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Y2 - Repro > Lecture 19 - The Pelvic Floor > Flashcards

Lecture 19 - The Pelvic Floor Flashcards

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1
Q

What are the functions of the pelvic floor?

A

Support the pelvic organs
Maintain Intra-abdominal pressure during coughing, vomiting, sneezing and micturition

CONTINENCE
FACILITATE CHILDBRITH
Facilitate defaecation adn micturtiion

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2
Q

What are the main pelvic organs the pelvic flor supports?

A

Vagina
Uterus
Ovaries
Bladder
Rectum

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3
Q

What are some structures that go through the pelvic floor?

A

Urethra
Vagina
Anus

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4
Q

What are the 3 mechanisms of support for the pelvic floor?

A

Suspension
Attachment
Fusion

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5
Q

What are the 3 ligaments important in suspension in the pelvic floor?

A

Cardinal ligament
Uterosacral ligaments
Round ligament

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6
Q

What does the cardinal ligament do?

A

Transverse ligament between the cervix and vagina holding them in place

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7
Q

What does the uterosacral ligament do?

A

Holds the back of the cervix and upper vagina laterally

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8
Q

What does the round ligament do?

A

Maintains the anteverted postiion of the uterus

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9
Q

What provides the attachment in the pelvic floor?

A

Arcus tendinosus fascia pelvis (THE WHITE LINE)

Endopelvic fascia

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10
Q

How does the endopelvic fascia run?

A

From lateral to medial.

Stretches like a hammock from the white line laterally to the vaginal wall medially

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11
Q

What fascia compresses the urethra when intraabdominal pressure increases to help matintain urinary continence?

A

Endopelivc fasica

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12
Q

What structures are fused in the pelvic floor?

A

Urogenital diaphragm and perineal body

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13
Q

What structures are fused to support the lower half of the vagina?

A

Endopelvic fascia to perineal body posteriorly, levator ani laterally and urethra anterioly

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14
Q

What structures make up the pelvic floor?

A

Levator ani muscles
Urogential diaphragm/perinal membrane
Perineal body
Perineal muscles
Posterior compartment

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15
Q

Look at the last slide:
Image 1

What are the muscles labelled 1:

A

Levator ani muscles

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16
Q

What are the 3 levator ani muscles?

A

Puborectalis
Pubococcygeus
Iliococcygeus

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17
Q

What is the origin and insertion of puborectalis?

A

Pubic symphysis to rectum

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18
Q

What is the origin and insertion of pubococcygeus?

A

Pubis to coccyx

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19
Q

What is the origin and insertion of iliococcygeus?

A

Ilium to coccyx

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20
Q

Look at the last slide at image 2

Label:

A

1 = sacrum
2 = ilium
3 = iliococcygeus
4 = pubococcygeus
5 = Puborectalis \

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21
Q

Look at slide 18 and label:

A

1 = piriformis
2 = Puborectalis
3 = pubococcygeus
4 = iliococcygeus

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22
Q

What is the next more superficial layer to the levator ani muscles?

A

Perineal muscles

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23
Q

What are the 2 most important perineal muscles?

Study These Flashcards
A

Transverse perineal muscles
Bulbospongiosus

24
Q

What is an episiotomy?

Study These Flashcards
A

Cutting the perinum to aid birth to help ensure tearing of the perineum doesn’t occur

25
Go to slide 23: Label the perineal muscles:
1 = transverse perineal muscles 2 = bulbospongiosus
26
What is the next more superficial layer to the perineal muscles?
Urogenital diaphragm
27
What is the urogenital diaphragm?
A triangular sheet of dense fibrous tissue in the anterior half of the pelvis
28
What is the function of the urogenital diaphragm?
Supports the pelvic floor Atttatches medially to the urethra, vagina and perineal body
29
What makes up the perineal body?
Insertion point of levator ani muscles
30
Where is the perineal body located and what does it attach to?
Central position on pelvic floor between the vagina and rectum Attathces posteriorly to the external anal sphincter and coccyx
31
Go to the last slide and label image 3:
1 = clitoris 2 = bulbospongiosus 3 = perineal body 4 = levator ani muscles
32
What is the blood supply and nerve supply to the pelvic floor?
Pudendal arteries and veins Pudendal nerve
33
What nodes drain the lymphatics from the pelvic floor?
Inguinal lymph nodes
34
What are the spinal nerve roots of the pudendal nerve?
S2, S3, S4
35
What are the layers of the pelvic floor from deep to more superficial?
Levator ani Perineal muscles Urogential diaphragm Perineal body
36
What is pelvic organ prolapse?
When there’s a loss of support to the uterus, bladder, colon or rectum leading to prolapse into the vagina
37
What can a pelvic organ prolapse cause?
Functioanl disturbances to: -anorectal -urinary -sexual
38
What is an anterior compartment/bladder related pelvic organ prolapse called?
Cystocele Urethrocoele (urethra) Cystourethocoele
39
What structure is not supported in a middle compartment pelvic organ prolapse?
Uterus
40
What is the term for an entire uterus prolapse?
Procidentia
41
What structure prolapses in a posterior compartment pelvic organ prolapse?
Rectum
42
What can the rectum prolapse into in a posterior compartment pelvic Organ prolapse?
Rectovaginal space (Pouch of Douglas)
43
What are the causes and risk factors for pelvic organ prolapse?
Post menopausal oestrogen deficieny Child birth Perineal Trauma Obesity Connective tissue disease
44
Why does obesity increase risk of pelvic organ prolapse?
Increased Intra-abdominal pressure
45
What are some connective tissue disorders increasing risk of pelvic organ prolapse?
Marfan’s Ehlers Danlos syndrome
46
How can we try and reduce the risk of pelvic organ prolapse due to child birth?
Episiotomy Encouraging mother to not push when head not crowning
47
What structures are cut thorough in an episiotomy?
Bulbocavernous muscle Transverse perineal muscle
48
What are the symptoms of prolapse?
Dragging sensation Lump Feeling of incomplete emptying of bladder Double voiding
49
What causes stress incontinence? What causes urge incontinence?
Stress = pelvic floor dysfunction Urge = bladder dysfunction
50
What is femal genital mutilation? (FGM)
Partial or total removal of external female genitalia or other injury to femal genital organs
51
Why may FGM be carried out?
Culture Social acceptance Fear of social exclusion
52
Go to slide 54 and label the vulva:
1 = labia minora 2 = labia majora
53
What are some consequences of FGM?
Haemorrhage Sepsis Blood borne infections Sexual difficulties Fertility issues Chronic Fear of childbirth PPH PTSD
54
What is the legality of FGM?
Illegal to perform Illegal to close back up after episiotomy
55
Why is the pelvic floor importnat?
Support Continence Aiding micturition Defaecation Childbirth
56
What is the main central structure of the pelvic floor?
Perineal body

Y2 - Repro (19 decks)

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