Physiotherapy in Women's Health and Geriatric

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Questions and Answers

What are the main functions of the bony pelvis?

Transmit the weight of the body from the vertebral column to the femurs, contain, support and protect the pelvic viscera, provide attachment to trunk and lower limb muscles

Name the bones that make up the pelvis.

Two Hip Bones, Sacrum, Coccyx

What are the functions of the hip bone? Choose the correct option:

Provide attachment to trunk and lower limb muscles

Bearing weight of the upper body

Contain, support, and protect the pelvic viscera

All of the above (correct)

The female pelvic outlet is in shape and the male pelvic outlet is in shape.

oval, heart Signup and view all the answers

Male and female pelvic promontories are usually of similar size.

False Signup and view all the answers

Match the following pelvic structures to their descriptions:

Ilium = Upper flattened part of the hip bone Ischium = Forms the inferior and posterior part of the hip bone Pubis = Forms the anterior and inferior part of the hip bone Coccyx = Consists of fused vertebrae forming a triangular piece Signup and view all the answers

What are the four types of female bony pelvis mentioned in the text?

Gynecoid, Android, Anthropoid, Platypelloid Signup and view all the answers

What are the functions of the pelvic floor muscles?

All of the above Signup and view all the answers

The __________ is a dome-shaped muscular sheet separating the pelvic cavity above from the perineal region below.

pelvic floor Signup and view all the answers

Match the components of the levator ani muscles with their descriptions:

Puborectalis = Most important for maintaining fecal continence Pubococcygeus = Forms the bulk of the levator ani complex Iliococcygeus = Elevates the pelvic floor and anorectal canal Signup and view all the answers

The abdominal muscles support the trunk, allow movement, and hold organs in place.

True Signup and view all the answers

What are the main functions of the female reproductive system?

Produce secondary oocytes, produce hormones, site for fertilization, pathway for sperm, outlet for menstrual flow, passageway for childbirth Signup and view all the answers

What is the primary event in the ovaries during the Preovulatory Phase?

Secondary follicle secrete estrogen and inhibin Signup and view all the answers

What event occurs in the uterus due to the increase in estrogen during the Preovulatory Phase?

Repair of endometrium and thickening of endometrium Signup and view all the answers

What is the process of rupture of the mature follicle and release of the secondary oocyte into the fallopian tube called?

Ovulation Signup and view all the answers

What stimulates the release of Gonadotropin-releasing hormone (GnRH) during ovulation?

Estrogen Signup and view all the answers

What happens to the corpus luteum if the secondary oocyte is fertilized?

Persist and is rescued from degeneration Signup and view all the answers

If fertilization does not occur, the corpus luteum will degenerate, leading to menstruation.

True Signup and view all the answers

Study Notes

Bony Pelvis

The bony pelvis provides a strong, stable connection between the trunk and lower extremities.
Its main functions are:
- Transmitting the weight of the body from the vertebral column to the femurs.
- Containing, supporting, and protecting the pelvic viscera.
- Providing attachment to trunk and lower limb muscles.
The pelvic girdle is composed of four bones:
- Two hip bones (coxal bones).
- Sacrum.
- Coccyx.
The hip bone is a large, irregular bone formed by the fusion of three bones:
- Ilium.
- Ischium.
- Pubis.

Hip Bone

The ilium is the upper, flattened part of the hip bone.
It possesses:
- Iliac crest.
- Iliac fossa.
- Auricular surface.
- Iliopectinial line.
The pubis forms the anterior and inferior part of the hip bone.
It has:
- Body.
- Pubic crest.
- Pubic tubercle.
- Two pubic rami.
- Obturator foramen.
The ischium forms the inferior and posterior part of the hip bone.
It has:
- Ischial tuberosity.
- Ischial spine.
- Greater sciatic notch.
- Lesser sciatic notch.

Articulations of Hip Bone

Symphysis pubis:
- A cartilaginous joint between the two pubic bones.
Sacroiliac joints:
- Strong synovial joints between the auricular surfaces of the ilium and sacrum.
Hip joint:
- The outer surface articulates at the acetabulum with the head of the femur.

Sacrum

The sacrum is a single, wedge-shaped bone formed by the fusion of five rudimentary vertebrae.
It has:
- Sacral promontory.
- Sacral canal.
- Sacral foramina.
- Sacral hiatus.

Coccyx

The coccyx is formed by the fusion of four vertebrae.
It articulates with the sacrum.

Male vs Female Pelvis

The female pelvis is wider and shorter than the male pelvis.
The pelvic outlet is oval-shaped in females and heart-shaped in males.
The angle of the pubic arch is wider in females.
The promontory and ischial spines are less projecting in females.

