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Anatomy of the Pelvic Floor
Rania Farouk El Sayed, MD, PhD
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TERMINOLOGY

  • Abbreviations

    • Arcus tendineus levator ani (ATLA)
    • Arcus tendineus fascia pelvis (ATFP)
  • Definitions

    • Pelvic floor
      • Pelvic diaphragm
      • Sphincter mechanism of lower urinary tract
      • Upper and lower vaginal support
      • Internal and external anal sphincter
    • Pelvic floor muscles (a.k.a. pelvic diaphragm)
      • Dome-shaped muscular sheet separating pelvic cavity above from perineal region below
        • Supports abdominal and pelvic viscera
        • Maintains urinary and fecal continence
        • Allows voiding, defecation, sexual activity, and childbirth

Bony Pelvis and Pelvic Ligaments

  • Bony Pelvis

    • Pelvic Ligaments

      • Pelvic Walls

        Topographic MR Anatomy of Pelvic Diaphragm

        • Puborectalis Muscle

          • Iliococcygeus Muscle

            • Levator Plate

              Approaches for Functional Description of Pelvic Floor

              • Classic 3-Compartment Approach

                • Multilayered System Approach

                  • Functional 3-Part Pelvic Supporting Systems Approach

                    Multilayered System Approach

                    • Supportive Connective Tissue

                      • 1st Layer: Endopelvic Fascia

                        • 2nd Layer: Pelvic Diaphragm

                          • 3rd Layer: Urogenital Diaphragm

                            • 4th Layer: Perineum

                              Clinical Implications

                              • Pelvic Floor Muscle and Endopelvic Fascial Interaction

                                Selected References

                                1. El Sayed RF: Magnetic resonance imaging of the female pelvic floor: anatomy overview, indications, and imaging protocols. Radiol Clin North Am. 58(2):291-303, 2020
                                2. Eickmeyer SM: Anatomy and physiology of the pelvic floor. Phys Med Rehabil Clin N Am. 28(3):455-60, 2017
                                3. Khatri G et al: MR imaging of the pelvic floor. Magn Reson Imaging Clin N Am. 25(3):457-80, 2017
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                TERMINOLOGY

                                • Abbreviations

                                  • Arcus tendineus levator ani (ATLA)
                                  • Arcus tendineus fascia pelvis (ATFP)
                                • Definitions

                                  • Pelvic floor
                                    • Pelvic diaphragm
                                    • Sphincter mechanism of lower urinary tract
                                    • Upper and lower vaginal support
                                    • Internal and external anal sphincter
                                  • Pelvic floor muscles (a.k.a. pelvic diaphragm)
                                    • Dome-shaped muscular sheet separating pelvic cavity above from perineal region below
                                      • Supports abdominal and pelvic viscera
                                      • Maintains urinary and fecal continence
                                      • Allows voiding, defecation, sexual activity, and childbirth

                                Bony Pelvis and Pelvic Ligaments

                                • Bony Pelvis

                                  • Pelvic Ligaments

                                    • Pelvic Walls

                                      Topographic MR Anatomy of Pelvic Diaphragm

                                      • Puborectalis Muscle

                                        • Iliococcygeus Muscle

                                          • Levator Plate

                                            Approaches for Functional Description of Pelvic Floor

                                            • Classic 3-Compartment Approach

                                              • Multilayered System Approach

                                                • Functional 3-Part Pelvic Supporting Systems Approach

                                                  Multilayered System Approach

                                                  • Supportive Connective Tissue

                                                    • 1st Layer: Endopelvic Fascia

                                                      • 2nd Layer: Pelvic Diaphragm

                                                        • 3rd Layer: Urogenital Diaphragm

                                                          • 4th Layer: Perineum

                                                            Clinical Implications

                                                            • Pelvic Floor Muscle and Endopelvic Fascial Interaction

                                                              Selected References

                                                              1. El Sayed RF: Magnetic resonance imaging of the female pelvic floor: anatomy overview, indications, and imaging protocols. Radiol Clin North Am. 58(2):291-303, 2020
                                                              2. Eickmeyer SM: Anatomy and physiology of the pelvic floor. Phys Med Rehabil Clin N Am. 28(3):455-60, 2017
                                                              3. Khatri G et al: MR imaging of the pelvic floor. Magn Reson Imaging Clin N Am. 25(3):457-80, 2017