Anatomy - Urinary Incontinence and Prolapse

Question 1

what are the main roles of the pelvic floor?

Answer 1

provides support to pelvic organs

maintaining continence

Question 2

what are the three layers of the pelvic floor?

Answer 2

pelvic diaphragm
muscles of perineal pouches
perineal membrane

Question 3

what is the deepest layer of the pelvic floor?

Answer 3

the pelvic diaphragm

Question 4

what two muscle groups make up the pelvic diaphragm?

Answer 4

levator ani

coccyges

Question 5

what is the anterior gap between the medial borders of the pelvic diaphragm called?

Answer 5

urogenital hiatus

Question 6

what is the role of the urogenital hiatus?

Answer 6

allows passage for the urethra and vagina

Question 7

which muscle of the pelvic diaphragm is located more anterior and medial?

Answer 7

levator ani

Question 8

which muscle of the pelvic diaphragm is located more posterior and lateral?

Answer 8

coccygeus

Question 9

what muscle forms most of the pelvic diaphragm?

Answer 9

levator ani

Question 10

what three muscles make up levator ani?

Answer 10

iliococcygeus
pubococcygeus
puborectalis

Question 11

what nerves innervate levator ani?

Answer 11

pudendal

nerve to levator ani

Question 12

what is the endopelvic fascia?

Answer 12

connective tissue that fills in the empty spaces around the pelvic organs

Question 13

what is the endopelvic fascia made of?

Answer 13

some loose, areolar tissue and some fibrous tissue

Question 14

what are the pelvic ligaments made of?

Answer 14

fibrous, thickened endopelvic fascia

Question 15

name the four pelvic ligaments

Answer 15

uterosacral
transverse cervical
lateral ligament of bladder
lateral rectal ligaments

Question 16

what is another name for the transverse cervical ligaments?

Answer 16

cardinal ligaments

Question 17

where does the deep perineal pouch lie?

Answer 17

below the fascia of the inferior pelvic diaphragm

above the perineal membrane

Question 18

what is found in the deep perineal pouch?

Answer 18

part of the urethra + vagina 
bulbourethral glands in males 
neuromuscular bundle for penis/clitoris 
fat 
muscles

Question 19

what is another name for the bulbourethral glands?

Answer 19

Cowper’s glands

Question 20

what is the role of Cowper’s glands?

Answer 20

create lubricating fluid in the male urethra

Question 21

what muscles are found in the deep perineal pouch?

Answer 21

external urethral sphincter
compressor urethrae
males = deep transverse perineal muscle
females = band of smooth muscle

Question 22

where is the perineal membrane located?

Answer 22

superficial to the deep perineal pouch

Question 23

what is the perineal membrane?

Answer 23

a thin sheet of tough, deep fascia

Question 24

where does the perineal membrane attach?

Answer 24

laterally to the side of the pubic arch

closes the urogenital triangle

Question 25

where does the superficial perineal pouch lie?

Answer 25

below the perineal membrane

Question 26

what does the superficial perineal pouch contain in females?

Answer 26

``` female erectile tissue associated muscle greater vestibular glands superficial transverse perineal muscle branches of pudendal vessels and nerve ```

Question 27

what elements make up the female erectile tissue?

Answer 27

clitoris crura bulbs of the vestibule

Question 28

what are the clitoris and crura made from?

Answer 28

corpus cavernosum

Question 29

what are the associated muscles of the female erectile tissue?

Answer 29

bulbospongiosus | ischiocavernosus

Question 30

what muscle lies over the crura?

Answer 30

ischiocavernosus

Question 31

what muscle lies over the bulb?

Answer 31

bublospongiosus

Question 32

what does the superficial perineal pouch contain in males?

Answer 32

the root of the penis proximal spongy urethra superficial transverse perineal muscle pudendal vessels and nerve

Question 33

what makes up the root of the penis?

Answer 33

bulb crura bulbospongiosus and ischiocavernosus

Question 34

what is the bulb of the penis made from?

Answer 34

corpus spongiosum

Question 35

what is the crura of the penis made from?

Answer 35

corpus cavernosum

Question 36

what three muscles are involved in the maintenance of urinary continence?

Answer 36

external urethral sphincter compressor urethrae levator ani

Question 37

what muscle is involved in the maintenance of faecal continence?

Answer 37

puborectalis

Question 38

what effect does tonic contraction of puborectalis have?

Answer 38

bends the anorectum anteriorly

Question 39

what is the aim of active contraction of the puborectalis?

Answer 39

maintaining faecal continence after rectal filling

Question 40

what is vaginal prolapse?

Answer 40

herniation of the urethra, bladder, rectum or recto-uterine pouch through the supporting fascia

Question 41

how does vaginal prolapse present?

Answer 41

a lump in the vaginal wall

Question 42

what is uterine prolapse?

Answer 42

descent of the uterus into the vagina

Question 43

what is first degree uterine prolapse?

Answer 43

when the cervix is dropping slighyly into the vagina

Question 44

what is second degree uterine prolapse?

Answer 44

when the cervix drops to a level just inside the opening of the vagina

Question 45

what is third degree uterine prolapse?

Answer 45

when the cervix is outside of the vagina

Question 46

what is fourth degree uterine prolapse?

Answer 46

when the entire uterus is outside of the vagina

Question 47

how can uterine prolapse present?

Answer 47

dragging sensation a feeling of a lump urinary incontinence

Question 48

how can uterine and vaginal prolapses be treated?

Answer 48

sacrospinous fixation

Question 49

what is involved in sacrospinous fixation?

Answer 49

sutures placed in the sacrospinous ligament just medial to the ischial spine performed vaginally

Question 50

what are the risks associated with sacrospinous fixation?

Answer 50

risk of injury to the pudendal neuromuscular bundle and the sciatic nerve