Pelvic Floor Anatomy

Pelvic floor (PF) muscles function to support pelvic floor organs, assist in urinary and fecal continence, aid in sexual performance (orgasm), stabilize connecting joints and act as a venous and lymphatic pump for the pelvis.

Male Pelvic Floor

Male Pelvic Floor

Female Pelvic Floor

Female Pelvic Floor

Male Urogenital System

Male Urogenital System

Female Urogenital System

Female Urogenital System

Coccygeus, Piriformis and Obturator Internus

Coccygeus, Piriformis and Obturator Internus

Bony Pelvis

Bony Pelvis

The pelvic floor consists of three muscle layers:

  1. Superficial perineal layer: innervated by the pudendal nerve
    • Bulbocavernosus
    • Ischiocavernosus
    • Superficial transverse perineal
    • External anal sphincter (EAS)
  2. Deep urogenital diaphragm layer: innervated by pudendal nerve
    • Compressor urethera
    • Uretrovaginal sphincter
    • Deep transverse perineal
  3. Pelvic diaphragm: innervated by sacral nerve roots S3-S5
    • Levator ani: pubococcygeus (pubovaginalis, puborectalis), iliococcygeus
    • Coccygeus/ischiococcygeus
    • Piriformis
    • Obturator internus

Trigger Points in the muscles of the PF may refer pain in the distribution of the pudendal nerve:

  • Bulbocavernosus and Ischiocavernosus refer pain to the perineum and adjoining urogenital structures
  • EAS refers to posterior pelvic floor
  • Levator ani and coccygeus refer to sacrococcygeal area
  • Levator ani to vagina
  • Obturator internus to vagina and anococcygeal area