8: Anatomy - Urinary incontinence and prolapse

Question 1

What separates the pelvic cavity from the perineum?

Answer 1

Pelvic floor

Question 2

What structures make up the pelvic floor?

Answer 2

Pelvic diaphragm

Perineal muscles

Perineal membrane

all in the urogenital triangle

Question 3

What are the two muscle groups found in the pelvic floor?

Answer 3

Levator ani

Coccygeus

Question 4

What is the gap between the levator ani muscles called?

What is contained within it?

Answer 4

Urogenital hiatus

Urethra (males and females) and vagina (in females)

Question 5

What is the innermost levator ani muscle?

What does it enclose?

Answer 5

Puborectalis

Rectum

Question 6

What are the three levator ani muscles?

Answer 6

Puborectalis

Pubococcygeus (to anococcygeal ligament, not a true sling)

Iliococcygeus

Question 7

The levator ani muscles are (contracted / relaxed) by default.

Answer 7

contracted

Question 8

Which somatic motor nerves supply the

a) superior
b) inferior

aspects of the levator ani muscles?

Answer 8

a) Nerve to levator ani S3-5

b) Pudendal nerve S2-4

Question 9

Which lateral rotator of the hip is iliococcygeus closely related to?

Answer 9

Obturator internus

Question 10

In what fascia does the neurovasculature of the pelvis descend?

Answer 10

Endopelvic fascia

Question 11

What structures hold the pelvic organs in place?

Can you give an example?

Answer 11

Pelvic ligaments

Uterosacral ligaments

Question 12

Which pouch is covered superiorly by the levator ani and inferiorly by the perineal membrane?

Answer 12

Deep perineal pouch

Question 13

Which muscle, found in the male and female, is found in the deep urethral pouch and attaches to the external urethral sphincter?

Answer 13

Compressor urethrae

Question 14

Which muscle is found posteriorly in the deep perineal pouch but is only named in males?

Answer 14

Deep transverse perineal muscle

Question 15

Which glands are found within the deep transverse perineal muscle in males?

Answer 15

Bulbourethral glands / Cowper’s glands

produce lubricant

Question 16

Which deep gluteal muscle is the iliococcygeus muscle closely related to?

Answer 16

Obturator internus

Question 17

What is the function of the bulbourethral glands?

What female gland are they homologous to?

Answer 17

Secrete lubricant and alkali amongst other things into the semen to improve chances of fertilisation

Bartholin’s glands / Greater vestibular glands

Question 18

Which veins are contained in the deep perineal pouch?

Answer 18

Dorsal veins of the penis / clitoris

Question 19

What are the contents of the deep perineal pouch?

Answer 19

In both sexes:

urethra, external urethral sphincter, compressor urethrae, fat, dorsal veins

In males:

+ deep transverse perineal muscle and bulbourethral glands

In females:

+ vagina

Question 20

Which lower limb muscles are closely related to the pelvic diaphragm muscles?

Answer 20

Obturator internus

Piriformis

remember these form the lateral walls of the pelvic cavity

Question 21

In which space is the root of the penis found in males?

Answer 21

Superficial perineal pouch

Question 22

The superficial perineal pouch contains the ___ of the penis in males.

Answer 22

root of the penis

Question 23

What are the two parts of the root of the penis?

Answer 23

Bulb

Crura

Question 24

Which structure develops from the bulb of the penis?

Answer 24

Corpus spongiosum

Question 25

What is the purpose of the corpus spongiosum?

Answer 25

Transmits spongy urethra

Question 26

Which structures develop from the two crura of the penis?

Answer 26

Corpus cavernosa

Question 27

What does crura mean?

Answer 27

Leg

So the penis has two legs –> corpus cavernosum(s?)

Question 28

What is the purpose of the corpus cavernosum?

Answer 28

Fill with blood during erection

Question 29

What are the muscles associated with urination and ejaculation in males?

Answer 29

Bulbospongiosus x1

Ischiocavernosus x2

named for what they attach to

Question 30

What are the three erector muscles found in the superficial perineal pouch in males?

Answer 30

Bulbospongiosus x1

Ischiocavernosus x2

Question 31

Which perineal muscle is found in the superficial perineal pouch in both males and females?

Answer 31

Superficial transverse perineal muscle

Remember the deep muscle is only found in males, in the deep perineal pouch

Question 32

Which nerve innervates the erector muscles in the male?

Answer 32

Internal pudendal nerve

Question 33

What are the greater vestibular glands in females also known as?

Where are they found?

Answer 33

Bartholin’s glands

Superficial perineal pouch

Question 34

In which perineal pouch are the Bartholin’s glands found?

Answer 34

Superficial perineal pouch

Question 35

What is the function of Bartholin’s glands?

Which male glands are they homologous to?

Answer 35

Secrete lubricant into the vagina

Bulbourethral / Cowper’s glands

Question 36

The deep transverse perineal muscle is found in (males / females).

The superficial transverse perineal muscle is found in (males / females).

Answer 36

deep transverse perineal - males only, deep perineal pouch

superficial transverse perineal - both, superficial perineal pouch

Question 37

Which structures help to maintain urinary continence?

Answer 37

a) Levator ani, external urethral sphincter, compressor urethrae (+ prostate gland in males)

Question 38

Which levator ani muscle controls faecal continence?

Answer 38

Puborectalis

Question 39

What are some different types of pelvic prolapse in women?

Answer 39

Vaginal

Uterine

Bladder (Cystocele)

Rectum (Rectocele)

Peritoneal (Enterocele)