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npte - other systems > genitourinary system and obstetrics > Flashcards

genitourinary system and obstetrics Flashcards

1
Q

muscles of pelvic floor

A
  • pelvic diagphragm: levator ani - pubococcygeus, puborectalis, iliococcygeus, coccygeus (ischiococcygeus)
  • urogenital diaphragm: deep transverse perineal, urethrae sphincter
  • urogenital triangle: female - bulbocavernosus, ischiocavernosus, superficial transverse perineal; male - bulbospongiusus, ischiocavernosus, superficial transverse perineal
  • anal triangle: internal anal sphincter, external anal sphincter
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2
Q

female geneital system

A
  • external genitalia: provides protection and hydration of vaginal tissue and urethra
  • vagina
  • uterus: house fetus during development
  • uterine tubes: transport for ovum from ovary fertilization and implantation within uterus
  • overies
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3
Q

male genital system

A
  • penis
  • scrotum: external sac for testes, ductus deferens, epididymis, nerves, blood vessels
  • testes: produce sperm and hormons (testosterone)
  • ductus/vas deferens: carries sperm from testes to seminal vesicle to form ejaculatory duct
  • epididymis: encased within scrotum, stores sperm
  • seminal vesicles: internal tubs that secrete thick fluid to combine sperm within ejaculatory duct
  • prostate: internal organ inferior to bladder, secretes fluid to combine sperm, seminal vesicle fluid, bulbourethral gland fluid to create semen
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4
Q

renal system

A
  • two kidneys, two ureters, urinary bladder, urethra -> form and eliminate urine
  • kidneys: remove water, salt, metabolic waste from blood through excretion of urine; contribute to homeostasis including - acid-base balance, regulation fo electrolyte concentrations, control of blood volume, regulation of BP through control of hormone secreted into blood stream
  • ureters: muscular tubes connecting kidneys to urinary bladder to transport urine
  • urinary bladder: temporary muscular reservoir for urine
  • urethra: muscular tube for excretion of urine, semen transport during ejaculation in males
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5
Q

endometriosis

A
  • uterus
  • development of endometrial tissue, which nomally lines uterus, in extrauterine locations within abdomen and pelvis - most commonly in uterosacral ligaments
  • level of pain does not always correlate with severity of extrauterine tissue growth
  • endometrial tissue bleeds during each menstrual cycle and causes subsequent scarring and adhesions
  • s/s vary but typically include moderate to severe lower abd, pelvic, or BLOP before or during menstruation, irregular menstrual cycles, presmenstrual spotting, dysparenuia, pain during defecation, infertility
  • treatment: TENS, pharm, surgery
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6
Q

uterine prolapse

A
  • descent of uterus and cervix into vagina
  • Balden0walker system grades using 5-pt system ranging from no prolapse to max descent of vaginal tissue outside body
  • symptoms vary - pn, incontinence
  • PT: pelvic floor msucle training, kegel, core strength, surgery
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7
Q

prostatitis

A
  • inflammation of prostate gland
  • d/t bacterial infection or backup of prostate secretions - chronic bacterial prostatitis, chronic pelvic pain syndrome, asymptomatic inflammatory prostatitis
  • s/s: watery urethral discharge, urgencu, frequency, pain with ejaculation or urination
  • treatment: lifestyle modifications, biofeedback, pharm, NSAIDs
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8
Q

erectile dysfunction

A
  • impotence, more prevalent in men with diabetes
  • d/t diabetes, coronary heart disease, HTN, hypothyroidism, hypopituitarism, MS, psych, etoh, smoking, kidney, pharm side effects
  • s/s: consistent inability to maintain erection for sexual intercourse
  • treatment: variable, pharm, surgical, injections, kegels
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9
Q

renal failure

A
  • kidneys experience decrease in glomerular filtration rate and fail to adequately filter toxins and waste from blood - can be acute or chronic
  • s/t DM or HTN but also from poison, trauma, genetics
  • acute: damage occurs quickly
  • chronic: damage occurs slowly
  • end-stage: nearly total or total renal failure, dialysis required
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10
Q

acute renal failure (ARF)

A
  • sudden decline in renal function
  • increase in BUN and creatinine
  • oliguria, hyperkalemia, sodium retention
  • prerenal etiology s/t decrease in blood flow
  • postrenal etiology s/t obstruction distal to kidney
  • intrarenal etiology s/t primary damage of renal tissue d/t toxins, intrarenal ischemia, vascular disorders
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11
Q

chronic renal failure (CRF)

