus of both the
side combinely forms pelvic diaphram
Diaphram seperates the pelvis from
These is devided into 3 parts
◦ Ischicoccygeus [coccygeus]
Having three parts of fibers
◦ Anterior fibers
◦ Middle fibers
◦ Posterior fibers
◦ Arise from medial part of the pelvic
surface of the body of the pubis
◦ In male
Fibers closely surround the prostate known as
◦ In female
these fibers are arround the vagina and forms
the sphincter vagina
In both cases anterior fibers inserted
into perineal body
The middle fibres constitute the
These arise from the lateral part of the
pelvic surface of the body of the pubis.
They form a loop arround the
In female anterior portion of
puborectalis is shorter
The posterior fibres of the
pubococcygeus arise from the anterior
half of the white line on the obturator
fascia. These get attached to
anococcygeal ligament and tip of
The fibres of this part arise from:
◦ The posterior half of the white line on the
obturator fascia; and
◦ The pelvic surface of the ischial spine.
They are inserted into the
◦ anococcygeal ligament and into the side
of the last two pieces of coccyx.
This muscle represents
◦ the posterior or ischiococcygeus part of the
It is triangular in shape.
It is partly muscular and partly tendinous.
Its fibres arise from
◦ (a) The pelvic surface of the ischial spine,
◦ (b) the sacrospinous ligament.
It is inserted into the side of the coccyx,
and into the fifth sacral vertebra
The levator ani is supplied by
◦ (1) a branch from the fourth sacral
◦ (2) a branch either from the inferior
rectal nerve, or from the perineal
division of the pudendal nerve.
The coccygeus is supplied by a
branch derived from the fourth and
fifth sacral nerves.
Actions of Levators Ani and
The levatores ani and coccygeus close the
posterior part of the pelvic outlet.
2. The levators ani fix the perineal body and
support the pelvic viscera.
3. During coughing, sneezing, lifting and
other muscular efforts, the levators ani and
coccygei counteract or resist increased intra-
abdominal pressure and help to maintain
continence of the bladder and the rectum.
In micturition, defaecation and parturition,
a particular pelvic outlet is open,
but contraction of fibres around other
openings resists increased intra-abdominal
pressure and prevents any prolapse
through the pelvic floor.
The increase in the intra-abdominal pressure
is momentary in coughing and sneezing and
is more prolonged in yawning, micturition,
defaecation and lifting heavy weights.
It is most prolonged and intense in
second stage of labour.
The coccygei pull forwards and
support the coccyx, after it has
been pressed backwards during
defaecation or parturition or child-
Relations of the Levator Ani
The superior or pelvic surface is
covered with pelvic fascia which
separates it from the bladder, the
prostate, the rectum and the
2. The inferior or perineal surface is
covered with anal fascia and forms the
medial boundary of the ischiorectal
3. The anterior borders of the two
muscles are separated by a triangular
space for the passage of the urethra
and the vagina.
4. The posterior border is free and
lies against the anterior margin of
evolution, the muscles have been
modified to form the pelvic diaphragm
which supports the viscera
. Such support became necessary
with the adoption of the erect
posture by man.
The muscles of the pelvic floor may be
injured during parturition
. When the perineal body is torn, and
has not been repaired satisfactorily,
the contraction of anterior fibres of
the levator ani increases the normal
gap in the pelvic floor, instead of
This results in abnormalities like
cystocoele, or prolapse of the
1. Part of the pelvic diaphram are all
2. Levator ani is supplied by
a) Branch from forth sacral nerve
b) Branch from the inferior rectal nerve
c) Both of them
d) None of them
3. which of the following is not true about
the relations of levator ani
a) Posterior border is lies against coccygeus
b) Anterior borders are joined with each other
c) Inferiorly covered with anal fascia
d) Superior is covered with pelvic fascia
4. Pelvic diaphram helps in all the actions
a. Prolapse of uterus
b. Micturation, Defecation
d. Lifting heavy wight
5.Branch of the posterior devision of the
internal iliac artery
a) Superior gluteal artery
b) Inferior gluteal artery
c) Superior vesical artery
d) Middle rectal artery