Flashcards in Pelvic Floor Deck (18):
What are the functions of the pelvic floor ?
-support pelvic organs (vagina,uterus,ovaries,bladder,rectum)
-maintain/resist intra-abdominal pressure during coughing ,sneezing...
-facilitate defaecation and micturition
How are the pelvic organs suspended (vertical support ) ?
Cardinal ligaments, uterosacral ligaments , round ligament , broad ligaments
How is the vagina supported in the pelvic cavity and what mechanism prevent prolapse of vaginalis and uterus when increased intra abdominal pressure ?
Supported by endopelvic fascia,perineal body, levator ani muscles and perineal muscles
Directed horizontally in standing position , uterus is anteverted and flexed so increased abdo pressure cause compression of uterus agains vagina
What is the main attachement of the endopelvic fascia ?
Arcus tendinosus fascia pelvis aka white line , obturator internus
To vaginal wall , urethra medially
Why does weakness to endopelvic fascia can lead to stress urinary incontinence ?
Urethra lies anteriorly and above endopelvic fascia, in raised abdo pressure gets compressed against it
What makes the pelvic floor ?
Pelvic diaphragm : levator ani , coccygeus
Urogenital diaphragm : perineal membrane
Perineal muscles : bulbospongiosus , superficial transverse perineal , external anal sphincter
What are the components or the levator ani muscles ?and describe insertion
U shaped sheet from back of body of pubic bone , white line, obturator internus , ischial spines
Encircle urethra vagina,rectum
Insert on perineal body , coccyx
Which layer lies just superficial to pelvic diaphragm ? What are the attachements?
Urogenital diaphragm , aka perineal membrane
From ischiopubic Ramus to urethra,vagina,perineal body
What is the perineal body , what is its function ?
Fibrous ulnar mass at junction of urogenital and anal triangles
Point of insertion for pelvic diaphragm muscles and perineal muscles
Function : resist tears between vagina and external anal sphincter , support of perineal structures , against prolapse
Name the perineal muscles
-superficial transverse perineal
-external anal sphincter
Which muscles are involved in an episiotomy ?
Superficial transverse perineal
What is the blood supply to the pelvic floor ?
Internal and external pudendal arteries
What is the innervation and lymphatic drainage of pelvic nerve ?
What pelvic dysfunction can occur ?
Pelvic organ prolapse
Posterior compartment pelvic floor dysfunction
What is pelvic organ prolapse ?
What are the consequences ?
Loss of support of pelvic organs , uterus,bladder,colon,or rectum , leading to prolapse of one or more of these organs into vagina
Impact on quality of life: anorectal, urinary,anorectal functional disturbances
What are the different types of POP ?
Anterior compartment prolapse : cystocele, urethrocele, cystourethrocele
Middle compartment : uterine prolapse , post hysterectomy vault prolapse
Posterior compartment : rectocele, enterocele (loops of bowel in pouch of Douglas)
What are the risk factors of pop ?
Post menopausal oestrogen deficiency
Obesity (increased intra abdominal deficiency )
Marfans, ehlers danlos