Week 5 - Anatomy of Incontinence and Prolapse

Question 1

The pelvic floor separates what structures?

Answer 1

The pelvic cavity and the perineum

Question 2

The pelvic floor has what two important roles?

Answer 2

Provides support to pelvic organs, and maintains continence

Question 3

What are the 3 components of the pelvic floor?

Answer 3

Perineal membrane, muscles of perineal pouches and the pelvic diaphragm

Question 4

Deep and superficial perineal pouches are broken up by what structure?

Answer 4

The perineal membrane

Question 5

What is the deepest layer of the pelvic floor?

Answer 5

Pelvic diaphragm

Question 6

What does the pelvic diaphragm consist of?

Answer 6

The levator ani and coccygeus

Question 7

There is an anterior gap between the medial borders of the pelvic diaphragm. This is known as what?

Answer 7

The urogenital hiatus

Question 8

There is an anterior gap between the medial borders of the pelvic diaphragm. This allows the passage of what structure(s) in males?

Answer 8

The urethra

Question 9

There is an anterior gap between the medial borders of the pelvic diaphragm. This allows the passage of what structure(s) in females?

Answer 9

The urethra and vagina

Question 10

What structures form the dynamic pelvic floor?

Answer 10

Levator ani and coccygeus

Question 11

Which muscle forms the majority of the pelvic diaphragm?

Answer 11

The levator ani

Question 12

What are the 3 parts of the levator ani?

Answer 12

Puborectalis, pubococcygeus and iliococcygeus

Question 13

Which one of the 3 components of the levator ani is not a true sling since it has a break in the muscle fibres?

Answer 13

Pubococcygeus

Question 14

The pelvic floor reflexively contracts when?

Answer 14

In situations of raised intra-abdominal pressure

Question 15

The levator ani spends most of its time in what state?

Answer 15

Tonically contracted

Question 16

To allow urination and defaecation, the levator ani muscle must do what?

Answer 16

Relax

Question 17

What is the innervation to the levator ani?

Answer 17

The pudendal nerve (S2, 3, 4) and nerve to levator ani (S3, 4, 5)

Question 18

The iliococcygeus overlies what structure?

Answer 18

Obturator foramen

Question 19

Which specific part of the levator ani is responsible for faecal continence?

Answer 19

Puborectalis

Question 20

As well as the pelvic floor, what other structures provide additional support for the pelvic organs?

Answer 20

Endopelvic fascia and pelvic ligaments

Question 21

Fibrous endopelvic fascia forms what?

Answer 21

Pelvic ligaments

Question 22

The deep perineal pouch lies below what?

Answer 22

The fascia covering the inferior aspect of the pelvic diaphragm

Question 23

The deep perineal pouch lies above what?

Answer 23

The perineal membrane

Question 24

What is the muscle of the deep perineal pouch which is present in both males and females?

Answer 24

Compressor urethrae

Question 25

What is the muscle of the deep perineal pouch which is only present in males? What type of muscle is this composed of?

Answer 25

Deep transverse perineal muscle - skeletal

Question 26

The female equivalent of the deep transverse perineal muscle is not named. What type of muscle is it formed of?

Answer 26

Smooth

Question 27

The perineal membrane lies where is relation to the deep perineal pouch?

Answer 27

Superficial

Question 28

What is the perineal membrane?

Answer 28

A thin sheet of tough, deep fascia

Question 29

The perineal membrane attaches laterally to the sides of what structure? It closes what triangle?

Answer 29

The pubic arch / the urogenital triangle

Question 30

The perineal membrane comprises openings for which structures?

Answer 30

The urethra (and vagina in females)

Question 31

The perineal membrane, along with the perineal body, is the last passive support of the pelvic organs. What is meant by this?

Answer 31

Everything superficial to this structure will be dynamic, i.e. it will move

Question 32

The superficial perineal pouch lies below (i.e. superficial) to what structure?

Answer 32

The perineal membrane

Question 33

Within the superficial perineal pouch, what forms the bulb of the penis?

Answer 33

The corpus spongiosum

Question 34

Within the superficial perineal pouch, what forms the crura of the penis?

Answer 34

The corpus cavernosum

Question 35

What are the muscles of the root of the penis which are found within the superficial perineal pouch?

Answer 35

The bulbospongiosus and ischiocavernosus

Question 36

What is the function of the bulbospongiosus muscle?

Answer 36

Rhythmically contracts to cause ejaculation

Question 37

What neurovascular structures lie within the superficial perineal pouch?

Answer 37

Pudendal nerve and internal pudendal vessels (specifically superficial perineal nerve)

Question 38

The Bartholin's gland is found within which aspect of the pelvic floor?

Answer 38

Superficial perineal pouch

Question 39

Which muscles of the pelvic floor are most responsible for maintaining urinary continence?

Answer 39

External urethral sphincter, compressor urethrae and levator ani