A
  • progressive deterioration in renal function
  • DM
  • severe HTN
  • glomerulopathies
  • obstructive uropathy
  • interstitial nephritis
  • polycystic kidney disease
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12
Q

stages of kidney disease according to national kidney foundation

A
  • stage 1: kidney damage with normal GFR (90 or greater)
  • stage 2: mild decrease in GFR (60-89)
  • stage 3: moderate decrease in GFR (30-59)
  • stage 4: severe reduction in GFR (15-29)
  • stage 5: kidney failure (GFR less than 15)
  • s/s based on severity - N/S, lethargy, weakness, hiccups, anorexia, ulceration of GI tract, HA, neuropathy, anemia, coma)
  • treatment: pharm, diuretics, nutritional support, hydration, pharmacological intervention, diuretics, nutritional support, HD, transfusions
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13
Q

hemodialysis

A
  • treatment process for advanced and permanent kidney failure - creates excess toxic waste, increased BP, retention of excess body fluids, decrease in RBC production
  • removes blood from body along with waste, excess sodium and fluids
  • cleanses blood and returns it to body
  • usually 3x per week, each requires 3-5 hours to complete treatment
  • side effects: anemia, renal osteodystrophy, pruitus (itching), sleep disorders (restless legs)
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14
Q

neurogenic bladder

A
  • damage to cerebral control that allows for urinary dysfunciton - can cause UTIs and kidney damage if urine cannot be properly release
  • d/t DM, diminished bladder capacity, hyperactive detrusor muscle, CVA, infection, nerve damage
  • s/s: frequent UTI, urine leakage, inability to empty bladder or loss of urge to urinate when bladder is full
  • treatment: dependent on etiology
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15
Q

urinary incontinence

A
  • involuntary loss of urine
  • general treatment: pelvic floor msucle training, lifestyle modifciations, bladder retraining, voiding programs, stretching, pharm intervention
  • stress urinary incontinence (SUI): sneezing, courching, laughing
  • urge urinary incontinence (UUI): sudden urge to void
  • overflow urinary incontinence (OUI): bladder pressure exceeds urethra’s capacity to remain closed
  • functional urinary incontinence (FUI): inability or unwillingness of person to get to bathroom before involuntary bladder relase
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16
Q

stress urinary incontinence (SUI)

A
  • loss of urine d.t activity that increase intra-abdominal pressure like sneezing, coughing, laughing, running, jumping
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17
Q

urge urinary incontinence (UUI)

A
  • loss of urine after a sudden, intense urge to void d/t detrusor muscle of bladder involuntarily contractin during bladder filling
  • most common incontinence in geriatric population
  • etiology: destrusor muscle overactivity, changes in smooth muscle of bladder, increased afferent activity, increased sensitivity of detrusor to ACh - also association with MS, SCI, CVA, PD
  • s/s: triggered by key in lock, running water, conditioned reflex
  • treatment: behavior modification, biofeedback, pelvic floor strenghtening, bladder retraining (scheduled voiding)
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18
Q

overflow urinary incontinence

A
  • loss of urine when intra-bladder pressure exceeds urethra’s capacity to remain closed d/t urinary retention
  • caused by outflow obstruction s/t narrowed or obstructed urethra that results from prolapsed pelvic organ, stricture, enlarged prostate, chronic constipation
  • s/s: difficulty initiating urine stream, eventual stram is weak and presents with post void dribble
  • treatment: likely include surgical intervention if there is obstruction, strengthening if weakness, intermittent catheterization
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19
Q

functional urinary incontinence (FUI)

A
  • loss of urine d/t inability or unwillingness of person to use facilities prior to involuntary bladder release
  • d/t decreased mental awareness or decrease in mobility - rarely seen w/o another bladder issue or neurological involvement
  • s/s impaired cognition or mobility
  • treatment: no urologic pathology associated with functional incontinence - address modifiable issue
  • restricted mobility or dexterity, environmental barriers, mental and psychosocial disability, pharmacological intervention
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20
Q

urinary tract infections (UTI)

A
  • common - higher incidence in women and geriatric population
  • can be uncomplicated, complicated, recurrent, or chronic
  • when bacteria infiltrate in urethra (urethritis) or further into bladder (cystitis) - can spread and cause kidney infection (pyelonephritis)
  • s/s increased urination frequency, pain/burning, cloudy urine, pressure, shakiness, fever, pain, fatigue
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21
Q

coccydnia

A
  • obstetric pathology
  • aftery childbirth, joint btw coccyx and sacrum can become hypermobile causing soft tissue surrounding coccyx to become painful
  • etiology: subluxation during delivery
  • treatment: heat, external joint mobilization, pelvic floor muscle relaxation, postural training
22
Q

diastasis recti

A
  • separation of rectus abdominis muscle along linea alba that occur during pregnancy
  • testing on all pregnant women prior to prescribing exercises that require use of abdominals
  • etiology: unknown, PT note how many fingers fit into seaparation (+ if > than 2 fingers when lifting head and shoulders of table)
  • treatment: stabilization and support, ab stregnthening, postural awareness body mechanics
23
Q

piriformis syndrome

A
  • severe radiatin LB and buttock pain spanning from sacrum to hip and post thigh
  • etiology: in pregnancy, piriformis may shorten or spasm d/t postural changes and hip lateral rotation while walking
  • s/s: sciatic paresthesia due to nerve entrapment as sciatic nerve passes under or through piriformis muscle
  • treatment: manual techniques, heat, deep tissue, edu for body mehcanics, surrounding muscles
24
Q

