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Women's Health > 8a - Intro/anatomy > Flashcards

8a - Intro/anatomy Flashcards

1
Q

WHAT ARE PELVIC ORGANS??

A

Organs that sits within the Pelvic Cavity

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2
Q

Anterior compartment pelvic floor

A

Bladder

Urethra

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3
Q

Central/apical compartment pelvic floor

A

Uterus

VAgina

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4
Q

Posterior compartment

A

Rectum

Anal Canal

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5
Q

Components of pelvic floor

A

Muscular

Fasicial

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6
Q

Muscular components of the PF

A

Deep pelvic floor layer:

  1. Levator Ani
  2. Coccygeus

Superficial Pelvic Floor Layer

  1. Urogenital Triangle
  2. External Anal Sphincter
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7
Q

Parts of Levator Ani

A
  1. Puborectalis
  2. Pubococcygeus
  3. Iliococcygeus
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8
Q

What does the deep pelvic floor do?

A
  1. FORWARD PULL OF STRUCTURES
    Compresses Lumens
    Maintains Anorectal Angle - “angle between rectum and anal canal”
  2. LIFT OF PELVIC STRUCTURES ie ‘levator”
    Lifts to support the pelvic organs, removing strain on the
    endopelvic fascia
    School of Physiotherapy
    What
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9
Q

Function superficial PF muscles

A

Provides added closure to vagina and anus (rather than lift)

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10
Q

Muscles of superficial PF - Anterior Half
“Urogenital
Triangle”

A

Ischiocavernosus

Bulbocavernosus /
Bulbospongiosus

Transverse Pereneii Superficialis

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11
Q

Muscles of superficial PF - posterior half

A

External anal sphincter

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12
Q

What is the perineal body?

A 
• Pyramidal fibro-muscular mass in
the midline of the perineum
between vagina and anus
• Central insertion point for
numerous structures (muscles and
fascia) that make up the pelvic floor
• Commonly torn during childbirth
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13
Q

Nerve supply deep pelvic floor

A

Levator Ani Nerve

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14
Q

Nerve supply superficial pelvic floor

A

Pudental nerve

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15
Q

Primary structures holding the pelvic organs in place

A

Endopelvic fascia

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16
Q

Sub-components of the EndoPelvic Fascia

A

Pubocervical Fascia
Rectovaginal Fascia
Uterosacral Ligaments

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17
Q

Pubocervical Fascia

A

Situated between the back of the bladder / urethra and the
front of the vagina
• Meant to holds the bladder and urethra in their normal
position away from anterior vaginal wall.

18
Q

Disruption to what can cause an anterior vaginal wall prolapse

A

Pubocervical fascia

19
Q

Rectovaginal Fascia

A

Meant to holds the rectum in it’s normal position away

from the posterior vaginal wall

20
Q

Disruption to what can cause an posterior vaginal wall prolapse

A

Break in rectovaginal fascia

21
Q

Uterosacral Ligaments

A

• Suspend lower aspect of uterus / cervix up and
attach to sacral base
• Maintains uterus high in apical section of vagina

22
Q

Disruption to what can cause uterine prolapse?

A

Uterosacral ligaments

23
Q

What is the Pelvic Floor?

A

The pelvic floor is a complex web of muscle, fascia and fibrous
tissue that helps support the pelvic organs.”

24
Q

Pelvic floor dysfunction =

A 
PELVIC FLOOR MUSCLE DYSFUNCTION
OR
PELVIC FLOOR FASCIAL DYSFUNCTION
OR
BOTH!!
25
Q

How does the bladder work

A

– “The Tank” - Storage facility for urine
– Receives urine from kidneys via Ureters
– Muscular wall called the “Detrusor” – contracts to push urine out

26
Q

Two phases of micturition

A 
Storage phase (>99%)
Voiding phase (< 1%)
27
Q

What happens during bladder storage phase?

A

Storage Phase (>99%)
Whilst bladder is filling
• Relaxed Detrusor expansion
• Contracted Urethral Sphincters

28
Q

What happens during bladder voiding phase?

A

Voiding Phase (<1%)
While bladder is emptying
• Contracting Detrusor
• Relaxed Urethral Sphincters

29
Q

Storage and expulsion of urine. - intra-vesical pressure and urethral pressure

A

For Storage of Urine to Occur
IVP < UP

For Expulsion of Urine to Occur
IVP > UP

30
Q

How IVP remains low despite increase in urine volume during storage phase?

A

Tightening of urethral sphincters

31
Q

What muscle activity occurs for normal voiding?

A

Detrusor contracts and urethral sphincters relax.

IVP increases and UP decreases
IVP becomes > UP
Urine Released through Urethra

32
Q

Function of stomach

A
  • Minimal absorption

* Primarily break up of food

33
Q

Function of small intestine

A
  • 3 Sections: Duodenum, Jejunum, Ileum
  • Primarily nutrient absorption
  • At end of small intestine consistency of ‘thick pea soup’
34
Q

Function of large intestine

A

• 4 Sections: ascending, transverse, descending, sigmoid
• Primarily re-absorption of H20
– 1500mls at start of colon reduced to150mls at end
• Stool consistency determined by time in colon
– The longer the transit time through the colon the harder the stool
• Transit time is usually 1-3 days

35
Q

Function of rectum

A

RECTUM (similar function to bladder)
• Lowest part of GIT
• Just before anal canal
• Purpose:
– Storage of feces until appropriate time to empty
– ie equivalent role as bladder in urinary system

36
Q

Function of anal canal

A

ANAL CANAL (similar fx to urethra)
• Starts at end of rectum, level with tip of coccyx,
• Ends at anal verge
• Purpose
– Release of faeces from the body at an appropriate
time

37
Q

Muscles that maintain faecal continence

A

Puborectalis
External Anal sphincter
Internal Anal Sphincter

38
Q

PUBORECTALIS action defecation

A

Pulls anorectal junction forward, maintaining anorectal angle and
acting as a ‘kink’.

39
Q

EXTERNAL ANAL SPHINCTER action defecation

A
  • Skeletal muscle
  • Voluntary Control via pudendal nerve
  • Responsible for 30% of anal closure pressure
40
Q

Internal anal sphincter action defecation

A

Smooth muscle
Involuntary control via ANS
70% resting anal closure pressure

41
Q

Normal Defecation Sequence

A
  1. Peristalsis triggered by food / fluid intake, exercise etc
  2. Stool is propelled into rectum
  3. Distension of rectal walls triggers relaxation of Internal Anal
    Sphincter……. “Recto-anal Inhibitory Reflex”
  4. Stool descends into upper anal canal
  5. PR and EAS increase activity until person reaches toilet
  6. At appropriate time, person relaxes PR and EAS
    defecation occurs

Women's Health (11 decks)

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