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T3 PREGNANCY > Class 1 - Pregnancy Theory > Flashcards

Class 1 - Pregnancy Theory Flashcards

1
Q

A component of the biopsychosocial lens referring to physiological or pathological factors.

A

Bio

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2
Q

A component of the biopsychosocial lens referring to thoughts, emotions and behaviours, such as psychological distress, fear/avoidance beliefs, current coping methods and attribution.

A

Psycho

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3
Q

A component of the biopsychosocial lens referring to socio-economical, socio-environmental and cultural factors, such as work issues, family circumstances and benefits/economics.

A

Social

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4
Q

The following are examples of __________ factors:
- Shifts in posture and alignment
- Changes to the musculoskeletal system (e.g. joints and ligaments, muscles and fascia, weight gain, re-distribution of weight)
- Changes to the hormonal system
- Changes to the organ system
- Changes to the epidermis

A

Biological

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5
Q

The following are examples of __________ factors:
- Increased susceptibility to postpartum depression (PPD) and anxiety (PPA)
- New fears related to pregnancy, postpartum and parenting
- New fears related to birth process
- Body image issues

A

Psychological

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6
Q

The following are examples of __________ factors:
- Changing roles in the family unit
- Changes to personal identity
- Increased sense of responsibility
- Increased home environment workload
- Possible changes in occupational workload, maternity leave, isolation from colleagues and changes to professional identity

A

Social

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7
Q

The average full-term pregnancy is ___ weeks ( ____ days).

A

40 weeks
280 days

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8
Q

Gestation can range from ___ to ___ weeks ( ____ to ____ days).

A

37-41 weeks
259-287 days

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9
Q

Premature birth occurs between ___ and ___ weeks gestation.

A

20 and 37 weeks

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10
Q

Babies born before the ____ week are classified as premature.

A

37th week

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11
Q

The first trimester is occurs from ___ to ___ weeks gestation.

A

0-13 weeks

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12
Q

The second trimester occurs from ___ to ___ weeks gestation.

A

14-27 weeks

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13
Q

The third trimester occurs from ___ to ___ weeks gestation.

A

28-40 weeks

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14
Q

Postpartum commences once the ________ is birthed.

A

Placenta

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15
Q

When the baby presents in a normal head down position, which occurs in the later weeks of pregnancy.

A

Cephalic/Vertex Presentation

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16
Q

When the baby presents in a buttock down position.

A

Breech Presentation

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17
Q

What fetal presentation is shown in the following image?

A

Cephalic/Vertex Presentation

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18
Q

What fetal presentation is shown in the following image?

A

Breech Presentation

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19
Q

When it comes to health care in Ontario, what are the 3 services pregnant patients have the choice of for pre-natal and postpartum care?

A

1) Midwife
2) Obstetrician
3) Family Doctor (GP)

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20
Q

A labour support role within our scope of practice as an RMT, but requiring additional training.

A

Doula

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21
Q

T/F - Doula services are not covered by OHIP for pregnant patients.

A

True

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22
Q

Some common side effects of __________ include:
- Edema
- Constipation
- Haemorrhoids
- Bladder & yeast infections
- Dyspnea
- Heartburn
- Nasal congestion & nose bleeds
- Spider angioma & varicosities in legs/vagina
- Mood disorder
- Nausea & vomiting

A

Pregnancy

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23
Q

A hormone that is only produced during pregnancy.

A

Human Chorionic Gonadotropin (hCG)

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24
Q

hCG is responsible for guaranteeing the ovaries produce _______ and __________ in the first 2 months of gestation before the placenta takes over.

A

Estrogen
Progesterone

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25
Q

A hormone produced in the ovaries that promotes growth of uterine muscles and blood supply.

A

Estrogen

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26
Q

T/F - Progesterone increases water retention, adipose tissue and skin darkening.

A

False - Estrogen increases water retention, adipose tissue and skin darkening.

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27
Q

Estrogen works in tandem with ________ to initiate labour.

A

Oxytocin

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28
Q

A hormone produced by the ovaries and placenta that relaxes the uterus, blood vessel walls, stomach walls, bowels and ligaments.

A

Progesterone

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29
Q

T/F - Progesterone increases blood pressure and can decrease constipation.

A

False - Progesterone decreases blood pressure and can increase constipation.

