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10 Cards in this Set
- Front
- Back
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pelvic viscera supports
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primarily: pubococcygeus, iliococcygeus, puborectalis
secondarily: endopelvic fascia lastly: urogenital diaphragm |
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blood supply and innervation of supporting muscles
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inferior gluteal a.
pudendal nerve (somatic & PSNS) pelvic splanchnic plexus (SNS) |
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causes of prolapse & incontinence
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damage to vasculature, nerves, muscles (vaginal delivery, constipation, heavy lifting, surgery)
*prolapse may occur years after initial insult |
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Types of prolapse
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anterior compartment - cystocele (dropped bladder)
mid-compartment - uterine prolapse, vaginal prolapse, enterocele posterior compartment - enterocele, rectocele |
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Prolapse interventions
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Pessary - intravaginal deviceusing the
bony pelvis and muscles for support Surgery |
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how pee stays in
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"hammock-like structure
circular and longitudinal smooth and striated muscle |
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Types of Incontinence
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Stress - failure of normal mechanism (denervation and devascularization)
Urge - disruption of normal voiding mechanism (neural pathways) Mixed Overflow - complete denervation of the bladder |
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Stress incontinence causes & txs
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anything that will damage muscle, fascia, devervate, devascularize (see prolapse causes)
tx: muscle exercises, surgery |
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Urge Incontinence causes & txs
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any interruption of neural pathway up and down the spinal cord (suprapontine lesions, pontine lesions, spinal cord lesions, sup sacral lesions)
Tx: retrain pathways, muscarinic blockade at the level of the detrusor |
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Overflow incontinence causes & txs
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complete denervation fo the bladder (DM, surgery, medications)
tx: self-catheterization |
