What is the function of the pelvic floor?
- Closes the abdominal cavity
- Supports pelvic organs
- Contributes to continence
- Contributes to childbirth
Name the muscles which form the pelvic diaphragm:
Coccygeus Levator ani: - Puborectalis - Pubococcygeus - Iliococcygeus
The anterior perineum is described as a ‘triangular sandwich’. Which structures form this sandwich?
- Fascia
- Sphincter urethrae
- Perineal membrane
If the urethra ruptures beneath the perineal membrane, where will urine collect?
Superficial perineal pouch
What is the arterial supply to the pelvic floor?
- Pudendal A’s
- Vaginal A’s
- Inferior Rectal A’s
Which nerves innervate the pelvic floor?
Pudendal nerves
S2, 3, 4, keep your guts off the floor
How does the pelvic floor help maintain rectal continence?
Sphincter mechanism of puborectalis maintains angle ~ 80’ between rectum and anus
Describe the location of the perineal body:
- @ midpoint of line joining ischial tuberosities
@ junction of anterior and posterior perineum
Which structures attach to the perineal body?
- Anal sphincters
- Bulbospongiosus
- Superficial transverse perineal muscles
- Levator ani
List some risk factors for pelvic floor dysfunction (ie incontinence/prolapse):
- Age
- Childbirth
- Menopause
- Obesity
- Chronic cough
- Intrinsic connective tissue laxity
- Malnutrition
- Previous pelvic surgery
- Increased intra-abdominal pressure
- Chronic constipation
Why are people with Ehlers-Danlos syndrome at increased risk of pelvic organ prolapse?
Intrinsic connective tissue laxity due to defects in collagen formation
How can a midline tear (and potential damage to anal sphincter) be avoided during childbirth?
Episiotomy
= Mediolateral cut 45-60’ to R side of vagina
Name a safe, easy, non-invasive treatment for pelvic floor dysfunction:
Pelvic floor exercises - ‘kegel exercises’
What are some side effects of continence/prolapse surgery?
- Recurrence
- Voiding difficulty
- New incontinence
- Dyspareunia
