4 - Pelvic Floor Flashcards
What are the ligaments supporting the uterus?
- Pubocervical
- Transverse/Cardinal (inferior broad ligament)
- Uterosacral
Arise from the sides of the cervix and lateral fornix of vagina
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/865/a_image_thumb.png?1570628849)
What is the clinical importance of the cardinal ligaments?
Commonly removed in a hysterectomy as a reservoir for cancerous cells sometimes
Label the following superficial structures of the female pelvic floor.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/873/q_image_thumb.jpeg?1570628989)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/873/a_image_thumb.jpeg?1570629061)
Label the deep muscles of the female pelvic floor
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/877/q_image_thumb.jpeg?1570629154)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/877/a_image_thumb.jpeg?1570629130)
What are the functions of the pelvic floor?
- Support the pelvic organs like vagina, uterus, ovaries, bladder, rectum
- Maintain intra-abdominal pressure during sneezing and laughing
- Facilitate childbirth
- Continence
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/892/a_image_thumb.jpeg?1570629669)
What are the 3 levels of support that the pelvic floor provides?
1. Suspension: by cardinal and uterosacral ligaments. round ligament holds in anteversion
2. Attachment: attachment to other pelvic organs e.g vagina to endopelvic fascia, levator ani and perineal body
3. Fusion: fusion of tissues, e.g urogenital diaphragm and perineal body
What is the lower half of the vagina supported by?
Anterior: urethra
Laterally: levator ani
Posterior: perineal body
How does the urethra maintain continence?
Lies anteriorly and above the fascia so in increased intra-abdominal pressure it gets compressed against the fascia closing it
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/896/a_image_thumb.png?1570629938)
What ar the main components of the pelvic floor?
- Urogenital diaphragm/Perineal membrane
- Perineal body
- Perineal muscles
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/899/a_image_thumb.png?1570630035)
What are the deep muscles of the pelvic floor?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/902/q_image_thumb.jpeg?1570630201)
- Coccygeus
- Levator ani: pubococcygeus, puborectalis, iliococcygeus
Midpoint is the perineal body. Fibres insert on lower part of coccyx and anococcygeal raphe
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/902/a_image_thumb.jpeg?1570630176)
What are the superficial muscles of the pelvic floor?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/906/q_image_thumb.jpeg?1570630568)
- Transverse hold vagina laterally
- Bulbospongiosus can be torn by stretching
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/906/a_image_thumb.jpeg?1570630525)
What might you do if a mother is having an issue with delivery as the baby is too large? What are the risks and benefits of this procedure?
- Medio-lateral episiotomy
- May cause issues with infection, haemorraghe, external anal sphincter and dyspareunia
- Done to avoid damage to perineal body as this is central to support
- Also done to prevent perineal damage like 2nd/3rd degree tears
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/913/a_image_thumb.png?1570630847)
What is the perineal body and the urogenital diaphragm?
- Perineal body: Central point between vagina and rectum. Site of attachment for pelvic floor muscles and structure
- Urogenital Diaphragm: Sheet of dense fibrous tissue across anterior half of pelvic floor, attached to vagina, urethra and perinally body. Support
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/916/a_image_thumb.png?1570631156)
What is the blood supply and innervation to the pelvic floor?
Blood: external and internal pudendal arteries
Lymphatics: inguinal
Nerve: pudendal nerves S2,S3,S4, so damage to this nerve issue with pelvic floor support
Label this diagram of the pelvic floor
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/919/q_image_thumb.jpeg?1570631390)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/340/645/919/a_image_thumb.jpeg?1570631346)