1210 SURGICAL ANATOMY OF THE PERINEUM. 



which covers the perineal aspect of the Levator ani muscle, called the ischio-rectal 

 (anal) fascia. 



The recto-vesical fascia (visceral layer of the pelvic fascia) descends into the 

 pelvis upon the upper surface of the Levator ani muscle, and invests the prostate, 

 bladder, and rectum. From the inner surface of the symphysis pubis a short 

 rounded band is continued to the anterior surface of the prostate and neck of the 

 bladder, forming the pubo-prostatic or anterior true ligaments of the bladder. At 

 the side this fascia is connected to the side of the prostate, enclosing this gland 

 and the vesico-prostatic plexus of veins, and is continued upward on the side of 

 the bladder, forming the lateral true ligaments of the organ. Another prolonga- 

 tion invests the vesiculae seminales, and passes across between the bladder and 

 rectum, being continuous with the same fascia of the opposite side. Another thin 

 prolongation is reflected round the surface of the lower end of the rectum. The 

 Levator ani muscle arises from the point of division of the pelvic fascia, the vis- 

 ceral layer of the fascia descending upon and being intimately adherent to the 

 upper surface of the muscle, while the under surface of the muscle is covered by a 

 thin layer derived from the obturator fascia, called the ischio-rectal or anal fascia. 

 In the female the vagina perforates the recto-vesical fascia, and receives a pro- 

 longation from it. 



