Repro 5.2- pelvic floor and perineum Flashcards
What organs does the pelvic cavity contain?
bladder
terminal urethra
rectum
pelvic genital organs
what is the inferior border of the pelvic cavity?
The pelvic floor
What’s the functions of the pelvic floor?
- to support the pelvic viscera, preventing prolapse
- to help with fecal and urinary continence
What structures make up the walls of the pelvic cavity?
- inferiorly– pelvic floor
- anteriorly-rami of pubic bone and pubic symphesis
- laterally- obtruator internus muscle
- posteriorly- sacrum, coccyx, pirifomis muscle and sacrococcygeal ligament.`
What structures pierce the pelvic floor?
- urethra
- vagina
- rectum
What muscles make up the pelvic floor?
- levator ani (puborectalis, pubococcygeus, illiococcygeus)
- coccygeus muscle
Where does the coccyeus muscle attach?
From the ischial spines to the inferior sacrum and coccyx.
What close association does the coccygeus muscle have?
sacrospinous ligament- it follows it’s path and some of it’s fibres attach to this ligament.
What 3 muscles is the levator Ani made of?
- puborectalis
- pucococcygeus
- illiococcygeus.
What are the attachments of the levator ani?
- pubic bone
- ischial spines
- tenidnous arch of the levator ani attaches to the coccyx.
How does the levator ani contribute to continence?
The puborectalis msucle wraps around the rectum and urethra.
In order to defecate or micturate, the puborectalis must first relax,
What is the perineum?
A shallow compartment found between the pelvic outlet, and the pelvic floor.
What osseofibrous structures outline the pelvic outlet?
- pubic symphesis
- ischiopubic rami
- ischial tuberosity
- sacrotuberous ligament
- sacrum and coccyx
How is the perineum further divided?
Into the anterior urogenital triangle, and the posteior anal triangle.
This is accomplished by a transverse line between the 2 ischial tuberosities.
What are the components of the anal triangle?
- anal appeture
- external anal sphincter
- 2 ischioanal fossae (space lying laterally to the anus, they contain fat and subcutaneous tissue and aid expansion during defecation)
Where do the ischioanal fossae extend from and to?
From the external anal sphincter to the pelvic floor superiorly.
How are the anterior and posteiror perineal triangles considered different?
posterior triangle is open
anterior triangle is closed by the perineal membrane (pierced by the urethra and vagina)
What is the perineal body?
a connective mass found in the middle of the perineum which anchors many muscles.
What muscles does the perineal body anchor?
- Bulbospngiosus
- levator ani
- superficial and deep perineal muscles
- external anal sphincter
- external urethral sphincter
What’s the function of the perineal body and to who is this most important?q
It acts to prevent tearing of the perineum, partiuclalry in women during childbirth.
What is a common cause of pelvic floor damage?
Childbirth, due to the trauma of a foetus’s head which gets supported by the pelvic floor during cervical dilation.
What can be a complication of damage to the pelvic floor?
Prolapse of the vagina or bladder.
urinary stress incontinence.
What is the name given to an intentional cut of the perineum?
Epiostomy
When is an epiostomy performed?
Why?
During traumatic childbirth when the childs head it stuggling to get out, and there is a lot of pressure being put on the perineal body.
an intentional cut prevents uncontrolled tearing and spares the perineal body.
Where should an epiostomy insision be made?
Inferolaterally.
This spares the perineal body and anal sphincter.
