Pelvic

Question 1

Pelvic Floor (3)

Answer 1

Pelvic Diaphragm - levator ani m.
External Urethral Spincter
Urogenital Diaphragm - most superficial

Question 2

Pelvic Diaphragm

Levator Ani m.

Answer 2

Puborectalis
Pubococygeus
Iliococcygeus

Question 3

Urogenital Diaphragm

Answer 3

Bulbospongiosus
 - assist w/ erection
 - ejaculation
 - push out residual urine
Ischiocavernosus
 - ejaculation
 - assists w/ penile rigidity

Question 4

Bulbocavernosus: O/I

Answer 4

Covers bulb of vestibule
O: Pubic Ramus
I: Perineal Body

Question 5

Ischiocavernosus: O/I

Answer 5

Covers crus of clitoris
O: Pubic Ramus
I: Ischial tuberosity

Question 6

Superficial Transverse Perineal

Answer 6

O: Ischial tuberosity
I: Perineal body

Question 7

Pelvic Floor Muscle Fibers

Answer 7

Orientation: all directions
striated, skeletal
70% slow
30% fast

Question 8

Somatic (voluntary)

Answer 8

Pudendal nerve (S2-4)
Contract relax external sphincter
Inhibit PNS

Question 9

Alcock’s Canal: nerve

Answer 9

Pudendal n. travels here

Question 10

3 Functions

Answer 10

Supportive
Sphincteric
Sexual

Question 11

Supportive Functions (4)

Answer 11

Supports pelvic organs
Reduces force of gravity
Reduces force of intra-abdominal pressure
Assists in pelvic and lumbar stability

Question 12

Sphincteric Functions (3)

Answer 12

Compression of urethra and rectum for continence
Continence w/ higher urethral pressure than bladder pressure
Slow and fast twitch fibers needed

Question 13

Sexual Functions: Female

Answer 13

Hypertrophied PFM

• smaller vagina for increased friction
• more sensory nerve stimulation
• improved pleasurable sensation

Question 14

Sexual Functions: Male

Answer 14

Assists w/ maintaining erection

Stronger contraction w/ orgasm/ejaculation

Question 15

Bladder phases (3)

Answer 15

1) Storage
2) Filling
3) Emptying

2-4 hours
Never empty!

Question 16

Bladder capacity

Answer 16

300-500 ml

Question 17

Voiding is what type of event?

Answer 17

Passive

Question 18

Autonomic (involuntary)

SNS

Answer 18

Sympathetic (T12-L2)
Hypogastic n. plexus
Constant tone in internal sphincter
Detrusor relaxation

Promotes storage

Question 19

Autonomic (involuntary)

PNS

Answer 19

Parasympathetic (S2-S4)
Pelvic n.
Relaxation of internal sphincter
detrusor contraction

Promotes emptying

Question 20

Bladder Cycle

Answer 20

1) Ureters fill bladder constantly
2) Detrusor is stretched and sends msg to brain for emptying
3) Brains responds w/ relaxing internal spincter and gentle detrusor contraction
4) Voluntary external sphincter relaxation
5) Voiding occurs til empty
6) Brain tells detrusors to relax
7) Internal sphincters tighten w/ low constant contraction
8) Urine begins to be stored

Question 21

Pelvic Floor Dysfunction

Answer 21

Poor sphincter closure - frequency, urgency, incontinence
Poort support of pelvic organs - prolapse
Hypertonia - pain, retention
Poor coordination w/ deep stabilizers
- transversus abdominis, lumbar multifidus
Poor coordination w/ global muscles
- decreased motor control, LBP

Question 22

Etiology

Answer 22

Childbirth
muscle tear, over-stretching
crush injury, PFM or nerve
UTI
Age
Neurological disorders (CNS/PNS)
HNP/SCI
Diabetes
CVA, MS, Parkinson's
Pelvic/Abdominal Sx
Pain Inhibition

Question 23

Impairments

Answer 23

Decreased muscle performance

Decreased muscle coordination

Question 24

Prostate Gland

Answer 24

Size of walnut
Directly below bladder
Surrounds urethra
Thins/liguefies seminal fluid
Rich in sugar to nourish sperm
Age >60
50% symptomes
Reasons: BPH, Tumor