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PTAP Woundcare > Pelvic Floor > Flashcards

Pelvic Floor Flashcards

1
Q

What are the primary functions of the Pelvic Floor?

A

supports bladder, bowel, and reproductive organs.

aids in holding and evacuation of waste.

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2
Q

What are the structures of the Anal Triangle?

A
  • (Anterior)
    Ischial tuberosities and superficial transverse ligament
  • (Posterior)
    Sacrotuberous ligament, gluteus maximus and coccyx
  • (Lateral)
    ischium and inferior part of obturator internus muscles
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3
Q

What are the superficial muscles of the Urogenital Triangle

A
  • Ischiocavernosus
  • bulbocavernosus
  • superficial transverse perineal
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4
Q

What are the functions and innervation of the Urogenital Triangle?

A
  • Aid in sexual responsiveness
  • Supports pelvic organs/fixes the perineal body
  • innervated by the pudendal nerve
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5
Q

What muscle works in the closure of the anus?

A

External Anal Sphincter

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6
Q

What are the insertion/origins of the Deep Transverse Perineal for men/women?

A

Originates from the pubic ramus
Males: wraps around the urethra and attaches on the same muscle of the opposite side; may be joined with the deep transverse perineal
Females: inserts into the vagina

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7
Q

What muscles support the Pelvic Diaphragm?

A

Levator

Coccygeus

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8
Q

What are the functions of the Pelvic Floor/Pelvic Diaphragm?

A
  • Supports the pelvic organs/viscera
  • Resists increases in intra-abdominal pressure
  • Pulls the rectum toward the pubic bone
  • Maintain continence at the urethral and anal sphincter
  • Stabilizes SI joint
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9
Q

What are the 3 fibers that make up the Levator Ani?

What innervates these fibers?

A

Pubococcygeus
Puborectalis
Iliococcygeus

S3 to S4

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10
Q

What muscle serves as a base of support for the bladder, supports the walls of vagina and provides tone during sexual activity?

A

Levator Ani

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11
Q

Originates on the ischial spine
Inserts on the sacrum and coccyx
Innervated by the spinal nerves S3-4
Flexes the coccyx

A

Coccygeus

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12
Q

Has a tendinous attachment to the levator ani
Refers pain to the sacral-coccyx area, posterior thigh and vagina
Tightness and trigger points can cause a feeling of fullness in the rectum.
Muscle tightness can cause pudendal and obturator nerve entrapment

A

Obturator Internus

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13
Q

An involuntary loss of urine that is sufficient to be a
problem and occurs most often when bladder pressure
exceeds sphincter resistance. More common in women and increases with age.

A

Urinary Incontinence

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14
Q

What are the different types of Incontinence?

A
  • Stress Incontinence
  • Urge Incontinence
  • Overflow Incontinence
  • Functional Incontinence
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15
Q

What are the causes of Stress Incontinence?

A
  • Weakness of pelvic floor or sphincter weakness
  • May be a result of childbirth
  • Trauma to internal sphincter mechanism
    (from prostate surgery in men)
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16
Q

A strong, unexpected urge to urinate followed by uncontrolled
loss of urine.

A

Urge Incontinence

17
Q

What are the causes of Urge Incontinence?

A
  • Decreased bladder capacity
  • Detrusor muscle instability
  • Neurologic disease affecting the bladder
  • Prolonged bladder outlet obstruction
18
Q

Urine leaks and dribbles from a bladder that is not full caused by pelvic relaxation, constipation, prostrate obstruction, DM and or SCI.

A

Overflow Incontinence

19
Q

Urinary loss when there is difficulty with mobility, dexterity, and impaired cognition.

A

Functional Incontinence

20
Q

Causes of Incontinence

A
  • Disuse atrophy
  • Childbirth trauma: loss of pelvic floor support
  • Hormonal changes
  • Repetitive Valsalva
  • Post surgical
  • Bacterial infection
  • Cystocele, Urethrocele, Rectocele, Enterocele - (Prolapse)
  • Neurogenic
21
Q

What data should you collect as a PTA regarding Incontinence?

A
  • PFM strength, coordination, and resting tone
  • Accessory muscle group strength/recruitment
  • Abdominal strength/muscles recruited
  • Diastasis recti
  • Bladder diary
22
Q

What are the treatment options for Incontinence?

A
  • E-stim
  • Biofeedback
  • Vaginal weights
  • Home exercise program
  • Diet/prevention education
  • Medication review
  • Bladder retraining
23
Q

Treatment Objectives/Interventions for Stress Incontinence.

A

improve pelvic floor muscle strength/endurance

improve support of abdominal viscera

24
Q

Treatment Objectives/Interventions for Overflow Incontinence.

A
  • Eliminate outflow obstruction or improve detrusor contractility
  • May require surgery
  • Pelvic floor relaxation exercises
  • Biofeedback
25
Q

Treatment Objectives/Interventions for Urge Incontinence.

A
  • Inhibit bladder contractions
  • Increase bladder capacity
  • Pelvic floor and abdominal exercises
26
Q

What are some examples of Bladder irritants?

A 
• Carbonated drinks
• Caffeine (coffee, tea)
• NutraSweet
• Alcoholic beverages
• Spicy foods
• Vinegar
• Strawberries
• Sugar, honey, chocolate, 
corn syrup
• Vit. B complex
• Tomato based products
• Milk/milk products
• Citrus juice and fruits
• Cranberry juice
27
Q

Physical Therapy Interventions for Pelvic Health and Rehab.

A
  • Kegel exercises
  • General strengthening exercises
  • Modalities to facilitate contraction of Pelvic Floor
  • Soft Tissue Massage
28
Q

Supine Kegel Exercise instruction and parameters.

A
  • Men: The penis moves upward and inward
  • Women: The vagina contracts and tightens as it moves upward
  • Isometric Hold
  • 10 seconds
  • Reps. 10x
  • Repeat 3x
29
Q

How are Kegel Exercises progressed?

A 
Perform Kegel Exercises in conjunction with following:
• Resisted TheraBand hip abduction and external rotation
• Resisted adduction with a squeeze ball
• Bridging
• Standing
• Squatting
• Lunges
• Sit to Stand
30
Q

What are the contraindications for E-stim for Incontinence?

A 
• Infection - bladder or vaginal
• Pregnancy or attempting 
pregnancy
• Urogential or colorectal 
cancer
• Anti-coagulation therapy, 
pacemaker, arrythmia
• History of urinary retention
• Cognitive impairment
31
Q

Parameters for Electrotherapy with Stress and Urge Incontinence.

A

15 min sessions
2x daily - 12 weeks
50Hz for Stress
10Hz for Urge

32
Q

Examples of strength exercises for Pelvic Health and Rehab.

A 
Pelvic Tilt
Bridging
Quadruped
SL Leg lift
Drawing-in
Wall Squat
Birddogs

PTAP Woundcare (9 decks)

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