Anatomy of the Perineum
By Elodie Poissenot PT and Virgil Bru PT, OT

Pelvic floor is a super trendy expression with new exercises to do or machine to train them. We use it more and more as we realised how it is important for women to protect and to exercise it correctly. But do you actually know what is it exactly? Do you have an idea how it looks like? No?

So today let's have a look at Pelvis & Pelvic floor Anatomy in order to understand how it works and to then be able to protect and exercise it correctly.

Pelvis bone
It is a complex of bone enclosing visceral organ of the perineum.

#1: Pubis symphysis is a junction (joint) between two bone.  In pregnancy a lot of pressure is appliedon this junction and may lead to inflammation and pain in this area or spread lower through the adductor muscles which insert directly on the pubis symphysis.

#2: Ischions are the bony prominence on which we sat. In pregnancy, this area is often painful due to muscles spasm of the piriform.

#1 : Iliac crest are the bony prominences you can feel on the side of your lower abdomen.

#2 : Vertebrae.

#3: Pubis symphysis.

#1 Vertebrae

#2 Sacrum is a big bone at the end of your spine. It ends with a small bone coccyx.

#3 Coccyx.

Genital Organs

#1 Ovary.

#2 Uterus is held by ligaments attached to the sacrum.

 #3 Bladder rest on the pubis symphysis.

#4 Vagina is a big gap in the middle of the pelvis.

#5 Urethra is a canal to empty the bladder.

#6 Sacrum.

#7 Rectum is terminated by an angle and the anus to allow anal continence.

#8 Pelvic floor muscles.

#9 Vaginal opening.

Pelvic Floor muscles

These muscles form a hammock holding the pelvis organs (bladder, uterus, vagina, rectum…) in place.

#1 Urethral orifice.

#2 Vagina.

#3 Anus.

Here you see what is visible from the outside:

1# Clitoris.

2# Labia minora.

3# Urethral orifice.

4# Labia majora.

5# Vagina.

1# Ischiocavernosus muscle.

2# Superficial transverse perineal muscle helps to close the urethra and allow urine continence.

3# External anal sphincter.

4# Bulbospongiosus muscle inserts around the clitoris. It helps to erect it and to close the vaginal opening.

5# External urethral sphincter as its name say, it close the urethra and allow urine continence.

6# Bulbo coccygeal muscle is an involuntary muscle and also helps to close the vaginal opening. It is always tear during natural birth.

7# Fibrous perineal body.

1&2 Levator ani muscles allow anus contraction and anal continence but also trigger its relaxation allowing defecation.

I hope this rapid review of Pelvis and Pelvic floor muscles anatomy will help you to understand what is going on down there.

Elodie Poissenot (Women’s health Physiotherapist)
Virgil Bru (Physiotherapist & Osteopath)

http://myfrenchphysio.london/