. A manual of gynæcology and pelvic surgery, for students and practitioners. 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
. A manual of gynæcology and pelvic surgery, for students and practitioners. 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. Fig. 5.—Pelvic diaphragm seen from above after removal of rectum andseparation of pubic bones. (After Morris.) uniting with the external sphincter ani and central tendon ofthe perineum. The few fibers which join the central tendonof the perineum correspond to the slip which surrounds theprostate of the male. The anterior borders of the pubo-coccygei leave a narrowtriangular interval between them, with its apex anal canal lies at the apex of this space just anterior to 14 ANATOMY the junction of the two muscles, while the vagina and urethrapass through the wider anterior portion of the interval. Thepubo-coccygei therefore lie lateral and posterior to the vaginanear its outlet and are subject to over-distension and lacerationduring labor. When the pubo-coccygei contract, the upperends remain so fixed by their attachments that the shorteningof the muscles diminishes the concavity of the shng whichthey form by their junction behind the anus. This actionraises the diaphra
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Keywords: ., bookcentury1900, bookdecade1910, bookidman, booksubjectgynecology
