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Overview 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)

Approaches for Functional Description of Pelvic Floor

  • Classic 3-Compartment Approach

    • Active and Passive Conceptual Approach

      • Multilayered System Approach

        • Functional 3-Part Pelvic Supporting Systems Approach

          Bony Pelvis

          • Osseous Structures

            • Functional Correlation of Bony Pelvis

              Pelvic Wall

              • Anterior

                • Posterior

                  • Lateral

                    Pelvic Diaphragm

                    • Definition

                      Coccygeus Muscle

                      • Anatomy and Function

                        Levator Ani Muscle

                        • Components

                          • Innervation

                            • Functional Correlation

                              MR Anatomy of Puborectalis Muscle

                              • Topographic MR Anatomy

                                • Parameters Measured

                                  • Movement of Puborectalis Muscle

                                    • Functional Correlation of Puborectalis Muscle

                                      MR Anatomy of Iliococcygeus Muscle

                                      • Topographic MR Anatomy

                                        • Parameters Measured

                                          • Movement of Iliococcygeus Muscle

                                            • Functional Correlation of Iliococcygeus Muscle

                                              MR Anatomy of Levator Plate

                                              • Topographic MR Anatomy

                                                • Parameters Measured

                                                  • Movement of Levator Plate

                                                    Supportive Connective Tissue

                                                    • Anatomy and Functional Correlation

                                                      • Endopelvic Fascia

                                                        • Ligaments

                                                          • Levels of Vaginal Support

                                                            Pelvic Floor Muscle and Endopelvic Fascial Interaction

                                                            • Normal

                                                              • Abnormal

                                                                Urogenital Diaphragm (Perineal Membrane)

                                                                • Location and Description

                                                                  Perineum

                                                                  • Location and Description

                                                                    • Divisions

                                                                      • Urogenital Triangle

                                                                        • Anal Triangle

                                                                          Superficial External Genital Muscles

                                                                          • Location

                                                                            • Muscles

                                                                              • Functional Correlation

                                                                                Selected References

                                                                                1. Farouk El Sayed R: The urogynecological side of pelvic floor MRI: the clinician's needs and the radiologist's role. Abdom Imaging. 38(5):912-29, 2013
                                                                                2. Petros P et al: Reconstructive Pelvic Floor Surgery According to the Integral Theory. In Petros P et al: The Female Pelvic Floor: Function, Dysfunction and Management According to the Integral Theory. 2nd ed. Berlin: Springer, 2007
                                                                                3. Delancey J et al: Functional Anatomy of the Pelvic Floor. In Bartram C et al: Imaging Pelvic Floor Disorders. 1st ed. Berlin: Springer, 2003
                                                                                4. Fielding JR: Practical MR imaging of female pelvic floor weakness. Radiographics. 22(2):295-304, 2002
                                                                                5. Singh K et al: Magnetic resonance imaging of normal levator ani anatomy and function. Obstet Gynecol. 99(3):433-8, 2002
                                                                                6. Bø K et al: Dynamic MRI of the pelvic floor muscles in an upright sitting position. Neurourol Urodyn. 20(2):167-74, 2001
                                                                                7. Shafik A: Levator ani muscle: new physioanatomical aspects and role in the micturition mechanism. World J Urol. 17(5):266-73, 1999
                                                                                8. Tunn R et al: Static magnetic resonance imaging of the pelvic floor muscle morphology in women with stress urinary incontinence and pelvic prolapse. Neurourol Urodyn. 17(6):579-89, 1998
                                                                                9. Fröhlich B et al: Tomographical anatomy of the pelvis, pelvic floor, and related structures. Clin Anat. 10(4):223-30, 1997
                                                                                10. Strohbehn K et al: Magnetic resonance imaging of the levator ani with anatomic correlation. Obstet Gynecol. 87(2):277-85, 1996
                                                                                11. Klutke CG et al: Functional female pelvic anatomy. Urol Clin North Am. 22(3):487-98, 1995
                                                                                12. Goodrich MA et al: Magnetic resonance imaging of pelvic floor relaxation: dynamic analysis and evaluation of patients before and after surgical repair. Obstet Gynecol. 82(6):883-91, 1993
                                                                                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)

