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OPP Spring 2015 Exam 1 > 1.28.15 - Osteopathic in Pregnancy > Flashcards

1.28.15 - Osteopathic in Pregnancy Flashcards

1
Q

back pain

A

2/3 pregnant women

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2
Q

contributions to mechanical issues in pregnancy

A 
multifetal gestation
spinal curve
leg length inequality
weight gain
ligament laxity
SD
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3
Q

low back pain in pregnant women

A

maternal structure affects pregnancy

pregnancy affects maternal structure

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4
Q

most common cause of LBP in pregnant women

A

biomechanical instability

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5
Q

pregnancy posture

A

1 - change in maternal structure
2 - increased body fluid
3 - hormone changes

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6
Q

spinal curves in pregnancy

A

lumbar lordosis

thoracic kyphosis

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7
Q

compensation to changed posture

A 
shoulder back
head forward
increased lordosis
sacrum nutates** flexion
ribs flare
feet flatten
stance widens
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8
Q

posterior paraspinal muscles

A

shorten
-unbalanced by overstretched abdominals

psoas also shortens

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9
Q

relaxin levels

A

increase - result in joint laxity during pregnancy

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10
Q

pubic symphysis widens

A

10-12 week of pregnancy

refer pain to medial thighs or low back

gets worse with walking

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11
Q

peripheral nerves

A

susceptible to injury

-compression, traction, ischemia

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12
Q

meralgia paresthetica

A

lateral femoral cutaneous nerve

-during pregnancy gets neuropathy

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13
Q

lumbosacral plexopathy

A

prolonged sitting, standing, squatting
-prox-distal lower limb weamness

foot drop**

rare - lumbar disc herniation

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14
Q

foot drop

A

result of compression of preoneal division of sciatic in pelvis
or compression of common peroneal nerve at fibular head

consider double crush

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15
Q

spondylolisthesis

A

vertebral body anterior displacement on one below

most common L5-S1

women who have had children - more at L4-5**

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16
Q

important to examine on pregnant patient

A

hip ROM

  • don’t want to miss osteoporosis
  • or avascular necrosis of femoral head
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17
Q

pain with weight bearing

A

osteoporosis of hip

tx - reduce weight bearing

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18
Q

avascular necrosis of femoral head

A

higher adrenocorticoid metabolism
-also weight gain, E and P increase, increased joint pressure
-diagnosis - hip ROM testing
tx - reduced weight bearing

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19
Q

lumbar epidural venous plexus

A

IVC thrombosis

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20
Q

posterior placenta

A

pain with enlarging uterus putting strain on vascular bed connected to placenta

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21
Q

history of trauma

A

placenta abruption

sudden onset of back pain

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22
Q

postpartum depression

A

3x more likely in patients with lumbo-pelvic pain in pregnant women

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23
Q

exam in pregnant patient with LBP

A

ROM, muscle imbalance, leg length, DTR, posture, gait, degree of lordosis

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24
Q

tx of LBP in pregnant

A

avoid excess heat

nutrition - vit D**, magnesium (muscle relaxant)

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25
Q

CI for OMT during pregnancy

A

undiagnosed vaginal bleeding
abortion
ectopic
PPROM

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26
Q

indications for OMT during pregnancy

A

SD
scoliosis
edema, congestion, etc.

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27
Q

structural stage

A

0-12 weeks

28
Q

symapthetics to uterus

A

T10-L2 - contractions and pain

29
Q

parasympathetics to cervix

A

S2-4 - dilation

30
Q

anterior stomach acidity chapmans

A

rib 5 and 6 MCL to sternum on left

31
Q

anterior stomach decreased peristalsis chapans

A

rib 6 an 7 MCL to sternum on left

32
Q

anterior gallbaldder chapmans

A

rib 6 and 7 MCL to sternum on right

33
Q

anterior liver chapmans

A

rib 5/6 and 6/7 from MCl to sternum on right

34
Q

anterior pancreas chapmans

A

rib 7/8 on right close to costochondral junction

35
Q

posterior liver chapmans

A

intertransverse space midway SP and TP between T5,6,7 on right

36
Q

gallbladder posterior chapmans

A

intertransverse space midway SP and TP T6/7 on right

37
Q

posterior kidney chapmans

A

intertransverse space T12 and L1

-midway between SP and TP

38
Q

stomach peristalsis chapmans posterior

A

intertransverse space, midway between SP and TP

-between T6/7 on left

39
Q

stomach acidity chapmans posterior

A

intertransverse space between Sp and TP between T5/6 on left

40
Q

broad ligament anterior chapmans

A

greater trochanter to within 2 inches of knee joint outer aspect of femur

41
Q

uterus anterior chapmans

A

upper edge of junction of pubic ramus with ischium

42
Q

intestinal peristalsis chapmans anterior

A

constipation**

between ASIS and greater trochanter

43
Q

rectum anterior chapmans

A

around lesser trochanter

44
Q

colon anterior chapmans

A

spastic constipation or colitis

1-2” wide
-greater troachanter to inch of patella on antero-lateral aspect of femur

right - upper 5th cecum, next 3/5 ascending colon, last 5th beginning of transverse colon

left - 5th above knee end of transverse colon, middle 3/5 descending colon, last 1/5 sigmoid colon

extreme upper end of trochanter on left side - rectosigmoid junction

45
Q

posterior broad ligament chapmans

A

between PSIS and spinous process of L5

46
Q

posterior uterus chapmans

A

tip of TP of L5 toward ilia crest between PSIS and SP of L5

47
Q

posteroir vagina chapmans

A

leukorrhea
-between PSIS and SP of L5, inner femoral condyle, and superiorly from 3-6” on posterior aspect

also upper inner aspect of posteiror thigh 3-5” long and 1.5-2” wide on side of articulation of coccyx with sacrum

48
Q

posterior clitoris chapmans

A

articulation of cocyx with sacrum

49
Q

posterior hemorrhoids chapmans

A

sacrum close to ilium at lower end of SI joint

-and on ischial tuberosity

50
Q

posterior colon chapmans

A

spastic constipation or colitis

TP of L2 to TP of L4
-triangular area reaching across iliac crest

51
Q

hyperemesis gravidarum

A

treat C2 and T5-9

as well as related chapmans

52
Q

constipation chapmans

A

ASIS and greater trochanter

anterior intestinal peristalsis point

53
Q

late structural change

A

12-28 weeks

  • pelvis rotated anterior at S2
  • increased lumbar lordosis
  • compensatory thoracic kyphosis
  • cervical lordosis
54
Q

round ligament pain

A

anterior counterstrain points L3-5 tx

55
Q

sharp inguinal pain

A

broad ligament

56
Q

carpal tunnel syndrome

A

increased incidence in pre-eclampsia and HTN

due to edematous state

resolves after delivery

57
Q

congestive stage

A

28-36 weeks

graviational effect on uterus**

increased pressure on lymph and venous

edema**

some get hypotensive - lay left lateral recumbent

58
Q

upper GI VSR

A

T5-9

59
Q

cranial during congestive stage

A

NO

-may provoke uterine contractions

60
Q

preparatory stage

A

36 weeks to delivery

weekly visits

maintian structural balance and lymph flow

psych support

61
Q

influence uterine contractions

A

sympathetics

62
Q

influence cervical dilation

A

parasympathetics

63
Q

CV4

A

influence uterine contractions

64
Q

recovery and maintenance stage

A

delivery to 6 weeks
-done in 2 visits

golden period

return to normal pre gravid state

65
Q

post partum depression

A

b/l flexed sacrum

OPP Spring 2015 Exam 1 (11 decks)

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