3: Examination Flashcards
What are some pelvic specific questions to ask during the history?
History of bed wetting, potty training difficulty, menstrual cycle, hormonal supplements, fluid intake, bladder and bowel habits, activities with symptoms, protection and frequency of usage
What should you observe when examining a pelvic patient?
LE edema, condition of skin, color of tissues, hemorrhoids, suprapubic distension, symmetry, prolapse, perineal descent, paradoxical strain
What three motions do you assess when examining the pt’s ability to contract and relax their pelvic floor?
- Lift and drawing in of perineal body
- Lift during cough
- Closure of anal sphincter
Where would you assess for sensation?
Perineal and perianal region
How do you assess the ability of the PFM to contract and relax?
Ask patient to lift and squeeze around finger or probe
How do you assess max lifting force?
Lift and hold for 3-5 seconds
What three types of movement should you assess for pelvic floor strength?
- Max lifting force
- Sustained contraction
- Repeated contractions
When should you assess anal pressure?
At rest and during contraction
What are you palpating for?
Resting muscle tension, symmetry, scarring, adhesions, muscle recruitment sequence
How do you grade pelvic muscle strength?
Oxford Grading Scale by Laycock
What is perineometer testing?
Measure of pressure to assess max, sustained, or repeated contractions
When would you used EMG with pelvic health?
Investigate denervation or re-innervation to see if improvement is possible
Why would you use pelvic diagnostic ultrasound?
Determine the position of internal organs for possible supportive dysfunction or prolapse
What four pathologies would you look for with pelvic ultrasound?
- Cystocele
- Urethrocele
- Uterine prolapse
- Rectocele
