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THE PELVIC FLOOR MUSCLES

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 �THE PELVIC FLOOR�

  • The floor is filled with soft tissues.
  • The muscles hang like hammock from the walls of the pelvis.
  • Through the muscle layers are the urethra, vagina and the anal canal.

FUNCTIONS

  • It provides support for pelvic organs(pubococcygeus).
  • Its maintain continence for urine/feaces.
  • The muscles relax during birth to allow exist of fetus.
  • Assist abdominal organs during defecation and expulsive movement.

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THE PELVIC FLOOR MUSCLES

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MUSCLE LAYER

  • Arrange in two layers.
  • Superficial muscle layer.
  • Deep muscle layer.

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SUPERFICIAL MUSCLES

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� �SUPERFICIAL MUSCLE LAYER ��

Composed of five layers

  • External anal sphincter.
  • Transverse perinei muscles
  • Bulbocavernosus muscle.
  • Ischiocavernosus muscle
  • Membranous sphincter of the urethra.

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THE PELVIC FLOOR MUSCLES

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2. DEEP MUSCLE LAYER

It consist of four main pairs of muscles

a) Pubococcygeous and puborectalis.

b) Iliococcygeous

c) Ischiococcygeous

PERINEAL BODY

  • Pyramid of muscles and fibrous tissue located between the vagina opening and anus measured approximately 3.5cm in each direction.
  • Triangular in shape.
  • The base is the skin and the apex is pointing upwards.

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STRUCTURE OF THE PERINEAL BODY

  • Has three layers of tissues.

1.Outer covering of skin.

2.Superficial pelvic floor muscles made up of

  1. Bulbocarvernosus

b.Transverse perinei

3. Deep pelvic floor muscles-pubococcygeus

 

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PERINEUM

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BLOOD SUPPLY

By Pudendal arteries

  • LYMPHATIC DRAINAGE: Iliac nodes and internal iliac nodes
  • NERVE SUPPLY: Pudendal nerve.

FUNCTIONS

  • Assist in the process of defecation and child birth.
  • NB It can be over stretched and torn.

 

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�PERINEAL TRAUMA�

  • Minor lacerations
  • First degree tear involves only the fourchette and perineal skin.
  • Secondary degree tear involves the skin mucous membranes, superficial pelvic floor muscles.
  • Third degree tear involves deep muscles and anterior area of the external anal sphincter.
  • Fourth degree tear extends into anterior walls of the rectum involve internal sphincter of the anus.

 

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PREVENTION OF PELVIC FLOOR TRAUMA

Antenatal period

Educate woman on Pelvic exercise

  • Assessment of pelvic tone.
  • Educate pregnant women about delivery.

During labour

  • Skilful management and delivery.
  • Post natal pelvic floor exercise.

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END

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Thank you