Topic 11: The Pelvic Floor

Question 1

Pelvic organs - lower urinary tract

Answer 1

bladder & urethra

Question 2

Pelvic organs - reproductive

Answer 2

Female- uterus, vagina

Male- prostate

Question 3

Pelvic organs - lower GIT (gastrointestinal tract)

Answer 3

Rectum, anal canal

Question 4

Anterior compartment of pelvic organs

Answer 4

Bladder, urethra

Question 5

Middle compartment of pelvic organs

Answer 5

Uterus, vagina/ prostate

Question 6

Posterior compartment of pelvic organs

Answer 6

Rectum, anal canal

Question 7

Pelvic Organs of the female

Answer 7

Bladder, urethra, uterus, vagina, rectum, anus

Question 8

Pelvic Organs of the male

Answer 8

bladder, urethra, prostate, rectum, anus

Question 9

Functions of the pelvic floor

Answer 9

• the pelvic floor = made up of both muscle and fascia
• helps support the pelvic (&abdominal) viscera
• contributed to increases in intra-abdominal pressure and then helps maintain intra-abd pressure
• act as sphincters for the passageways through the pelvis - urethra, vagina, anus
• assist in childbirth – form a ‘gutter’ for the head of the foetus

Question 10

Pelvic floor muscles

Answer 10

Levator Ani --> helps raise pelvic floor
- iliococcygeus 
- pubococcygeus
- puborectalis
Coccygeus

Question 11

Coccygeus Proximal attachments

Answer 11

Spine of ischium

Question 12

Coccygeus Distal attachments

Answer 12

• lateral coccyx

- lower lateral sacrum

Question 13

Coccygeus actions

Answer 13

• increases intra-abd pressure
• stops organs from coming out (viscera)
• pulls coccyx anteriorly & repositions it

Question 14

Coccygeus nerve supply

Answer 14

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Question 15

Puborectalis PA &DA

Answer 15

• originates lateral from the symphysis on both sides and encircles the rectum (anorectal junction)

Question 16

Puborectalis function

Answer 16

Sphincter for the rectum
- acts as a ‘sling’
When contracted- shortens + pinches off the rectum
Kinks the rectum to stop ‘fecal incontinence’

Question 17

Puborectalis nerve supply

Answer 17

Nerve to Levator Ani

Question 18

Pubococcygeus PA

Answer 18

• posterior surface of body of pubis

- tendinous arch

Question 19

Pubococcygeus DA

Answer 19

• coccyx
• perineal body
• anococcygeal raphe

Question 20

Pubococcygeus Actions

Answer 20

• supports the vagina and prostate in females + males respectively
• aids ejaculation & assists proper positioning of foetus’ head
• increases intra-abdominal pressure

Question 21

Pubococcygeus nerve supply

Answer 21

Nerve to Levator Ani

Question 22

Iliococcygeus PA

Answer 22

• ischial spine

- tendinous arch

Question 23

Uterosacral ligaments

Answer 23

suspends & supports the uterus and cervix in position

Question 24

Iliococcygeus actions

Answer 24

• supports the viscera in the abdominal cavity

- increases intra-abdominal pressure

Question 25

Endopelvic fascia

Answer 25

- complex web made up of loose connective tissue, adipose tissue, and smooth muscle - provides a conduit for passage of nerves & blood vessels to the organs -- helps run them to the right areas - helps maintain the organs in place (supports muscles)

Question 26

Rectovaginal or Rectovesical/ rectoprostatic fascia

Answer 26

Between rectum & either vagina (female) or bladder plus prostate (male)

Question 27

Iliococcygeus DA

Answer 27

- coccyx - perineal body - anococcygeal raphe

Question 28

Pubocervical fascia

Answer 28

between bladder/ urethra & vagina

Question 29

The Perineum

Answer 29

Superficial layer of muscles | - inferior to pelvic floor muscles

Question 30

two main regions of perineum

Answer 30

1. urogenital triangle | 2. anal triangle

Question 31

Iliococcygeus nerve supply

Answer 31

Nerve to Levator Ani

Question 32

Urogenital Triangle

Answer 32

Urinary + genital organs come through here (anteriorly)

Question 33

Anal triangle

Answer 33

Anal muscles come through here

Question 34

Urogenital triangle muscles

Answer 34

- ischiocavernosus - bulbospongiosus - superficial transverse perineal - deep transverse perineal

Question 35

Anal triangle muscles

Answer 35

External anal sphincter

Question 36

Perineal muscles functions

Answer 36

- provide added closure to vagina & anus - support & fix the perineal body - maintain erection of penis/ clitoris

Question 37

Male bulbospongiosus

Answer 37

around base of penis

Question 38

female bulbospongiosus

Answer 38

around vaginal opening

Question 39

Perineal Body

Answer 39

- irregular fibromuscular mass - located in the midline between the anus and the vagina/ bulb of the penis - site of convergence for both muscle + fascia which form the pelvic floor

Question 40

Nerve supply to pelvic floor

Answer 40

Nerve to levator ani - with slight input from the Pudendal nerve

Question 41

Nerve supply to the perineum

Answer 41

Pudendal nerve- with slight input from the nerve to levator ani