Genital-Urinary Flashcards
Describe Functional Incontinence
Inability to reach toilet, or physical issue not allowing to reach bathroom in time
Overflow Incontinence (also know as retention incontinence)
Continual leakage because bladder is full and unable to empty so it overflows typically due to issues with detrusor muscle
or obstruction
Cauda Equina and MS
Intervention
“improve flow”
fluid regulation
May require intermittent catheter
Stress Incontinence
Loss in urine with intraabdominal pressure due to coughing, laughing, etc due to weak bladder.
Fix by strengthening pelvic floor (Kegel
Urge Incontinence
Overactive (urge) due to involuntary contraction of the detrusor muscle
or reduced bladder capacity
Due to meds, infection, neuro, old folks
Fluid regulation
Scheduled voiding
Prostatitis vs Benign Prostatic hyperplasia vs prostate cancer
*typically refer out b/c potential cancer
Prostatitis (infection usually)
- Acute conditions like fever, chills
- Local pain
- Nocturia
- Weak urine outflow
BPH (enlarged)
- Bladder distention, - frequency
PC
-Hematuria
- LBP (local)
- Cancer signs
Detrusor muscle
Contracts to EXPEL urine (pushes on bladder)
When contracted, bladder contracts and squeezed pushing urine out
RELAXES TO STORE (keeps bladder stable)
So issues occur due to lack of motor control, with urge, and stress incontence people contract by mistake
GFR rate levels for kidney
Stage 1 (Kidney damage but normal GFR) : 90 or more
Stage 2 (Mild decrease) 60-90
Stage 3 (Moderate) 30-60
Stage 4 (severe) 15-30
Stage 5 End stage Less than 15
Lifestyle modifications for bladder symptoms
2,500 mL or 10 cups
Reduce irritants like coffee, alcohol, spicy, etc, artificial sweeteners
Schedule voiding would be every 3-4 hr
Fiber intake for bowels
No fluid within 2-3 hours of bed
Smoke cessation for stress
Weight loss to reduce pressure on the pelvic floor
Changes with pregnancy
Increased ant tilt
Uterus ascends into the abdominal cavity
Ribs expand and the diaphragm elevates
Increased depth of respiration, TV, and MV
Increased O consumption 15-20 percent, blood volume increased 40-50, cardiac output 30-60
Supine causes hypotension due to IVC compression which is why left side-lying is ideal
Joints become hypermobile laxity due to relaxin
SI is very relaxed
Back pain
Many reasons, but take severe back pain seriously
Pelvic floor exercese
80-100 contractions daily
quick 3x10 is for stability with abd pressure
longer holds 3x5 w/ 5 sec hold for endurance, posture, etc.
preeclampsia vs eclampsia
Preclampsia is high blood pressure, blood and protein issues
Eclampsia is what it can develop into, more severe and includes seizures, death
Absolute contraindications
Multiple gestation with premature labor
Peristent bleeding in 2nd and 3rd trimester
Incompetent cervix
Obvioius stuff
Ectopic pregnancy
An ectopic pregnancy occurs when a fertilized egg attaches outside of the uterus, usually in a fallopian tube. The pregnancy will miscarry and the embryo will not survive
Blood loss, back shoulder pain, in pregnant female
Pregnancy exercise
mild to moderate 3x week
NWB exercise like cycling and swimming lower risk of injury
Require at least an extra 300 calories to stay afloat
For high risk
Abdominal contractions can cause uterine contractions
Avoid valsalva maneuver in exercises
Kidney stone
Renal calculi radiates to groin perineal area area. Dependent on stone location
Ureter vs urethra vs uterus
Ureter comes from kidney and goes to bladder
Urethra is where we pee out of both male and female
Uterus is where baby forms
Diastasis recti
Seperation 2 cm or two fingers
Pillos under R hip for
Pregnancy
Especially after 1st trimester
Pelvic floor activation
Levels based on gravity
Easiest:
trendelenberg>Supine >hooklying >quadruped>Seated>standing>during activity
Crede maneuver
pressure on lower abdomen for emptying
Suprapubic tapping
Stimulates detrusor for emptying
Cystitis
Goal is to relax and stretch muscles
Bladder infection
Endometriosis
Development of endometrial tissue that lines uterus
Related to menstrual cycle
bleeds, scarring, adhesions
Manual therapy and tens to treat it
Uterine prolapse
Treat with kegel exercises, biofeedback, intravaginal mechanincal support
Coccyodynia
Piriformis syndrome
like sciatica but related to pregnany.
Symphysis pubic pain
May use muscle energy techniques, pelvic floor exercises, due to laxity weakness, and abnormal structure due after birth.
Pelvic floor muscles
Must relax for urine and feces to pass
when contracted, holds everything in place
which is why these muscles must be trained with pelvic floor exercises with incontinence , because if weak it is not holding things in
If too relaxed and not contracting then things come out = incontinence
Diastasis Recti
- With a 3-cm diastasis, the head lift is the most appropriate exercise initially. The patient braces the abdomen toward the midline to approximate the diastasis while performing the head lift. This will help to keep the separation of the abdominal muscles to a minimum, minimize the action of the obliques, and control intraabdominal pressure.
- Given the strength of this patient’s abdominal muscles in addition to the extent of the diastasis, this activity would be too strenuous and may further compromise the diastasis. The head lift should be performed exclusive of all other abdominal exercises until the diastasis is 2 cm or less.
- Lower trunk rotation should be avoided until the diastasis is 2 cm or less. Due to the angle of attachment of the obliques into the linea alba, there is a possibility that trunk rotation exercises will perpetuate the diastasis.
- With an abdominal strength of Fair minus (3-/5) and a diastasis of 3 cm, bilateral straight leg raises could cause a further separation of the diastasis by increasing intraabdominal pressure as the patient tries to stabilize while lifting the legs. The head lift corrective exercise should be performed exclusive of all other abdominal exercises until the diastasis is reduced to 2 cm or less.
