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Reproduction > Anatomy of Urinary Incontinence and Prolapse > Flashcards

Anatomy of Urinary Incontinence and Prolapse Flashcards

1
Q

What is the role of the pelvic floor?

A

Separates pelvic cavity from perineum

Plays important role in providing support to pelvic organs

Plays an important role in maintaining continence

  • Urinary
  • Faecal
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2
Q

Name the 3 layers that make up pelvic flor

A
  1. Pelvic diaphragm
  2. Muscles of perineal pouches
  3. Perineal membrane
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3
Q

Which is the deepest/most internal layer of the pelvic floor?

A

Pelvic diaphragm

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4
Q

Which two muscle groups make up the pelvic diaphragm?

A

Levator ani: more anteromedial part

Coccygeus: Posterolateral

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5
Q

What is the significance of the anterior gap between medial borders of pelvic diaphragm?

A

Urogenital hiatus

Passage for urethra and vagina

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6
Q

Which muscle forms most of pelvic diaphragm?

A

Levator ani

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7
Q

Name the origin of puborectalis and pubococcygeus

A

Posterior aspect of coccygeus

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8
Q

What are the 3 parts of the levator ani?

A

Puborectalis
Pubococcygeus
Iliococcygeus - comes mainly from ischial spine, main attachment point is towards the coccyx

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9
Q

What is the function of levator ani?

A

Tonically contracted most of time

Must relax to allow urination and defecation

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10
Q

What is perineal body?

A

Fibro-muscular skeleton of pelvic floor

SUPER important for support to the pelvic floor (incontinence)

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11
Q

Name the innervations of levator ani

A

Pudendal nerve - S2 to S4

Nerve to levator ani

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12
Q

What are the additional layers of support apart from pelvic diaphragm?

A

Endo pelvic fascia

Pelvic ligaments

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13
Q

What is endopelvic fascia?

A

connective tissue ‘packing’

some loose areolar tissue

some fibrous
- collagen and elastic fibres

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14
Q

What are the pelvic ligaments?

A 
Fibrous endo-pelvic fascia
Provide support to pelvic organs
Uterosacral
Transverse cervical (cardinal)
Lateral ligament of bladder
Lateral rectal ligaments
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15
Q

What is the tendinous arch of pelvic fascia?

A

Thickened area of fascia that covers the obturator internus

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16
Q

Where is deep perineal pouch located?

A

Underneath pelvic diaphragm and above perineal membrane

17
Q

What does deep perineal pouch contain?

A

Urethra
Vagina
Bulbourethral gland/Cowper’s glands (homologus for bartholin glands in females)
Neurovascular bundle for penis/clitoris
Extensions of the ischioanal fat pads and muscles

18
Q

Which urethral muscles work together to maintain continence

A

External urethral sphincter

Compressor urethrae

19
Q

What is the perineal membrane?

A

Thin sheath of tough membrane

20
Q

Where does the perineal membrane attach?

A

Laterally to the side of the pubic arch, closing the urogenital triangle

21
Q

What are the perineal membrane openings?

A

For urethra in males and vagina in females

22
Q

Which is the last layer of passive support for pelvic organs?

A

Perineal body together with perineal membrane

23
Q

Where is the superficial perineal pouch in males?

A

below perineal membrane

24
Q

Contents of the superficial perineal pouch in males

A

Contains root of penis:
Bulb – corpus spongiosum, crura – corpus cavernosum
Associated muscles – bulbospongiosus and ischiocavernosus

Also contains proximal spongy (penile) urethra, superficial transverse perineal muscle and branches of internal pudendal vessels and pudendal nerve

25
Q

Which erectile tissue contains 90% of blood flow in an erection?

A

Corpus cavernosum

26
Q

Which muscle covers the bulb of penis?

A

Bulbospongiosus

27
Q

Which muscle covers the crura of penis?

A

Ischiocavernosus

28
Q

Ischiocavernosus muscles contributes to perineal body - T or F

A

F

29
Q

Where is superficial perineal pouch located in females?

A

Below perineal membrane

30
Q

What is the contents of the superficial perineal pouch in females?

A

Contains female erectile tissue and associated muscle:
Clitoris and crura – corpus cavernosum
Bulbs of vestibule – paired
Associated muscles – bulbospongiosus and ischiocavernosus

Also contains greater vestibular glands, superficial transverse perineal muscle and branches of internal pudendal vessels and pudendal nerve

31
Q

Which structures of pelvic floor maintains urinary continence?

A

External urethral sphincter, Compressor urethrae,

Levator ani

32
Q

Which features of pelvic floor maintains fecal continence?

A

Tonic contraction of puborectalis bends the anorectum anteriorly

Active contraction maintains continence after rectal filling

33
Q

Which events cause injury to pelvic floor?

A

Pregnancy

Childbirth

  • stretching or tearing
  • pudendal nerve damage

Chronic constipation

Obesity

Heavy lifting

Chronic cough or sneeze

Previous injury to pelvis/pelvic floor

Menopause

Reproduction (32 decks)

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