Urogenital Diaphragm

Question 1

What are the components of the pelvic brim?

Answer 1

• Pubic symphysis
• Pubic crest and tubercle
• Pectin pubis
• Arcuate line
• Sacral promontory

NOTE: Everything above the pelvic brim is the false bony pelvis.

Question 2

What organs are apart of the false pelvis?

Answer 2

Organs of the abdominal cavity

Question 3

What are the components of the true pelvis?

Answer 3

• Uterus
• Prostate gland
• Bladder

Question 4

The narrowest point in the pelvic outlet is the distance between the _________.

Answer 4

Ischial spines

NOTE: Difficulties in deliveries occur when the distance between spines is too small. (i.e. <9.5 cm)

Question 5

_____________ (Anteriorly/ Posteriorly), the pelvic diapgragm is incomplete.

Answer 5

Anteriorly

Question 6

What structures transverse the space of the incomplete pelvic diaphragm?

Answer 6

Vagina

Urethra

Question 7

The _______ fills in the anterior space in the pelvic diaphragm.

Answer 7

Urogenital diaphragm

NOTE: This muscle can be controlled

Question 8

When the pelvic diaphragm ______ (relaxes/cotnracts) it flattens out.

Answer 8

Contracts

NOTE: The UG diaphragm forms a subfloor in the pelvic diaphragm.

Question 9

What are the contents of the urogenital diaphragm?

Answer 9

• Skeletal muscles
  
  • Deep transverse perineus
  • Sphincter urethrae (external urethral sphincter)
• Superior fascia
• Inferior fascia (perineal membrane)

Question 10

Which two muscles surround the UG diaphragm?

Answer 10

• Sphicter urethrae
• Deep transverse perineus
  
  • Between ischial spines

NOTE: Portions of the UG diaphragm surrounds the vagina.

Question 11

The deep perineal pouche contains the __________.

Answer 11

UG diaphragm

Question 12

The superfical perineal pouch contains the ________

Answer 12

External genitalia

Question 13

________ fascia is continuous with Scarpa’s fascia.

Answer 13

Colles

Question 14

What are ways that the urethra can be damaged?

Answer 14

• Surgery
• Kick in grown
• Bullet to the urethra
• Jamming penis

Question 15

Label

Answer 15

Question 16

_____________ fascia fuses with the perineal body.

Answer 16

Colles’

REMEMBER: The perineal body is in between the anal and the urogenital triangle

Question 17

How does urine from a ruptured urethra flow?

Answer 17

In males, fluid goes upward

Question 18

What are the contents of the deep pouch in males?

Answer 18

• Membranous urethra
• Bulbourethral glands
  
  • Secretes mucus
• Dorsal artery, vein, and nerve of the penis

Question 19

Function of the bulbourethral gland

Answer 19

The mucus secreted by the bulbourethral gland purges the urethra of any residual urine and this mucus secretion lubricates the urethra for ejaculation

Question 20

What are the contents of the deep perineal space in females?

Answer 20

• Urethra
• Vagina
• Perineal membrane
• Dorsal artery, vein and nerve of the clitoris

Question 21

What are the contents of teh superficial pouch in males?

Answer 21

• Crus of penis
• Bulb of penis
• Ischiocavernosus
  
  • Contracts and compresses blood and forces blood to the shaft of the penis
• Bulbospongiosus
• Superficial transverse perineus

Question 22

What are the contents of the superifical pouch in females?

Answer 22

• Crus of clitoris
• Bulb of vestibule
• Vestibular glands
  
  • Mucus secreting. Lubricate the vestibule
• Ishiocavernosus
• Bulbospongiosus
• Superficial transverse perineus

Question 23

What is the course of the pudendal nerve?

Answer 23

• Greater sciatic foramen (exits pelvis)
• Lesser sciatic foramen (re-enters pelvis)
• Pudendal canal
• Urogenital triangle (terminates in the UG triangle)

Question 24

What are the spinal contributions to the pudendal nerve?

Answer 24

S2, S3, and S4

Question 25

\_\_\_\_\_\_\_\_\_\_\_\_\_\_ nerve innervates the external anal sphincter.

Answer 25

Inferior rectal nerve

Question 26

The pudental nerve can become entrapped under the _______ ligament.

Answer 26

Sacrospinous **NOTE:** This can result in chronic pain in the perineum. Severe entrapment of the nerves become over excitable and produce lack of sensation of external genitalia.

Question 27

Too little tone in the UG and pelvic diaphragms can result from?

Answer 27

Damage, trauma, lack of exercise

Question 28

As a child's head goes through the pelvic diapgragm it goes through ________ and ________ muscles.

Answer 28

Pubococcygeus and puborectalis

Question 29

Prolapse of Uterus

Answer 29

Sinking of the uterus into the vaginal canal * **1st degree:** Cervis fills up portion of the vagina * **2nd degree:** Cervix protrudes all the way to the vaginal opening * **3rd degree**: Cervis extends out of the vaginal opening

Question 30

Prolaspe of the bladder is known as \_\_\_\_\_\_\_\_.

Answer 30

Cystocele \*may result in urinary incontinence

Question 31

Prolaspe of the rectum is known as a \_\_\_\_\_\_\_.

Answer 31

Rectocele \*may result in fetal incontinence

Question 32

What is the cause of a rectocele?

Answer 32

Absorption of fat in ischioanal fossa. If a person is under starvation, the fat in the fossa is absorbed long with buccal fat pad. The rectum is no longer supported by fat which is very important and you begin to get rectal prolapse

Question 33

Spastic pelvic floor syndrome

Answer 33

Muscles are under tonic contractions and can't relax

Question 34

Failure for the puborectal sling and the external anal spchinter to relax during defection results in \_\_\_\_\_\_\_\_\_.

Answer 34

Constipation

Question 35

What can result from spasms of the urethral sphincter?

Answer 35

* Incomplete voiding * Urinary retention * Cystitis * Chronic bladder infections **REMEMBER:** Part of the UG diaphragm surrounds the membranous urethra, so failure of the UG diaphragm to relax can result in the aforementioned problems.

Question 36

In males, excessive tone in the external uterthral sphincter may result in:

Answer 36

* Regurgitation of urine into the prostate gland * Prostatitis

Question 37

In females, spasms in the pelvic floor may result in:

Answer 37

* Vaginismus * Involuntary spasm of the vagina * Dyspareunia * Painful intercourse

Question 38

When the grafenburg spot is stimulated it produces a distinct orgasm mediated by ________ fibers.

Answer 38

GVA **NOTE:** The G spot may be remnant of the prostate gland in females. A vulval orgasm stimulates GSA fibers and a uterine orgasm stimulates GVA fibers.