Pelvic floor Flashcards
the pelvic diaphragm is composed of what 2 muscle blocks
levator ani anteriorly
coccygeus posteriorly
what forms the muscular roof of the anal triangle
levator ani
what are the attachments of coccygeus
ischial spine and sacrospinous ligament to the coccyx and inferior sacrum
what is the function of coccygeus
support pelvic viscera, flexion of coccyx
what is the innervation of coccygeus
direct branches from sacral plexus (S4, S5)
what are the 2 main parts of levator ani
pubococcygeus and iliococcygeus
which fibres are more medial in the levator ani
pubococcygeus
what does the pubococcygeus support
vagina/prostate and rectum
what are the more lateral fibres of the levator ani
iliococcygeus
iliococcygeus is found ____ to coccygeus
anterior
where does iliococcygeus attach
fascia above obturator internus
what does levator ani contract to do
prevent prolapse of the pelvic viscera
what does levator ani relax to do
permit the passage of urine and faeces through the urethra and anal canal and out of the body
what is the motor innervation of levator ani
nerve to levator ani and the pudendal nerve
what does pubococcygeus divide into
puborectalis, levator prostatae (puboprostaticus) and pubovaginalis
structures in the gap of the pelvic diaphragm near the pubic bones are supported by what
urogenital diaphragm
where do the fibres of pubococcygeus pass
from the pubic bones to wrap around the prostate gland or vagina and the rectum
fibres that support the vagina and prostate gland insert into where
perineal body
in males, the most medial fibres of pubococcygeus pass around what and insert where
the prostate and insert into the perineal body (levator prostatae - puboprostaticus)
in females, the most medial fibres of pubococcygeus pass around what and insert where
the vagina and insert into the perineal body (pubovaginalis)
in both sexes, the more posterior fibres of pubococcygeus wrap around what
rectum - puborectalis
what is the motor innervation to pubococcygeus
pudendal nerve and nerve to levator ani
what is the function of puborectalis
acts to maintain feacal continence by bending the rectum and making the release of faeces more difficult
describe the state of the pelvic floor muscles normally
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
what is the innervation of puborectalis
pudendal nerve (S2-4) and nerve to levator ani (S4)
fibres of the puborectalis mix with
those from external anal sphincter forming a modified sling around the rectum
when is puborectalis especially important
immediately after the rectum has filled and the internal anal sphincter is open
what are the attachments of iliococcygeus
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)
is iliococcygeus or pubococcygeus more fibrous
iliococcygeus
what is the tendinous arch of levator ani
area of attachment of iliococcygeus to the fascia of obturator internus
the area of attachment of iliococcygeus to the fascia of obturator internus is known as what
tendinous arch of levator ani
what is the innervation of iliococcygeus
pudendal nerve and nerve to levator ani
what muscle lies between iliococcygeus and the bony pelvis
obturator internus
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
perineal body
what is the perineal body composed of
fibrous connective tissue
the perineal body provides attachment sites for what
levator prostatae
pubovaginalis
EAS
perienal muscles
what is thought to be the function of the perineal body
act as an area that distributes forces across the pelvic and urogenital diaphragms as it is attached to both structures
describe the parietal pelvic fascia covering the internal wall of the pelvis
thickened over obturator internus to form the tendinous arch of the pelvis (and levator ani)
in a male, what is the name for the parietal pelvic fascia anteriorly
puboprostatic ligament
in the female, what is the name for the parietal pelvic fascia anteriorly
pubovesical ligament
what is the paracolpium
lateral extension of visceral fascia from vagina to tendinous arch
describe the visceral pelvic fascia
covers the organs, parietal and visceral blend as organs pierce the pelvic floor
what is the endopelvic fascia
acts as a packing materal around the organs
what are the 2 types of endopelvic fascia
loose and condensed
what does the loose endopelvic fascia do
fills spaces in the pelvis e.g. the retropubic (pre-vesical) space
what is the condensed endopelvic fascia
thickenings of the fascia
what is the primary condensation (an example of condensed endopelvic fascia)
the hypogastric sheaths running along the posterolateral walls of the pelvis
are the pelvic organs intra or retroperitoneal
subperitoneal / infraperitoneal
how are the pelvic pouches formed
pelvic organs are covered by a continuation of the peritoneal lining of the abdominal cavity which forms pouches
what are the two peritoneal pouches in the female
vesico-uterine pouch
recto-uterine pouch
what is the peritoneal pouch in males
vesico-rectal pouch
