this lecture was presented to the December 2016 Midwifery class of the school for Enrolled Nurses and Midwives- The Gambia.

1. PELVIC FLOOR MUSCLES
& THE PERINEAL BODY
MR. ABDOU PANNEH
(RM, FWACN, DHAF,NT, RN)

2. ORDER OF PRESENTATION
• DESCRIPTION
• FUNCTIONS
• MUSCLE LAYER
• SUPERFICIAL LAYER
• DEEP LAYER
• NERVE SUPPLY
• THE PERINEAL BODY

3. PELVIC FLOOR MUSCLES
• The pelvic floor is form by the soft tissue that
fills the outlet of the pelvis. The most important
of these is the strong diaphragm of muscle slung
like a hammock from the walls of the pelvis.
Through it pass the urethra, the vagina and the
anal canal

4. FUNCTIONS
• It supports the weight of the abdominal and
pelvic organ.
• It forms sphincters that control the passage of
urine and faeces.
• It provides the outlet to the reproductive tract,
the vagina and introitus.
• During child birth, it influences the passive
movements of the fetus through the birth canal
• It relaxes to allow the exit of fetus from the
pelvis

5. MUSCLE LAYERS
• Superficial layer
• Deep layer

6. SUPERFICIAL LAYERS
• The external anal sphincter encircles the anus and is
attached behind by few fibers to the coccyx.
• The transverse perineal muscles passes from the ischial
tuberosity to the center of the perineum
• The bulbocavernosus muscles passes from the perineum
forwards around the vagina to the corpora cavernosa of the
clitoris just under the pubic arch.
• Ischiocavernosus muscles pass from the ischial tuberosity
along the pubic arch to the corporacavernosa.
• The membranous sphincter of the urethra is compose of
muscle fibers passing above and below the urethra and
attach to the pubic bone. It is not a true sphincter since it is
not circular, but it acts to close the urethra.

7. SUPERFICIAL LAYER MUSCLES

8. DEEP LAYERS
• Pubococcygeus muscle passes from the pubis to
the coccyx, with a few fibers crossing over in the
perineal body to form its deepest part.
• Iliococcygeus muscle passes from the fascia
covering the obturator internus muscle to the
coccyx.
• Ischiococcygeus muscle passes from the ischial
spines to the coccyx, infront of the sacrospinous.

9. DEEP MUSCLE LAYER

10. NERVE SUPPLY
• Pudendal nerve
• Sacral nerve roots S3-S5

11. THE PERINEAL BODY
• This is a pyramid of muscle and fibrous tissue
situated between the vagina and the rectum. It is
made up of fibers from the muscles described
above. The apex, which is the deepest part is
formed from the fibers of the pubococcygeus
muscle which cross over at this point; the base is
formed from the transverse perineal muscles,
which meet in the perineum, together with the
bulbocavernosus in front and the external anal
sphincter behind. The perineal body measures
4cm in each direction.

12. THE RELAXATION OF PELVIC FLOOR
MUSCLES CAN LEAD TO STRESS
INCONTINENCE AND PROLAPSE OF
THE UTERUS, BLADDER AND BOWEL
AFTER CHILDBIRTH.

13. ASSIGNMENT????
Describe different exercises needed
to keep the pelvic floor muscles
strong during and after pregnancy.
NB: To be done individually & submitted
on Monday 6th March, 2017.

14. CONTRIBUTION
S,
CLARIFICATION
S &
CONSTRUCTIVE
CRITICISMS???