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30
Q

During late pregnancy, __________ decreases allowing contractions to take place.

A

Progesterone

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31
Q

A hormone produced by the ovaries and placenta that relaxes and softens ligaments, cartilage and cervix.

A

Relaxin

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32
Q

Laxity in ligaments, tendon and fascia contribute to joint ________ and strain on all joints, particularly weight bearing structures, especially in the ______ spine and pelvis.

A

Instability
Lumbar

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33
Q

T/F - Relaxin allows for stretch of tissues during pregnancy and facilitates opening of pelvic joints during labour and delivery.

A

True

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34
Q

A hormone produced by the hypothalamus and released by the pituitary glands that stimulates uterine contractions, which triggers and promotes labour.

A

Oxytocin

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35
Q

________ is responsible for the “_______” reflex during breastfeeding and creates feelings of calmness and well-being.

A

Oxytocin
Let Down

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36
Q

An organ for producing hormones and exchanging nutrients and waste products that is completely formed by 12 weeks of gestation.

A

Placenta

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37
Q

The ________ _____ attaches from the placenta to the baby’s navel and is responsible for providing oxygen and nutrients to the baby.

A

Umbilical Cord

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38
Q

The ________ acts as a strong barrier for bacteria in the pregnant patient’s bloodstream, however most viruses and drugs will pass to baby.

A

Placenta

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39
Q

T/F - The pregnant patient’s bloodstream and baby’s bloodstream are separate.

A

True

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40
Q

The placenta is responsible for removing the baby’s waste products and the pregnant patient will dispose of waste through the ________ and ______.

A

Kidneys
Lungs

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41
Q

During pregnancy, total blood volume increases by ___ to ___% ( __ to __ pounds).

A

45-50%
2-3 pounds

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42
Q

T/F - Blood volume returns to normal volume by 8 weeks postpartum.

A

False - Blood volume returns to normal volume by 6 weeks postpartum.

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43
Q

The heart enlarges in pregnancy by ___% and body temperature increases.

A

12%

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44
Q

Blood pressure ________ in the 2nd trimester and then ________ in the 3rd trimester.

A

Declines
Increases

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45
Q

_____ changes are a normal part of pregnancy and include:
- Presence or disappearance of acne
- Increase or decrease in hair growth
- Darkening or stretching of _____

A

Skin

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46
Q

During pregnancy, the linea _____ may darken to the linea _____.

A

Alba
Nigra

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47
Q

What is shown in the following image?

A

Linea Nigra

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48
Q

A skin disorder characterized by darkened macules on the face and referred to as the mask of pregnancy.

A

Chloasma (Melasma Gravidarum)

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49
Q

What skin disorder is shown in the following image?

A

Chloasma (Melasma Gravidarum)

50
Q

Skin will stretch due to possible ______ or baby/uterine growth. Therefore, abdominal massage in the 2nd and 3rd trimester is beneficial.

A

Edema

51
Q

A term given to stretch marks occurring during pregnancy, shown in the following image.

A

Striae Gravidarum

52
Q

__________ fascia stretch marks are white, and _______ fascia stretch marks become red or dark brown.

A

Superficial
Deeper

53
Q

During pregnancy, airway resistance is _______ and total lung capacity decreases by __% at term.

A

Reduced
5%

54
Q

__________ directly impacts the lungs and the respiratory system by relaxing the bronchial musculature.

A

Progesterone

55
Q

In later stages of pregnancy, the enlarged uterus presses against the ________ and creates issues with apical breathing.

A

Diaphragm

56
Q

The average weight gain during pregnancy is ___ to ___ pounds, and by the end most of this weight is on the _______ portion of the body.

A

20-35 pounds
Anterior

57
Q

Which muscles are most affected supporting the weight of the abdomen three dimensionally?

A

Abdominals, iliopsoas, erectors, adductors, hip rotators and pelvic floor.

58
Q

Which muscles are most affected supporting the weight of the breasts?

A

Rhomboids, pectorals, subscapularis, scalenes and levator scapulae.

59
Q

Joints and ligaments become lax due to the hormone _______. Therefore, muscles will _______ in MRT to support these structures, which places a great deal of strain on the musculature.

A

Relaxin
Increase

60
Q

During pregnancy, there are possible dysfunctions of the _____ ________ or sacroiliac joints.

