Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Practice Topics Exam 4 > GI Disorders and Pelvic PT Considerations > Flashcards

GI Disorders and Pelvic PT Considerations Flashcards

1
Q

Upper GI

A

Difficulty swallowing
Nausea/vomit
Indigestion
Acid reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lower GI

A

Severe pain in lower quadrant
Loss of bowel control
Change in stools

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Systemic

A 
Loss of appetite
Unexplained weight loss
Sever bloating
Sudden loss of b/b control
Night pain
Night sweats
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cardiac

A

Chest tightness

Thoracic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Anatomy - rectum - function and from where to where

A

Storage
15-20 cm long
Starts at S3 at rectosigmoid junction and ends just below tip of coccyx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Anatomy - rectum - Ampula is what

A

Bottom 2/3 of rectum

Most distensible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Anatomy - rectum - what type of mm

A

smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Anatomy - rectum - Sensation

A

Distension is sensed due to fascia surrounding rectum or receptors in rectal lining
If less than 15cm = gas
If more than 15 cm = stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Anatomy - anus

A

3-4 cm long starting at levator ani mm
2/5 cm below coccyx
Pectinate line - 1.5-2 cm above anal verge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anatomy - Anorectal mm

A

Muscular ring comprised of external anal sphincter and puborectalis
They contract simultaneously to kink off anorectal junction and aid in fecal continence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Puborectalis maintains anorectal angle at

A

90 degrees
Greater than 100 = fecal incontinence
Less than 80 or 90 = constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anatomy - vascular supply - arteries

A

Superior, medial, inferior rectal arteries
Superior = above pectineal line
Inferior = below

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anatomy - Vascular supply - veins

A

Superior, medial, inferior rectal veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Anatomy - vascular supply - Anal cushions

A

3 submucosal vascular plexes formed from anastamosis of veins
Hemorrhoids:
- internal - usually not P
- external - generally P

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anatomy - nerve supply

A

Autonomic
Spinal
Somatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Anatomy - nerve supply - Autonomic

A 
(visceral)
Sensitive to stretch
Above the pectineal line
Sympathetics - L1-L3
Parasymp - S2-S4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Anatomy - nerve supply - spinal

A

S1, S2, S3

Supply striated muscle, travel in pudendal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Anatomy - nerve supply - somatic

A

Pudendal nerve
S2-S4
Pain temp touch sensation
Below pectineal line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Anatomy - nerve supply - inferior rectal nerve

A

Sensory and motor below dentate line including EAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anatomy - nerve supply - perineal

A

Sensory and motor to perianal region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Physiology of defecation - define it

A

Final act of digestion with expulsion of solid, semi solid, or liquid material through anus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Defecation - normal

A

2-3 times a day to 2-3 times a week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Defecation - transit time

A

Variable - ranges from 1-4 days
50% of stamch is emptied in 2.5-3 hrs
Small intestine - 4 to 6 hrs
Colonic transit - 24 to 72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Physiology of defecation - Colonic function “storage and mixing” - Ascending

A

Stores chyme

Mixes with mucus and bacteria to form feces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Physiology of defecation - Colonic function “storage and mixing” - Transverse

A

Contents change from liquid to semi solid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Physiology of defecation - Colonic function “storage and mixing” - transverse to descending

A

Absorption of water and electrolytes

Bacteria work to decompose fiber which nourishes the lining of the colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Physiology of defecation - Colonic function “storage and mixing” - Descending

A

Transports stool to rectosigmoid colon for storage

Motility is irregular with bursts of propogated contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Physiology of defection - Rectal function

A

Distends from filling with stool
Stretch receptors signal sensory receptors for urge to defecate
Rectal compliance allows stretch receptors to initiate urge and peristalsis
Rectoanal inhibitory reflex and rectoanal excitatory reflex cause IAS to relax and EAS to contract
Respond to “call to stool”
EAS relaxation for passage of stool
Slight inc in abdominal pressure
Anorectal angle decrease and sphincters return to normal resting tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Evacuation dysfunction defined by

A

frequency (goal 1/day)
Stool consistency and shape
Effort and time needed to evacuate (should be less than 1 min)
Feelings of incomplete emptying
Colon transit (slow/fast)
Colonic inertia and megacolon, megarectum
Sphincter/PFM function or dyssnergia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Constipation - Rome III criteria

