Anatomy of the Pelvic Floor
Summary
Learn about the complexities of the pelvic floor anatomy in this educational session, designed for medical professionals. Master the knowledge of the origins, courses, and relations of the uterine and ovarian arteries. Understand the composition and positioning of the uterus along with its supporting ligaments, and its fundamental anatomical position in the pelvic cavity. Familiarize yourself with the bony pelvis, the anterior and posterior pelvic wall, and the structure of the pelvic floor. You'll also learn how to identify key elements such as the recto-uterine and vesico-uterine pouch, the mons pubis, and the major viscera of the female pelvis along with other critical points. This comprehensive course will enhance your understanding of pelvic anatomy, significantly improving your clinical practice.
Learning objectives
- By the end of the session, participants should be able to accurately describe the origins, courses and relations of the uterine and ovarian arteries.
- Participants should be able to demonstrate knowledge on the anatomical position, structure, and various parts of the uterus.
- Learners should be able to identify the ligaments that support the uterus, the bony structures of the pelvis, and the divisions of the pelvic region.
- Participants should be able to recognize the components of the anterior and posterior pelvic wall, the pelvic floor, and the various pouches in relation to the uterus.
- By the conclusion of the session, learners should be knowledgeable about the features of the female external genitalia, the major viscera of the female pelvis, and the functional anatomy of pelvic floor muscles.
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Anatomy of the pelvic floor Anagha NayakThanks to our partners!Anatomy learning objectives ● Describe the origins, courses and relations of the uterine and ovarian arteries ● Describe the three parts of the uterus ● Describe the anatomical position of the uterus (anteverted vs anteflexed) ● Describe the tissue layers that make up the uterus ● Recognise the ligaments that support the uterus ● Identify features of the bony pelvis and define the terms greater and lesser pelvis ● Describe and identify the components of the anterior and posterior pelvic wall and pelvic floor ● Identify the recto-uterine pouch and the vesico-uterine pouch ● Identify the mons pubis, parts of the female external genitalia, vestibule, urethral orifice and vaginal orifice ● Identify the major viscera of the female pelvisANATOMICAL POSITION OF THE UTERUS • The uterus is located in the pelvic cavity between the bladder and the rectum. • It is connected to the: Ovaries (laterally) Vagina (distally) • UTEROVESICAL POUCH: the uterus lies posterosuperior to the bladder and forms the uterovesical pouch. • RECTOUTERINE POUCH: the uterus lies anterior to the rectum and forms the pouch of Douglas.BONY PELVIS: Innominate bones, sacrum and coccyx. FEATURES OF THE BONY PELVIS The Innominate bones: Ilium Ischium Pubis GREATER AND LESSER PELVIS GREATER PELVIS: It is superior to the pelvic inlet and is surrounded by the superior pelvic girdle. It contains the inferior parts of the abdominal organs. LESSER PELVIS: It is located between the pelvic inlet and outlet. It is surrounded by the inferior pelvic girdle and houses all the pelvic viscera.Image source: Female pelvic anatomy (alberta.ca) MAJOR VISCERA OF THE FEMALE PELVIS PELVIC FLOOR PELVIC FLOOR: Formed by 3 components – Levator Ani, coccygeus and fascia of the muscles. Levator Ani is a broad sheet of muscle formed by : Iliococcygeus, pubococcygeus and puborectalis muscles. FUNCTION: Supports abdominopelvic viscera. Contributes to urinary and fecal continence. Image source: The Pelvic Floor - Structure - Function - Muscles - TeachMeAnatomy BLOOD SUPPLY AND MUSCLE FUNCTION INNERVATION NERVES: Anterior Rami of of spinal Helps flex the coccyx nerves (S4 - S5) COCCYGEUS Supports the pelvic viscera BLOOD SUPPLY: Inferior vesical, inferior gluteal and pudendal arteries NERVES: Pudendal nerve, perineal Helps elevate anorectal canal nerve ILIOCOCCYGEUS Helps elevate pelvic floor BLOOD SUPPLY: Inferior vesical, inferior gluteal and pudendal arteries NERVES: Pudendal nerve, perineal Helps tonic contraction of anal canal tonerve PUBORECTALIS maintain anorectal angle to maintain BLOOD SUPPLY: Inferior vesical, fecal continence inferior gluteal and pudendal arteries NERVES: Pudendal nerve, perineal PUBOCOCCYGEUS Supports and stabilizes pelvic viscera nerve BLOOD SUPPLY: Inferior vesical, inferior gluteal and pudendal arteries PELVIC WALLS ANTERIOR WALL: formed by posterior surfaces of the pubic symphysis, pubic rami and the bodies of the pubic bones. POSTERIOR WALL: formed by the sacrum, coccyx, piriformis muscle and pelvic fascia. EXTERNAL FEMALE GENETALIA Image source: https://med.libretexts.org/Bookshelves/Anatomy_and_Physiology/Human_Anatomy_(Lange_et_ al.)/23%3A_Reproductive_Systems/23.03%3A_Anatomy_of_the_Female_Reproductive_System• Anatomy, Abdomen and Pelvis: Uterus - StatPearls - NCBI Bookshelf (nih.gov) • The uterus | Canadian Cancer Society • The Uterus - Structure - Location - Vasculature – TeachMeAnatomy • The Ovaries - Structure - Ligaments - Vascular Supply - Function (teachmeanatomy.info) Pelvic floor muscles (youtube.com)@supta_uk @SUPTAUK www.supta.uk