Session 5 - The Pelvic Floor

Question 1

What are the two main components of the pelvic floor?

Answer 1

Pelvic diaphragm
- The coccygeus and levator ani muscles
Superficial muscles and structures 
- Anterior perineum
- Posterior perineum

Question 2

What are the functions of the pelvic floor?

Answer 2

Supports the pelvic viscera
Exerts a sphincter action on the rectum and vagina and an resist increases in intra-abdominal pressure associated with coughing, defecation and heavy lifting

Question 3

What is the anterior perineum?

Answer 3

The urogenital diaphragm fills the gaps of the pubic arch, stretching between the converging ischiopubic rami.

Question 4

What three things is the anterior perineum made up of?

Answer 4

Superior fascia
Sphincter urethrae
Inferior or superficial fascia

Question 5

What two structures penetrate the anterior perineum

Answer 5

The urethra and the vagina

Question 6

What are the four structures below the perineal membrane in males

Answer 6

o Superficial transverse perineal membrane
o Bulbospongiosus muscle
o Ischiocavernosus muscle
- Superficial perineal pouch

Question 7

What is located below the perineal membrane in women?

Answer 7

The superficial perineal pouch

Question 8

What is the superfiical perineal pouch?

Answer 8

The site of collection of urine if the urethera is ruptured below the perineal membrane

Question 9

What does the posterior pereum form a triangle between?

Answer 9

The iscial tuberosities and the coccyx

Question 10

What three structures is the posterior perineum made up of?

Answer 10

Anus
Levator ani
Isciorectal fossae

Question 11

What is the ischioectal fossae?

Answer 11

A fatty fossa that may become infected, spreading bacteria beghind anus

Question 12

What is the perineal body?

Answer 12

A pyramidal fibromuscular mass found at the junction between the urogenital and anal triangles

Question 13

What is the perineal body a point of attachment for?

Answer 13

o Anal sphincters
o Bulbospongiosus
o Superficial transverse perineal muscles
o Fibres of levator ani

Question 14

What is the function of an epiostomy?

Answer 14

Allows the vaginal orifice to expand in a controlled way, rather than rupturing.

Question 15

What are the three mmain effects of childbirht on the pelvic floor?

Answer 15

o Stretch of the Pudendal Nerve
 Neuropraxia and muscle weakness
o Stretch and damage of the pelvic floor and perineal muscles
 Muscle weakness
o Stretch / Rupture of ligament supports of muscles
 Ineffective muscle action

Question 16

What are risk factors for pelvic floor dysfunction?

Answer 16

o	Age
o	Menopause
	Atrophy of tissues after oestrogen withdrawal
o	Obesity
o	Chronic cough
o	Intrinsic connective tissue laxity
	Defined conditions
	Constitutional

Question 17

What is continence surgery?

Answer 17

Give increased support to sphincter mechanism and prevents descent of neck of bladder (Tension- free vaginal tape)

Question 18

Give two side effects of continence surgery

Answer 18

Voiding difficulty

Overactive bladder disease

Question 19

What is a prolapse procedure?

Answer 19

Replace prolapsed organs
Restore connective tissue supports
Maintain function

Question 20

What are three side effects of prolapse procedures?

Answer 20

Recurrence
New incontinence
Dyspareunia