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Reproductive system > Session 5 - Part II > Flashcards

Session 5 - Part II Flashcards

1
Q

What muscles make up the walls of the pelvic cavity?

A

Obturator internus

Piriformis

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2
Q

What are the openings of the pelvic floor?

A

Urogeninital hiatus – allows passage of the urethra (and the vagina in females).
Rectal hiatus – A centrally positioned gap, which allows passage of the anal canal.

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3
Q

What is between the Urogenital hiatus and anal canal?

A

A fibrous node known as the perineal body which joins the pelvic floor to the perineum

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4
Q

What are the functions of the pelvic floor?

A

Support of abdominopelvic viscera through their tonic contraction.
Resistance to increase in intra-pelvic/abdominal pressure eg coughing
Urinary and fecal continence.The muscle fibers have a sphincter action on the rectum and urethra. They relax to allow urination and defecation

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5
Q

What are the 3 components of the pelvic floor?

A

Levator ani muscles (largest component).
Coccygeus muscle.
Fascia coverings of the muscles.

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6
Q

What innervates the Levator ani muscles?

A

Pudendal nerve (roots S2, S3 and S4.)

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7
Q

What is the Levator ani muscle?

A

A large sheet of muscle that is composed of three separate paired muscles.

  • Pubococcygeus
  • Puborectalis
  • Iliococcygeus
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8
Q

How do these muscles attach to the pelvis?

A

Anterior – The pubic bodies of the hip bone.
Laterally – Thickened fascia of the obturator internus muscle, known as the tendinous arch.
Posteriorly – The ischial spines of the hip bone.

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9
Q

What is the Puborectalis muscle?

A

U-shaped sling, extending from the bodies of the pubic bones, past the urogenital hiatus, around the anal canal.

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10
Q

What does the Puborectalis muscle do?

A

Its tonic contraction bends the canal anteriorly, creating the anorectal angle (90degrees) at the anorectal junction (where the rectum meets the anus). This aids continence
Also aids continence as pulls the urethra and vagina against the pubic symphyses

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11
Q

Where does the Pubococcygeus muscle attach?

A

Arise from the body of the pubic bone and anterior aspect of the tendinous arch.
Fibres travel around the margin of the urogenital hiatus and run posteriomedially,attaching at the coccyx and anococcygeal ligament.

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12
Q

Where does the Iliococcygeus muscle attach?

A

Anteriorly at the ischial spines and posterior aspect of the tendinous arch.
They attach posteriorly to the coccyx and the anococcygeal ligament.

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13
Q

What are the openings of the pelvic floor?

A

Urogeninital hiatus – allows passage of the urethra (and the vagina in females).
Rectal hiatus – A centrally positioned gap, which allows passage of the anal canal.

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14
Q

What is between the Urogenital hiatus and anal canal?

A

A fibrous node known as the perineal body which joins the pelvic floor to the perineum

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15
Q

What are the functions of the pelvic floor?

A

Support of abdominopelvic viscera through their tonic contraction.
Resistance to increase in intra-pelvic/abdominal pressure eg coughing
Urinary and fecal continence.The muscle fibers have a sphincter action on the rectum and urethra. They relax to allow urination and defecation

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16
Q

What are the 3 components of the pelvic floor?

A

Levator ani muscles (largest component).
Coccygeus muscle.
Fascia coverings of the muscles.

17
Q

What innervates the Levator ani muscles?

A

Pudendal nerve (roots S2, S3 and S4.)

18
Q

What is the Levator ani muscle?

A

A large sheet of muscle that is composed of three separate paired muscles.

  • Pubococcygeus
  • Puborectalis
  • Iliococcygeus
19
Q

How do these muscles attach to the pelvis?

A

Anterior – The pubic bodies of the hip bone.
Laterally – Thickened fascia of the obturator internus muscle, known as the tendinous arch.
Posteriorly – The ischial spines of the hip bone.

20
Q

What is the Puborectalis muscle?

A

U-shaped sling, extending from the bodies of the pubic bones, past the urogenital hiatus, around the anal canal.

21
Q

What does the Puborectalis muscle do?

A

Its tonic contraction bends the canal anteriorly, creating the anorectal angle (90degrees) at the anorectal junction (where the rectum meets the anus). This aids continence
Also aids continence as pulls the urethra and vagina against the pubic symphyses

22
Q

Where does the Pubococcygeus muscle attach?

A

Arise from the body of the pubic bone and anterior aspect of the tendinous arch.
Fibres travel around the margin of the urogenital hiatus and run posteriomedially,attaching at the coccyx and anococcygeal ligament.

23
Q

Where does the Iliococcygeus muscle attach?

A

Anteriorly at the ischial spines and posterior aspect of the tendinous arch.
They attach posteriorly to the coccyx and the anococcygeal ligament.

24
Q

What innervates the Coccygeus muscle?

A

Anterior rami of S4 & S5.

25
Q

What is the Coccygeus muscle?

A

Most posterior and smallest muscle in the pelvic floor
Originates from the ischial spines, travels to the lateral aspect of the sacrum and coccyx. (Along the sacrospinous ligament)

26
Q

How are the Levator ani muscles involved in childbirth?

A

They help to support the foetal head during cervix dilation and childbirth

27
Q

What is most at risk during childbirth?

A

Levator ani muscles (Pubococcygeus & puborectalis most prone to injury due to being most medial)
Pudendal nerve

28
Q

What commonly occurs when there is damage to the pelvic floor muscles?

A

Incontinence

29
Q

What causes prolapses?

A

Damage to the perineal body during childbirth
Trauma to the pelvic floor
Muscle fibres of the pelvic floor have poor tone

30
Q

How can damage to the pelvic floor during childbirth be minimised?

A

By performing an episiotomy

31
Q

What is an episiotomy?

A

A surgical cut in the perineum (Mediolateral in the UK, Midline in the USA)

32
Q

What risk factors increase the risk of a prolapse?

A 
Age
Number of vaginal deliveries
Obesity
Chronic cough
Connective tissue laxity (Can be genetic)
33
Q

What is the effect of childbirth on the pelvic floor?

A

Stretching of the Pudendal nerve
Muscle weakness
Stretch/Rupture of the ligaments supporting muscles resulting in ineffective muscle action

34
Q

How can you treat issues with the pelvic floor?

A

Pelvic floor exercises

Surgery

35
Q

What are continence procedures?

A

Increase support to the sphincter mechanism, prevent descent of the bladder neck
Example is tension free vaginal tape

36
Q

What are Prolapse procedures?

A

Remove the prolapses organs whilst restoring connective tissue supports and maintaining function.

37
Q

What are some of the side effects of Prolapse procedures?

A

Recurrence (Can insert a synthetic mesh to reduce recurrence)
New incontinence
Dyspareunia

Reproductive system (16 decks)

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