The Pelvic Floor Flashcards
What are some of the muscles that help make up walls of the pelvic cavity?
The obturator internus and the piriformis muscles
What is the pelvic floor?
A funnel shaped musculature structure, that attaches t the walls of the lesser pelvis separating the pelvic cavity from the perineum
What is the urogenital hiatus?
An anteriorly situated gap which allows for passage of the urethra and the vagina in females
What is the rectal hiatus?
A centrally positioned gap which allows the passage of the anal canal
What is found between the urogenital hiatus and the anal canal?
The perineal body
What are the functions of the pelvic floor muscles?
The support f the abdominal pelvic vsicera through their tonic contraction, and resistance to increase in intra- pelvic or abdominal pressure during activities such as coughing or lifting heavy objects, and urianry and fecal continence as the muscle fibres have a spincther action on the rectum and urethra, and they relax to allow urination and delectation
What are the main groups of fascia that are involved in the pelvic floor?
The levator ani muscles adn the coccygeus muscles
What are the levator ani muscles from inner to outer?
The puborectalis, the pubococcygeus and the illioccoygeus
What is the main nerve that innervates the levator ani muscles?
The puedenal nerve, S2-4
What are some of the key features of the puborectalis muscle?
Is a U shaped sling, and has a main function to maintain fecal continence and during defectation the muscle relaxes
What are the main features of the pubococcygeus?
Is the main consituent of the levator ani, and has some fibres that divide and loop around the prostate in males(levator prostate) and around the vagina in females (pubovaginalis), and some fibres also terminate in the perineal body
What are some of the main features of the illiococcygeus/
Has thin muscle fibres that start anteriorly at the ischial spines and the posteior aspect of the tenidinous arch
What innervates the coccygeus?
The anterior rami of S4 and S5
What are some of the features of the coccygeus?
The smallest and most posterior of the pelvic floor componet/
Which of the levator ani muscles are most at risk during the second part of childbirth?
The puborectalis and the pubococcygeus
What nerve is at risk during the second phase of childbirth?
The puedenal nerve, which can be streched
What problems can be caused by injury to the pelvic floor muscles?
Urinary stress incontiance and rectal incontinance
When can prolaspe of the pelvic viscera occur?
If there is trauma to the pelvic floor or if the muscle fibres have poor tone,
When can prolaspe of the vagina occur?
Is there is damage to the perineal body during childbirth
What is a episiotomy?
A surgical cut in the perineum
What can happen if the medial fibres of the puborectalis are torn>
Rectal herniation can occur as the anal spincther is disrupted
Which is the safest direction to do an episomty?
Mediolateral
What is the perineum?
The most inferior part of the pelvic outlated, located between the thighs and is seperated from the pelvic cavity superiorly by the pelvic floor
What are the contents of the perineum?
The anterior urogenital and the posterior anal triangles
What is the anal triangle?
The posterior part of the perineum, nd contant the anal appeture the external anal sphinter muscle and two ishioanal fossae
What is the urogenital triangle?
The anterior half of the perineum,
What is the deep perineal puch?
A ponteital space between the pelvic floor superioly and the perineal membrane inferiroly, and contains part of the urethra and the external urethral spincther
What is the perineal membrane?
A layer of touch fascia which is perforated by the urethra and the vagina,, and is to provide attachment for the muscels of the superifical external geneitalia
What is the superifical perineal pouch?
A potential space between the perineal membrane superiorly and the perinela fascia inferiorly, and contains that erectile tissues that fomr the penis and the clitoris, and three muscles, the ischicavernous, the bulbospongisu and the superifical tranverse perineal muscles
What is the deep perineal fascia?
The fascia covering the superifical perineal muscles
What is the superifical perineal fascia?
Continous with the superifical fascia of the abdominal wall/
What is the perineal body?
A irregualr and fibromusculr mass, that is located at the junction of the urogenital and anal trianges, and functions as a point of attachment for muscle fibres
Which muscle fibres attach to the perineal body?
The levator ani, the bulbospongius muscle, the superifical and deep tranverse perineal muscles and the external anal spincther and the external urethral spintcher