Types of Female Bony Pelvis

Gynecoid/genuine pelvis:
- Round brim.
- Wider pelvic cavity.
- Less prominent ischial spines.
Android pelvis:
- Heart-shaped brim.
- Narrower pelvic cavity.
- Prominent ischial spines.
Anthropoid pelvis:
- Oval brim.
- Slightly narrower pelvic cavity.
- Larger outlet diameter.
Platypelloid pelvis:
- Shallow pelvic cavity.
- Decreased anteroposterior diameter.
- Broad outlet.

Pelvic Floor Muscle

The pelvic floor is a dome-shaped muscular sheet separating the pelvic cavity from the perineal region.
It encloses the pelvic viscera (bladder, intestines, and uterus in females).
Functions:
- Supports the abdominal and pelvic viscera.
- Maintains continence of urine and faeces.
- Allows voiding, defecation, sexual activity, and childbirth.

Pelvic Floor Muscles

The pelvic floor is a funnel-shaped structure.
It consists of three main components:
- Levator ani muscles.
- Coccygeus muscle.
- Fascia coverings of the muscles.

Levator Ani Muscles

The levator ani is a broad sheet of muscle.
It consists of three paired muscles:
- Pubococcygeus.
- Puborectalis.
- Iliococcygeus.

Abdominal Muscles

The abdominal muscles are the muscles forming the abdominal walls.
Functions:
- Support the trunk.
- Allow movement.
- Hold organs in place.
- Are distensible.

Muscles of the Abdominal Wall

Rectus abdominis.
External oblique.
Internal oblique.
Transversus abdominis.

Rectus Abdominis

Origin: Crest of pubis and symphysis pubis.
Insertion: Xiphoid process of sternum and costal cartilages of 5th to 7th ribs.
Action: Tenses abdominal wall, compresses abdominal contents, and flexes vertebral column.

External Oblique

Origin: Outer surfaces of lower 8 ribs.
Insertion: Iliac crest and linea alba.
Action: Tenses abdominal wall and compresses abdominal contents.

Internal Oblique

Origin: Crest of ilium and inguinal ligament.
Insertion: Cartilages of lower ribs, linea alba, and crest of pubis.
Action: Tenses abdominal wall and compresses abdominal contents.

Transversus Abdominis

Origin: Costal cartilages of lower ribs, processes of lumbar vertebrae, and lip of iliac crest.
Insertion: Linea alba and crest of pubis.
Action: Tenses abdominal wall and compresses abdominal contents.### Abdominal Wall
Consists of skin, external oblique, internal oblique, transversus abdominis, and peritoneum
Rectus abdominis muscle located in the anterior abdominal wall

Female Reproductive System

Consists of ovaries, uterine tubes, uterus, vagina, and external organs (vulva or pudendum)
Mammary glands also part of the female reproductive system

Ovaries

Paired organs that produce secondary oocytes and hormones
Located in the pelvic cavity on each side
Ovarian follicles consist of an oocyte and surrounding cells that nourish the oocyte and produce hormones
Follicles develop into mature (graafian) follicles, which rupture to release a secondary oocyte (ovulation)
Remnants of an ovulated follicle develop into corpus luteum, which produces progesterone, estrogen, relaxin, and inhibin

Uterine Tubes (Fallopian Tubes)

Two tubes that extend laterally from the uterus
Infundibulum is the open and funnel-shaped end of the tube
Fimbriae sweep the secondary oocyte into the tube
Site of fertilization (occurs within 24 hours after ovulation)
Unfertilized ova disintegrate, while the zygote reaches the uterus in approximately 7 days

Uterus

Pathway for sperm and site of implantation
Structure consists of:
- Fundus: dome-shaped area above the uterine tubes
- Body: tapering central portion
- Cervix: narrow opening into the vagina
Uterine cavity: interior of the body
Middle muscular layer: myometrium
Innermost layer: endometrium, which sheds each month during menstruation if fertilization doesn't occur

Vagina

Extends from the cervix to the exterior
Functions include:
- Receptacle for the penis during sexual intercourse
- Outlet for menstrual flow
- Passageway for childbirth
Acid environment prevents bacterial growth
Smooth muscular layer adjusts for intercourse or birth
Hymen: a thin membrane fold that can cover the vaginal orifice

Menstrual Cycle

Consists of menstrual phase, preovulatory phase, ovulation, and postovulatory phase
Menstrual phase: 5-7 days, characterized by menstruation and repair of the endometrium
Preovulatory phase: increase in estrogen stimulates the thickening of the endometrium
Ovulation: rupture of the mature follicle and release of the secondary oocyte into the fallopian tube
Postovulatory phase: corpus luteum produces progesterone and estrogen, which promote thickening of the endometrium

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Description

Learn about the anatomy and physiology of female patients, and understand the role of physiotherapy in women's health and geriatric care.