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Pelvic Health > H&W Pelvic Function Level 1 > Flashcards

H&W Pelvic Function Level 1 Flashcards

1
Q

Layer 1: Superficial PFM

A
  1. superficial transverse perineal
  2. ischiocavernosus
  3. bulbocavernosus/bulbospongiosus
  4. external anal sphincter
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2
Q

where is the superficial transverse perineal muscle located

A

from ischial tuberosities to perineal body

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3
Q

what layer 1 muscle is the main difference between males and females

A

bulbocavernosus/bulbospongiosus

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4
Q

Layer 2: Intermediate PFM

A
  1. deep transverse perineal
  2. perineal membrane
  3. external urethral sphincter
  4. compressor urethra
  5. sphincter urethrovaginalis
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5
Q

what layer 2 muscles are different in males vs females

A

females have:
1. sphincter urethrovaginalis
2. compressor urethra

males do not

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6
Q

what is embedded in layer 2 PFM

A

perineal membrane - thick fibrous sheet of dense fascia
- external genitalia and structures attach to this

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7
Q

Layer 3: Deep PFM

A
  1. Levator Ani:
    * pubococcygeus
    * iliococcygeus
  2. (ischio)coccygeus
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8
Q

what muscles are associated with the pelvic floor hammock

A

levator ani
- pubococcygeus
- iliococcygeus

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9
Q

why is the coccygeus not considered part of the levator ani group

A

doesn’t elevate the anus

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10
Q

what layer is at the level of the pelvic diaphragm

A

layer 3 (deep PFM)

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11
Q

what are the borders of layer 3

A

Anterior
- pubic bone

Lateral
- ischiopubic ramus
- ilium
- arcus tendineus levator ani (ATLA)

Posterior
- sacrum
- coccyx
- piriformis

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12
Q

what muscles make up the pelvic wall

A
  1. piriformis
  2. obturator internus
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13
Q

perineal pain can be referred from

A

bulbocavernosus
ischiocavernosus

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14
Q

posterior pelvic floor pain can be referred from

A

sphincter ani

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15
Q

anococcygeal pain can be referred from

A

obturator internus

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16
Q

sacrococcygeal pain can be referred from

A

levator ani
coccygeus

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17
Q

anterior thigh pain can be referred from

A

iliopsoas

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18
Q

posterior thigh pain can be referred from

A

obturator internus
piriformis

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19
Q

vaginal pain can be referred from

A

levator ani
obturator internus
ischiocavernosus
bulbocavernosus

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20
Q

penile pain can be referred from

A

bulbocavernosus
ischiocavernosus

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21
Q

scrotal pain can be referred from

A

iliopsoas

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22
Q

pelvic clock: what is 12 o’clock?

A

pubic symphysis inferior angle

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23
Q

pelvic clock: what is 1 o’clock?

A

bulbocavernosus

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24
Q

pelvic clock: what is 2 o’clock?

A

ischiocavernosus

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25
pelvic clock: what is 3 o'clock?
superficial transverse perineal
26
pelvic clock: what is 4 o'clock?
levator ani: pubococcygeus
27
pelvic clock: what is 5 o'clock?
levator ani: iliococcygeus
28
pelvic clock: what is 6 o'clock?
coccyx
29
pelvic clock: what is 7 o'clock?
levator ani: iliococcygeus
30
pelvic clock: what is 8 o'clock?
levator ani: pubococcygeus
31
pelvic clock: what is 9 o'clock?
superficial transverse perineal
32
pelvic clock: what is 10 o'clock?
ischiocavernosus
33
pelvic clock: what is 11 o'clock?
bulbocavernosus
34
stages of POP: what is a stage 0 and what intervention(s) is indicated
absent, none no intervention
35
stages of POP: what is a stage 1 and what intervention(s) is indicated
> 1 cm above hymen pelvic PT
36
stages of POP: what is a stage 2 and what intervention(s) is indicated
1 cm above or beyond the hymen pelvic PT pessary
37
stages of POP: what is a stage 3 and what intervention(s) is indicated
> 1 cm beyond hymen pessary external support surgical consult
38
stages of POP: what is a stage 4 and what intervention(s) is indicated
complete eversion surgical consult external support
39
how is the stage of a POP measured
with pt doing maximum strain effort
40
perineal lacerations: 1st degree
vaginal mucosa skin
41
perineal lacerations: 2nd degree
mucosa skin perineal muscles (layers 1&2)
42
perineal lacerations: 3rd degree
mucosa skin perineal muscles (layers 1&2) perineal body external anal sphincter (EAS)
43
perineal lacerations: 4th degree
mucosa skin perineal muscles (layers 1&2) EAS + anterior rectal wall internal anal sphincter rectal mucosa
44
type of prolapse: cystocele
bladder (anterior wall)
45
type of prolapse: urethrocele
urethra (anterior wall)
46
type of prolapse: urethrocystocele
urethra + bladder (anterior wall)
47
type of prolapse: rectocele
rectum (posterior wall)
48
type of prolapse: enterocele
small intestine (posterior wall)
49
type of prolapse: vaginal vault prolapse
apical vagina after hysterectomy (vagina)
50
type of prolapse: rectal prolapse
rectum
51
type of prolapse: uterine prolapse
uterus
52
what are the 3 most common POP types
cystocele rectocele uterine prolapse
53
s/sx of cystocele, urethrocele, or urethrocystocele
- poor/prolonged urinary stream - feeling incomplete emptying - positioning changes to start/complete emptying - SUI - urinary retention w bladder outlet obstruction - post-void dribble
54
what is a clinical pearl of pt education in cystocele, urethrocele, or urethrocystocele
**double void**: after 1st void, do some PFM/squats/hip circles, then void again to fully empty bladder/urethra
55
s/sx of rectocele
- vaginal pressure/discomfort - protrusion from post vaginal wall - need to reposition during BM, incomplete emptying - difficulty evacuating rectum w splinting
56
what is a clinical pearl of pt education in rectocele
**splinting**: apply pressure to perineum manually OR insert finger in vaginal canal to push on back wall to better empty rectum during BM
57
s/sx of enterocele
- pelvic/vaginal pressure - difficulty evacuating rectum/bladder - low back discomfort worsening as day progresses - inc discomfort w prolonged standing, relieved by lying down
58
what is a clinical pearl in enterocele
consider further medical referral for additional dx testing for sx that persist or not improving in therapy
59
s/sx of uterine prolapse
- blood stained purulent dc - difficulty w bowel/bladder emptying - LBP or discomfort worsening as day progresses - inc discomfort w prolonged standing better in supine
60
what is a clinical pearl of pt education in uterine prolapse
optimal bowel strategies pressure management decreasing gravity/pessary
61
s/sx of vaginal vault prolapse
- pelvic/vaginal pressure - difficulty evacuating rectum/bladder - low back discomfort worsening as day progresses - inc discomfort w prolonged standing, relieved by lying down
62

Pelvic Health (1 decks)

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