Instructions for making the model of pelvic floor muscles Note this model has been developed to match

a small model pelvis. The model pelvis is one of a set of educational tools provided free of charge online at the Hesperian Foundation web site. This is the URL for that website http://www.hesperian.org/publications_download.php. You will find the pattern and instructions for the model pelvis in Chapter 25 (Page 454) of the free online book for midwives from the Hesperian website. Levator ani: On page one identify the Ischiococcygeus muscle Illiocoyggeus muscles right and left Pubococcygeus muscle

. Together these muscles make up the deep muscle layer known as the Levator ani The Ischiococcygeus originates at the ischial spine passing downwards and back to insert into the coccyx and lower sacrum The Illiococcygeus muscles arise in the white line of the pelvic fascia and insert into the anococcygeal body and coccyx The Pubococcygeus muscles are the larges and most important component of the Levator ani. These are the musles that support the urethra vagina and rectum. They orginate in the anterior part of the obdurator foramen, near the pubis and and support the pelvic organs eventually passing downwards and back to insert into the annococcygeal body and coccyx. Dahlen, H. (2010) Perineal care and repair, In S. Pairman, S, Tracy, C. Thoroughgood & J. Pincombe. Midwifery preparation for practice. (pp 544-561). Sydney, Australia. Elsevier.

Steps, 1. Cut out all pieces noting matching numbers. 2. Mold pieces with your fingers to start to make hammock shape. 3. Align point 1 on pubococcygeus with point one on ischiococcygeus, overlapping along the dotted line. Tape or glue these together. 4. Align point 2 on illiococcygeus with point 2 on ischio coccygeus and join with tape 5. Align point 4 of illiooccygeus with point four of ischiococcygeus and join with tape 6. You will now need to mold these so that points 3 nd 5 will come together and the hammock shape of the muscle will be formed. Note that you may need to overlap the edges here a little to get a good fit.

On page 2 identify Deep transverse perineal muscle Anal Sphincter Bulbocavernosus muscle Ischiocavernosis muscle Superficial transverse perineal muscle

The deep transverse perineal muscle are thin muscles which arise at the ischiopubic rami and converge at the perineal body. The anal Sphincter surrounds the anus. The bulbocavernosus muscles arises in the perineum and surround the urethra and vagina. The ischiocavernosis muscles originate in the ischial tuberosities and terminate at the clitoris. Finally the Superficial transverse perineal muscles pass from the ischial tubersities to the perineal body and join with the bulbocavernosus. Dahlen, H. (2010) Perineal care and repair, In S. Pairman, S, Tracy, C. Thoroughgood & J. Pincombe. Midwifery preparation for practice. (pp 544-561). Sydney, Australia. Elsevier.

Steps 1. Cut out all the pieces and mold them with your fingers to curve them a little and give them some shape and body. 2. Align point 1 on the anal sphincter with point 1 on the deep transverse perineal muscle and tape of glue 3. Align point 2 on the bulbocaverosus muscle with point two on the deep transverse perineal muscle and tape of glue 4. Align point 3 of the ischiocavernosus muscle with point 3 on the deep transverse perineal muscle and tape or glue. 5. Align point 4 on the ischiocavernosus muscle with point 4 on the deep transverse perineal muscle 6. Overlay the superficial perineal muscle with on point 5 (over the top of point 1 and 2) on the deep transverse perineal muscle. 7. Finally align the anal sphincter on the superficial muscle layer with the rectum on the deep muscle layer. Note that the deep layer sits ontop of the superficial layer which cups around it. Notes Note the layering of muscle between the vaginal (within the bulbocavernosus) and the anal sphincter. This is known as the perineal body. These muscles thin out and stretch to allow the infant to be born during childbirth and it is these muscles which can sometimes be traumatised and require repair with surgical sutures. While this is a representation of the pelvic floor muscles you will see from the descriptions of these muscles that it is not a completely accurate illustration which would be impossible to achieve in a paper model without all the other anatomical structures. It is however a guide to the pelvic floor structure.

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