Pelvic Floor

Question 1

Pelvic diaphragm

Answer 1

Musculofascial - forms the internal floor of the pelvic floor
Fascia
Muscles - Coccygeus and Levator ani group

Question 2

Fascia

Answer 2

Sheet of connective tissue - strong in all directions sue to collagen fibres running in every direction
Primarily collagen
Surrounds, supports and encloses
Forms compartments - lining the bowls of the pelvis

Question 3

Obturator facia

Answer 3

Sits on top of the obturator internus
Loops through the pelvis and out to become an important hip rotator muscle

Question 4

Superior pelvic diaphragm (facia)

Answer 4

Overlies the muscle tissue that closes off the base of the abdomen and bowl of the pelvis

Question 5

Walls of the pelvic floor - anterior wall

Answer 5

Pubic bone
Pubic symphysis

Question 6

Walls of the pelvic floor - posterior wall

Answer 6

Sacrum
Coccyx
Lined with the anterior longitudinal ligament

Question 7

Walls of the pelvic floor - lateral wall

Answer 7

Obturators - internus, obturator facia sister on top of the muscle, attaches to the greater trochanter
Piriformis - from sacrum out of the bowl of the pelvis to greater trochanter, lateroposterior wall
Coccygeus - on the sacrospinous ligament, inserts into ischial spine
Sacrotuberous ligament
Iliac bones
Iliacus

Question 8

Muscles of the pelvic diaphragm - Coccygeus

Answer 8

Lays on the sacrospinous ligament
Inserts to the ischial spine

Question 9

Muscles of the pelvic diaphragm - Levator ani group

Answer 9

Iliococcygeus
Puborectalis
Pubococcygeus

Question 10

Muscles of the pelvic diaphragm - Levator ani group; Iliococcygeus

Answer 10

Tendinous, structural
Runs from the obturator facia to the anococcygeal body

Question 11

Muscles of the pelvic diaphragm - Levator ani group: puborectalis

Answer 11

Forms a loop from the pubic bone round behind the rectum then back to the pubic bone
Helps maintain the ano-rectum angle
Damage can lead to faecal incontinence

Question 12

Muscles of the pelvic diaphragm - Levator ani group: Pubococcygeus

Answer 12

Runs from the pubic bone to the anococcygeal body

Question 13

Anococcygeal body

Answer 13

Strip of fibrous tissue that acts as an insertion point
Supports the anus by linking across the coccyx

Question 14

Muscles of the pelvic diaphragm - pubovaginalis

Answer 14

From the pubis, around the vagina back to the pubis
Inserts on the periano body - collection of connective tissue
Supports the action of the vaginal sphincter
Guards against urinary incontinence
Maintains tone of vaginal wall

Question 15

Urogenital hiatus

Answer 15

Area that the vagina and ureter passes

Question 16

Levator ani main roles

Answer 16

Closes the inferior opening - support and tone
Supports pelvic organs and baby if pregnant
Actively controls defecation - puborectalis muscle tone, puborectum sling

Question 17

Nerve supply

Answer 17

Levator ani group - pudendal nerve via the spinal roots of S2, S3 and S4
Coccygeus - spinal root of S4 and S5

Question 18

Pundenal nerve

Answer 18

Impulses to the Levator ani group, external genitalia, bladder sphincter, anus and perineum
Target for nerve blockers during child birth

Question 19

Perineal membrane

Answer 19

Strong and heavy
Connective tissue facia
Posterior aspect is open - not heavily attached to the muscles above, create and area for the deep perineal pouch
Supports external genitalia

Question 20

Deep perineal pouch - deep transverse perineal muscle

Answer 20

Strap like
Found within the deep perineal pouch
Sits beneath the perineal membrane
Helps stabilise the perineal body

Question 21

Deep perineal pouch - compressor urethrae

Answer 21

Only in women
Helps close the urethra
Support the external urethral sphincter
Guard against urinary incontinence
Fine, grassile strap of muscle

Question 22

Deep perineal pouch - urethrovaginalis

Answer 22

Only in women
Loop of muscle
Supports the vaginal and urethral openings
Assists the closure of the vagina
Guard against urinary incontinence