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Final Exam Flashcards

1
Q

Purpose of pelvic floor

A
  • support
  • sphincter
  • sexual
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2
Q

Pelvic Floor Layer 1 muscles (4)

A
  • external anal sphincter
  • superficial transverse perineal
  • ischiocavernosus
  • bulbocavernosus
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3
Q

Layer 1 function

A
  • sphincteric control of vagina
  • maintain blood flow to vagina
  • closure of rectum
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4
Q

Layer 2 muscles

A
  • deep transverse perineal
  • compressor urethrae
  • sphincter urethrae
  • urethrovaginalis
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5
Q

Layer 2 function

A

-sphincteric

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6
Q

Layer 3 muscles

A
  • levator ani
  • iliococcygeus
  • pubococcygeus
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7
Q

Layer 3 function

A
  • supportive
  • elevation
  • continence
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8
Q

Possible causes of pelvic floor dysfunction

A
  • injury to muscles
  • visceral pain syndrome
  • orthopedic impairments (abs, hips, spine)
  • voiding/defecation dysfunction
  • sexual abuse
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9
Q

Laylock PERF meaning

A
  • Power
  • Endurance
  • Repetitions
  • Fast twitch
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10
Q

PERF P levels

A

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

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11
Q

PERF E

A

Endurance of sustained MVC up to 10 seconds

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12
Q

PERF R

A

Repetitions w/ MVC

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13
Q

PERF F

A

number of 1 second contractions

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14
Q

Supportive Dysfunction Pt reports and findings

A
  • pt reports LBP/SIJ pain
  • incontinence and prolapse
  • decreased pelvic m. strength/endurance
  • decreased core stabilization
  • prolapse
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15
Q

Supportive Dysfunction interventions

A
  • kegel progressions
  • pelvic floor coordination
  • core stabilization
  • diastasis rectus abdominis correction
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16
Q

Urge incontinence

A
  • caused by inappropriate detrusor muscle contractions

- triggered by urgency, running water, “key in door”

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17
Q

Stress Incontinence

A
  • active insufficiency

- lengthened muscles

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18
Q

Mixed Incontinence

A

both urge and stress

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19
Q

Hypertonic/non relaxing pelvic floor pt reports

A
  • sexual dysfunction
  • bladder/bowel dysfunction
  • orthopedic = abdominal, low back, hip, pain, sciatica, femoral nerve pain
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20
Q

Hypertonic/non relaxing pelvic floor findings

A
  • trigger points
  • muscle tightness in hip/pelvis
  • impaired pelvic contractions/endurance/strength
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21
Q

Hypertonic/non relaxing pelvic floor interventions

A
  • external/internal muscle release
  • therex/ diaphragmatic breathing
  • NO KEGELS
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22
Q

How to suppress urgency

A
  • stop what you are doing
  • 5 fast contractions
  • diaphragm breathing
  • slow walk to bathroom
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23
Q

Pregnancy posture changes

A
  • increased cervical lordosis
  • increased thoracic kyphosis
  • increased lumbar lordosis
  • increased anterior pelvic tilt
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24
Q

