Description

Description:
The diaphragmatic part of the pelvic fascia covers both surfaces of the Levatores ani. The inferior layer is known as the anal fascia; it is attached above to the obturator fascia along the line of origin of the Levator ani, while below it is continuous with the superior fascia of the urogenital diaphragm, and with the fascia on the Sphincter ani internus. The layer covering the upper surface of the pelvic diaphragm follows, above, the line of origin of the Levator ani and is therefore somewhat variable. In front it is attached to the back of the symphysis pubis about 2 cm. above its lower border. It can then be traced laterally across the back of the superior ramus of the pubis for a distance of about 1.25 cm., when it reaches the obturator fascia. It is attached to this fascia along a line which pursues a somewhat irregular course to the spine of the ischium. The irregularity of this line is due to the fact that the origin of the Levator ani, which in lower forms is from the pelvic brim, is in man lower down, on the obturator fascia. Tendinous fibers of origin of the muscle are therefore often found extending up toward, and in some cases reaching, the pelvic brim, and on these the fascia is carried.
It will be evident that the fascia covering that part of the Obturator internus which lies above the origin of the Levator ani is a composite fascia and includes the following: (a) the obturator fascia; (b) the fascia of the Levator ani; (c) degenerated fibers of origin of the Levator ani.
The lower margin of the fascia covering the upper surface of the pelvic diaphragm is attached along the line of insertion of the Levator ani.
At the level of a line extending from the lower part of the symphysis pubis to the spine of the ischium is a thickened whitish band in this upper layer of the diaphragmatic part of the pelvic fascia. It is termed the tendinous arch or white line of the pelvic fascia, and marks the line of attachment of the special fascia (pars endopelvina fasciae pelvis) which is associated with the pelvic viscera.


Éponyme

Denonvillier'

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