Anatomy of urinary incontinence and prolapse

Question 1

pelvic floor

Answer 1

Separates pelvic cavity from perineum
Plays important role in providing support to pelvic organs
Plays an important role in maintaining continence
-Urinary
-Faecal

Question 2

pelvic floor is made up of three layers:

Answer 2

1. pelvic diaphragm
2. muscles of perineal pouches
3. perineal membranes

Question 3

1. pelvic diaphragm

Answer 3

Deepest layer of pelvic floor
Consists of two muscle groups: levator ani 
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coccygeus
Has the appearance of a sling

Question 4

Anterior gap between medial border of levator ani

Answer 4

urogenital hiatus- passage of urethra and vagina

Question 5

levator ani has 3 parts-

Answer 5

Puborectalis
Pubococcygeus
Iliococcygeus

Question 6

levator ani attaches to-

Answer 6

Pubic bones, ischial spines and tendinous arch of levator ani

Perineal body, coccyx and walls of organs in midline

Question 7

levator ani is innervated by

Answer 7

pudendal nerve

Question 8

pelvic ligaments

Answer 8

fibrous endo-pelvic fascia
provide support to pelvic organs
uterosacral
transverse cervical (cardinal)
lateral ligament of bladder
lateral rectal ligaments

Question 9

2. deep perineal pouch

Answer 9

Contains part of the urethra (and vagina in females), bulbourethral glands in male, neurovascular bundle for penis/clitoris, extensions of the ischioanal fat pads and muscles

Question 10

3. perineal membrane

Answer 10

Superficial to deep perineal pouch

Thin sheet of tough, deep fascia

Attaches laterally to the sides of the pubic arch, closing the urogenital triangle

Openings for the urethra (and vagina in females)

Together with the perineal body, it is the last passive support of the pelvic organs

Question 11

superficial perineal pouch in males

Answer 11

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

Question 12

superficial perineal pouch in females

Answer 12

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

Question 13

perineal body

Answer 13

vital structure for the pelvic floor