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Reproductive System > Pelvic Floor > Flashcards

Pelvic Floor Flashcards

1
Q

What is the main function of the pelvic floor?

A

To support the pelvic organs (Vagina, uterus, bladder, ovaries and rectum)

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2
Q

Describe the 3 levels of support of the pelvic organs

A
  1. Support:
    - Strong vertical, anti-gravity support mainly from Cardinal, Uterosacral and Round ligaments
  2. Attachment;
    - Support coming from attachments on the pelvic organs
    - (E.g vagina supported by its attachment to Endopelvic Fascia, Levator Ani muscles and Perineal Body)
  3. Fusion;
    - Support that arises from fusion of different tissues
    - (E.g Perineal body and Urogenital Diaphragm)
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3
Q

Other than support list 4 functions of pelvic floor

A
  • Maitain Intra-abdominal pressure (during sneezing/ coughing/ laughing)
  • Facilitate defecation and micturition
  • Maintain unitary and faecal continence
  • Faciltiate childbirth
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4
Q

The Pelvic floor is composed of 3 Deep and 3 Superficial muscles

Describe the arrangement and name the 3 DEEP muscles

A
  • These 3 muscles make up the Levator Ani muscles
  • U shaped muscles, act like a sing
  • Pubococcygeus
  • Puborectalis
  • Iliococcygeus
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5
Q

What structures are encircled and supported by the Deep Pelvic Floor Muscles/ Levator Ani Muscles

A
  • Urethra
  • Vagina
  • Rectum
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6
Q

What is the midpoint of the attachments of the Levator Ani muscles

A

Perineal body

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7
Q

What are the 3 superficial muscles of the pelvic floor?

Are they found in men or women?

A
  • Ischiocavernous
  • Bulbospongiosus (More medial)
  • Superficial transverse perineal muscle

Both genders

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8
Q

Which 2 muscles can undergo Iatrogenic damage during medio-lateral epitostomy in childbirth?

Why is this done?

A

Bulbospongiosus and transverse perineal muscles

To avoid damage to perineal body

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9
Q

What are 3 occasions an epitostomy is done?

Why is one of these done?

A
  • Large baby
  • Difficult delivery
  • Using instruments such as forceps during delivery

To prevent perineal body damage

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10
Q

List 4 complications of an Epiostomy

A
  • Infection
  • Haemorrhage
  • Damage to anal sphincter
  • Dyspareunia (Recurring pain in pelvis/ genital region before/ during/ after sexual intercourse)
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11
Q

What is the central point between vagina and rectum?

Its main function is?

What is it attached to posteriorly?

A

Perineal body, acts as site of attachment for pelvic floor muscles

Posteriorly attached to External Anal Sphincter

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12
Q

What is the Urogenital Diaphragm?

Name 3 things it attaches to

A

A dense sheet of fibrous tissue that spans the anterior half of the pelvic floor.

  • Urethra
  • Vagina
  • Perineal body
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13
Q

Name the blood supply, lymphatic drainage and innervation to the pelvic floor muscles

A

Blood:
- Internal and external pudendal arteries and veins

Lymph:
- Inguinal nodes

Innervation:
- Pudendal nerve

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14
Q

List 4 examples of Pelvic Floor Dysunction

A
  • Pelvic organ prolapse
  • Urinary incontinence (Stress incontinence to be exact)
  • Female genial mutilation
  • Vaginismus
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15
Q

What is pelvic organ prolapse?

What are 5 ways it affects quality of life?

A

Prolapse of Uterus/ Bladder/ Colon (possibly into vagina) due to loss of support

  • Altered sense of body image leading to depressive symptoms
  • Source of pain/ infection

Disturbance to;

  • Anorectal functiom
  • Urinary function
  • Sexual function
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16
Q

Pelvic organ prolapse can be classified by compartment that prolapse has occurred in and the organ that has prolapsed

What are the 3 possible compartment in can occur in?

A
  • Anterior
  • Middle
  • Posterior
17
Q

What are 3 types of Anterior Compartment Pelvic Organ Prolpase

A
  • Cystocoele: Bladder prolapses
  • Urethrocoele: Urethra prolpases
  • Cysourethrocoele: Both prolapse
18
Q

Describe Middle Compartment Pelvic Organ Prolpase

A

Uterus prolpases into vagina to various degrees

19
Q

List 2 types of Posterior Compartment Pelvic Organ Prolpase

A
  • Rectocoele: Rectum prolpase

- Enterocoele: Loops of bowel entering Rectouterine pouch

20
Q

List 7 risk factors of pelvic organ prolapse

A
  • Age
  • Parity (No. of pregnancies resulting in childbirth)
  • Vaginal delivery
  • Obesity
  • Chronic raised intra abdominal pressure
  • Oestrogen deficiency
  • CT/ Neurological disorders
21
Q

How will a patient with Pelvic Organ Prolpase present?

A
  • Will feel a ‘lump’/ something ‘coming down’

- Possibly symptoms related to where prolapse occurs

22
Q

List some management plans for patient with Pelvic Organ Prolpase

(Remember prolpases can occur)

A

Non surgical;
- Insertion of Pessaries to provide additional support

Surgical;

  • Removal of uterus
  • Use of mesh support in a vault prolpase
23
Q

What is a vault prolpase

A

Prolapse of apex of vagina

Can occur after a hysterectomy, as ligaments have to be cut

24
Q

Describe stress inctoninence in pelvic floor dysfunction

A

Raised intra abdominal pressure causes leaks of urine as support to urethral sphincter is inadequate

25
Q

What are the risk factors for stress incontinence?

A

Same as those for Pelvic Organ Prolpase, ESPECIALLY Age and Oestrogen Deficiency

POP RFs:

  • Age
  • Parity (No. of pregnancies resulting in childbirth)
  • Vaginal delivery
  • Obesity
  • Chronic raised intra abdominal pressure
  • Oestrogen deficiency
  • CT/ Neurological disorders
26
Q

What are some symptoms of stress incontinence?

A

Passing urine on;

  • Coughing
  • Laughing
  • Other activities than increase abdominal pressure (sneezing)
27
Q

What are 2 methods of management of stress incontinence/

A
  • Pelvic floor muscle training (1st Line)

- Surgical intervention to create slings to support urethral sphincter

28
Q

What is Vulval pain often related to?

A

Tension of Levator ani muscles

29
Q

What are 3 Acute consequences of FGM?

A
  • Pain
  • Sepsis
  • Haemorrhage
30
Q

What are 5 Chronic consequences of FGM?

A
  • Psychological effects/ trauma
  • Sexual dysfunction
  • Difficulty conceiving/ fertility issues
  • Chronic pain
  • Menstrual disorders
31
Q

What are 2 examples of posterior compartment pelvic floor dysfunction?

A
  • Constipation/ incomplete evacuation
  • Anal inctoninence due to anal sphincter injury

(Anal sphincter is attached to Levator Ani muscles, so any damage can lead to loss voluntary control of defecation)

Reproductive System (21 decks)

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