Final Exam Flashcards
Purpose of pelvic floor
- support
- sphincter
- sexual
Pelvic Floor Layer 1 muscles (4)
- external anal sphincter
- superficial transverse perineal
- ischiocavernosus
- bulbocavernosus
Layer 1 function
- sphincteric control of vagina
- maintain blood flow to vagina
- closure of rectum
Layer 2 muscles
- deep transverse perineal
- compressor urethrae
- sphincter urethrae
- urethrovaginalis
Layer 2 function
-sphincteric
Layer 3 muscles
- levator ani
- iliococcygeus
- pubococcygeus
Layer 3 function
- supportive
- elevation
- continence
Possible causes of pelvic floor dysfunction
- injury to muscles
- visceral pain syndrome
- orthopedic impairments (abs, hips, spine)
- voiding/defecation dysfunction
- sexual abuse
Laylock PERF meaning
- Power
- Endurance
- Repetitions
- Fast twitch
PERF P levels
0-no palpable contraction
1-trace contraction
2-contraction, no lift
3- moderate contraction, lift posterior more than anterior
4-contraction and lift w/ pressure from all walls
5- stronger lift and contraction w/ resistance from posterior wall
PERF E
Endurance of sustained MVC up to 10 seconds
PERF R
Repetitions w/ MVC
PERF F
number of 1 second contractions
Supportive Dysfunction Pt reports and findings
- pt reports LBP/SIJ pain
- incontinence and prolapse
- decreased pelvic m. strength/endurance
- decreased core stabilization
- prolapse
Supportive Dysfunction interventions
- kegel progressions
- pelvic floor coordination
- core stabilization
- diastasis rectus abdominis correction
Urge incontinence
- caused by inappropriate detrusor muscle contractions
- triggered by urgency, running water, “key in door”
Stress Incontinence
- active insufficiency
- lengthened muscles
Mixed Incontinence
both urge and stress
Hypertonic/non relaxing pelvic floor pt reports
- sexual dysfunction
- bladder/bowel dysfunction
- orthopedic = abdominal, low back, hip, pain, sciatica, femoral nerve pain
Hypertonic/non relaxing pelvic floor findings
- trigger points
- muscle tightness in hip/pelvis
- impaired pelvic contractions/endurance/strength
Hypertonic/non relaxing pelvic floor interventions
- external/internal muscle release
- therex/ diaphragmatic breathing
- NO KEGELS
How to suppress urgency
- stop what you are doing
- 5 fast contractions
- diaphragm breathing
- slow walk to bathroom
Pregnancy posture changes
- increased cervical lordosis
- increased thoracic kyphosis
- increased lumbar lordosis
- increased anterior pelvic tilt
Pregnancy biomechanical changes
- increased demand on hip extensors abductors and ankle plantar flexors
- COG shifts forwards and up
- average weight gain 20-35 lbs
Cardiovascular changes in pregnancy
- increased blood volume
- increased venous pressure in LEs
- HR increase 15-20 bpm
- CO increase 30-50%
- decreased BP
Pre eclampsia
- acute hypertension after 24 weeks
- edema, sudden weight gain, HA, visual disturbances, hyperreflexic
Respiratory changes in pregnancy
- elevated diaphragm
- thoracic widening