                                                                                Approaches for Functional Description of Pelvic Floor

                                                                                • Classic 3-Compartment Approach

                                                                                  • Active and Passive Conceptual Approach

                                                                                    • Multilayered System Approach

                                                                                      • Functional 3-Part Pelvic Supporting Systems Approach

                                                                                        Bony Pelvis

                                                                                        • Osseous Structures

                                                                                          • Functional Correlation of Bony Pelvis

                                                                                            Pelvic Wall

                                                                                            • Anterior

                                                                                              • Posterior

                                                                                                • Lateral

                                                                                                  Pelvic Diaphragm

                                                                                                  • Definition

                                                                                                    Coccygeus Muscle

                                                                                                    • Anatomy and Function

                                                                                                      Levator Ani Muscle

                                                                                                      • Components

                                                                                                        • Innervation

                                                                                                          • Functional Correlation

                                                                                                            MR Anatomy of Puborectalis Muscle

                                                                                                            • Topographic MR Anatomy

                                                                                                              • Parameters Measured

                                                                                                                • Movement of Puborectalis Muscle

                                                                                                                  • Functional Correlation of Puborectalis Muscle

                                                                                                                    MR Anatomy of Iliococcygeus Muscle

                                                                                                                    • Topographic MR Anatomy

                                                                                                                      • Parameters Measured

                                                                                                                        • Movement of Iliococcygeus Muscle

                                                                                                                          • Functional Correlation of Iliococcygeus Muscle

                                                                                                                            MR Anatomy of Levator Plate

                                                                                                                            • Topographic MR Anatomy

                                                                                                                              • Parameters Measured

                                                                                                                                • Movement of Levator Plate

                                                                                                                                  Supportive Connective Tissue

                                                                                                                                  • Anatomy and Functional Correlation

                                                                                                                                    • Endopelvic Fascia

                                                                                                                                      • Ligaments

                                                                                                                                        • Levels of Vaginal Support

                                                                                                                                          Pelvic Floor Muscle and Endopelvic Fascial Interaction

                                                                                                                                          • Normal

                                                                                                                                            • Abnormal

                                                                                                                                              Urogenital Diaphragm (Perineal Membrane)

                                                                                                                                              • Location and Description

                                                                                                                                                Perineum

                                                                                                                                                • Location and Description

                                                                                                                                                  • Divisions

                                                                                                                                                    • Urogenital Triangle

                                                                                                                                                      • Anal Triangle

                                                                                                                                                        Superficial External Genital Muscles

                                                                                                                                                        • Location

                                                                                                                                                          • Muscles

                                                                                                                                                            • Functional Correlation

                                                                                                                                                              Selected References

                                                                                                                                                              1. Farouk El Sayed R: The urogynecological side of pelvic floor MRI: the clinician's needs and the radiologist's role. Abdom Imaging. 38(5):912-29, 2013
                                                                                                                                                              2. Petros P et al: Reconstructive Pelvic Floor Surgery According to the Integral Theory. In Petros P et al: The Female Pelvic Floor: Function, Dysfunction and Management According to the Integral Theory. 2nd ed. Berlin: Springer, 2007
                                                                                                                                                              3. Delancey J et al: Functional Anatomy of the Pelvic Floor. In Bartram C et al: Imaging Pelvic Floor Disorders. 1st ed. Berlin: Springer, 2003
                                                                                                                                                              4. Fielding JR: Practical MR imaging of female pelvic floor weakness. Radiographics. 22(2):295-304, 2002
                                                                                                                                                              5. Singh K et al: Magnetic resonance imaging of normal levator ani anatomy and function. Obstet Gynecol. 99(3):433-8, 2002
                                                                                                                                                              6. Bø K et al: Dynamic MRI of the pelvic floor muscles in an upright sitting position. Neurourol Urodyn. 20(2):167-74, 2001
                                                                                                                                                              7. Shafik A: Levator ani muscle: new physioanatomical aspects and role in the micturition mechanism. World J Urol. 17(5):266-73, 1999
                                                                                                                                                              8. Tunn R et al: Static magnetic resonance imaging of the pelvic floor muscle morphology in women with stress urinary incontinence and pelvic prolapse. Neurourol Urodyn. 17(6):579-89, 1998
                                                                                                                                                              9. Fröhlich B et al: Tomographical anatomy of the pelvis, pelvic floor, and related structures. Clin Anat. 10(4):223-30, 1997
                                                                                                                                                              10. Strohbehn K et al: Magnetic resonance imaging of the levator ani with anatomic correlation. Obstet Gynecol. 87(2):277-85, 1996
                                                                                                                                                              11. Klutke CG et al: Functional female pelvic anatomy. Urol Clin North Am. 22(3):487-98, 1995
                                                                                                                                                              12. Goodrich MA et al: Magnetic resonance imaging of pelvic floor relaxation: dynamic analysis and evaluation of patients before and after surgical repair. Obstet Gynecol. 82(6):883-91, 1993