Perineum

Question 1

what is the perineum

Answer 1

an anatomical area found between the thighs

Question 2

what is the function of the pelvic floor

Answer 2

support the pelvic organs, maintain abdominal pressure, help defecation and micturition and help facilitate childbirth

Question 3

what muscles predominately make up the pelvic floor

Answer 3

levator ani muscles

Question 4

what are the names of the 3 elevator ani muscles

Answer 4

pubococcygeus, puborectalis, iliococcygeus

Question 5

what is the perineal body

Answer 5

a fibrous patch which allows for the attachments of the pelvic floor muscles and prevents tearing between the vagina and external anal sphincter

Question 6

what nerve supplies the pelvic floor

Answer 6

pudendal nerve

Question 7

what is the function of bartholin’s glands

Answer 7

produce a mucus like fluid to keep the vagina moist

Question 8

what is bartholintis

Answer 8

where the bartholin’s glands become blocked causing a cyst to form which then becomes infected/inflammed

Question 9

what is an episiotomy

Answer 9

a medial-lateral incision in the bulbocarvernous in childbirth

Question 10

when is an episiotomy done

Answer 10

when there is uncontrolled spitting of the perineum, if the baby is large, if the delivery is long/difficult (shoulder distortion)

Question 11

what happens if the perineal body spilts

Answer 11

• dysfunction of external anal sphincter

- prolapse of the rectum (rectocele)

Question 12

what are the complications of a spilt of the perineal body

Answer 12

haemorrhage, extension to the anal sphincters, infection and pain

Question 13

what is a pelvic floor prolapse

Answer 13

where the pelvic floor muscles/ligaments weaken giving a loss of support for the pelvic organs

Question 14

what are anterior pelvic prolapses

Answer 14

where the bladder prolapses onto the vagina - cystocele

Question 15

what is a posterior pelvic prolapse

Answer 15

where the rectum prolapses onto the vagina - rectocele

Question 16

what is a middle pelvic prolapse

Answer 16

where the uterus prolapses onto the vagina and through it

Question 17

what can occur after a hysterectomy

Answer 17

the top of the vagina may prolapse giving a vaginal vault

Question 18

where can the uterus be displaced to in a posterior pelvic prolapse

Answer 18

pouch of Douglas/retrovaginal space

Question 19

what are the symptoms of a prolapse

Answer 19

not feeling emptied, discomfort, heaviness, lump

Question 20

what is the management for pelvic floor prolapse

Answer 20

pelvic muscle exercises
surgery
pesseries

Question 21

what are the risk factors for a pelvic prolapse

Answer 21

connective tissue disorders, giving birth, having a large baby, difficult delivery

Question 22

how does damage to the pelvic floor cause urinary incontinence

Answer 22

the muscles contributing to the floor also contribute to the sphincters

Question 23

what is the management of urinary incontinence

Answer 23

surgery

pelvic floor muscle exercises

Question 24

what are the 4 types of FGM

Answer 24

1 = removal of the clitoris 
2 = removal of clitoris, labia minora and labia majora
3 = sealing the vaginal orifice by bringing together the labia majora
4 = any other injure e.g. piercing, burning, scraping

Question 25

define FGM

Answer 25

procedures involving total or partial removal of the external female genitalia or any other injury to the female genital organs

Question 26

what are the consequences of FGM

Answer 26

PTSD, pain, obstructed urinary outflow, difficultly conceiving, sepsis, haemorrhage, infection, keloid scar

Question 27

what are the obstetric consequences of FGM

Answer 27

haemorrhage, difficult delivery, laceration