. The diagnosis and treatment of diseases of women. of the perineum with the muscle of the opposite sideand with the sphincter vaginae and with the sphincter ani muscles. When theperineum is torn, the action of all these muscles, particularly of the transversemuscles, is to draw the torn surfaces outward and keep them apart. 31 468 LACERATIONS AND PTSTUL^ When all the superficial tissues, including the clitoris and the crura, are clearedaway, then there is exposed the real pelvic floor—the supporting structures are, the levator ani muscles, one on each side (Fig. 489) called a
. The diagnosis and treatment of diseases of women. of the perineum with the muscle of the opposite sideand with the sphincter vaginae and with the sphincter ani muscles. When theperineum is torn, the action of all these muscles, particularly of the transversemuscles, is to draw the torn surfaces outward and keep them apart. 31 468 LACERATIONS AND PTSTUL^ When all the superficial tissues, including the clitoris and the crura, are clearedaway, then there is exposed the real pelvic floor—the supporting structures are, the levator ani muscles, one on each side (Fig. 489) called alsothe levator ani et vaginae, and the fascia above and below them (Figs. 490, 491).The fascia under the muscle is thin and is called the levator fascia, while thestrong fascia above the muscle is called the recto-vesical (Fig. 490). Thelevator ani muscles, arising from each side of the pelvis and joining in the medianline, form a sling which holds up the vagina and rectum and at the same time holdstheir lower ends forward under the pubic Fig. 4S7. A diagrammatic representation of an antero-posterior section of tlie pelvis,showing the various Fascial Layers of the Pelvic floor. (Dickinson—American Text-book of Obstetrics.) Each levator ani muscle arises in front from the posterior surface of the pubicbone, behind from the spine of the ischium and between these points from thewhite line (Fig. 87) that marks the division of the pelvic fascia. The anteriorportion of the muscle passes downward and toward the median line and uniteswith a corresponding portion of the muscle of the opposite side. Some of thefibers unite with the lower part of the vagina, some with the lower part of the POINTS IN ANATOMY 469 rectum, some between the vagina and rectum and many of them back of the rec-tum. The most posterior fibers of the muscle unite with the coccyx. Lying back Suspensory ligament of clitorisGlans clitoridisPosterior superficial perineal nFuscia pudendal n Sphinct
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