Pelvic relaxation Flashcards
the ureter runs under which ligament?
uterosacral
what are the signs and symptoms of pelvic floor prolapse?
- pelvic pressure or pain
- bulging from the vagina
- dyspareunia or difficulties with intercourse
- difficulties voiding or evacuating bowels
what are the 3 levels of vaginal support? which is most important?
level 1 - CT support to upper vagina
level 2 - fascial arcus in mid vagina
level 3 - anterior: fusion of anterior vagina and urethra and muscles involved in urethral support, posterior: fusion of posterior vagina and perineal body
level 1 is most important
an anterior compartment prolapse is AKA:
- cystocele
- cystourethrocele
- hypermobile urethra
a posterior compartment prolapse is AKA:
rectocele
an apical vaginal prolapse is AKA:
vaginal vault prolapse
what is the dove tail sign? what does is mean?
flattening around anterior surface of anus
indicates perineal injury
what is the result of damage to level 1 vaginal support? what is level 1 support?
uterine or vaginal vault prolapse
level 1 support = CT support to upper vagina
what causes an apical prolapse?
loss of apical support from the uterosacral ligaments
cystocele / rectocele is a result of failure of which level of vaginal support?
level 2
fascial arcus in the mid vagina
level 2 of vaginal support
loss of fusion of the posterior vagina and perineal body results in:
what level of vaginal support is this?
perineocele
level 3 posterior
loss of support in the fusion of anterior vagina and urethra and muscles involved in urethral support results in:
what level of vaginal support is this?
hyeprmobile urethra
level 3 anterior
definition: hypermobile urethra
over 30 degrees from horizontal by Q tip test
proximal urethra moves out of abdominal cavity
what are the risk factors for fecal incontinence and parturition?
- instrumental delivery
- prolonged 2nd stage labor
- birth weight over 4 kg
- OP position
- episiotomy
why do patients with stage III or IV prolapse present without incontinence?
functional obstruction in the outflow tract that can simulate continence
what are the two main categories of urinary incontinence?
- hypermobility
- intrinsic sphincter deficiency
how does hypermobility cause urine incontinence?
related to movement of bladder neck and urethra triggered by abdominal straining (lifting, jogging)
how does intrinsic sphincter deficiency cause urine incontinence?
leakage of urine with minimal exertion related to instrinsic weakening of the bladder outlet closure mechanism
which type of incontinence results in continuous leakage of small amounts of urine?
overflow incontinence
what are the baden walker classifications of pelvic floor prolapse?
grade 1 - prolapsed tissue descends halfway to the hymen
grade 2 - prolapsed tissue extends to the level of the hymen
grade 3 - prolapsed tissue extends outside the hymen with straining
grade 4 - prolapsed tissue extends outside the hymen without straining
grade 1 baden walker classifications of pelvic floor prolapse
prolapsed tissue descends halfway to the hymen
grade 2 baden walker classifications of pelvic floor prolapse
prolapsed tissue extends to the level of the hymen
grade 3 baden walker classifications of pelvic floor prolapse
prolapsed tissue extends outside the hymen with straining
grade 4 baden walker classifications of pelvic floor prolapse
prolapsed tissue extends outside the hymen without straining
prolapsed tissue extends to the level of the hymen
grade 2
prolapsed tissue extends outside the hymen with straining
grade 3
prolapsed tissue descends halfway to the hymen
grade 1
prolapsed tissue extends outside the hymen without straining
grade 4
