Week 7

Pelvic floor

Muscular and connective-tissue structures forming the inferior wall of the pelvis and supporting pelvic organs

Pelvic cavity

The space within the bony pelvis containing pelvic organs and bounded inferiorly by the pelvic floor

Pelvic peritoneum

The peritoneal lining associated with the pelvic cavity

Perineum

The region between the pelvic floor and the external perineal skin

Viscera

Internal organs within the pelvic and abdominal cavities

Smooth muscle

Involuntary muscle found in viscera and sphincters

Striated muscle

Voluntary skeletal muscle found in the pelvic floor and pelvic wall

Pelvic floor muscles

Muscles that support pelvic organs and contribute to continence sexual function and pressure management

ASIS

Anterior superior iliac spine which is a bony landmark on the front of the pelvis

Pubic symphysis

The joint connecting the left and right pubic bones at the front of the pelvis

Pelvic tilt

The position of the pelvis relative to the trunk and lower limbs

Female pelvis

Generally wider shorter and larger with a rounder pelvic inlet and greater distance between the sides of the pelvis

Female pelvic inlet

Generally rounder and wider than the male pelvic inlet

Inferior pubic rami angle

The angle between the lower pubic bones which is generally obtuse in females

Female sacrum

Shorter wider and more curved posteriorly than the male sacrum

Male pelvis

Generally narrower taller more compact and deeper than the female pelvis

Male pelvic inlet

Generally heart-shaped with the sides converging

Inferior pubic rami angle

The angle between the lower pubic bones which is generally acute in males

Male sacrum

Longer narrower and relatively straighter than the female sacrum

Pelvic floor contraction

Active shortening of the pelvic floor muscles to generate force and support

Pelvic floor holding

Ability of the pelvic floor muscles to sustain a contraction over time

Pelvic floor relaxation

Ability of the pelvic floor muscles to lengthen and reduce activity when contraction is no longer required

Sphincteric function

Pelvic floor function that helps control storage and evacuation of urine faeces and wind

Supportive function

Pelvic floor function that supports abdominal and pelvic viscera and contributes to stability of the sacroiliac joints and pubic symphysis

Sexual function

Pelvic floor involvement in sexual activity intercourse and parturition

Diaphragmatic function

Contribution of the pelvic floor to maintaining and controlling intra-abdominal pressure

Intra-abdominal pressure

Pressure within the abdominal cavity that changes with breathing movement lifting and other activities

Pelvic floor dysfunction

Impaired ability of the pelvic floor and associated structures to perform their supportive sphincteric sexual and pressure-management functions

Chronic cough

Persistent coughing that repeatedly increases intra-abdominal pressure and may increase pelvic floor loading

Chronic constipation

Persistent difficulty passing stools that may involve repeated straining and increased pelvic floor loading

Occupational heavy lifting

Repeated lifting of heavy loads that can increase intra-abdominal pressure and pelvic floor demand

Urinary dysfunction

Problems involving the storage or emptying of urine

Urinary storage dysfunction

Difficulty keeping urine in the bladder appropriately

Urinary emptying dysfunction

Difficulty emptying the bladder completely or effectively

Urinary incontinence

Involuntary leakage of urine

Stress urinary incontinence

Involuntary leakage of urine during physical effort or exertion such as coughing sneezing laughing or jumping

Urethral support

Support around the bladder neck and urethra that helps maintain continence when intra-abdominal pressure rises

Urgency urinary incontinence

Involuntary urine leakage associated with a sudden or difficult-to-control urge to urinate

Urinary urgency

A sudden compelling desire to urinate that is difficult to defer

Mixed urinary incontinence

A combination of stress and urgency urinary incontinence

Overflow incontinence

Involuntary leakage caused by an excessively overfilled bladder usually associated with impaired bladder emptying

Constipation

Infrequent and or hard stools that are difficult to pass and may involve incomplete emptying or straining

Faecal incontinence

Involuntary leakage or loss of control of stool

Flatal incontinence

Involuntary leakage or loss of control of intestinal wind

Anal incontinence

Involuntary loss of control of stool and or wind

Stress faecal incontinence

Leakage of stool or wind associated with an activity or increase in pressure

Urge faecal incontinence

Inability to defer the urge to empty the bowel

Passive faecal incontinence

Unintentional leakage that occurs without awareness or an obvious triggering factor and is often associated with weakness

Pelvic organ prolapse

Symptomatic descent of one or more pelvic organs into the vagina and sometimes beyond the vaginal opening

