Pelvic floor

Question 1

the pelvic diaphragm is composed of what 2 muscle blocks

Answer 1

levator ani anteriorly

coccygeus posteriorly

Question 2

what forms the muscular roof of the anal triangle

Answer 2

levator ani

Question 3

what are the attachments of coccygeus

Answer 3

ischial spine and sacrospinous ligament to the coccyx and inferior sacrum

Question 4

what is the function of coccygeus

Answer 4

support pelvic viscera, flexion of coccyx

Question 5

what is the innervation of coccygeus

Answer 5

direct branches from sacral plexus (S4, S5)

Question 6

what are the 2 main parts of levator ani

Answer 6

pubococcygeus and iliococcygeus

Question 7

which fibres are more medial in the levator ani

Answer 7

pubococcygeus

Question 8

what does the pubococcygeus support

Answer 8

vagina/prostate and rectum

Question 9

what are the more lateral fibres of the levator ani

Answer 9

iliococcygeus

Question 10

iliococcygeus is found ____ to coccygeus

Answer 10

anterior

Question 11

where does iliococcygeus attach

Answer 11

fascia above obturator internus

Question 12

what does levator ani contract to do

Answer 12

prevent prolapse of the pelvic viscera

Question 13

what does levator ani relax to do

Answer 13

permit the passage of urine and faeces through the urethra and anal canal and out of the body

Question 14

what is the motor innervation of levator ani

Answer 14

nerve to levator ani and the pudendal nerve

Question 15

what does pubococcygeus divide into

Answer 15

puborectalis, levator prostatae (puboprostaticus) and pubovaginalis

Question 16

structures in the gap of the pelvic diaphragm near the pubic bones are supported by what

Answer 16

urogenital diaphragm

Question 17

where do the fibres of pubococcygeus pass

Answer 17

from the pubic bones to wrap around the prostate gland or vagina and the rectum

Question 18

fibres that support the vagina and prostate gland insert into where

Answer 18

perineal body

Question 19

in males, the most medial fibres of pubococcygeus pass around what and insert where

Answer 19

the prostate and insert into the perineal body (levator prostatae - puboprostaticus)

Question 20

in females, the most medial fibres of pubococcygeus pass around what and insert where

Answer 20

the vagina and insert into the perineal body (pubovaginalis)

Question 21

in both sexes, the more posterior fibres of pubococcygeus wrap around what

Answer 21

rectum - puborectalis

Question 22

what is the motor innervation to pubococcygeus

Answer 22

pudendal nerve and nerve to levator ani

Question 23

what is the function of puborectalis

Answer 23

acts to maintain feacal continence by bending the rectum and making the release of faeces more difficult

Question 24

describe the state of the pelvic floor muscles normally

Answer 24

small amount of tonic contraction to support the viscera but the muscles can contract to increase the bend in the rectum or relax to straighten the rectum and make it easier to push faeces out of the body

Question 25

what is the innervation of puborectalis

Answer 25

pudendal nerve (S2-4) and nerve to levator ani (S4)

Question 26

fibres of the puborectalis mix with

Answer 26

those from external anal sphincter forming a modified sling around the rectum

Question 27

when is puborectalis especially important

Answer 27

immediately after the rectum has filled and the internal anal sphincter is open

Question 28

what are the attachments of iliococcygeus

Answer 28

thickened fascia above obturator internus and passes medially to the anococcygeal body/ligament/levator plate (connective tissue that lies between the anal canal and the coccyx)

Question 29

is iliococcygeus or pubococcygeus more fibrous

Answer 29

iliococcygeus

Question 30

what is the tendinous arch of levator ani

Answer 30

area of attachment of iliococcygeus to the fascia of obturator internus

Question 31

the area of attachment of iliococcygeus to the fascia of obturator internus is known as what

Answer 31

tendinous arch of levator ani

Question 32

what is the innervation of iliococcygeus

Answer 32

pudendal nerve and nerve to levator ani

Question 33

what muscle lies between iliococcygeus and the bony pelvis

Answer 33

obturator internus

Question 34

what is the name of the small piece of tough connective tissue that lies in the pelvic floor at the edge of the urogenital diaphragm between the openings of the vagina (female) or urethra (male) and the anal canal

Answer 34

perineal body

Question 35

what is the perineal body composed of

Answer 35

fibrous connective tissue

Question 36

the perineal body provides attachment sites for what

Answer 36

levator prostatae pubovaginalis EAS perienal muscles

Question 37

what is thought to be the function of the perineal body

Answer 37

act as an area that distributes forces across the pelvic and urogenital diaphragms as it is attached to both structures

Question 38

describe the parietal pelvic fascia covering the internal wall of the pelvis

Answer 38

thickened over obturator internus to form the tendinous arch of the pelvis (and levator ani)

Question 39

in a male, what is the name for the parietal pelvic fascia anteriorly

Answer 39

puboprostatic ligament

Question 40

in the female, what is the name for the parietal pelvic fascia anteriorly

Answer 40

pubovesical ligament

Question 41

what is the paracolpium

Answer 41

lateral extension of visceral fascia from vagina to tendinous arch

Question 42

describe the visceral pelvic fascia

Answer 42

covers the organs, parietal and visceral blend as organs pierce the pelvic floor

Question 43

what is the endopelvic fascia

Answer 43

acts as a packing materal around the organs

Question 44

what are the 2 types of endopelvic fascia

Answer 44

loose and condensed

Question 45

what does the loose endopelvic fascia do

Answer 45

fills spaces in the pelvis e.g. the retropubic (pre-vesical) space

Question 46

what is the condensed endopelvic fascia

Answer 46

thickenings of the fascia

Question 47

what is the primary condensation (an example of condensed endopelvic fascia)

Answer 47

the hypogastric sheaths running along the posterolateral walls of the pelvis

Question 48

are the pelvic organs intra or retroperitoneal

Answer 48

subperitoneal / infraperitoneal

Question 49

how are the pelvic pouches formed

Answer 49

pelvic organs are covered by a continuation of the peritoneal lining of the abdominal cavity which forms pouches

Question 50

what are the two peritoneal pouches in the female

Answer 50

vesico-uterine pouch | recto-uterine pouch

Question 51

what is the peritoneal pouch in males

Answer 51

vesico-rectal pouch