Male and Female Reproductive Conditions Chapter 11 Flashcards
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Reproductive System Pathologies are part of urinary system, musculoskeletal system
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- Boney support for pelvic floor musculature
- Joints: SI and symphysis pubis
- Contents: reproductive organs, bladder, rectum, SI, LI
Boney Structure of pelvis
- Uterus
- Cervix
- Vagina
- Ovaries
- Fallopian tubes
Reproductive Organs
Inner layer: coccygeus, levator ani
Attach to inner aspect of ischial spines and pubic rami, obturator fascia, perineal body and raphe posterior to rectum
Forms sphincters of rectum, provide support for opening of rectum and vagina
Pelvic Floor muscles
Superficial muscles Urogenital diaphragm (urogenital and anal triangles)
Pelvic Floor muscles
Pain in female related to intercourse
-Physical or psychological
-Scar tissue from endometriosis
*****Can involve spasm of pubococcygeus muscles
-Other causes: pelvic inflammatory disease, postpartum trauma, tumors, inflammation or infection, vaginal atrophy, genital mutilation
=PT: work with pt in womens health setting with psychologists/psychiatrists
Dyspareunia
- Endometrial tissue grows outside of uterus
- Can grow anywhere: ovaries, peritoneal cavity, pelvic ligaments, heart, lungs
- Causes irritation, inflammation and pain
***Etiology: unknown
S/S: severe pain and bleeding, painful BM, painful urination, infertility, pain in coccygeal and sacral area, dyspareunia
Endometriosis
- No cure
- MI: exploratory laparoscopy, excise tissue, may do oophorectomy or hysterectomy
- PT: treat for pain: TENS
Endometriosis
-more common with early sexual intercourse, multiple partners, STD’s: HSV 2, HPV, HIV
-Early detection when have cervical dysplasia improves outcomes
-S/S usually none: regular PAP smears detect precancerous cells
-Prognosis: depends on staging
MI: Gardisil, surgical excision
PT: none
Cancer, carcinoma of the cervix:
usually fluid filled and benign, cause is unknown
Ovarian cysts
Related to high estrogen levels
Slow growing
S/S: painless vaginal bleeding
Diagnosis: Direct aspiration of uterine cells
Treatment: surgery, radiation, chemotherapy
Endometrial cancer
Prognosis:
Ovarian cysts:
excellent
Prognosis: Ovarian cancer:
common, majority of deaths from female reproductive cancers
MI: gyn exams, contraceptive medications, removal of ovaries, US, MRI
PT: strengthening
Ovarian cancer:
Muscle weakness due to stretching, weakness, lack of use
Lack control of bladder or bowel
Usually older women
Up to 55% older women symptoms of incontinence
Pelvic Floor Incompetence and Weakness
- Genetic
- Post vaginal delivery
- Obesity
- Chronic cough
- Heavy lifting
- Straining with BM
- Surgeries
- Nerve injuries
Pelvic floor weakness
- S/S: stretching from PG and delivery: temporary urinary incontinence, if stretching is severe :
- Stress incontinence: cough, sneeze, laugh: increase intraabdominal pressure
- Urge/overflow incontinence: detrusor muscle is weak, cannot empty bladder fully
- Prognosis: good if can improve pelvic floor function
Pelvic floor weakness
-MI: diagnose by exam and history possibly MRI
**urge incontinence: medications
**Stress incontinence: bladder suspension/sling
-PT: estim and biofeedback, vaginal weights, kegel -exercises
Pelvic floor weakness
-Herniation of uterus into or beyond vagina
**After several vaginal deliveries
**Menopause
-First degree: uterus partly into vagina
-Second degree: descends all way into vagina
-Third degree: uterus and cervix protrudes out of external vaginal opening
Uterine Prolapse
-Etiology
**Weak pelvic floor structures: genetics, vaginal deliveries, low estrogen, obesity, cough
-S/S: LBP with standing, walking, pain at end of day, pelvic pain, dyspareunia
-Prognosis: premature delivery,
-MI: topical estrogen, vaginal pessaries, hysterectomy, suspension
-PT: exercise to strengthen pelvic floor
Uterine Prolapse
-Used as form of birth control
**Can cause low back or abdominal pain if dysfunctions
**Cannot use Short waive diathermy over the area
IUD
- Second most common cancer in females
- 1 in 8 chance of developing
- S/S: palpable lump, nipple discharge, retraction or inversion of nipple, pitting or redness of skin
- Prognosis: depends on type, staging. If no mets: 97% 5 year survival rate
Breast Carcinoma
- MI: mammography, US, biopsy, sentinal node biopsy, blood testing, surgery, radiation, chemo
- PT: UE exercises post surgery, instructions to avoid edema, strengthening exercises, lymphedema control
Breast Carcinoma
- Gestational diabetes
- Low Back Pain
Pregnancy related issues requiring physical therapy
- Diabetes that occurs during pregnancy
- Usually no signs, blood testing done
- Is risk factor developing diabetes later, if uncontrolled can have large baby, low glucose in fetus, jaundice, respiratory distress
- Detect through glucose testing/ glucose tolerance test
Gestational diabetes
- Treat with exercise, diet, weight control, monitor blood sugar, may have to take insulin
- PT: may have to prescribe exercise
Gestational diabetes
- 50% of pregnant women
- Ligamentous laxity, altered Center of Gravity stretch weakness of abdominal muscles
Low back pain
- S/s: pain in low back or pelvic floor, radiate into buttocks or legs
- Prognosis: usually resolves after delivery
- MI: limited testing, acetaminophen, ex, rest in left sidelying
- PT: exercise, back supports, caution to avoid rectus abdominis diastesis
Pregnancy related Low Back Pain
- Decreased estrogen production
- Increased incidence of osteoporosis
- Hip, spine and forearm fractures
- Protection: calcium intake, vitamin D, healthy diet, weigh bearing exercise
menopause
Disease symptoms between reproductive and urinary tract are often associated
Male Reproductive
- Levator Ani Syndrome
- Prostatitis
- Pundendal nerve entrapment
- Constipation
- Post prostatectomy urinary incontinence
Pelvic Pain
S/S burning, aching, pressure groin, low back, buttocks, abdomen or thigh
PT
Pelvic Pain
Noncancerous, nonmalignant hyperplasia prostate tissue
May compress urethra
Most common over age 50: 50% of men over age 50 have some symptoms
Unknown etiology
S/S: problems with urination, slow urine flow, urge incontinence, nocturia, UTI
Benign Prostatic Hyperplasia
Prognosis: responds to medical treatment
MI: rectal exam, cystoscope, monitor, medications, TURP
PT: none
Benign Prostatic Hyperplasia
Usually after age 65
1 in 6
Etiology is unknown, increase risk if family history, higher in African Americans
S/S: may not have any, hematuria, increased fequency of urination, nocturia, weak/interrupted flow
Prognosis: 5 yr survival is 100%
Prostate Cancer
MI: regular screening: blood test: PSA, Digital rectal exam, ultrasound, biopsy, radiation, prostatectomy
PT: none
Prostate Cancer
