L13 - REPRODUCTIVE SYSTEM

The Pelvic Floor and Sex-Specific Viscera:

The Pelvic Girdle: contains the hip bones, sacrum inside the pelvic brim “inlet” (the hole inside), at the end of the sacrum is the coccyx at the end piece, and pubic symphysis is the little connected joint. There is pelvic outlet the on top hole.

False pelvis above inlet and true pelvis above outlet but below inlet

The Pelvis - Sex Specific Features:

Assigned female at birth pelvis —> subpubic angle of 90-100 degree

• wide and shallow

• wide oval inlet

• round outlet

assigned male at birth pelvis —> subpubic angle of 70 degree

• narrow and deep

• heart shaped inlet

• narrow oblong outlet

The Levator Ani (the pelvic floor):

contains the piriformis (leaves pelvis to gluteal region), coccygeus and then levator ani which is inwards, the rectal hiatus is middle of levator ani and below is the urogential hiatus, outlining the rectal hiatus and levator ani is tendinous arch of obturator internus, and outside of the tendinous arch is obturator internus (covered in fascia, leaves pelvis to gluteal region)

Levator ani —> Iliococcygeus, pubococcygeus, puborectalis (from outward to inward)

• functions:

  • support of abdominopelvic viscera

  • urinary and fecal contience

  • resistance increase intrapelvic/abdominal pressure

The rectum and puborectalis: tonic contraction of puborectalis contributes to fecal contience

• rectum should be 90 degree

• “we are designed to squat”, sitting posutre the puborectalis muscle chokes and squatting the muscle is relax

The rectum and anal canal:

the anorectal junction is in between the rectum and anal canal - 3 to 5 cm lengthwise

rectal folds: superior transverse, middle transverse, inferior transverse,

there is anal valves at the end towards the anus