A

Pubic Symphysis

61
Q

What condition is shown in the following image?

A

Symphysis Pubis Dysfunction

62
Q

Breast tissue and nipples become very sensitive in the ___ trimester, which is important to consider when treating in prone.

A

1st Trimester

63
Q

Areolas and nipples _______ and become darker due to the hormone ________.

A

Enlarge
Estrogen

64
Q

First food for baby that is produced in the 3rd trimester. Milk can take __ to __ days to come in.

A

Colostrum
3-4 days

65
Q

T/F - Pregnant patients experience increased nausea and vomiting in the 1st trimester due to hormones.

A

True

66
Q

A rare disorder characterized by severe and persistent nausea and vomiting during pregnancy that may necessitate hospitalization due to dehydration.

A

Hyperemesis Gravidarum

67
Q

Constipation during the 1st trimester is due to _________ changes, but during the 3rd trimester it is due to the ______ of the baby and uterus.

A

Hormonal
Weight

68
Q

A burning sensation in the esophagus caused by acidic stomach contents creeping back up.

A

Heartburn

69
Q

T/F - In pregnancy, heartburn is due to hormone changes, especially relaxin.

A

False - In pregnancy, heartburn is due to hormone changes, especially progesterone.

70
Q

During pregnancy, fluids increase in the body by ___% and the _______ must filter this extra fluid.

A

50%
Kidneys

71
Q

Increased urination during the ___ trimester is due to hormonal changes, but during the ___ trimester it is due to the weight of the baby and uterus.

A

1st Trimester
3rd Trimester

72
Q

Symptoms due to ________ changes, which occur during the ___ trimester include:
- Possible exhaustion
- Increased urination
- Nausea & vomiting
- Constipation
- Heartburn
- Headaches
- Food and odour aversions
- Increased breast size, nipple tenderness and darkening of areola
- Mood changes (e.g. anxiety and depression)

A

Hormonal
1st Trimester

73
Q

Symptoms due to ________ changes, which occur during the ___ trimester include:
- Dull ache above pubic bone
- Musculoskeletal concerns (e.g. heavier breasts can increase strain on HNS)
- Laxity of joints and ligaments
- Changes to pelvic floor

A

Physical
1st Trimester

74
Q

T/F - Relaxin is present from 8 weeks onwards affecting joints and ligaments.

A

False - Relaxin is present from 10 weeks onwards affecting joints and ligaments.

75
Q

Symptoms due to ________ changes, which occur during the ___ trimester include:
- Birth parent may be anxious about pregnancy
- Worried about maintaining pregnancy and baby

A

Emotional
1st Trimester

76
Q

___ trimester treatment planning includes and considers:
- Addressing MSK concerns (e.g. postural assessment)
- Increasing relaxation (e.g. support person regarding emotional changes)
- Effects of relaxin on joints and ligaments
- Treatment length regarding exhaustion
- Positioning for heartburn and breast tenderness
- Reflexive techniques for constipation
- Possible hormonal headaches (e.g. incorporating HNS massage)
- Breast massage for pain and congestion

A

1st Trimester

77
Q

Contraindications for massage during the ___ trimester include:
- No abdominal massage
- No abdominal pillow in prone (creates increased intra-uterine pressure)
- No joint mobs to pelvis or sacrum
- No deep sacrum work, pointed pressure or prolonged work
- No overpressure (passive relaxed ROM)
- No deep work to specific areas (follow DVT protocol)
- No full body heat treatments without modification
- No heat over pelvis or abdomen without modification

A

1st Trimester

78
Q

T/F - Mid-range gentle passive stretches and low grade joint mobs can be performed during the 1st trimester.

A

True

79
Q

Name 3 areas to avoid using deep work on (e.g. muscle stripping, specific compressions) during the 1st trimester.

A

1) Adductors
2) Inguinal
3) Posterior Calf

80
Q

T/F - During the 1st trimester, precaution should be taken when using essential oils and specific reflexology/acupressure points are contraindicated.

