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Functional Anatomy of the Female Pelvic Floor

dc.contributor.authorAshton-Miller, James A.en_US
dc.contributor.authorDeLancey, John O. L.en_US
dc.date.accessioned2010-06-01T19:27:26Z
dc.date.available2010-06-01T19:27:26Z
dc.date.issued2007-04en_US
dc.identifier.citationASHTON-MILLER, JAMES A.; DeLANCEY, JOHN O. L. (2007). "Functional Anatomy of the Female Pelvic Floor." Annals of the New York Academy of Sciences 1101(1 Reproductive Biomechanics ): 266-296. <http://hdl.handle.net/2027.42/72597>en_US
dc.identifier.issn0077-8923en_US
dc.identifier.issn1749-6632en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/72597
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=17416924&dopt=citationen_US
dc.description.abstractThe anatomic structures in the female that prevent incontinence and genital organ prolapse on increases in abdominal pressure during daily activities include sphincteric and supportive systems. In the urethra, the action of the vesical neck and urethral sphincteric mechanisms maintains urethral closure pressure above bladder pressure. Decreases in the number of striated muscle fibers of the sphincter occur with age and parity. A supportive hammock under the urethra and vesical neck provides a firm backstop against which the urethra is compressed during increases in abdominal pressure to maintain urethral closure pressures above the rapidly increasing bladder pressure. This supporting layer consists of the anterior vaginal wall and the connective tissue that attaches it to the pelvic bones through the pubovaginal portion of the levator ani muscle, and the uterosacral and cardinal ligaments comprising the tendinous arch of the pelvic fascia. At rest the levator ani maintains closure of the urogenital hiatus. They are additionally recruited to maintain hiatal closure in the face of inertial loads related to visceral accelerations as well as abdominal pressurization in daily activities involving recruitment of the abdominal wall musculature and diaphragm. Vaginal birth is associated with an increased risk of levator ani defects, as well as genital organ prolapse and urinary incontinence. Computer models indicate that vaginal birth places the levator ani under tissue stretch ratios of up to 3.3 and the pudendal nerve under strains of up to 33%, respectively. Research is needed to better identify the pathomechanics of these conditions.en_US
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dc.format.extent3109 bytes
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dc.publisherBlackwell Publishing Incen_US
dc.rights2007 New York Academy of Sciencesen_US
dc.subject.otherFunctional Anatomyen_US
dc.subject.otherFemale Pelvic Flooren_US
dc.subject.otherLevator Ani Musclesen_US
dc.subject.otherUrethraen_US
dc.subject.otherProlapseen_US
dc.subject.otherIncontinenceen_US
dc.subject.otherVaginal Birthen_US
dc.titleFunctional Anatomy of the Female Pelvic Flooren_US
dc.typeArticleen_US
dc.subject.hlbsecondlevelScience (General)en_US
dc.subject.hlbtoplevelScienceen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumDepartment of Mechanical Engineering, Biomedical Engineering, and Institute of Gerontology, University of Michigan, Ann Arbor, Michigan, USAen_US
dc.contributor.affiliationumDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USAen_US
dc.identifier.pmid17416924en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/72597/1/annals.1389.034.pdf
dc.identifier.doi10.1196/annals.1389.034en_US
dc.identifier.sourceAnnals of the New York Academy of Sciencesen_US
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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