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PELVIC FLOOR

PELVIC FLOOR. PERINEAL BODY is essential for the integrity of the pelvic floor, particularly in females. Levator ani- 3 striated muscles: Puborectalis Pubococcygeous Iliococcygeous . Puborectalis is innermost and merges with the external anal sphincter.

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PELVIC FLOOR

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  1. PELVIC FLOOR

  2. PERINEAL BODY is essential for the integrity of the pelvic floor, particularly in females

  3. Levator ani- 3 striated muscles: Puborectalis Pubococcygeous Iliococcygeous

  4. Puborectalis is innermost and merges with the external anal sphincter. Causes 120 deg angulation of anorectum due to the pull against the pubic bones. Shuts the lumen by apposing the post and the side walls of rectum

  5. Puborectalis – from myotome S1-S4 Pubococcygeous and iliococcygeous help to close the urogenital diaphragm

  6. EXTERNAL ANAL SPHINCTER: Superficial external sphincter Deep external sphincter – continuous with the puborectalis

  7. The external anal sphincter and puborectalis muscles are innervated by the pudendal nerve.

  8. INTERNAL ANAL SPHINCTER Circular layer of rectum becomes internal anal sphincter

  9. Colon innervation: Intrinsic • Auerbach plexus- segmentation and peristalsis • Plexus of Meissner- secretions and sensation Extrinsic • Parasympathetic increases and relaxes sphincters • Sympathetic decreases motility and contracts sphincters

  10. The muscular wall of the cecum and colon is innervated by: Vagus nerve- cranial nerve X in PNS Superior mesenteric plexus – SNS cord segment T9-L2 The rectum and anal canal innervation: Pelvic splanchnic nerves- parasympathetic S2-4 Hypogastric nerve- sympathetic T11-L2

  11. Anal sphincters innervation: Internal anal sphincter- pelvic splanchnic nerves and hypogastric nerves External anal sphincter – pudendal nerve

  12. Neural organization of anorectal sphincters: Somatic from S2,3,4 (pudendal nerve) to the external anal sphincter Sympathetic from L2,3,4 (superior hypogastric plexus/pelvic plexus) through hypogastric nerve to the internal anal sphincter Parasympathetic S2-4 (nervi erigentis or pelvic splanchnic nerves) to the internal anal sphincter

  13. ADDITIONAL SLIDES FOR URINARY SYSTEM

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