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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
-facilitate childbirth


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 ?

Endopelvic fascia
Pelvic diaphragm : levator ani , coccygeus
Urogenital diaphragm : perineal membrane
Perineal body
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 ?

Pudendal nerve
Inguinal nodes


What pelvic dysfunction can occur ?

Pelvic organ prolapse
Urinary incontinence
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 ?

Vaginal delivery
Post menopausal oestrogen deficiency
Obesity (increased intra abdominal deficiency )
Marfans, ehlers danlos


What is an episiotomy ? Why ?

Surgical cut in the perineum to avoid uncontrolled tear that can damage the perineal body