What are the 3 layers of the pelvic floor?
- pelvic diaphragm (levator ani muscles)
- external urethral sphincter
- urogenital diaphragm
What are the levator ani muscles?
- pubococcygeus
- puborectalis
- iliococcygeus
- coccygeus muscle
- arcus tendineus
What nerve runs through the obturator internus and piriformis?
sciatic N
What muscles and sphincter are a part of the urogenital diaphragm? What is the epicenter of these structures?
- bulbospongiosus
- superficial transverse perineal
- external anal sphincter
- connect at the perineal body
What is the function of the bulbospongiosus in makes?
- increase tone of penile veins so blood can’t come back out to assist with erection
- contracts during climax to push out semen since the prostate’s smooth muscle can’t pust it out all the way
- contracts at the end of urination to push the rest of the urine out from the ureter
What is the function of the ischiocavernosus in males?
- ejaculation
- assists with penile regidity
What is the function of the bulbocavernosus in females? and where does it O,I?
- runs from the pubic ramus to perineal body
- covers bulb of vestibule (vaginal opening)
What is the function of the ischiocavernosus in females? and where does it O,I?
- runs from pubic ramus to ischial tuberosity
- covers crus of clitoris
Why doe we have more slow twitch than fast twitch muscles?
-need endurance because we are always contracting when upright
What is the Alcock’s canal? Where is it? Where is the male version of this?
- tunnel where pudendal N runs
- behind coccygeus and next to OI
-runs b/w sacrospinous and sacrotuberous ligaments
What are the 3 functions of the pelvic floor?
- supportive
- sphinteric
- sexual
What are the supportive functions of the pelvic floor?
- supports pelvic organs
- reduces force of gravity and intra-abdominal pressure
- pelvic/lumbar stability
What are the sphinteric functions of the pelvic floor?
- compression of urethra and rectum for continence
- continence with higher urethral pressure than bladder pressure
What are the sexual functions of the pelvic floor?
females:
-hypertrophied= smaller vagina for increased friction and more sensory nerve stim
males:
-assists with maintaining erection
What are the 3 phases of the bladder? Is voiding passive or active?
- storage, filling, emptying
- passive event
What is the neural input of the bladder?
- sympathetic nervous system promotes storage by keeping tone in internal sphincter and relaxing detrusor muscles
- parasympathetic promotes bladder emptying by doing the opposite
What is the bladder cycle?
1) ureters fill bladder
2) detrusor is stretched and sends messages to brain for emptying
3) brain responds with relaxing of internal sphincter and gentle detrusor contraction
4) voluntary external sphincter relaxation
5) voiding
6) brain tells detrusor to relax
What are the 3 classifications of dysfunction?
- poor sphincter closure
- poor support of pelvic organs (prolapse)
- hypertonia (pain)
- poor coordination w/ deep stabilizers (multifidus, TA)
- poor coordination w/ global muscles (LBP)
What can cause decreased muscle coordination in the PF?
- hypertonia
- detrusor
- diaphragm
What is the function of the prostate gland? What is the biggest issue for the prostate gland?
- surrounds the urethra and thins/liquefies seminal fluid, nourishes sperm, and protects sperm from acidity
- enlargment due to benign prostatic hyperplasia or cancer
