Repro 5.2- pelvic floor and perineum

Question 1

What organs does the pelvic cavity contain?

Answer 1

bladder
terminal urethra
rectum
pelvic genital organs

Question 2

what is the inferior border of the pelvic cavity?

Answer 2

The pelvic floor

Question 3

What’s the functions of the pelvic floor?

Answer 3

• to support the pelvic viscera, preventing prolapse

- to help with fecal and urinary continence

Question 4

What structures make up the walls of the pelvic cavity?

Answer 4

• inferiorly– pelvic floor
• anteriorly-rami of pubic bone and pubic symphesis
• laterally- obtruator internus muscle
• posteriorly- sacrum, coccyx, pirifomis muscle and sacrococcygeal ligament.`

Question 5

What structures pierce the pelvic floor?

Answer 5

• urethra
• vagina
• rectum

Question 6

What muscles make up the pelvic floor?

Answer 6

• levator ani (puborectalis, pubococcygeus, illiococcygeus)

- coccygeus muscle

Question 7

Where does the coccyeus muscle attach?

Answer 7

From the ischial spines to the inferior sacrum and coccyx.

Question 8

What close association does the coccygeus muscle have?

Answer 8

sacrospinous ligament- it follows it’s path and some of it’s fibres attach to this ligament.

Question 9

What 3 muscles is the levator Ani made of?

Answer 9

• puborectalis
• pucococcygeus
• illiococcygeus.

Question 10

What are the attachments of the levator ani?

Answer 10

• pubic bone
• ischial spines
• tenidnous arch of the levator ani attaches to the coccyx.

Question 11

How does the levator ani contribute to continence?

Answer 11

The puborectalis msucle wraps around the rectum and urethra.

In order to defecate or micturate, the puborectalis must first relax,

Question 12

What is the perineum?

Answer 12

A shallow compartment found between the pelvic outlet, and the pelvic floor.

Question 13

What osseofibrous structures outline the pelvic outlet?

Answer 13

• pubic symphesis
• ischiopubic rami
• ischial tuberosity
• sacrotuberous ligament
• sacrum and coccyx

Question 14

How is the perineum further divided?

Answer 14

Into the anterior urogenital triangle, and the posteior anal triangle.

This is accomplished by a transverse line between the 2 ischial tuberosities.

Question 15

What are the components of the anal triangle?

Answer 15

• 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)

Question 16

Where do the ischioanal fossae extend from and to?

Answer 16

From the external anal sphincter to the pelvic floor superiorly.

Question 17

How are the anterior and posteiror perineal triangles considered different?

Answer 17

posterior triangle is open

anterior triangle is closed by the perineal membrane (pierced by the urethra and vagina)

Question 18

What is the perineal body?

Answer 18

a connective mass found in the middle of the perineum which anchors many muscles.

Question 19

What muscles does the perineal body anchor?

Answer 19

• Bulbospngiosus
• levator ani
• superficial and deep perineal muscles
• external anal sphincter
• external urethral sphincter

Question 20

What’s the function of the perineal body and to who is this most important?q

Answer 20

It acts to prevent tearing of the perineum, partiuclalry in women during childbirth.

Question 21

What is a common cause of pelvic floor damage?

Answer 21

Childbirth, due to the trauma of a foetus’s head which gets supported by the pelvic floor during cervical dilation.

Question 22

What can be a complication of damage to the pelvic floor?

Answer 22

Prolapse of the vagina or bladder.

urinary stress incontinence.

Question 23

What is the name given to an intentional cut of the perineum?

Answer 23

Epiostomy

Question 24

When is an epiostomy performed?

Why?

Answer 24

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.

Question 25

Where should an epiostomy insision be made?

Answer 25

Inferolaterally.

This spares the perineal body and anal sphincter.