Clinical Applications in Obstetrics and Gynecology

Question 1

Sympathetic Nervous system:
Ovaries
Uterus
Cervix

Answer 1

Sympathetic Nervous system:
Ovaries: T9-T10- decreases blood flow
Uterus: T10-L1- contracts uterus, decreases blood flow
Cervix: T10-L2- relaxes cervix
**cumulative action of the sympaathetics is to evacuate the contents of the uterus

Question 2

Sympathetic Nervous system:
Ovaries
Uterus
Cervix

Answer 2

Sympathetic Nervous system:
Ovaries: Vagus/S2-S4- incrase blood flow
Uterus: S2-S4 increase blood flow, relax uterus
Cervix: S2-S4c- constricts cervix
**cumulative action is to maintain the contents of the uterus

Question 3

Chapman’s Points
Ovary
Uterus
Broad Ligament

Answer 3

Chapman’s Points
Ovary: Pubic tubercles/T10 transverse process
Uterus: Inferior pubic rami/L5 transverse process
Broad Ligament: Lateral IT band/ PSIS

Question 4

The three main functions of the pelvic floor

Answer 4

The three main functions of the pelvic floor are to

1. support
2. sphincteric
3. sexual

Question 5

Structural changes in the 1st trimester

Answer 5

Pubic shear/tenderness
Posterior rotation of the pelvis
glattening/decrease of the lumbar lordosis

Question 6

What is secreted by the corpus lutem that causes increased mobility of the SI joints and pubic symphysis

Answer 6

Relaxin targets the cervix, uterus, and pelvic ligaments

Question 7

What is a common location of a pain complaint during the 2nd trimester?

Answer 7

Pain over the sympaysis pubis is a common complaint during the second trimester beausse the uterus emerges from the pelvis into the abdomen
*treat with all techniques. MFR and counterstrain rae the safest

Question 8

the third trimester is marked by _______ of the sacrum

Answer 8

The third trimester is marked by exaggerated sacral flexion

Question 9

The first trimester is marked by _________ rotation of the pelvis

Answer 9

The first trimester is marked by posterior rotation of the pelvis

Question 10

The second trimester is marked by _________ rotation of the pelvis

Answer 10

The second trimester is marked by anterior rotation of the pelvis

Question 11

Preterm labor

What OMT can we do?

Answer 11

Preterm labor is defined as regular contraction of the uterus resulting in changes in the cervix that start before 37 weeks of pregnancy.

ANOTHER TRICK QUESTION! OMT is contraindicated in the preterm labor patient. But it may help to prevent preterm labor and may help resolve uterine irritability but there is a great possibility of stimulating contractions

Question 12

during labor, what can we do to improve the quality of contractions?

Answer 12

We can stimulate T12-L1 with a percussive technique to improve the quality of contractions

Question 13

__________ can cause a viscerosomatic response to the psoas

Answer 13

Ruptured ovarian cysts or endometriosis can cause a viscerosomatic response to the psoas

Question 14

How do we treat pubic shear in a pregnant patient

Answer 14

Pubic shear in a pregnant patient begins with a patient is rising from a seated position and may make it impossible to bear weight. Diagnosed by pain and asymmetry to the pubic symphysis.

Treat with MET to low side or HVLA tug to the superior side and relief is immediate

Question 15

What are the best OMT treatments for GYN condition?

Answer 15

Sacral rocking to calm pelvic hypogastric plexus

sympathetic stimulation will increase uterine contraction (treat S/D at T10-L1 to decrease sympathetic input) while parasympathetic stimulation will cause uterine relaxation

Question 16

how do we improve passive venous and lymphatic drainage from the lower abdomen and pelvis?

Answer 16

Marion Clark Technique- Butt in the air, on elbows. Helps with menstrual cramps. Allows for optimal venous/lymphatic drainage from the pelvis