Pregnancy biomechanical changes

A
  • increased demand on hip extensors abductors and ankle plantar flexors
  • COG shifts forwards and up
  • average weight gain 20-35 lbs
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25
Cardiovascular changes in pregnancy
- increased blood volume - increased venous pressure in LEs - HR increase 15-20 bpm - CO increase 30-50% - decreased BP
26
Pre eclampsia
- acute hypertension after 24 weeks | - edema, sudden weight gain, HA, visual disturbances, hyperreflexic
27
Respiratory changes in pregnancy
- elevated diaphragm | - thoracic widening
28
Hormonal changes in pregnancy (relaxin)
- pubic symphysis separation - avoid HVLAT - relaxed pelvic ligaments - still present after delivery
29
Pregnancy STOP exercise
- vaginal bleeding - painful contractions - dizziness - Headache - chest pain - SOB prior to exercise - leakage - calf pain
30
Pubic Symphysis separation
- >10mm separation is diastisis of pubic symphsis - pain 7-10, relieved by rest - shooting, stabbing, burning, grinding - SIJ belt, pt education, stabilization
31
Diastisis rectus abdominis
- separation from midline > 2 cm - symmetrical stabilization therex (bridges, quadraped, planks) - avoid sit ups, leg raises, trunk rotation
32
Kinesiotape uses
- muscle factilitation/inhibition - pain relief - stabilization - improve circulation/healing
33
Kinesiotape contraindications
- active malignancy - open wound - active cellulitis - DVT - PMH
34
Activation tape
- apply origin to insertion | - 15-50% tension
35
Relaxation tape
- apply insertion to origin | - 15-25% tension
36
BMI ranges
``` <18.5 = underweight 18.5-24.9 = normal 25.0-29.9 = overweight 30.0-34.9 = obese 35.0 -39.9 = severe obese 40.0 - 50 = morbid obese >50 = super obese ```
37
Obesity
a very high amount of body fat in relation to lean body mass
38
How much of obesity in genetic
80%
39
What is obesity caused by
- genetics - environment - behavior
40
Obesity left ventricle changes
- increased filling causes dilation - hypertrophy - heart failure - venous insufficiency = clotting
41
Blood pressure changes with obesity
-for every 10 lbs gained 3-4mmHg systolic and 2 mmHg diastolic increase
42
Respiratory changes with obesity
- altered mechanics due to flattened diaphragm - increased airway resistance - decreased chest wall/lung elasticity - obstructive sleep apnea
43
Changes in O2 consumption obesity
-O2 consumption per kg body weight is lower in obese people
44
Step 1 behavior modification
-recommended for BMI >25 -exercise and diet -most fail long term 90% regain lost weight
45
Step 2 pharmacotherapy
- most work by suppressing appetite - OTC options dont work - prescriptions have side effects
46
Strategies to behavior modifications
- set realistic goals - meet the patient - think creatively - change your frame of reference - let patient help you define their success
47
Exercise recommendations for obese
>5 days per week mod to vigorous intensity -30-60 mins/day which can be 10 min bouts -aerobic exercise with large muscle groups -reduce body weight by 5-10% over 3-6 months -reduce calories by 500-1000/day
48
Initial Motor learning stage
- teach patient about faulty movement patterns | - start working on how to correct consciously
49
Skill acquisition motor learning stage
work on precision of movement - increase repetitions - change positions and environment
50
Autonomous motor learning stage
-task becomes automatic and no longer takes conscious effort
51
Polestar principles (6)
1. breathing 2. axial elongation and core control 3. efficiency of movement through organization of shoulder, thoracic, and cervical spine 4. Spine articulation 5. Align movement of LE and UE 6. movement integrates pelvis, thorax, head, and extremities
52
Inhale vs exhale exercise
- important part of exercise during exhale because more core stability - trunk extension during exhale and flexion during inhale
53
Factors that affect aerobic training responses
- initial fitness level - training intensity - training duration - training frequency
54
What is conversational exercise?
60-70% VO2 max
55
What are the factors affecting VO2 max
- mode of exercise - heredity - state of training - gender - body size and composition - age
56
Interval training intensity and rest
- short 1:2 - long 1:3 - long aerobic 1:1/1.5
57
How to decrease likelihood of non responder
-increase frequency to 4x/week
58
Therapy goals of inflammatory process
- decrease pain and edema | - maintain mobility and strength of surrounding tissues while allowing involved tissue to rest
59
Therapy goals of proliferative phase
-slowly increase load of tissue to promote collagen alignment
60
Therapy goal of remodeling phase
increase load of tissue to promote collagen alignment
61
When do hip fractures have worse outcomes?
- decreased function prior to fracture - comorbid conditions - cognitive impairment - poor nutrition - depression - poor social support
62
ACL reconstruction different types of grafts
patellar = gold standard, better for athletes, more AKP hamstring= smaller incision, higher failure rate -autograft better than allograft
63
ACL reconstruction rehab timeline
open chain 40-90° at 4 weeks - eccentric quad and NMES at 6 weeks - plyos at 12-16 weeks
64
When does rotator cuff repair reach normal strength and elasticity
-6 months
65
RCR ASSET guidlines
- 2 weeks immobilization - protected PROM after 2 weeks - AROM at 6 weeks - resisted strengthening at 12 weeks
66
What should you increase first in early CV training program?
-time and duration | 5-10 mins every 1-2 weeks for first 4-6 weeks, then increase intensity
67
3 parts of social cognitive theory
individual behavior environment
68
Task self efficacy
person's belief that they can do the behavior in question
69
Barrier self efficacy
whether the person believes that they can exercise in the face of common barriers (time)

Advanced Therex (2 decks)

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