Session 10 - The Pelvic Floor Flashcards
Where is the pelvic cavity (or true pelvis) located?
Lesser part of the pelvis, beneath the pelvic brim.
Which muscle forms the posterior wall of the pelvic cavity?
Piriformis
The pelvic floor separates the pelvic cavity from what?
The perineum
What are the two ‘holes’ found in the pelvic floor that are particularly significant?
The urogenital hiatus (passage of urethra and vagina)
The rectal hiatus (passage of the anal canal)
What is found between the urogenital hiatus and the rectal hiatus?
The perineal body
What are the roles of the pelvic floor muscles?
Support of abdominopelvic viscera (bladder, intestines, uterus, etc.).
Resistance to increases in intra-pelvic/abdominal pressure during activities like coughing and lifting heavy objects.
Urinary and fecal continence, the muscle fibres have a sphincter action on the rectum and urethra. They relax to allow urination and defecation.
What are the tree components of the pelvic floor?
Levator ani muscles
Coccyogeus muscle
Fascia coverings of the muscles
What nerve innervates the levator ani muscles?
Branches of the pudendal nerve (S2-S4)
Which three muscles make up the levator ani?
Puborectalis
Pubococcygeus
Iliococcygeus
What is the main function of puborectalis?
To maintain faecal continence
What is the role of the levator ani muscles during child birth?
Supporting the foetal head during cervix dilation during child birth
Which muscles are most prone to damage during child birth?
Puborectalis and pubococcygeus (because they are situated most medially)
What problems can damage to the levator ani muscles cause?
Urinary stress incontinence
Rectal incontinence
Urinary incontinence is most noticeable during activities which increase the intra-abdominal pressure, such as coughing and lifting heavy objects.
Why might prolapse of pelvic viscera occur?
If there is trauma to the pelvic floor
If the pelvic floor muscles have poor tone
Prolapse of the vagina may occur if the is damage to the perineal body during child birth
What is an episiotomy? Why are they performed?
A surgical cut in the perineum.
Delivered to avoid tearing of the perineum and/or the pelvic floor
If the medial fibres of the puborectalis muscle are torn, then what kind of herniation might occur?
Rectal herniation
Give some risk factors that increase the chance of prolapse of pelvic viscera.
Age Number of vaginal deliveries Family history of pelvic floor dysfunction Weight Chronic coughing
How can the pelvic floor be repaired?
Can be repaired surgically, however a way of generally strengthening the pelvic floor muscles is to carry out pelvic floor exercises on a regular basis.
The rectum is at an 80 degree angle to the anal canal. What muscle is responsible for marinating this angle?
Puborectalis. Forms puborectal sling that passes posteriorly to the anorectal junction. The tone of this muscle is responsible for maintain the angle.
