Anatomy of Urinary Incontinence and Prolapse

Question 1

name the 3 components of the pelvic floor

Answer 1

pelvic diaphragm
muscle of perineal pouches
perineal membrane

Question 2

what fossa is located around the outside of the anogenital triangle of the levator ani?

Answer 2

ischioanal fossa

Question 3

deepest layer of pelvic floor?

Answer 3

pelvic diaphragm

Question 4

what muscle groups make up the pelvic diaphragm?

Answer 4

levator ani

coccygeus

Question 5

puborectalis supplies the rectum only T or F

Answer 5

F, supplies the pelvic cavity via its slings

Question 6

coccygeus is located posterior to __ and anterior to ____

Answer 6

posterior to levator ani and anterior to the sacrospinous ligament.

Question 7

midline attachments of levator ani?

Answer 7

perineal body
coccyx
organ walls

Question 8

name the 3 parts of the levator ani from most medial to most lateral

Answer 8

puborectalis
pubococcygeus
iliococcygeus

Question 9

the levator ani are usually contracted/relaxed

Answer 9

contracted

Question 10

innervation of levator ani

Answer 10

pudental nerve

nerve to levator ani

Question 11

what does the nerve to levator ani supply?

Answer 11

superior aspect of levator ani

Question 12

nerve roots of nerve to levator ani? where does it branch from?

Answer 12

S3, 4, 5

sacral plexus

Question 13

what substance fills the space in the pelvic cavity around ligaments and organs?

Answer 13

endopelvic fascia

Question 14

what forms endopelvic fascia? why does it have these fibres?

Answer 14

connective tissue
loose areolar tissue
fibrous tissue eg collagen and elastic fibres to give it elasticity and recoil

Question 15

where does the uterosacral ligament originate and insert?

Answer 15

top of cervix

SI joint

Question 16

name the pelvic ligaments in charge of supporting the pelvic organs and muscles?

Answer 16

uterosacral ligament
trasverse cervical ligament
lateral ligaments of bladder and rectum

Question 17

the deep perineal pouch is inferior to ____ and superior to ____

Answer 17

inferior to levator ani

superior to perineal membrane

Question 18

what does the deep perineal pouch contain?

Answer 18

part of the urethra
part of the vagina/bulbourethral gland in men
clitoral neurovascular bundle
ischioanal fat pad extensions
muscles

Question 19

where does the perineal membrane laterally attach?

Answer 19

sides of the pubic arch

Question 20

last passive support of the pelvic organs?

Answer 20

perineal body and membrane

Question 21

which muscle of the levator ani doesnt have a bony attachment? what is its insertion?

Answer 21

iliococcygeus

coccyx

Question 22

most inferolateral muscle located in the pelvic floor?

Answer 22

piriformis

Question 23

crura means…

Answer 23

legs

Question 24

what does the crura of the male form?

Answer 24

the corpus cavernosum of the penis, forming most of the body

Question 25

what forms the corpus spongiosum?

Answer 25

bulb of the penis

Question 26

what muscles are associated with the penis? where are they located?

Answer 26

bulbospongiosus
ischiocavernsus
superficial perineal pouch

Question 27

what does the bulbospongiosus do?

Answer 27

initiates ejaculation

Question 28

muscles of the superior perineal pouch of the female?

Answer 28

bulbospongiosus

ischiocavernosus - same as male!

Question 29

name the glands associated with the erectile tissue of the female?

Answer 29

greater vestibular glands

Question 30

the superficial perineal pouch is located ___ to the perineal membrane?

Answer 30

inferior

Question 31

what muscle loops around the external urethral sphincter?

Answer 31

compressor urethrae

Question 32

what muscle hooks round the rectum to bend it anteriorly?

Answer 32

puborectalis

Question 33

what is vaginal prolapse?

Answer 33

herniation of urethra, bladder, rectum or PoD through supporting fascia

Question 34

presentation of vaginal prolapse?

Answer 34

lump in vaginal wall by a urethrocele, cytocele etc

Question 35

if PoD herniates, what structure is responsible for this?

Answer 35

intestines (these are located in PoD)

Question 36

presentation of uterine prolapse?

Answer 36

dragging sensation
feeling of lump
urinary incontinence

Question 37

Tx of uterine prolapse?

Answer 37

sacrospinous fixation

incontinence surgery

Question 38

how does sacrospinous fixation work?

Answer 38

sutures placed in sacrospinous ligament medial to ischial spines to repair cervical/vault descent

Question 39

where is mesh placed in incontinence surgery and why?

Answer 39

obturator canal to create a sling around the urethra