3. The Levator Ani
The levator ani is a broad, thin muscle,
situated on either side of the pelvis.
Regarded as one morphological entity,
divisible from before backwards into the
pubococcygeus, the Illiococcygeus and the
ischiococcygeus or coccygeus.
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4. Pelvic Floor Muscles
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The Levator Ani
The leavtor ani forms the main part of the
pelvic diaphragm, which separates the pelvis
from the perineum (the area between the anus
and the scrotum or vulva)
The leavtor ani is made up of three parts;
• Puborectalis
• Pubococcygeus
• Illiococcygeus
5. Origin of Levator Ani
Puborectalis
Pelvic Floor Muscles
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• The puborectalis originates lateral from the
symphysis on both sides and encircles the
rectum, which causes a ventral bend
between the rectum and anal canal.
• Middle fibres.
• It is partly interwoven with the external anal
sphincter.
6. Origin of Levator Ani
Pubococcygeus Part
o The Anterior fibres of this part arise from the
medial part of the pelvic surface of the body of the
pubis.
o The posterior fibres arise from the anterior half of
the white line on the obturator fascia.
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7. Pelvic Floor Muscles
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Origin of Levator Ani
Iliococcygeus Part
• The posterior half of the white line on the
obturator fascia.
• The pelvic surface of the ischial spine.
8. Insertion of Levator Ani
Pubococcygeus Part
o The Anterior fibres are inserted into the perineal
body.
o The Posterior fibres get attached to anococcygeal
ligament and tip of coccyx.
Iliococcygeus Part
o They are inserted into the anococcygeal ligament
and into the side of the last two pieces of coccyx.
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9. Innervations of
Levator Ani
The levator Ani is supplied by:
o A branch from the fourth sacral nerve
o A branch from the inferior rectal nerve
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10. Action of Levator Ani
o The levator ani and coccygeus close the posterior part of the pelvic outlet.
o The levator ani fix the perineal body and support the pelvic viscera.
o During coughing, sneezing, lifting and other muscular efforts, the levator
ani and coccygei counteract or resist increased intra-abdominal pressure
and help to maintain continence of the bladder and rectum.
o The slings formed by the puborectalis muscles pulls the anorectal junction
forwards, thus it prevents the untimely descent of the faeces.
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11. Coccygeus
o The Coccygeus or ischiococcygeus is a muscle of the
pelvic floor, located posterior to levator ani and
anterior to the sacrospinous ligament.
o It is triangular in shape.
o Partly muscular and partly tendanious.
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14. Pelvic Floor Muscles
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Innervation of
Coccygeus
The coccygeus is supplied by a branch derived
from the anterior rami of fourth and fifth sacral
nerves.
15. Action of Coccygeus
Pelvic Floor Muscles
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o The levator ani and coccygeus close the posterior part of the pelvic outlet.
o The levator ani fix the perineal body and support the pelvic viscera.
o During coughing, sneezing, lifting and other muscular efforts, the levator ani and coccygei counteract or
resist increased intra-abdominal pressure and help to maintain continence of the bladder and rectum.
o The slings formed by the puborectalis muscles pulls the anorectal junction forwards, thus it prevents the
untimely descent of the faeces.
o The coccygeus pulls forwards and supports the coccyx, after it has been pressed backwards during
defecation, parturition or childbirth.
16. Clinical Anatomy
The muscles of the pelvic floor maybe 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 decreasing it. This results in
the prolapse of the uterus.
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17. SUMMARY
The pelvic floor is a dome-shaped muscular
sheet separating the pelvic cavity above from
the perineal region below. This cavity encloses
the pelvic viscera - bladder, intestines, and
uterus(in females).
The main function of the pelvic
floor muscles are:
•To support the abdominal and pelvic viscera
•To maintain the continence of urine and
faeces
•Allows voiding, defecation, sexual activity,
and childbirth
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