Urogenital Diaphragm Flashcards
What are the components of the pelvic brim?
- Pubic symphysis
- Pubic crest and tubercle
- Pectin pubis
- Arcuate line
- Sacral promontory
NOTE: Everything above the pelvic brim is the false bony pelvis.
What organs are apart of the false pelvis?
Organs of the abdominal cavity
What are the components of the true pelvis?
- Uterus
- Prostate gland
- Bladder
The narrowest point in the pelvic outlet is the distance between the _________.
Ischial spines
NOTE: Difficulties in deliveries occur when the distance between spines is too small. (i.e. <9.5 cm)
_____________ (Anteriorly/ Posteriorly), the pelvic diapgragm is incomplete.
Anteriorly
What structures transverse the space of the incomplete pelvic diaphragm?
Vagina
Urethra
The _______ fills in the anterior space in the pelvic diaphragm.
Urogenital diaphragm
NOTE: This muscle can be controlled
When the pelvic diaphragm ______ (relaxes/cotnracts) it flattens out.
Contracts
NOTE: The UG diaphragm forms a subfloor in the pelvic diaphragm.
What are the contents of the urogenital diaphragm?
- Skeletal muscles
- Deep transverse perineus
- Sphincter urethrae (external urethral sphincter)
- Superior fascia
- Inferior fascia (perineal membrane)
Which two muscles surround the UG diaphragm?
- Sphicter urethrae
- Deep transverse perineus
- Between ischial spines
NOTE: Portions of the UG diaphragm surrounds the vagina.
The deep perineal pouche contains the __________.
UG diaphragm
The superfical perineal pouch contains the ________
External genitalia
________ fascia is continuous with Scarpa’s fascia.
Colles
What are ways that the urethra can be damaged?
- Surgery
- Kick in grown
- Bullet to the urethra
- Jamming penis
Label
_____________ fascia fuses with the perineal body.
Colles’
REMEMBER: The perineal body is in between the anal and the urogenital triangle
How does urine from a ruptured urethra flow?
In males, fluid goes upward
What are the contents of the deep pouch in males?
- Membranous urethra
- Bulbourethral glands
- Secretes mucus
- Dorsal artery, vein, and nerve of the penis
Function of the bulbourethral gland
The mucus secreted by the bulbourethral gland purges the urethra of any residual urine and this mucus secretion lubricates the urethra for ejaculation
What are the contents of the deep perineal space in females?
- Urethra
- Vagina
- Perineal membrane
- Dorsal artery, vein and nerve of the clitoris
What are the contents of teh superficial pouch in males?
- Crus of penis
- Bulb of penis
- Ischiocavernosus
- Contracts and compresses blood and forces blood to the shaft of the penis
- Bulbospongiosus
- Superficial transverse perineus
What are the contents of the superifical pouch in females?
- Crus of clitoris
- Bulb of vestibule
- Vestibular glands
- Mucus secreting. Lubricate the vestibule
- Ishiocavernosus
- Bulbospongiosus
- Superficial transverse perineus
What is the course of the pudendal nerve?
- Greater sciatic foramen (exits pelvis)
- Lesser sciatic foramen (re-enters pelvis)
- Pudendal canal
- Urogenital triangle (terminates in the UG triangle)
What are the spinal contributions to the pudendal nerve?
S2, S3, and S4
______________ nerve innervates the external anal sphincter.
Inferior rectal nerve
The pudental nerve can become entrapped under the _______ ligament.
Sacrospinous
NOTE: This can result in chronic pain in the perineum. Severe entrapment of the nerves become over excitable and produce lack of sensation of external genitalia.
Too little tone in the UG and pelvic diaphragms can result from?
Damage, trauma, lack of exercise
As a child’s head goes through the pelvic diapgragm it goes through ________ and ________ muscles.
Pubococcygeus and puborectalis
Prolapse of Uterus
Sinking of the uterus into the vaginal canal
- 1st degree: Cervis fills up portion of the vagina
- 2nd degree: Cervix protrudes all the way to the vaginal opening
- 3rd degree: Cervis extends out of the vaginal opening
Prolaspe of the bladder is known as ________.
Cystocele
*may result in urinary incontinence
Prolaspe of the rectum is known as a _______.
Rectocele
*may result in fetal incontinence
What is the cause of a rectocele?
Absorption of fat in ischioanal fossa. If a person is under starvation, the fat in the fossa is absorbed long with buccal fat pad. The rectum is no longer supported by fat which is very important and you begin to get rectal prolapse
Spastic pelvic floor syndrome
Muscles are under tonic contractions and can’t relax
Failure for the puborectal sling and the external anal spchinter to relax during defection results in _________.
Constipation
What can result from spasms of the urethral sphincter?
- Incomplete voiding
- Urinary retention
- Cystitis
- Chronic bladder infections
REMEMBER: Part of the UG diaphragm surrounds the membranous urethra, so failure of the UG diaphragm to relax can result in the aforementioned problems.
In males, excessive tone in the external uterthral sphincter may result in:
- Regurgitation of urine into the prostate gland
- Prostatitis
In females, spasms in the pelvic floor may result in:
- Vaginismus
- Involuntary spasm of the vagina
- Dyspareunia
- Painful intercourse
When the grafenburg spot is stimulated it produces a distinct orgasm mediated by ________ fibers.
GVA
NOTE: The G spot may be remnant of the prostate gland in females. A vulval orgasm stimulates GSA fibers and a uterine orgasm stimulates GVA fibers.
