Anatomy of Urinary Incontinence and Prolapse Flashcards
What are the 3 layers of the pelvic floor?
pelvic diaphragm; muscles of perineal pouches and perineal membrane
What 2 muscle groups form the pelvic diaphragm?
levator ani and coccygeus
What is the name for the anteiror gap between medial borders of the pelvic diaphragm?
urogenital hiatus
What are the 3 parts of levator ani?
puborectalis; pubococcygeus and iliococcygeus
What are the nerve roots of nerve to levator ani?
S3-5
What is hte most medial of the muscles of levator ani?
puborectalis
What are the attachments of levator ani?
pubic bones; ischial spines; tendinous arch of levator ani; perineal body; coccyx and walls of organs
What is the endopelvic fascia?
connective tissue packing; some loose areolar tissue; some fibrous- condenses to form pelvic ligaments
What is the function of the areolar tissue of the endopelvic fascia?
allows expansion of pelvic organs
What are the significant ligaments formed by the endopelvic fascia?
uterosacral; transverse cervical; lateral ligament of bladder and lateral rectal ligaments
What other name is the transverse cervical ligament known as?
cardinal ligament
Where does the deep perineal pouch lie?
below the fascia covering the inferior aspect of the pelvic diaphragm and above the perineal membrane
What muscles are found within the deep perineal pouch?
external urethral spincter; compressor urethrae and deep trasnverse perineal muscle
What is the difference between the deep transverse perineal muscle in males and females?
in females it is formed of smooth muscle whereas in males it is skeletal muscle
What is found within the deep perineal pouch?
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
What other name is given to bulbourethral glands?
Cowper’s glands
What is the perineal membrane?
thin sheet of tough, deep fascia
Where does the perineal membraen lie?
attaches laterall to the sides of the pubic arch and closes the urogenital triangle
What is found within the superficial perineal pouch in males?
root of penis and assoc. muscles; urethra; superfiical perineal muscle and internal pudendal vessels and nerve
What forms the root of penis?
bulb-corpus spongiosum and crura- corpus cavernosum
What muscle is associated with the bulb/corpus spongiosum?
bulbospongiosus
What muscle is associated the crura/corpus cavernosum?
ischiocavernosus
What is the difference between crura in females and males?
crura in males come together but do not fuse; in females they fuse to form clitoris
What is the difference ebtween the bulb in females and males?
the bulb in females is 2 seprates tubes vs 1 in male
What is the female equivalent of Cowper’s glands?
greater vestibular glands/ Bartholins
What is the difference between the muscles of the superficial perineal pouch in females and males?
males- much more developed as give supprt to erectile tissue
Where is the perineal body found?
posteiror aspect of vagina
What muscles contribute to the perneal body?
levator ani; compressor urethrae; external urethra; deep superficial transverse perineal; bulbospongiosus
What area of the anorectum does pubuorectalis sling around?
anorectal angle- pulls anorectum anteirorly to create angle
What does the urinary continence depend on?
urinary bladder neck supprt; external urethral spincter; smooth muscle in urethral wall