sumphysis pubis pain

A
  • symphysis pubis joint becomes mobile to allow joint to slightly separate during delivery
  • etiology: postural adaptations, ligamentous laxiety, complications in delivery or birthing of large infant
  • s/s: severe pain in symphysis pubis and SI joints, blood in urine d/t injury to bladder
  • treatment: pharm internvetion for pain; stabilization exercises, use of lumbo-pelvic brace or binder
25
Q

physiological and postural changes during pregnancy

A
  • weight gain btwn 25-35 lbs
  • anemia
  • uterus ascends into abdominal cavity becoming an abdominal organ
  • ribs expand to accommodate uterine ascent
  • respiratory diaphragm elevates 4 cm
  • increased depth of respiration, tidal volume, minute ventilation
  • increase O2 consumption (15-20%), blood volume (40-50%), cardiac output (30-60%)
  • hypotension in supine position during pregnancy from pressure on inferior vena cava
  • abdominals overstrethced
  • ligaments become lax s/t hormonal change
  • joints hypermobile
26
Q

exercise and pregnancy

A
  • use 50-60% max HR for exercise, approx 30 minute session
  • NWB activities preferred d/t continuous change in COG and balance
  • avoid overtiring and supine position after first trimester
  • pelvic floor muscle exercise:
26
Q

contraindications to exercise in pregnancy

A
  • relative
  • severe anemia
  • unevaluated maternal cardiac dysrhthmia
  • chronic bronchitis
  • poorly controlled T1D
  • extreme morbid obesity
  • extreme underweight
  • history of extremely sedentary lifestyle
  • poorly controlled HTN
  • ortho limitations
  • poorly controlled seizure disorders
  • heavy smoker
  • absolute
  • hemodynamically significant heart disease
  • restrictive lung disease
  • incompetent cervix
  • multiple gestation at risk for premature labor
  • persistent second or third trimester bleeding
  • placenta previa
  • premature labor
  • ruptured membranes
  • preeclampsia, pregnancy-induced HTN
27
Q

american college of obstetricians and gynecologists (ACOG) recommendations for exercises in preg and postpartum

A
  1. continue to exercise and derive helath benefits from mild to mod exercise routines; exercise regularly (3x per week at least)
  2. avoid exercise in supine after first trimester -> could lead to decreased CO
  3. decreased O2 available for aerobic exercise in pregnancy; avoid exhaustion
  4. morphologic changes affect balance and abdominal trauma avoided
  5. additional 300 cal/day to maintain metabolic homesotasis (adequate diet)
  6. augment heat dissipation by ensuring adequate hydration, appropriate clothing
  7. pre-pregnancy routines should be resumed gradually upon a woman’s physical capability
27
Q

guidelines for working w/ high risk pregnancy patients

A
  • L sidelying is best positoin
  • abdominal exercises should be modified or discontinued
  • keep things slow, simple, smooth, minimal exertion
  • avoid valsalva
  • educate
27
Q

overactive bladder agents

A
  • relieve symptoms of overactive bladder - noted by involuntary contractions of bladder (detrusor muscle)
  • ditropan, detrol
28
Q

urinary anti-infective agents

A
  • treat UTI but are not traditional antibiotics
  • can be independently used or with other meds
  • cinobac, furadantin
29
Q

anuria

A
  • inadequate urine output in 24 hr period
  • less than 100 ml
  • severe dehydration, shock, end stage renal disease
30
Q

benign prostatic hypertrophy

A
  • non-cancerous enlargement of prostate gland that is progressive
  • common in males > 60 YO
  • can interfere with normal voiding
31
Q

cystocele

A
  • bulging of bladder into vagina
32
Q

ectopic

A

implantation of fertilized ovum outside uterus, fallopian tube is most common site of ectopic pregnancy

33
Q

endometrium

A
  • inner lining of uterus shed monthly in response to hormonal influence
34
Q

glomerular filtration rate

A
  • an estimate of the filtering capcity of kidneys
  • volume of filtrate produced per minute by kidneys
35
Q

glomerulus

A
  • specialized tuft of capillaries needed for filtration of fluid as blood passes through arterioles of kidneys
36
Q

hematuria

A

presence of blood in urine

37
Q

myometrium

A

muscular outer layer of uterus

38
Q

nephrolithiasis

A

condition of developing kidney stones

39
Q

nocturia

A
  • urinary frequency at night
40
Q

oliguria

A
  • inadquate urine output in 24 hour period, less than 400 ml
41
Q

polyuria

A
  • large volume of urine excreted at one time
42
Q

perimetrium

A

serous peritoneal coat of uterus

43
Q

radical mastectomy

A

surgical procedure in which breast, pectoral muscles, axillary lymph nodes, some skin are removed usually secondary to breast cancer

44
Q

rectocele

A

bulging of anterior wall of rectum into vagina s/t weakening pelvic supporting structures

45
Q

seminiferous tubes

A

coiled tubes found within each lobe of testes where spermatogenesis takes place

46
Q

urea

A

major nitrogen-containing end product of protein metabolism normally cleared from body by kidney into urine

47
Q

urinary frequency

A

voiding > 8 times in 24 hour period

48
Q

urinary urgency

A

sudden desire stronger than usual to urinate, difficult to defer

npte - other systems (11 decks)

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