A

True

81
Q

Symptoms due to ________ changes, which occur during the ___ trimester include:
- Acne
- Chloasma
- Decrease in fatigue and nausea; energy generally improves
- Linea alba becomes linea nigra

A

Hormonal
2nd Trimester

82
Q

Symptoms due to ________ changes, which occur during the ___ trimester include:
- Begin to “show”
- Centre of gravity changes due to enlarged uterus, placenta and growing baby
- Begin to feel baby’s first movements
- Increased strain to lumbar spine
- Increased strain to thoracic spine (kyphosis)
- Strain on respiratory muscles
- Joints become looser due to relaxin
- Increased MRT in gluteal muscles due to gait changes
- Uterine ligament referral
- Presence of stretch marks on breasts and abdomen
- Presence of spider veins or varicosities
- Increased edema
- Gait changes
- Blood pressure drops
- Frequent urination due to pressure on bladder
- Constipation due to mechanical pressure on bowel
- Increased heartburn due to enlarging uterus
- Practice contractions begin

A

Physical
2nd Trimester

83
Q

The baby’s first movements are felt when __________ begins between ___ to ___ weeks on average.

A

Quickening
14-21 weeks

84
Q

T/F - Increased strain to the lumbar spine during the 2nd trimester results in a posterior pelvic tilt.

A

False - Increased strain to the lumbar spine during the second trimester results in an anterior pelvic tilt.

85
Q

Increased strain to the thoracic spine during the 2nd trimester results in ________ due to increased weight on the anterior torso.

A

Kyphosis

86
Q

During the 2nd trimester, the ________ flares up and out and the patient may experience ______ margin pain.

A

Ribcage
Costal

87
Q

_________ pressure in abdomen leads to _________ pressure in lungs during the 2nd trimester.

A

Increased
Decreased

88
Q

Name 3 things a pregnant patient may experience during the 2nd and 3rd trimesters related to gait changes.

A

1) Plantar Fasciitis
2) Pes Planus
3) Callouses

89
Q

Practice contractions of the uterus that occur during the 2nd and 3rd trimesters.

A

Braxton Hicks Contractions

90
Q

___ trimester treatment planning includes and considers:
- Re-assessment of posture and gait (e.g. pelvic changes, thoracic spine/ribcage changes, nerve compression)
- Abdominal massage indicated if patient desires
- Lymphatic drainage indicated for edema
- Breast massage indicated for congestion and drainage
- Greater trochanter pain due to side sleeping
- Orthostatic hypotension due to low blood pressure

A

2nd Trimester

91
Q

Pelvic changes during the ___ & ___ trimesters include:
- Increased anterior pelvic tilt
- Sacroiliac joint dysfunction
- Innominate dysfunction
- Pubic symphysis dysfunction

A

2nd & 3rd Trimesters

92
Q

A condition involving the compression of the sciatic nerve due to ligament and postural changes during the 2nd and 3rd trimesters.

A

Piriformis Syndrome

93
Q

A group of disorders involving the compression of blood vessels or nerves between the clavicle and first rib that occurs during the 2nd and 3rd trimesters.

A

Thoracic Outlet Syndrome (TOS)

94
Q

T/F - TOS can be caused by short pec major and scalene muscles due to spine changes, apical breathing and increased edema.

A

False - TOS can be caused by short pec minor and scalene muscles due to spine changes, apical breathing and increased edema.

95
Q

A condition involving compression of the median nerve from increased edema during the 2nd and 3rd trimesters.

A

Carpel Tunnel Syndrome

96
Q

T/F - Abdominal massage during the 2nd and 3rd trimesters should not involve deep downward pressure.

A

True

97
Q

During the 2nd and 3rd trimesters, extra _______ can be used to promote drainage from limbs, as well as _____ foot and arm baths.

A

Pillows
Cool

98
Q

A condition that occurs during the 2nd and 3rd trimesters due to side sleeping. Compression leads to ischemia, fascial and ITB restrictions.