A

Symptom based diagnosis
Must have at least 2 of the following symptoms for at least 6 months prior to diagnosis:
Defecation less than 3/wk
Straining or lumpy hard stools 25% of time (type 1 or 2)
Sensation of incomplete evacuation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Constipation - prevalence

A 
Most common GI complaint in US
Affects 1 in 6 individuals 
2.5 million visits a year
Women 2-3x more than men
Only 22% discuss with doc
$400 million spent on laxatives a year
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Bristol Stool Chart

A

Types 1-3 are said to be indicators of constipation

Types 1 -7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Bristol Stool chart - type 1

A

Separate hard lumps, like nuts

Hard to pass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Bristol Stool Chart - type 2

A

sausage shaped but lumpy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Bristol Stool Chart - type 3

A

like a sausage but with cracks on its surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Bristol Stool Chart - type 4

A

like a sausage or snake, smooth and soft

37
Q

Bristol Stool Chart - type 5

A

soft blobs with clean cut edges (passed easily)

38
Q

Bristol Stool Chart - type 6

A

fluffy pieces with ragged edges

A mushy stool

39
Q

Bristol Stool Chart - type 7

A

watery, no solid pieces

entirely liquid

40
Q

Conditions with constipation - colonic disorders

A 
IBS
Cancer
Inflammation (divertic, crohns)
Chronic laxative use
Pelvic mm injury (prolapse)
Anal disease
41
Q

Conditions with constipation - Hormonal

A

Pregnancy
Diabetes
Abnormalities of thyroid or parathyroid

42
Q

Conditions with constipation - Neurological

A

MS
Stroke
SCI

43
Q

Meds that cause constipation

A 
Antacids that contain Al or Ca
Iron supplements
Opiate pain meds
Antidepressants
Antiparkinson drugs
Meds for BP 
Diuretics (K loss)
Nasal decongestants
Antihistamines
44
Q

Other causes of constipation

A

Hydration
Diet (high process, sugar, low fiber)
Inactivity

45
Q

PT eval for bowel disorders

A

Assess for QOL impact

Constipation scoring system (good questions but not good sensitivity to track overtime)

46
Q

Subjective hx

A

Screening of urological and gynecological systems and surgical hx
Bowel screening
Exercise, sleep, stress

47
Q

Eval with pelvic PT

A 
Postural and functional assess
SI, coccyx, low back, hip
Strength and core stabilization
Breathing
External and internal vaginal and rectal exams
48
Q

PT interventions for constipation

A 
Pelvic floor mm rehab
Posture, exercise, manual
Relaxation training, stress reduction
Bowel mechanics
Manual perineal support (esp with prolapse)
49
Q

Constipation treatment

A

Pelvic floor retraining
Biofeedback
Bowel retraining
Diet/supplements

50
Q

Constipation treatment - pelvic floor retraining

A

Goal of eccentric length of abdominals and PFM
Big hard belly
Sensory training

51
Q

Constipation treatment - bowel retraining

A

sit on toilet 10-15 min after eating

toileting posture

52
Q

Constipation treatment - diet/supplements

A

FIber

Mg citrate

53
Q

Obstructed defecation - what is it

A

Incoordination with paradoxical contractions
PFM and EAS inappropriately contract with vasalva for defecation
Failure of anorectal angel to inc with bearing down
Pudendal nerve dysfunction

54
Q

Obstructed defecation - consists of

A 
Anismus
sphincter dyssynergia
non relaxing puborectalis
dyssnergic defecation
PFM dyssynergia
55
Q

Obstructed defecation - symptoms

A

Small, skinny stools
Pressure in pelvic floor
Pain with BM/coccydynia/dyspareunia
Leaking feces or mucus

56
Q

Obstructed defecation - treatment

A

Focus on PFM dysfunction with EMG feedback to dec paradoxical dyssynergy
Consider diet, fiber, bx program if stool is hard

57
Q

Dyssynergic defecation - is what

A

Difficulty or inability to expel stool

58
Q

Dyssynergic defecation - Failure to

A

Adequately relax the puborectalis (which inc the angle btw rectal vault and anal canal)
Coordinate with abdominal mm contraction to inc intraabdominal pressure

59
Q

Dyssynergic defecation - present with

A

Impaired sensory awareness of rectal filling
Can be present with slow transit or IBS-C
May be a learned bx

