Anatomy of Urinary Incontinence and Prolapse

Question 1

What are the 3 layers of the pelvic floor?

Answer 1

pelvic diaphragm; muscles of perineal pouches and perineal membrane

Question 2

What 2 muscle groups form the pelvic diaphragm?

Answer 2

levator ani and coccygeus

Question 3

What is the name for the anteiror gap between medial borders of the pelvic diaphragm?

Answer 3

urogenital hiatus

Question 4

What are the 3 parts of levator ani?

Answer 4

puborectalis; pubococcygeus and iliococcygeus

Question 5

What are the nerve roots of nerve to levator ani?

Answer 5

S3-5

Question 6

What is hte most medial of the muscles of levator ani?

Answer 6

puborectalis

Question 7

What are the attachments of levator ani?

Answer 7

pubic bones; ischial spines; tendinous arch of levator ani; perineal body; coccyx and walls of organs

Question 8

What is the endopelvic fascia?

Answer 8

connective tissue packing; some loose areolar tissue; some fibrous- condenses to form pelvic ligaments

Question 9

What is the function of the areolar tissue of the endopelvic fascia?

Answer 9

allows expansion of pelvic organs

Question 10

What are the significant ligaments formed by the endopelvic fascia?

Answer 10

uterosacral; transverse cervical; lateral ligament of bladder and lateral rectal ligaments

Question 11

What other name is the transverse cervical ligament known as?

Answer 11

cardinal ligament

Question 12

Where does the deep perineal pouch lie?

Answer 12

below the fascia covering the inferior aspect of the pelvic diaphragm and above the perineal membrane

Question 13

What muscles are found within the deep perineal pouch?

Answer 13

external urethral spincter; compressor urethrae and deep trasnverse perineal muscle

Question 14

What is the difference between the deep transverse perineal muscle in males and females?

Answer 14

in females it is formed of smooth muscle whereas in males it is skeletal muscle

Question 15

What is found within the deep perineal pouch?

Answer 15

part of urethra and vagina; bulbourethral glands (M); NVBs for penis/clitoris; extensions of ischioanal fat pads; external urethral sphincter; compressor urethrae; deep transverse perineal muscle

Question 16

What other name is given to bulbourethral glands?

Answer 16

Cowper’s glands

Question 17

What is the perineal membrane?

Answer 17

thin sheet of tough, deep fascia

Question 18

Where does the perineal membraen lie?

Answer 18

attaches laterall to the sides of the pubic arch and closes the urogenital triangle

Question 19

What is found within the superficial perineal pouch in males?

Answer 19

root of penis and assoc. muscles; urethra; superfiical perineal muscle and internal pudendal vessels and nerve

Question 20

What forms the root of penis?

Answer 20

bulb-corpus spongiosum and crura- corpus cavernosum

Question 21

What muscle is associated with the bulb/corpus spongiosum?

Answer 21

bulbospongiosus

Question 22

What muscle is associated the crura/corpus cavernosum?

Answer 22

ischiocavernosus

Question 23

What is the difference between crura in females and males?

Answer 23

crura in males come together but do not fuse; in females they fuse to form clitoris

Question 24

What is the difference ebtween the bulb in females and males?

Answer 24

the bulb in females is 2 seprates tubes vs 1 in male

Question 25

What is the female equivalent of Cowper’s glands?

Answer 25

greater vestibular glands/ Bartholins

Question 26

What is the difference between the muscles of the superficial perineal pouch in females and males?

Answer 26

males- much more developed as give supprt to erectile tissue

Question 27

Where is the perineal body found?

Answer 27

posteiror aspect of vagina

Question 28

What muscles contribute to the perneal body?

Answer 28

levator ani; compressor urethrae; external urethra; deep superficial transverse perineal; bulbospongiosus

Question 29

What area of the anorectum does pubuorectalis sling around?

Answer 29

anorectal angle- pulls anorectum anteirorly to create angle

Question 30

What does the urinary continence depend on?

Answer 30

urinary bladder neck supprt; external urethral spincter; smooth muscle in urethral wall