A

Greater Trochanteric Pain Syndrome

99
Q

Contraindications for massage during the ___ & ___ trimesters include:
- No abdominal pillow in prone (creates increased intra-uterine pressure)
- No joint mobs to pelvis or sacrum
- No deep sacrum work, pointed pressure or prolonged work
- No overpressure (passive relaxed ROM)
- No deep work to specific areas (follow DVT protocol)
- No full body heat treatments without modification
- No heat over pelvis or abdomen without modification
- Follow DVT precautions if patient is on bed rest (consider exhaustion/fatigue)
- Modify accordingly for gestational diabetes

A

2nd & 3rd Trimesters

100
Q

Symptoms due to ________ changes, which occur during the ___ trimester include:
- Increased fatigue
- Formation or increased Diastasis Recti
- Possible Pubic Symphysis Dysfunction
- Increased pressure on bladder
- Increased Braxton Hicks contractions
- Shortness of breath
- Increased gait changes (e.g. may see plantar fasciitis, pes planus and callouses)
- Baby “drops”
- Increased weight gain
- May feel nauseated again due to pressure from stomach

A

Physical
3rd Trimester

101
Q

A condition during the 3rd trimester where the rectus muscles become separated by an abnormal distance.

A

Diastasis Recti

102
Q

A term that refers to when the baby “drops” and engages on top of cervix during the 3rd trimester.

A

Lightening

103
Q

Symptoms due to ________ changes, which occur during the ___ trimester include:
- Eagerness and anxiousness about new baby, pregnancy to end, labour and delivery, changing relationships/roles

A

Emotional
3rd Trimester

104
Q

___ trimester treatment planning includes and considers:
- Re-assessment of posture and gait (e.g. pelvic changes, thoracic spine/ribcage changes, gait changes, nerve compression)
- Abdominal massage indicated if patient desires
- Lymphatic drainage indicated for edema
- Breast massage indicated for congestion and drainage
- Greater trochanter pain due to side sleeping
- Modify for high blood pressure
- Increased calf cramps (e.g use cold foot bath, GTO release, reciprocal inhibition)

A

3rd Trimester

105
Q

During the 3rd trimester, greater trochanter pain may develop into greater trochanter ________.

A

Bursitis

106
Q

During the 3rd trimester, increased calf cramps may be due to a _______/__________ imbalance and the patient should be referred to their primary caregiver.

A

Calcium/Magnesium

107
Q

With increased calf cramps, it is important to check for DVT possibility using _______ sign and refer the patient to their medical doctor.

A

Homan’s

108
Q

T/F - You can only massage the abdomen in the 3rd trimester, if the patient desires and consents.

A

False - You can only massage the abdomen in the 2nd and 3rd trimesters, if the patient desires and consents.

109
Q

___ trimester positioning includes:
- Supine with additional lumbar support (e.g. 2x pillows under knees)
- Prone with no abdominal pillow
- Semi fowlers with additional lumbar support (e.g. 2x pillows under knees)
- Sidelying

A

1st Trimester

110
Q

___ & ___ trimester positioning includes and considers:
- Sidelying
- Semi fowlers
- Supine with modifications
- Extra pillows under limbs to help facilitate lymph drainage
- Small support under lateral aspect of abdomen to decrease pelvic ligament strain

A

2nd & 3rd Trimesters

111
Q

During the 2nd and 3rd trimesters, treatment in supine should be no longer than ___ minutes and the ______ hip should be bolstered due to supine __________.

A

15 Minutes
Right
Hypotension

112
Q

A decrease in blood pressure when the pregnant patient is supine due to the weight of the baby and uterine contents placing pressure on the aorta and inferior vena cava.

A

Supine Hypotension

113
Q

T/F - Supine hypotension only affects the pregnant patient.

A

False - Supine hypotension affects the pregnant patient and baby.

114
Q

With supine hypotension, the ________ will feel dizzy, nauseated and uneasy; the ______ will have decreased heart rate and oxygen.

A

Patient
Baby

115
Q

T/F - Prone positioning is contraindicated in the 2nd and 3rd trimesters.

A

True

116
Q

Many postpartum patients may not be comfortable lying ______ due to ________ birth, breast issues and low back/epidural procedure.

A

Prone
Caesarean

117
Q

For a caesarean birth, the patient should only ever be treated in __________ position until the incision has healed __ to __ weeks postpartum and cleared by medical doctor.

A

Sidelying
4-6 weeks

118
Q

T/F - Semi fowlers is always a safe and generally comfortable position for any trimester.

A

False - Sidelying is always a safe and generally comfortable position for any trimester.

119
Q

Cut out tables are often not safe because they create __________ pressure, strain on musculature and supporting ligaments.

A

Intrauterine

120
Q

T/F - Sidelying position supports a neutral pelvis with no tilt or rotation.

A

True

T3 PREGNANCY (6 decks)

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