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Anatomy > Pelvic Floor Lecture 2 > Flashcards

Pelvic Floor Lecture 2 Flashcards

1
Q

Describe the alignment of the ASIS with the pubic bone for women and men

A

for men its inline and for women the pelvis is slightly tilted forward

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2
Q

Lots of sacral sitting may cause what

A

weak pelvic floor muscles because they are not working against gravity

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3
Q

What does the angle of the spine in the sacral region do to the pelvic area?

A

condenses/pushes it in

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4
Q

Perineum

A

surface region in both males and females between the pubic sympyhsis and coccyx

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5
Q

What 2 triangles make up the perineum?

A

urogential and anal

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6
Q

List the *anatomical borders of the perinuem

A

anterior - pubic symphysis

inferior border - tip of coccyx

lateral border - ischiopubic rami and sacrotuberous ligament

Perineal body runs unbetween triangles

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7
Q

List the *surface borders of the perinuem

A

anterior - mons pubis

inferior - intergluteal cleft

lateral - medial surface of thigh

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8
Q

What structures lies directly under the lateral border of the perineum?

A

Ischiocavernosis lies directly under the ischiopubic ramus/ST ligament

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9
Q

What 3 branches does the pudendal nerve split into?

A

rectal
dorsal
perineal

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10
Q

Pudendal neuralgia is

A

pain with sitting because the nerve stretches

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11
Q

What is the inguinal canal

A

passage way from the abdominal cavity though the anterior abdominal wall, formed by the folds of the external obliques aponeurosis

Contains the inguinal ring

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12
Q

What are the contents of the inguinal canal?

A

MALES - spermatic cord
FEMALES - round ligament of the uterus

Inguinal nerve

blood and lymph vessels

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13
Q

Inguinal ligament attachments

A

fibrous band from ASIS to puberic tubercle

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14
Q

Sacroiliac joint type

A

synovial

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15
Q

Pubic symphysis joint type

A

fibrocartilaginous disc between pubic bones

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16
Q

Sacrococcygeal joint

A

cartilaginous
symphysis

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17
Q

Know the location of the anterior longitudinal ligament, iliolumbar ligament, sacroiliac ligament, sacrospinous and sacrotuberous ligament

A
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18
Q

What are the borders of the pelvic inlet?

A

anterior - pubic symphysis

posterior - sacral promontory and sacral wings/ala

lateral - arcuate line on the inner surface of the ilium and the pectineal line on the superior pubic ramus

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19
Q

Borders of the pelvic outlet

A

Anterior - pubic arch (inferior border of ischiopubic rami)

Posterior - tip of coccyx

lateral - ischial tuberosities and margin of ST ligament

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20
Q

Describe the differences between the male and female pelvis

A

male is more heart shaped and female more of a wider circle

males is heavier

males sacral promontory more prominent and have a more narrow pubic arch

males have ischial spines more medially

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21
Q

What msucles make up the 1 layer of the pelvic floor

A

ishiocavernosus
bulbospongiosus
superficial transverse perineum

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22
Q

What two muscles does the perineal body connect

A

bulbospongiosus and external anal sphincter

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23
Q

Layer 2 of the pelvic floor

A

urogenital diaphragm - the middle muscle layer

external urethral sphincter deep

transverse perineal muscle

compressor urethrae

24
Q

Whats the main function of the second layer of the pelvic floor?

A

stop flow of urine

25
Q

What muscle makes up the walls of the bladder?

A

Detrusor

26
Q

What feature of the male reproductive system helps with leakage?

A

prostate gland helps close urethra

sits on top of pelvic floor

27
Q

Layer 3 of pelvic floor

A

levator ani:
puborectalis
pubococcygeus
iliococcygeus

coccygeus

(walls = obturator internus and piriformis)

28
Q

Which of the leavator ani muscles does not connect to the coccyx or sacrum?

A

puborectalis

29
Q

Coccygeus attachments (what structure does it follow?)

A

ischial spine to coccyx, follows sacrospinous muscle below it

30
Q

Layer 3 walls

A

obturator internus and piriformis

piriformis coming off of sacrum in the back

obturator internal more on the lateral anterior side (obturator foramen)

31
Q

What layer is referred to as the pelvic diaphragm?

A

the second layer

32
Q

If your levator ani muscles are tight, what issues might you have at the hip?

A

Levator ani is connected via tissue to the obturator internus, so a tight levator ani would pull on your obturator internus (pull inwards), which connects to the greater trochanter of the femur and can medially rotate the femur

33
Q

What muscle keeps the rectum at 90 degrees, preventing you from pooping without squating?

A

puborectalis - wraps around rectum and connects to pubic bone

34
Q

The internal and external anal sphincter muscles are ___

A

connected via smooth muscle

35
Q

What spinal levels does the sensory innervation of the pelvis span?

A

T12-S4

36
Q

pudendal nerve entrapment

A

pudendal canal!

37
Q

Who is the pudendal nerves travel buddy

A

pudendal artery - you can feel pulse

38
Q

What artery supplies most of the pelvis? List the arterial supply

A

internal iliac artery anterior trunk

obturator artery
inferior gluteal artery
internal pudendal artery

(posterior trunk - superior gluteal)

39
Q

Functions of the pelvic floor

A

support
sphincter
sexual
stability
blow and lymph pump

40
Q

When you contract the pelvic floor the perineal body goes

A

up

41
Q

What muscle often co-contracts with the pelvic floor?

A

transverse abdominis

42
Q

How often should you pee a day? What about poop?

A

4-8x pee

1-2/day or every other day or 3 times a day - 3/week is normal range

43
Q

What are common overactive urinary issues?

A

frequency, urgency and nocturia

may not be a weakness issue always but may need coordination of the muscles

sometimes tight pelvic floor causes urgency - C-section scar near bladder can contribute to this

44
Q

Stress incontinence

A

leakage of urine with increased intra-abdominal pressure (cough, sneeze, laugh, exercise, sit to stand)

pregnancy

45
Q

Urge incontinence

A

leakage associated with a strong urge often on the way to the bathroom

OAB is urgency and frequency without leakage

46
Q

mixed incontinence

A

combo, usually one predominant

47
Q

overflow incontinence

A

leakage from full baldder, urge to go missed or blockage to urethra

48
Q

functional incontinence

A

patient with mobility issues preventing getting to the bathroom in time

49
Q

What are some negative affects of consitpation?

A

pushes on bladder - urinary incontence

full colon - back pain

50
Q

pelvic floor prolapse

A

condition in which one or more of the pelvic organs (bladder, uterus, rectum, small intestine) descend or bulge into the vaginal canal due to weakness or damage to the pelvic floor muscles

51
Q

What are some postural changes that occur during pregnancy?

A

COG shifts anteriorly

increase lumbar lordosis

anterior pelvic tilt

posterior head position

52
Q

What are some cardiovascular changes with pregnancy?

A

increased CO

decreased blood pressure

increased fluid volume

53
Q

What are some respiratory changes with pregnancy?

A

increased tidal volume

decreased total lung capacity

dyspnea

54
Q

What degree of perineal tears can contribute to fecal incontinence?

A

3rd or 4th

55
Q

In a C section, muscles are not ___

A

sewn back together

56
Q

What is diastasis recti?

A

separation of rectus abdominis (in middle)

c-section or weak pelvic floor can cause

you will see midline budging

57
Q

What can endometriosis contribute to

A

urinary or bowel dysfunction or pain with urination and bowel movements

Anatomy (23 decks)

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