Urinary Incontinence and Prolapse Flashcards Preview

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Flashcards in Urinary Incontinence and Prolapse Deck (50)
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1

What does the pelvic floor separate?

Pelvic Cavity
Perineum
(perineum --> Pelvic Floor --> Pelvic Cavity)

2

What are the 2 main functions of the pelvic floor?

Support Pelvic organs
Maintains both urinary and faecal continence in women

3

Which 3 muscles maintain urinary continence?

External urethral sphincter
Compressor Urethrae
Levator ani

4

Which muscle maintains faecal continence?

Puborectalis muscle (contraction)

5

What are the 3 layers of the Pelvic Floor?

external --> internal

Perineal membrane
Muscles of perineal pushes
Pelvic Diaphragm

6

Which 2 muscles make up the pelvic diaphragm?

Levator Ani
Coccygenous

7

what are the 3 muscles of the levator ani?

(PPI)
Puborectalis (U-shaped sling)
Pubococcygenus
Iliococcygeus

8

Is the pelvic diaphragm normally contracted?

Yes,
Must relax to release urine and faeces

9

What nerves innervate the pelvic diaphragm?

Pudendal nerve
Nerve to Levator Ani

10

What structures support the pelvic Diaphragm?

Endopelvic Fascia
Ligaments

11

What are the main ligaments which support the pelvic diaphragm?

Utero-sacral ligament
Transverse cervical ligament
tendinous arch of pelvic fascia
tendinous arch of levator ani
lateral ligament of bladder

12

Which nerves supply the Detrusor muscle?

Parasympathetic nerves
--> from pelvic splanchnic
(S2,3,4)

13

Which nerve supplies urethral smooth muscle?

Sympathetic nerves
--> from spinal cord
(T10 to L2)

14

Which nerve supplied striated urethral sphincter and pelvic floor muscles?

Branches of pudendal nerve
(S2,3,4)

15

Which structures support the cervix and upper vagina?

Uterosacral
Transverse cervical
Pubocervical ligaments

16

Which structures support the middle vagina?

Pelvic fascia

17

Which structures support the lower vagina?

Levator ani muscles
Perineal Body

18

What causes the pelvic floor to weaken?

Increased intra-ado pressure
Pelvic floor muscle trauma and denervation
Connective tissue disorder

19

what are causes of increased intra-abdominal pressure?

Obesity
Chronic cough
Occupational/recreational exercise
Constipation
Intra-abdominal mass

20

What are casues of pelvic floor muscle trauma and denervation?

Obstetric trauma
Pelvic fracture
Pelvic Surgery
Congenital

21

What are causes of connective tissue disorder?

Age related
Oestrogen deficiency
Drug related (steroids)

22

What is urinary incontinence?

Involuntary leakage of urine

23

What is stress incontinence?

Involuntary leakage of urine when intra-ado pressure, with the absence of detrusor muscle contraction

24

what are some triggers of stress incontinence?

Coughing
Sneezing
Exercise

25

What are the investigations for stress incontinence?

EXCLUDE UTI
- Frequency/volume charts
- Urodynamic studies

26

What are some lifestyle changes which can manage stress incontinence

Weight loss
Smoking Cessation
Avoid constipation
Avoid heavy lifting
Caffeine reduction

27

What a medical treatment for stress incontinence?

Duloxetine
LOTS of side effects

28

What is urge incontinence?

Individual has increased and frequency to void urine
--> Nocturia

29

How much urine is expelled in stress incontinence?

small amounts

30

How much urine is expelled in urge incontinence?

large volumes