Lecture 8

Question 1

What is a sunny side up baby

Answer 1

ideal baby position
baby is on left side w occiput ant

when sunny side up the occiput is post and head on sacrum

Question 2

Symphysis pubis dysfunction in what % of preg women

Answer 2

31.7%

Question 3

Where is pain located in symphysis pubis dysfunction

Answer 3

tends to be more central

Question 4

aggravating factors of symphysis pubis dysfunction

Answer 4

anything one legged

Question 5

Proposedd pathophysiology of symphysis pubis dysfunction

Answer 5

• 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

Question 6

Chiropractic care of symphysis pubis dysfunction

Answer 6

• Trochanteric belt
• STT (psoas, rectus abdominus, adductors, piriformis, glut)
• SMT
• K tape
• advice (ice, move legs as unit, rehab)

Question 7

What is round lig pain/why

Answer 7

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

Question 8

How to find round lig

Answer 8

asis to umbilicus 45 degree angle bw them

Question 9

type of pain in round lig pain

Answer 9

sharp and shooting

transitions like rolling over the bed can cause pain

Question 10

What is meralgia perasthetica + why

Answer 10

mononeruopathy resulting from compression of lat femoral cutaneous nerve
-from growing stomach and weight gain (usually gets worse as preg progresses_

Question 11

chiropractic care of meralgia perasthetica

Answer 11

STT
SMT
Advice
Rehab
Pelvic flossing/mobility exercises (dont do cat/camel when 2nd try)
Pelvic stability ex

Question 12

Osteitis condensans illii what is it, who gets it

Answer 12

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

Question 13

what is the proposed pathophysiology of osteitis candansans illii

Answer 13

hormonal/mechnical

• -as we get increased mvmt and ligs are trying to resist the mvmt
• -increased laying down of bon e

Question 14

why does thoracic/rib pain occur in preg women

Answer 14

presents similar to non preg pop

-postural changes due to change in COG

Question 15

how to educate for thoracic/rib pain in preg

Answer 15

cues to tuck in bum
roll shoulders back and bring the chin in
change bra size/straps

Question 16

what is intercostal neuralgia

Answer 16

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

Question 17

Carpal tunnel syndrome is in what proportion of preg women

Answer 17

1/5

or 62% in late third trimester

Question 18

Proposed pathophysiology of carpal tunnel syndrome in preg

Answer 18

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

Question 19

Is SMT safe during preg

Answer 19

Cervical spine had serious adverse events
-lumbar had mild/transient

Hypercoagubility + relaxin makes it a bit more worrisome for the cervical spin e

Question 20

% of women who suffer from preg related back pain

Answer 20

4-90%

1/3 state that its their first episode

Question 21

When does preg related back pain usually start week wise

Answer 21

18-28th week of preg

should spon resolve

Question 22

risk factors for preg related back pain

Answer 22

prev hx of LBP
LBP in prev preg or postpartum
high anxiety score
work dissatisfaction

Question 23

Why is LBP higher postpartum usually

Answer 23

because women have to take care of baby, constantly bend over, pick up baby, breathed etc

Question 24

women who exeperencei back pain during preg and post party are at what increased risk of having mental issues

Answer 24

3x greater risk

Question 25

Loc, pain, radiation, frequency of LBP vs PGP

Answer 25

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

Question 26

When is LBP pain more severe compared to PGP

Answer 26

LBP more severe post, PGP during pro

Question 27

Contraindications to SMT during preg

Answer 27

vag bleeding
abdominopelvic cramping
ruptured membranes, premature labor
placenta previa
placental abruption
ectopic preg
sudden onset pelvic pain
bowel obstruction
preg induced hyerpetnsion
preclampsia

Question 28

multimodal approach for preg pain

Answer 28

support for multimodal including
SMT
Exercisw

Question 29

pt education/info for preg pain

Answer 29

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