Anatomy of Urinary Incontinence and Prolapse Flashcards
name the 3 components of the pelvic floor
pelvic diaphragm
muscle of perineal pouches
perineal membrane
what fossa is located around the outside of the anogenital triangle of the levator ani?
ischioanal fossa
deepest layer of pelvic floor?
pelvic diaphragm
what muscle groups make up the pelvic diaphragm?
levator ani
coccygeus
puborectalis supplies the rectum only T or F
F, supplies the pelvic cavity via its slings
coccygeus is located posterior to __ and anterior to ____
posterior to levator ani and anterior to the sacrospinous ligament.
midline attachments of levator ani?
perineal body
coccyx
organ walls
name the 3 parts of the levator ani from most medial to most lateral
puborectalis
pubococcygeus
iliococcygeus
the levator ani are usually contracted/relaxed
contracted
innervation of levator ani
pudental nerve
nerve to levator ani
what does the nerve to levator ani supply?
superior aspect of levator ani
nerve roots of nerve to levator ani? where does it branch from?
S3, 4, 5
sacral plexus
what substance fills the space in the pelvic cavity around ligaments and organs?
endopelvic fascia
what forms endopelvic fascia? why does it have these fibres?
connective tissue
loose areolar tissue
fibrous tissue eg collagen and elastic fibres to give it elasticity and recoil
where does the uterosacral ligament originate and insert?
top of cervix
SI joint
name the pelvic ligaments in charge of supporting the pelvic organs and muscles?
uterosacral ligament
trasverse cervical ligament
lateral ligaments of bladder and rectum
the deep perineal pouch is inferior to ____ and superior to ____
inferior to levator ani
superior to perineal membrane
what does the deep perineal pouch contain?
part of the urethra part of the vagina/bulbourethral gland in men clitoral neurovascular bundle ischioanal fat pad extensions muscles
where does the perineal membrane laterally attach?
sides of the pubic arch
last passive support of the pelvic organs?
perineal body and membrane
which muscle of the levator ani doesnt have a bony attachment? what is its insertion?
iliococcygeus
coccyx
most inferolateral muscle located in the pelvic floor?
piriformis
crura means…
legs
what does the crura of the male form?
the corpus cavernosum of the penis, forming most of the body
what forms the corpus spongiosum?
bulb of the penis
what muscles are associated with the penis? where are they located?
bulbospongiosus
ischiocavernsus
superficial perineal pouch
what does the bulbospongiosus do?
initiates ejaculation
muscles of the superior perineal pouch of the female?
bulbospongiosus
ischiocavernosus - same as male!
name the glands associated with the erectile tissue of the female?
greater vestibular glands
the superficial perineal pouch is located ___ to the perineal membrane?
inferior
what muscle loops around the external urethral sphincter?
compressor urethrae
what muscle hooks round the rectum to bend it anteriorly?
puborectalis
what is vaginal prolapse?
herniation of urethra, bladder, rectum or PoD through supporting fascia
presentation of vaginal prolapse?
lump in vaginal wall by a urethrocele, cytocele etc
if PoD herniates, what structure is responsible for this?
intestines (these are located in PoD)
presentation of uterine prolapse?
dragging sensation
feeling of lump
urinary incontinence
Tx of uterine prolapse?
sacrospinous fixation
incontinence surgery
how does sacrospinous fixation work?
sutures placed in sacrospinous ligament medial to ischial spines to repair cervical/vault descent
where is mesh placed in incontinence surgery and why?
obturator canal to create a sling around the urethra
