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The levator ani muscle and the nerve supply of its puborectalis component
Author(s) -
Roberts W. H.,
Harrison C. W.,
Mitchell D. A.,
Fischer H. F.
Publication year - 1988
Publication title -
clinical anatomy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.667
H-Index - 71
eISSN - 1098-2353
pISSN - 0897-3806
DOI - 10.1002/ca.980010404
Subject(s) - levator ani , medicine , anatomy , sling (weapon) , cadaver , pelvic floor , surgery
Abstract This study of 50 embalmed and 4 unembalmed cadavers was undertaken to try to better understand the rationale for the varied descriptions of the levator ani muscle and its components. Our findings are in harmony with those which have determined M. puborectalis to be the caudal component of the levator ani and to have superior and inferior laminae. The inferior lamina contributes significantly to the mass of the puborectalis, forming the major part of its so‐called sling component that angulates the anorectal junction. The more superficial of the anterior fibers of both the M. pubococcygeus and M. puborectalis insert prerectally and contribute to what is called M. levator prostatae (pubovaginalis). Their fused borders bound the levator (urogenital) hiatus. The deeper fibers insert into the posterolateral wall of the vagina in the female. Both M. pubococcygeus and M. puborectalis also insert between the Ms. sphincter ani externus and internus, and both contribute to the postanal levator plate. The nerve supply of M. puborectalis is from the nerve to the levator ani (S 3,4) on its superior aspect, but it frequently receives an auxiliary supply from the inferior rectal and perineal branches of the pudendal nerve on its inferior aspect. The surgical significance of M. levator ani is commented on.