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Muscles and Fascia of Pelvic Wall

Muscles and Fascia of Pelvic Wall. Dr. Sama-ul-Haque. Objectives. Describe the origin, insertion, nerve supply and actions of the Piriformis, obturator internus & levator ani . Describe the pelvic fascia organization. Pelvic Walls. Anterior pelvic wall:

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Muscles and Fascia of Pelvic Wall

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  1. Muscles and Fascia of Pelvic Wall Dr. Sama-ul-Haque

  2. Objectives • Describe the origin, insertion, nerve supply and actions of the Piriformis, obturator internus & levator ani. • Describe the pelvic fascia organization.

  3. Pelvic Walls • Anterior pelvic wall: Formed primarily by the bodies and rami of the pubic bones and the pubic Symphysis • Lateral pelvic walls: Formed by the hip bones and the obturator internus muscles: Origin: Proximal surface of the ilium & ischium; obturator membrane Insertion: Greater trochanter of the femur

  4. Obturator Internus Muscle

  5. Pelvic Walls • Posterior Pelvic Wall: Formed by the sacrum, coccyx, adjacent parts of the ilia, Sacroiliac joints and Piriformis muscle: Origin: Pelvic surface of 2nd and 4thsacral segments, superior margin of the greater sciatic notch and sacrotuberous ligament. Insertion: Greater trochanter of femur

  6. Piriformis Muscle

  7. Pelvic Floor • Formed by the funnel shaped pelvic diaphragm • Pelvic Diaphragm: Consists of the levator ani and coccygeus muscles and their fascia • Stretches between the pubis anteriorly and the coccyx posteriorly and from one lateral pelvic wall to the other.

  8. Levator Ani • Three parts • Pubococcygeus • Puborectalis • Iliococcygeus • Origin: Collectively they run from the body of the pubis, the tendinous arch of the obturator fascia and the Ischial spine. • Insertion: To the perineal body, the coccyx, the anococcygeal ligament, the walls of the prostate or vagina, the rectum and the anal canal

  9. Levator Ani • Nerve supply: • Nerve to levator ani (S4) • Pudendal nerve • Action: Help to support the pelvic viscera; acting together they raise the pelvic floor and assist the abdominal muscles in forced expiration activities.

  10. Pelvic Walls

  11. Pelvic Diaphragm

  12. Pelvic Floor (Male)

  13. Pelvic Floor (Female)

  14. Female Pelvic Floor (Medial view)

  15. Perineal Body

  16. Coccygeus Muscle Origin: Ischial spine Insertion: Lower end of the sacrum and coccyx Nerve supply: Branches of S4 and S5 Action: Forms a small part of the pelvic diaphragm that supports the pelvic viscera, flexes the coccyx.

  17. Pelvic Fascia

  18. Pelvic Fascia

  19. Thank you

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