Anterior vaginal wall prolapse

Descent involving the front wall of the vagina

Posterior vaginal wall prolapse

Descent involving the back wall of the vagina

Cervical prolapse

Descent of the cervix towards or through the vaginal opening

Active support system

Muscular support provided by structures such as the pelvic floor muscles

Passive support system

Support provided by connective tissues ligaments and other passive structures

Prolapse symptoms

Symptoms including vaginal heaviness pressure dragging a palpable lump or bulge a feeling that something is coming down or difficulty inserting or retaining tampons

Pelvic health screening

A process used to identify pelvic health risk factors symptoms and associated impact and determine whether referral is required

Associated bother

The degree to which a symptom affects a person's activities wellbeing or quality of life

Antenatal

The period during pregnancy before childbirth

Basal metabolic rate

The energy required by the body to maintain basic physiological functions at rest

Thermoregulation

The body's process of controlling and maintaining its temperature

Normal pregnancy weight gain

Approximately 11.4 to 15.9 kg for a woman who begins pregnancy with a normal BMI

Maternal fat storage

Approximately 4 to 4.5 kg of additional maternal energy storage during pregnancy

Oxygen demand

Increased demand for oxygen during pregnancy due to increased metabolic requirements

Oxygen consumption

Absolute oxygen consumption increases approximately 30 to 40 percent during pregnancy

Carbon dioxide sensitivity

Increased sensitivity during pregnancy which contributes to changes in breathing

Tidal volume

The amount of air moved in or out of the lungs with each breath which increases approximately 30 to 50 percent during pregnancy

Minute ventilation

The total volume of air breathed per minute which increases approximately 20 to 50 percent during pregnancy

Pregnancy-related breathlessness

Breathlessness that can occur without hypoxia particularly later in pregnancy as the uterus enlarges

Diaphragm displacement

The growing uterus pushes the diaphragm upwards reducing residual volume and expiratory reserve

Cardiac output

The amount of blood pumped by the heart per minute which increases during pregnancy

Heart rate

The number of heart beats per minute which increases during pregnancy

Haemodilution

Dilution of blood caused by plasma volume increasing more than red blood cell volume

Physiological anaemia

The normal reduction in haemoglobin concentration resulting from pregnancy-related haemodilution

Venous thrombosis risk

Increased risk of blood clots during pregnancy due to increased clotting tendency

Supine hypotension

A drop in blood pressure when lying on the back due to compression of the inferior vena cava by the uterus

Inferior vena cava

A large vein returning blood from the lower body to the heart

Venous return

The amount of blood returning to the heart

Stroke volume

The amount of blood pumped by the heart with each heartbeat

Human chorionic gonadotropin

A hormone released during pregnancy that can contribute to nausea and vomiting

Progesterone

A pregnancy hormone that relaxes smooth muscle and reduces gastrointestinal motility

Lower oesophageal sphincter

A muscular valve between the oesophagus and stomach that becomes more relaxed with increased progesterone

Oestrogen

A hormone involved in breast development and preparation for breastfeeding as well as changes to connective and musculoskeletal tissues

Relaxin

A hormone that alters connective tissue integrity and contributes to increased joint laxity

Varicose veins

Enlarged veins caused by altered venous return and increased vascular pressure

Peripheral oedema

Accumulation of fluid in peripheral tissues which commonly causes swelling of the legs and feet

Haemorrhoids

Swollen veins around the anus and lower rectum

Orthostatic dizziness

Dizziness occurring when moving from lying or sitting to standing

Mucosal congestion

Increased blood flow and swelling of mucous membranes

Nausea and vomiting

Common pregnancy symptoms influenced by hormonal changes and which generally improve by around 20 weeks

Gastro-oesophageal reflux

Backflow of stomach contents into the oesophagus promoted by reduced lower oesophageal sphincter tone and upward displacement of the stomach

Gastrointestinal motility

Movement of food and waste through the digestive tract

Renal blood flow

Blood flow to the kidneys which increases during pregnancy

Glomerular filtration rate

The rate at which the kidneys filter blood which increases during pregnancy

Urinary frequency

Increased need to urinate caused by increased urine production early bladder sensitivity and later mechanical compression from the uterus

Centre of gravity

The point around which body mass is balanced and which shifts during pregnancy

Postural changes

Adjustments in posture made to compensate for changes in body shape weight and centre of gravity

Lumbar lordosis

The inward curve of the lower spine which may increase during pregnancy

Pelvic floor lengthening

Lengthening of the pelvic floor muscles to accommodate the growing foetus

Linea alba

A connective tissue structure running along the midline of the abdominal wall which can stretch during pregnancy

Carpal tunnel syndrome

Compression of the median nerve at the wrist causing symptoms such as pain numbness or tingling