60
Q

Dyssynergic defecation - also labeled as

A

Obstructive defecation
Anismus
Pelvic floor dyssynergia
Outlet obstruction

61
Q

Fecal incontinence etiology

A 
Impaired anal closure mechanism
- imapired triad:
1 exertnal anal sphinter
2 internal anal sphincter (most important)
3 puborectalis
62
Q

Fecal incontinence - consistency of stool

A

liquid or solid

63
Q

Fecal incontinence - Causes

A

Constipation
Anxiety/stress
Poor diet

64
Q

Fecal and anal incontinence - Internal anal sphincter

A

Smooth mm

has 70-80% contractility for resting tone

65
Q

Fecal and anal incontinence - external anal sphincter

A

20% resting tone

Striated mm has 20% contractility for resting tone

66
Q

Fecal and anal incontinence - Continence is maintained by

A

striated muscles and increasing their strength

67
Q

PT tx of fecal incontinence

A 
Diet considerations
PFM activation with estim
Strengthen core and PFM
Sensory retrain with balloon
Bowel diary/train
Improve stool consistency - diet, meds, ANS
68
Q

Medicare Reimbursement for biofeedback

A

Yes for urinary and fecal incontinence

But not for down regulation or relaxation

69
Q

Irritable bowel syndrome is what

A

Functional disorder
No structural, inflammatory, or biomechanical abnormalities
Brain-gut connection and immune system theories

70
Q

IBS - diagnosis based on

A

symptoms, no definitive tests

71
Q

IBS - diagnosis - symptoms used

A

Recurrent abdominal pain/discomfort at least 3 days/month during previous 3 months
Relieved by defecation
Onset associated with change in stool freq
Onset associated with change in stool form/appearance

72
Q

IBS - symptoms

A

Abdominal pain, bloating, gas

Change in bowel habits

73
Q

IBS - Rome III criteria

A

IBS D
IBS C
IBS M
IBS U

74
Q

IBS - Rome III criteria - D =

A

diarrhea predominent

75
Q

IBS - Rome III criteria - C =

A

Constipation predominent

76
Q

IBS - Rome III criteria - M

A

Mixed diarrhea and constipation

77
Q

IBS - Rome III criteria - U

A

Unsubtyped - insufficient abnormality of consistency of stool to meet other types

78
Q

IBS - Rome III criteria - changing subtypes

A

In one year 75% of pts changed subtypes and 29% change between C and D

79
Q

IBS prevalence

A

60-65% F
35-40% M

Onset between 20 and 40
Overall 10-15% population

80
Q

IBS tx

A 
Relieving symptoms
Pharm
Psychotherapy
Dietician
PT
81
Q

IBS - PT tx

A 
Pain mngmnt
soft tissue impairments
muscular imbalance
PFM dyscuntion
Biofeedback
Breathing
Exercise (aerobic and trunk stab)
Relax/stree reduction
82
Q

Colorectal CA - epidemilogy

A

3rd leading among american M and W
3rd leading cause of cancer death
On decline though because of screening

83
Q

Colorectal CA - risk factors

A

Cause unknown but hought to be influenced by familial and environment

84
Q

Colorectal CA - symptoms

A 
Few early on
Frequently asymp until metastasis
Blood loss from colon
Abdominal pain/bloating
Weight loss
Change in bowel habits
85
Q

COlorectal CA - complications

A 
Intestinal obstruction
GI bleeding
Perforation
Anemia
Ascites
Metastasis to liver, lungs, bone brain
86
Q

COlon CA - prevention

A

Screening is effective with colonoscopy 90%
Performed at age 50 and ever 10 years after if normal
Dets high in fruits, vegt, and fiber
Mod activity dec risk by 50%

87
Q

Colon CA - tx

A

Surgery
Chemo
Radiation

88
Q

COlon CA - PT considerations

A 
Impaired posture from abdominal scars
Lymphedema
Strengthenign based on deconditioned status
Movement to stimulate bowels
PFM retrainign to relearn bowel control
Complications from radiation - dilators
89
Q

Rehab for bowel disorders

A 
Education
Normal fluid intake needs
Dietary counseling
Bwel management with gastocolic reflex
Attn to toilet postures to inc puborectalis angle 
Biofeedback
Urge control
Cog bx therapy
Exercise for post evacuation seepage - hip isometric ER with EAS contraction

Practice Topics Exam 4 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions