Lecture 8 Flashcards
What is a sunny side up baby
ideal baby position
baby is on left side w occiput ant
when sunny side up the occiput is post and head on sacrum
Symphysis pubis dysfunction in what % of preg women
31.7%
Where is pain located in symphysis pubis dysfunction
tends to be more central
aggravating factors of symphysis pubis dysfunction
anything one legged
Proposedd pathophysiology of symphysis pubis dysfunction
- metabolic + hormonal changes leading to lig lax
- pathological weakening of the jt (due to contant pressure of fetus head on pelvis)
- tearing of fibrocartilageous disk during delivery
- mm weakness
- increased fetal + preg related weight gain
Chiropractic care of symphysis pubis dysfunction
- Trochanteric belt
- STT (psoas, rectus abdominus, adductors, piriformis, glut)
- SMT
- K tape
- advice (ice, move legs as unit, rehab)
What is round lig pain/why
mc prenatal discomforts
-as the uterus starts to grow, the lig starts to become long and taught w transitions- when roll over may get sharp catching pain
How to find round lig
asis to umbilicus 45 degree angle bw them
type of pain in round lig pain
sharp and shooting
transitions like rolling over the bed can cause pain
What is meralgia perasthetica + why
mononeruopathy resulting from compression of lat femoral cutaneous nerve
-from growing stomach and weight gain (usually gets worse as preg progresses_
chiropractic care of meralgia perasthetica
STT SMT Advice Rehab Pelvic flossing/mobility exercises (dont do cat/camel when 2nd try) Pelvic stability ex
Osteitis condensans illii what is it, who gets it
benign condition typically seen after prog and not associated w any inflammatory arthritis
-bilateral/symetrical
-more of a nagging pain and mild compared to SI jt dysfunction which is sharp and catching
what is the proposed pathophysiology of osteitis candansans illii
hormonal/mechnical
- -as we get increased mvmt and ligs are trying to resist the mvmt
- -increased laying down of bon e
why does thoracic/rib pain occur in preg women
presents similar to non preg pop
-postural changes due to change in COG
how to educate for thoracic/rib pain in preg
cues to tuck in bum
roll shoulders back and bring the chin in
change bra size/straps
what is intercostal neuralgia
pain in mid back wrapping around pathway of intercostal nerves in a band like pattern
- described as stabbing, tearing, sharp, spasm like
- pain can intensify during exertion or with sudden mints such as coughing/laughing
Carpal tunnel syndrome is in what proportion of preg women
1/5
or 62% in late third trimester
Proposed pathophysiology of carpal tunnel syndrome in preg
hormonal changes in MSK system or fluid retention and edema
- gestational diabetes can play a role due to generalized slowing of nerve conduction
- elevated bp may also be a risk factor
- possible correlation w preeclampsia
Is SMT safe during preg
Cervical spine had serious adverse events
-lumbar had mild/transient
Hypercoagubility + relaxin makes it a bit more worrisome for the cervical spin e
% of women who suffer from preg related back pain
4-90%
1/3 state that its their first episode
When does preg related back pain usually start week wise
18-28th week of preg
should spon resolve
risk factors for preg related back pain
prev hx of LBP
LBP in prev preg or postpartum
high anxiety score
work dissatisfaction
Why is LBP higher postpartum usually
because women have to take care of baby, constantly bend over, pick up baby, breathed etc
women who exeperencei back pain during preg and post party are at what increased risk of having mental issues
3x greater risk
Loc, pain, radiation, frequency of LBP vs PGP
LBP in lumbar region bw costal margins and inf folds
PGP in are between iliac crest and gluteal folds
LBP- dull
PGP- stabbing/shooting
LBP- no radiation but constant
PGP- may radiate to post thigh
When is LBP pain more severe compared to PGP
LBP more severe post, PGP during pro
Contraindications to SMT during preg
vag bleeding abdominopelvic cramping ruptured membranes, premature labor placenta previa placental abruption ectopic preg sudden onset pelvic pain bowel obstruction preg induced hyerpetnsion preclampsia
multimodal approach for preg pain
support for multimodal including
SMT
Exercisw
pt education/info for preg pain
mixed results but it has been suggested that w who receive information experience less discomfort and decreased pain compared to controls
- avoid twisting, unrelenting postures
- maintaine good posture
- frequent breaks
- individualized self management strats
