. A manual of gynæcology and pelvic surgery, for students and practitioners. closes in the lower end of the abdomino-pelvic cavity, its principal component parts being the coccygeusand levator ani muscles with the fascia covering them. The coccygeus is in direct relation with the anterior borderof the pyriformis. It arises from the spine of the ischium,the border of the sacro-sciatic notch, and the sacro-spinousligaments, and spreads out to become attached to the sides ofthe lower sacral and upper coccygeal vertebrae. The distendedrectum is in contact with its visceral surface. The levator ani
. A manual of gynæcology and pelvic surgery, for students and practitioners. closes in the lower end of the abdomino-pelvic cavity, its principal component parts being the coccygeusand levator ani muscles with the fascia covering them. The coccygeus is in direct relation with the anterior borderof the pyriformis. It arises from the spine of the ischium,the border of the sacro-sciatic notch, and the sacro-spinousligaments, and spreads out to become attached to the sides ofthe lower sacral and upper coccygeal vertebrae. The distendedrectum is in contact with its visceral surface. The levator ani forms the greater portion of the muscular 12 ANATOMY pelvic diaphragm and really is composed of two separatemuscles, an anterior, the pubo-coccygeus, and a posterior,the ilio-coccygeus. Each of these arises from the pelvic walland both are covered on their superior or visceral surfaces bythe endo-pelvic fascia. The posterior portion, or ilio-coccygeusmuscle, takes its origin from the tendinous arch of the levatorani muscle (white Hne of the pelvis) which extends from the. Fig. 4.—Pelvic diaphragm seen from below and behind. {AJkr Morris.) posterior surface of the os pubis to the spine of the muscle fibers extend in a thin sheet posteriorly and mediad,the muscles of the right and left sides meeting in the mid-Hnebetween the tip of the coccyx and the anus, the most posteriorfibers being inserted into the coccyx. This bundle of fibersis slight and of less importance than the anterior. The pubo-coccygeus takes its origin from the posterior surface THE PELVIC DIAPHRAGM 13 of the OS pubis and from the anterior portion of the tendinousarch of the levator ani. Its fibers pass inferiorly, posteriorly,and mediad, lateral to the vagina and rectum, joining theirfellows of the opposite side in the median hne posterior tothe anus. A few of the fibers are attached to the rectal wall,and a small slip joins the median raphe anterior to the anus
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Keywords: ., bookcentury1900, bookdecade1910, bookidman, booksubjectgynecology
