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Reproductive System > Pelvic Floor and Perineum > Flashcards

Pelvic Floor and Perineum Flashcards

1
Q

What is the pelvic floor?

A 
Muscular and fibrous diaphragm 
Fills lower part of pelvic canal 
Closes the abdo cavity 
Defines upper border of perineum 
Supports pelvic organs
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2
Q

What pierces the pelvic floor?

A

Urethra
Vagina
Rectum

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3
Q

What is the approximate sub-pubic arch angle of females and males?

A 
Females = >90
Males = <90
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4
Q

What does the ischial spine separate?

A

Greater and lesser sciatic notches

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5
Q

Describe a pudendal nerve block

A

Locate ischial spine for insertion of needle

Pain relief during childbirth

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6
Q

What are the 3 parts of the levator ani?

A

Puborectalis
Pubococcygeus
Iliococcygeus

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7
Q

Which viscera are associated with anterior vaginal wall?

A

Urethra

Bladder

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8
Q

What is the perineal body?

A

Condensation of CT - irregular and fibromuscular
Point of attachment for muscles of pelvic floor and perineum
At junction between 2 triangles
Lies just deep to skin

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9
Q

Which ligament helps to create the greater and lesser sciatic foramen?

A

Sacrospinous lig

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10
Q

What is the perineum?

A

Fibromuscular sheet with closes the pelvic outlet

Lower limit of perineal space

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11
Q

How do we divide the perineum?

A

Anterior (urogenital) and posterior (anal) triangle

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12
Q

What is the role of bulbospongiosus in females and males?

A

Female - muscle tone for perineum and vaginal opening

Male - maintaining an erection

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13
Q

Why is a midline tear in childbirth dangerous?

A

Endangers the anal sphincter

Faecal incontinence

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14
Q

What type of episiotomy is favoured in the UK?

A

Mediolateral

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15
Q

Give some risk factors for prolapse

A 
Childbirth 
Age
Menopause
Obesity
Chronic cough 
CT laxity
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16
Q

Where is the theoretical line that can divide the perineum?

A

Between the ischial tuberosities

17
Q

What is found in the anal triangle?

A

Anal aperture
External anal sphincter
2 ischioanal fossa

18
Q

What are the ischioanal fossa?

A

Spaces lateral to the anus
Contain fat and CT
Aid expansion of anal canal

19
Q

What is found in the urogenital triangle?

A

External genitalia

Urethra

20
Q

The perineal membrane only occurs which part of the perineum?

A

Urogenital (anterior) triangle

21
Q

What are the layers of the urogenital triangle, deep to superficial?

A 
Deep perineal pouch 
Perineal membrane 
Superficial perineal pouch 
Deep perineal fascia 
Superficial perineal fascia
Skin
22
Q

What is the deep perineal pouch and what does it contain?

A

Potential space between the pelvic floor and the perineal membrane
Contains part of urethra and external urethral sphincter
Males: (also contains) bulbourethral glands and deep transverse perineal muscles

23
Q

What is the role of the perineal membrane?

A

Provides attachments for muscles of superficial external genitalia
Helps support pelvic viscera

24
Q

What is the superficial perineal pouch and what does it contain?

A

Potential space between perineal membrane and perineal fascia
Contains erectile tissue of penis and clitoris
Contains 3 muscles: ischiocavernosus, bulbospongiosus and superficial transverse perineal
And contains Bartholin’s glands

25
Q

What are the 2 gaps in the pelvic floor called?

A

Urogenital hiatus

Rectal hiatus

26
Q

What are the functions of the pelvic floor?

A

Support viscera
Resistance to increases in pressure
Urinary and faecal continence

27
Q

What innervates the levator ani muscles?

A

Branches of the pudendal nerve (S2-4)

28
Q

Describe puborectalis

A

U shaped sling
Past urogenital hiatus and around anal canal
Tonic contraction bends the canal anteriorly creating the anorectal angle for faecal continence

29
Q

Describe pubococcygeus

A

Main constituent of levator ani

Some fibres divide and loop around the prostate (men) or vagina (women)

30
Q

Describe coccygeus

A

Small and posterior

Run along sacrospinous lig

31
Q

What innervates the coccygeus?

A

Anterior rami of S4 and S5

32
Q

Which muscles are most likely to be injured in childbirth and why?

A

Pubococcygeus and puborectalis

Sit the most medially

33
Q

Define episiotomy

A

Surgical cut in the perineum which damages the vaginal mucosa and submucosa but helps prevent uncontrolled tearing of perineal muscles

Reproductive System (17 decks)

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