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GI Week 3 > Pelvic Floor Anatomy > Flashcards

Pelvic Floor Anatomy Flashcards

1
Q

What is the normal position of the pelvic bone?

A

Vertical (tilted forward)

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2
Q

What is the true pelvis?

A

(lesser! pelvic cavity)

-It is the space between the pelvic inlet and pelvic outlet.

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3
Q

What does the pelvic diaphragm separate?

A

Separates the pelvic cavity from the perineum.

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4
Q

What muscle makes up the pelvic diaphragm?

A

Levator ani

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5
Q

What is the only item that goes through the pelvic diaphragm?

A

Rectum

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6
Q

What muscle forms the Obturator Foramen?

A

Obturator internus

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7
Q

What goes through the Obturator internus?

A

Obturator artery and vein

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8
Q

What is the thickening on the wall of the Obturator internus?

A

Tendinous arch of the Obturator Internus

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9
Q

What does the external sphincter consist of?

A

Fibers from the pelvic diaphragm

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10
Q

What is the ischioanal fossa?

A

Surrounds the Rectum and is a fat-filled space. It is fatty to accommodate the rectum bloating and emptying

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11
Q

How can you describe the pelvic diaphragm?

A

It is a funnel shaped sling

-A “shed roof” having from the tendinous arch of the obturator internus.

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12
Q

What is the Tendinous arch of the Obturator Internus?

A

A thickened region of the deep fascia of the muscle.

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13
Q

What does the obturator fascia form?

A

Obturator fascia also forms the pudendal canal –> pudendal nerve, artery and vein come through after exiting the sciatic foramen

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14
Q

What muscles make up the pelvic diaphragm?

A
  • Levator ani

- Coccygeus

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15
Q

Where is the Coccygeus found?

A

On the inside of the sacrospinous ligament

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16
Q

What is the order of the Vagina, Urethra and Rectum from front to back?

A

Urethra, Vagina, Rectum

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17
Q

What two muscles is the Levator Ani the collective name for?

A
  • Iliococcygesus muscle

- Pubococcygeus muscle

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18
Q

What is the Pubococcygeus muscle often divided into?

A
  1. Puborectalis muscle (puborectal sling)

2. Levator prostatae in males or Pubovaginalis in females

19
Q

Where is the Coccygeus muscle?

A

It is a slip of muscle that lies on the deep surface of the sacrospinous ligament.
-In dogs this muscle pulls the tail between the legs

20
Q

Where is the puborectal sling and what is its function?

A

(Puborectalis muscle) encircles the rectum. Normally, the muscle is contracted, kinking the rectum and contributing to sphincteric control.

21
Q

What happens to the Puborectalis muscle during defecation?

A

The muscle relaxes (parasympathetic, via S2,3,4) allowing the anorectal junction to straighten

22
Q

What is the Urogenital diaphragm?

A

A little layer of muscle that holds up and in the bladder, reproductive organs.

23
Q

What does the puborectal sling do?

A

Creates a kink in the rectum. It stops movement of feces through rectum like a kink in a garden hose

24
Q

What state is Puborectalis commonly in? What happens under parasympathetic stimulation?

A

It is tonically contracted. Under parasympathetic stimulation, during defamation, it relaxes, allowing the anorectal angle to increase (straighten)

25
Q

What does the Puborectal sling act as?

A

A sphincter itself when contracted.

26
Q

Where does the Coccygeus muscle lie?

A

Just above the Sacrospinal ligament (from sacrum to the ischial spine/sacrospinal ligament)

27
Q

What makes up the external anal sphincter?

A

Fibers of the Levator Ani (pelvic diaphragm) blend with the outer longitudinal fibers of the rectum forming a thickened band, the external anal sphincter.

28
Q

How is the internal anal sphincter controlled?

A

Parasympathetically

29
Q

How is the external anal sphincter controlled?

A

Voluntarily

30
Q

What forms the lateral muscular wall of the pelvis?

A

Obturator internus

31
Q

What forms the posterior muscular wall of the pelvis?

A

Piriformis

32
Q

What does the Ischial spine mark?

A
  • Posterior edge of the levator ani
  • Attachment of the coccygeus
  • Marks narrowest diameter of pelvis, an important measure in OB
33
Q

What nerve location does the Ischial spine mark?

A

Pudendal nerve - where it exists the greater sciatic foramen and enters the lesser sciatic formen

34
Q

What identifies where the anesthetic should be deposited for a pudendal block?

A

Ischial spin (location of pudendal nerve block)

35
Q

What is the only thing that goes through the pelvic diaphragm without support?

A

Rectum

36
Q

What ligament attaches at the ischial spine?

A

Sacrospinous ligament

37
Q

What is the action of the pelvic diaphragm?

A
  • Supports the pelvic floor and the organs that pierce it
  • Resists outward thrusts accompanying increases in intra-abdominal pressure
  • Assists in defecation and urination
38
Q

Portions of the pelvic diaphragm surrounding hollow organs…

A

…have specialized to become sphincter for that organ.

39
Q

When does Rectal Prolapse occur?

A

When there is a loss of tone in the muscles that normally create an angle between rectum and anal canal (puborectalis).

40
Q

What things cause Rectal Prolapse?

A
  • Chronic straining to have bowel movements
  • Strain during childbirth
  • Some neurological disorders
  • Disruption of the perineal body, as in episiotomy, may also precipitate rectal prolapse.
41
Q

What is difficult to distinguish between?

A

Prolapsed internal hemorrhoids and prolapsed rectum - but hemorrhoids are far more common.

42
Q

What two things often occur together?

A

Internal and external hemorrhoids often occur together.

43
Q

What does rectal prolapse look like?

A

It has concentric folds of rectal mucosa. It is difficult to distinguish between prolapsed internal hemorrhoids and prolapsed rectum.

GI Week 3 (10 decks)

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