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Reproduction Y3 > Urinary incontinence and prolapse > Flashcards

Urinary incontinence and prolapse Flashcards

1
Q

Functions of pelvic floor?

A
  • Separates pelvic cavity (above) from perineum (below)
  • Plays important role in providing support to pelvic organs
  • Plays an important role in maintaining continence (urinary & faecal)
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2
Q

3 layers of pelvic floor?

A

Pelvic diaphragm
Muscles of perineal pouches
Perineal membrane

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3
Q

Pelvic diaphragm?

A

Deepest later of pelvic floor
Levator ani and coccygeus

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4
Q

Appearance of pelvic diaphragm?

A

Sling

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5
Q

Name areas

A
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6
Q

What forms most of pelvic diaphragm?

A

Levator ani

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7
Q

What are the attachments of the levator ani?

A
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8
Q

Is levator ani contracted or relaxed?

A

Tonically contracted most of the time

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9
Q

Innervation of levator ani?

A

Pudendal nerve and nerve to levator ani

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10
Q

Most medial part of levator ani?

A

Puborectalis

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11
Q

3 parts of levator ani?

A

Puborectalis

Pubococcygeus

Iliococcygeus

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12
Q

What must relax to allow urination and defeceation?

A

Levator ani

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13
Q

Name muscles of levator ani

A
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14
Q

Additional support to pelvic floor?

A

Endopelvic fascia

Pelvic ligaments

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15
Q

Where does the deep perineal pouch lie

A

Below the fascia covering the inferior aspect of pelvic diaphragm

Above perineal membrane

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16
Q

What does the deep perineal pouch contain?

A

Part of urethra (and vag in females)

Bulbourethral glands (male)

Neurovascular bundle for penis/ clitoris

Extensions of ischiocanal fat pads and muscles

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17
Q

Name the areas

A
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18
Q

Do male or females have deep transverse perineal muscle?

A

Males

19
Q

What is perineal membrane?

A

Thin sheet of tough, deep fascia

Lies superficial to deep perineal pouch

20
Q

Where does the perineal membrane attach

A

Laterally to the sides of the pubic arch, closing urogenital triangle

21
Q

Openings in perineal membrane?

A

Urethra

Vagina in females

22
Q

Name this membrane

A
23
Q

Where does the female superficial peroneal pouch lie?

A

Below perineal membrane

24
Q

Where is the female erectile tissue contained?

A

Superficial perineal pouch

25
Q

What does the superficial perineal pouch contain?

A

Clitoris and crura

Bulbs of vestibule

Associated muscles - bulbospingiosus (covers bulb) and ischiocavernous (covers crura)

Greater vestibular glands, superficial transverse perineal muscle and branches of internal pudendal vessels and nerve

26
Q

Name the areas

A
27
Q

Where does male perineal pouch lie?

A

Below the perineal membrane

28
Q

What does male superficial perineal pouch contain?

A

Root of penis (bulb, crura and associated muscles)

Associated muscles - bulbospingiosus and ischiocavernosus

Proximal; spongy urethra, superficial transverse perineal muscle & branches of internal pudendal vessels and nerve

29
Q

What is male bulb made from?

A

Corpus spongiosum

30
Q

What is male crura made from?

A

Corpus cavernosum

31
Q

Name areas of male superficial perineal pouch

A
32
Q

Perineal body?

A

Ball of tissue

Contains fibrous tissue and skeletal and smooth muscle

Important in support of pelvic floor

33
Q

where is perineal body in females?

A

In between rectum and most posterior part of vagina

34
Q

Where is perineal body in males?

A

Slightly anterior to rectum, behind urethra

35
Q

Which muscles converge at perineal body?

A

Bulbospongiosis, external anal sphincter, perineal muscles (superficial and deep), slips of muscle from levator ani, external urethral sphincter and muscular coating of rectum

36
Q

When does pelvic floor actively contract?

A

Coughing, sneezing and vomiting

37
Q

What structures help maintain urinary continence?

A

External urethral spincter

Compressor urethrae

Levator ani

38
Q

What structures help maintain faecal continence?

A

Tonic contraction of puborectalis bends anorectum anteriorly

Active contraction maintains continence after rectal filling

39
Q

1st degree uterine prolapse?

A

Just cervix dropped into vagina

40
Q

2nd degree uterine prolapse?

A

Cervix drops just inside opening of vagina

41
Q

3rd degree uterine prolapse?

A

Cervix just outisde of vagina

42
Q

4th degree uterine tear?

A

Entire uterus outside of vagina

43
Q
A

Reproduction Y3 (7 decks)

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