The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below.

The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during parturition. Some fibers are inserted into the prostate, urethra, and vagina. The right and left puborectalis unite behind the anorectal junction to form a muscular sling . Some regard them as a part of the sphincter ani externus. The iliococcygeus, the most posterior part of the levator ani, is often poorly developed.

The coccygeus, situated behind the levator ani and frequently tendinous as much as muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.

The pelvic cavity of the true pelvis has the pelvic floor as its inferior border (and the pelvic brim as its superior border.) The perineum has the pelvic floor as its superior border.

Some sources do not consider “pelvic floor” and “pelvic diaphragm” to be identical, with the “diaphragm” consisting of only the levator ani and coccygeus, while the “floor” also includes the perineal membrane and deep perineal pouch. However, other sources include the fascia as part of the diaphragm. In practice, the two terms are often used interchangeably.

Inferiorly, the pelvic floor extends into the anal triangle.

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-A finding of ASC on cytology requires further investigation to exclude precancerous lesions. Recommendations differ for women age 21 -24 and those age ;::25. For women age 21 -24 with ASCUS or low-grade squamous intraepitheliallesion (LSIL), current guidelines recommend repeating Pap smear in one year. In this younger patient population, HPV infection is transient and malignant transformation is rare. Therefore, colposcopy is not performed unless the patient demonstrates ASC-US or LSIL on 3

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A testicular examination is mainly performed on male patients who present with testicular pathology e.g. pain, swelling, a lump. Although titled testicular examination it involves the examination of the penis, scrotum and testes. As this is an intimate examination it is pertinent to gain a good rapport with your patient, maintain good communication and ensure the patient’s dignity at all times. Remember to offer a chaperone for this skill. For the purposes of your exam, you will most likely be examining a mannequin.

Paget's disease of bone disrupts your body's normal bone recycling process, in which old bone tissue is gradually replaced with new bone tissue. Over time, the affected bones may become fragile and misshapen. Paget's disease of bone most commonly occurs in the pelvis, skull, spine and legs.

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CORRECTION: After review of this video, it is clear that this video is of a baby who is near full term (40 weeks) based on the size. Late trimester "abortions" are defined only to viability of a baby (24 weeks) A 24 week baby is much smaller than this baby shown and by definition this is not a late "abortion" procedure. The proper labeling of this video should be management of a deceased breech baby with "head entrapment" as this was almost certainly a naturally occuring delivery and an OB nightmare (Reviewed by Dr. Frederick Bright)

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