Genital/Reproductive System Flashcards
Common Changes of Pregnancy and Physical Therapy Interventions
Postural changes
Balance changes
Ligament Laxity
Muscle Weakness
Urinary changes
Respiratory Changes
Cardiovascular Changes
Altered Thermoregulation
- Postural changes
- kyphosis, forward head, lumbar lordosis
- evaluation, postural strength/eduation, palvic stabilization/tilts, correct body mechanics
- limit supine position in 3rd trimester IVC
- Balance changes
- COG shifts forward and up with fetus growth
- teach safety
- ligament laxity
- SIJ hypermobility, injury in WB joints
- Muscle Weakness
- abdominal and pelvic floor weakness
- stress incontinence and treatment
- Urinary changes
- secondary to pressure on bladder
- Respiratory Changes
- elevation of diaphragm w/ widening of thoracic cage; hyperventilation, dyspnea
- Cardiovascular Changes
- increased blood volume; increased venous pressure in LE, HR, CO, decreased BP due to venous distensibility
- teach safe aerobic progression, ankle pumps etc
- Altered Thermoregulation
- increased basal metabolic rate and increased heat production
Distatis Recti Abdominis: Define
Lateral separation or split of the rectus abdominis from midline linea alba > 2cm (significant) associated with loss of abdominal wall support and increased back p!
- PT intervention
- teach protection of abdominal musculature; avoid abdominal exercise
- resume abdominal exercises when separation is less than 2cm - safe abdominal activities - partial sit ups, pelvic tilts etc
Treatment Diastasis Recti
- Check diastasis recti before initiating abdominal exercise
- Head lift >> head lift w/ pelvic tilt>> pelvic floor exercises can be used if separation is
- teach protection of abdominal musculature;
- avoid abdominal exercise until resolved
- double leg lifts
- curl ups
- leg lowering
- quadruped
Pelvic Floor disorders
Result of weakening PUBOCOCCYGEAL muscles
- partial or total muscle prolapse:
- cystocele: herniation of bladder into vagina
- rectocele: herniation of rectum into vagina
- uterine prolapse: bulging of uterus into vagina
- symptpms
- pelvic pain
- urinary incontinence
- pain with sexual intercourse
- red flag = pain and radiate down posterior thigh
- PT intervention
- observe for signs/symptoms
- teach pelvic floor exercises
- postural education and ms re-education (stretch tight LE muscles)
Pregnancy Low Back and Pelvic Pain
teach proper body mechanics
balance rest with activity
emphasize use of firm mattress
Massage, modalities for pain (no deep heat)
Pregnancy SIJ Dysfunction
secondary to postural changes and ligamentous laxity
- symptoms
- posterior pelvic pain
- pain in buttock
- may radiate to post thigh
- associated with prolonged sitting, standing or walking
- treatment
- external stabilization (SIJ support belt)
- avoid single-limb weight bearing
Pregnancy varicose veins
elevate extremities, avoid crossing legs
use elastic support stocking
Preeclampsia
pregancy induced, acute hypertension after 24th week of gestation mild or severe
- symptoms
- hypertension
- edema
- sudden excessive weight gain
- HA
- visual disturbances
- hyperreflexia
- PROMPT PHYSICIAL REFERRAL
Cesarean Childbirth
indicated in pelvic disproportion, failure of the birth process to progress, fetal or maternal distress or other complications
- PT intervention
- post op TENS for incisional pain
- electrodes parallel to incision
- prevent post op pulmonary complications
- post C-section Exercises
- gentle abdominal exercises
- pelvic floor exercises
- postural exercises
- precautions about lifting for 4-6 weeks
- ambulation
- prevent incisional adhesions
- post op TENS for incisional pain
Endometriosis
ectopic growth and function of endometrial tissue outside of the uterus, responds to hormonal influence but is not able to be shed as uterine tissue during menstruation.
- symptoms
- pain
- dysmenorrhea
- dyspareunia (pain during intercourse)
- infertility
- Treatment
- pain management
- endometrial supression and surgery
Pelvic Inflammatory Disease PID
inflammation of the upper reproductive tract involving the uterus (endometriosis), fallopian tubes (salpingitis) or ovaries (oophoritis)
Caused by polymicrobial agent that ascends through the endocervical canal
- Symptoms
- include lower abdominal pain starts after cycle
- purulent cervical discharge
- painful cervix
- fever
- elevated WBC
- increased ESR
- complications
- Treatment
- antibiotic therapy to treat the infection and prevent complications
Prostatitis
infection and inflammation of the prostate gland. types include bacterial, chronic, and nonbacterial
- symptoms
- urinary frequency
- urgency
- nocturia
- dysuria
- urethral discharge
- fever and chills
- malaise
- myalgia
- arthralgia
- pain
- *Dull, aching pain may be found in the lower abdominal, rectal, lower back, sacral and groin regions
Red Flags: Endometriosis
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Patients may complain of back pain. Or endometrial implants on muscle (psoas major or pelvic floor) may cause p! w/ palpation or contraction
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Red Flags: Prostatitis
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*Dull, aching pain may be found in the lower abdominal, rectal, lower back, sacral and groin regions
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Red Flags: Female Reproductive System
- <!--StartFragment-->Osteoporosis and risk of bone fracture increase dramatically after menopause (estrogen increases bone reabsorption
- Estrogens increase Thyroid and increase HDL
- Heart disease and stroke risk increase dramatically after menopause
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