Pelvic Floor

Question 1

How many layers of muscle does the pelvic floor have?

Answer 1

3 layers of muscle

Question 2

What are the Six S’s of pelvic floor function?

Answer 2

sexual; spinteric; supportive; stabilizing; pressure; slide out

Question 3

What are the fiber types of the pelvic floor?

Answer 3

70% slow and 30% fast

Question 4

What are the 3 layers of the pelvic floor?

Answer 4

1: superficial (sexual)
2: spincteric
3: supportive/stabilizing

Question 5

What innervates the first muscular layer?

Answer 5

perineal branch of Pudendal N.

Question 6

What muscles are part of the third layer of the PFM?

Answer 6

pubococcygeus; illiococcygeus; puborectalis; coccygeus

Question 7

What are the purposes of the third muscle layer?

Answer 7

forms the floor of the pelvis and supports the viscera (organs, bladder, bowel)

Question 8

What muscle is the tail wagger?

Answer 8

coccygeus

Question 9

What are the ER’s of the hip?

Answer 9

PGOGOQ

Question 10

Which direction does a concentric muscle contraction of the pelvic floor move the coccyx?

Answer 10

anterior

Question 11

What is commonly used to assess the PFM?

Answer 11

real-time US

Question 12

What is micturition?

Answer 12

excretion of urine

Question 13

What are common causes of pelvic organ prolapse?

Answer 13

pregnancy/childbirth; constipation; obesity; heavy lifting; chronic cough; organ removal

Question 14

What are common symptoms of a pelvic organ prolapse?

Answer 14

pelvic heaviness; feeling of descent; LBP; incomplete voiding; urgency; painful intercourse

Question 15

What is a cystocele?

Answer 15

displacement of the bladder creating a bulge into the anterior vaginal wall

Question 16

What is a rectocele?

Answer 16

displacement of the rectum creating a bulge into the posterior vaginal wall

Question 17

What is a uterine prolapse?

Answer 17

displacement of the uterus downward into the vaginal vault

Question 18

What are the grades of an organ prolapse?

Answer 18

Grade I: mild bulge (25%)
Grade II: moderate bulge (50%)
Grade III: sever bulge; to/beyond vaginal opening
Grade IV: bulge is completely out

Question 19

What grades of organ prolapse are physical therapy appropriate for?

Answer 19

Grades I and II

Question 20

What are contraindications for internal PFM exams?

Answer 20

prenant; post-partum (6 weeks); infection; sever pain; sexual abuse; lack of patient consent

Question 21

What are the steps to teaching pelvic floor exercise?

Answer 21

contract; relax; bulge/elongate; verbal/manual cues

Question 22

How can we test to ensure a patient is performing a kegel correctly?

Answer 22

stop urine flow mid-stream

Question 23

What are the benefits of sEMG?

Answer 23

non-invasive; saves and prints data; any position; monitors multiple muscles; times contractions

Question 24

What are the various pelvic floor muscle disorders?

Answer 24

pelvic floor tension myalgia; vaginismus; vulvodynia; coccydynia; pudendal neuralgia

Question 25

What are the typical symptoms of pelvic pain?

Answer 25

pelvic/vaginal/LBP; bloating; difficulty starting urine; painful intercourse (dyspareunia)

Question 26

What differentiates between visceral and somatic pain?

Answer 26

somatic changes with body position, specific location