The Pelvic Floor Flashcards
A first degree perineal tear includes…
Only the perineal skin (the skin between the vaginal opening and the rectum and the tissues directly beneath the skin)
A second degree tear involves…
The skin and muscle of the perineum and might extend deep into the vagina
A third degree year includes…
A tear that extends into the muscle that controls the anus (the anal sphincter)
A fourth degree tear includes…
Injury to the anal sphincter complex and the anal epithelium
The arteries and veins which supply the pelvic floor are called…
Pudendal
The nerves which supply the pelvic floor are called…
The third and fourth sacral nerves
The perineal body consists of…
- Puboccygeus muscle
- A layer of skin at the base
-Bulbocaverosus and transverse perineal muscles
What are the functions of the pelvic floor?
- Support organs
- Micturition
- Defaecation
- Sexual Intercourse
- Pregnancy
- Labour and Delivery
What does the deep muscle layer include?
- Pubococcygeus muscle
- Ilicoccygeus muscle
- Ischiococcygeus muscle
What is the function of the Puboccygeus muscle?
Supports the vagina and aids in the proper positioning of the foetus’s head
Where does the Pubococcygeus extend from?
It extends from the inner aspect of the pubic bone to the coccyx
What is the function of the Ilicoccygeus muscle?
It acts in association with the internal and external anal sphincter in the process of defecation
Where is the Ilicoccygeus located?
It extends from the inner aspect of the iliac bone and fibres from each side meet in the midline in the perineum, before extending to the coccyx
Where is the Ischioccygeus muscle?
Arises from the ischia spines and pass to the lower sacrum and upper coccyx
What is the function of the Ischiococcygeus muscle?
These muscles help support the sacroiliac and sacrococcygeal joints of the pelvis
Within the pelvic floor, where is blood supplied from?
The pudendal arteries
Within the pelvic floor what is the nerve supply provided by?
The third and fourth sacral nerves
Where do the lymph nodes within the pelvic floor drain?
Into the inguinal and external iliac glands
What does the Superficial muscle layer consist of?
- Ischiocavernosis muscle
- Bulbocavernosus muscles
- Transverse perineal muscles
Where does the Ischiocavernosus muscle extend from?
The ischial tuberosity to the clitoris
Where are the Bulbocavernosus muscle located?
They arise in the perineum around the vagina and embed in the clitoris
Where are the Transverse perineal muscles located?
They extend from the ischial tuberosities to the perineum, where they intermingle with muscles of the perineal body
Where is the external anal sphincter muscles located?
It surrounds the anal orifice with some fibres extending back through the perineal body to attach to the coccyx
Where is the external sphincter of the urethra located?
It arises and embeds in the pubic bone, having passed above and below the urethra
The perineal body consists of…
- The layer of the skin at the base
- The bulbocavernosus and transverse perinei of the superficial muscles
- The Pubococcygeus of the deep muscles
What physiological changes happen to the pelvic floor within pregnancy?
- Relaxin: the hormones relax the smooth perineal muscles
- Pelvic floor exercises and Perineal massage to support the foetus and the uterus
- Stress incontinence
- Prolapse
How many layers of muscle are there in the pelvic floor?
- 2
- The deep muscle layer and the superficial muscle layer
What aspects in labour are related to the pelvic floor?
- Rotation of the presenting part
- Decent of the presenting part
- Maternal position
- Perineal massage
- Birth
- Perineal trauma
- Episiotomy
