Session 6 - Pelvic Floor Muscles

Question 1

Answer 1

Question 2

Answer 2

Question 3

Where do pelvic viscera lie?

Answer 3

Pelvic cavity (true pelvis) found in lesser part of pelvis

Question 4

What are the 2 holes found in the pelvic floor. What is their function?

Answer 4

• Urogenital hiatus – anteriorly positioned, allows passage of urethra (and vagina in females).
• Rectal hiatus – centrally positioned, allows passage of anal canal.

Question 5

What is the 3 functions of pelvic floor viscera?

Answer 5

• Support of abdominopelvic viscera through tonic contraction
• Resistance to increase in intra-abdominal pressure during activities such as coughing or lifting.
• Urinary and fecal continence – muscle fibres have a sphincter action on rectum and urethra.

Question 6

What is the innervation of the levator ani muscles?

Answer 6

Pudendal S2-4

Question 7

What are the 3 muscles which make up the levator ani?

Answer 7

pubococcygeus, puborectalis, iliococcygeus

Question 8

What are the 3 components of the pelvic floor?

Answer 8

1. Levator ani muscles
2. Coccygeus muscle
3. Fascia coverings of muscles

Question 9

What is the function of puborectalis and how does it achieve this?

Answer 9

• Forms sling around rectum
• Maintains faecal continence

Question 10

What is the perineal body and its function?

Answer 10

Connective tissue mass in centre of perineum

Anchors perineal muscles and rectum

Question 11

What are the boundaries of the perineum?

Answer 11

Anterior – Pubic symphysis.
Posterior– The tip of the coccyx.
Laterally – Inferior pubic rami and inferior ischial rami, and the sacrotuberous ligament.
Roof – The pelvic floor.
Base – Skin and fascia.

Question 12

What can the perineum be subdivided into?

Answer 12

Anterior urogenital triangle

Posterior anal triangle

Question 13

What are the contents of the anal triangle?

Answer 13

Anal aperture

External anal sphincter

2 ischioanal fossae

Question 14

What are the layers of the urogenital triangle?

Answer 14

1. Skin
2. Superficial perineal fascia
3. Deep perineal fascia
4. Superficial perineal pouch
5. Perineal membrane
6. Deep perineal pouch

Question 15

What is contained in the deep perineal pouch in males and females?

Answer 15

Both - part of urethra and external urethral sphincter and deep transverse perineal muscles

Males - bulbourethral glands

Females - urethrovaginal sphincter

Question 16

What is found within the superficial perineal pouch?

Answer 16

Both sexes - ischiocavernosus, bulbospongiosus, superficial transverse perineal muscle. Bartholin’s glands.

Question 17

Answer 17

Question 18

What is the neurovascular supply to the perineum?

Answer 18

Pudendal - S2 to S4

Internal pudendal artery

Question 19

How can damage to the perineal body during labour be avoided?

Answer 19

episiotomy - surgical cut in the perineum which prevents tearing of perineal body

Question 20

How can damage occur to the pelvic floor during childbirth?

Answer 20

Mechanical - muscles stretched or pudendal nerve damaged.

Iatrogenic - damaged in episiotomy