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Reproductive System > Pelvic Foor > Flashcards

Pelvic Foor Flashcards

1
Q

Function of the pelvic floor

A
  • support pelvic organs
  • maintain intrabdominal pressure during coughing, vomiting, sneezing etc.
  • facilities defaecation + micturition
  • maintain continence
  • facilities childbirth
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2
Q

Outline the 3 mechanism of how pelvic floor provides support

A
  • Suspension: provides sling like support inferiorly in pelvis against gravity
  • Attachment: vagina is support by attachments to endopelvic fascia, levator ani muscles + perineal body
  • Fusion: of urogenital diaphragm + perineal body
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3
Q

What are the levator ani muscles?

A

Puborectalis
Pubococcygeus
Iliococcygeus

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4
Q

List the deep pelvic floor muscles

A

puborectalis
pubococcygeus
iliococcygeus
coccygeus

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5
Q

What maintains the anteverted position of the uterus?

A

Round ligament

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6
Q

List the superficial pelvic floor muscles

A

Bulbospongiosus
Ischiocavernosus
Superficial + deep transverse perineal

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7
Q

Ligaments of the pelvic floor

A
  • cardinal/transverse ligaments
  • pubocervical ligaments
  • uterosacral/rectouterine ligaments
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8
Q

Nervous supply to the pelvic floor

A

Pudendal nerve S2-4

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9
Q

Blood supply to pelvic floor

A

Pudendal arteries

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10
Q

What do the levator ani muscles take part in forming?

A

Perineal body

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11
Q

What is the urogenital diaphragm?

A
  • triangular sheet of dense fibrous tissue
  • spans anterior half of pelvic floor
  • attaches to urethra, vagina + perineal body
  • supports pelvic floor
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12
Q

Lymphatic drainage of pelvic floor

A

Inguinal lymph nodes

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13
Q

Types of pelvic floor dysfunction

A

Pelvic organ prolapse
Vaginismus
Stress urinary incontinence
Female genital mutilation

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14
Q

Risk factors of pelvic organ prolapse

A
  • increase age
  • given birth
  • number of vaginal deliveries
  • oestrogen deficiency (menopause)
  • obesity (raised intra abdominal pressure)
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15
Q

Management of pelvic organ prolapse

A

Depends on severity + how patient is coping
- surgical: mesh supports, hysterectomy if central
- non-surgical: pessaries to provide support +/- topical oestrogen + pelvic floor exercises

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16
Q

Symptoms of pelvic organ prolapse

A
  • dragging/bugling sensation in vagina
  • lump
  • feeling of incomplete emptying of bladder
  • double voiding
17
Q

How can a pelvic organ prolapse be classified?

A
  • anteior: bladder or urethra
  • central: uterus
  • posterior: rectum or colon
18
Q

Types of anterior pelvic organ prolapse

A
  • cystocele: bladder prolapses into vaginal space
  • urethrocele: urethral collapse
  • cytourethrocele: bladder + urethra
19
Q

Types of posterior pelvic organ prolapse

A
  • rectocele: rectum prolapses into vaginal space
  • enterocele: loops of colon pressing across Rectouterine space
20
Q

What is a vault prolapse?

A

Central pelvic organ prolapse when the superior portion of vagina collapses downwards after a hysterectomy

21
Q

Risk factors for stress urinary incontinence

A

Increased age
Oestrogen deficiency (menopause)

22
Q

Managment of stress urinary incontience

A

Pelvic floor exercises
Surgical sling to support urethral sphincter

23
Q

How are vaginal tears graded?

A
  • grade 1: extends into vaginal mucosa
  • grade 2: extends into perineal muscles
  • grade 3: extended into anal sphincter
  • grade 4: extends into rectum
24
Q

What is a central pelvic organ prolapse called post hysterectomy?

A

Vault prolapse

25
Q

What is an episiotomy?

A

A surgical incision made to perineum during child birth if there is risk of tearing, distressed baby or instrumental delivery

26
Q

What is involved in a episiotomy?

A

Cutting of bulbospongiosus + transverse perineal muscles at oblique angle to relieve pressure + allow for more space

27
Q

Define female genital multination

A

All procedures involving partial or total removal of external female genitalia or other injury

28
Q

Types of FGM

A

1- partial/total removal of clitoris
2- partial/total removal of clitoris + labia minora
3- removal of labia minora + sewing labia majora together only leaving a small hole for urine + menstrual blood
4- any other harmful procedure e.g. piercing, cutting

29
Q

Consequence of FGM

A
  • haemorrhage > sepsis or death
  • blood born infections
  • chronic pain
  • sexual + fertility issues
  • urinary outflow obstruction
  • flashbacks/PTSD
  • self esteem issues
30
Q

How does the perineal body function to maintain pelvic organ support?

A

Central point of attachment for perineal muscles

31
Q

Why can vaginal childbirth delivery cause pelvic floor dysfunction?

A
  • damage to pelvic floor muscles
  • stretch of ligament support
  • stretch of pudenal nerve
  • perineal body injury
32
Q

What are pessaries?
What are they used for?

A
  • removable devices that go inside your vagina > provide support to your pelvic organs
  • used for non surgical treatment of pelvic organ prolapse or stress UI
33
Q

What is vaginismus?

A

The body’s automatic reaction to the fear of vaginal penetration > contraction of vaginal muscles

Reproductive System (20 decks)

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