Male and Female Reproductive Conditions Chapter 11

Question 1

fyi

Reproductive System Pathologies are part of urinary system, musculoskeletal system

Answer 1

fyi

Question 2

• Boney support for pelvic floor musculature
• Joints: SI and symphysis pubis
• Contents: reproductive organs, bladder, rectum, SI, LI

Answer 2

Boney Structure of pelvis

Question 3

• Uterus
• Cervix
• Vagina
• Ovaries
• Fallopian tubes

Answer 3

Reproductive Organs

Question 4

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

Answer 4

Pelvic Floor muscles

Question 5

Superficial muscles
 Urogenital diaphragm (urogenital and anal triangles)

Answer 5

Pelvic Floor muscles

Question 6

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

Answer 6

Dyspareunia

Question 7

• 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

Answer 7

Endometriosis

Question 8

• No cure
• MI: exploratory laparoscopy, excise tissue, may do oophorectomy or hysterectomy
• PT: treat for pain: TENS

Answer 8

Endometriosis

Question 9

-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

Answer 9

Cancer, carcinoma of the cervix:

Question 10

usually fluid filled and benign, cause is unknown

Answer 10

Ovarian cysts

Question 11

Related to high estrogen levels
Slow growing
S/S: painless vaginal bleeding
Diagnosis: Direct aspiration of uterine cells
Treatment: surgery, radiation, chemotherapy

Answer 11

Endometrial cancer

Question 12

Prognosis:
Ovarian cysts:

Answer 12

excellent

Question 13

Prognosis: Ovarian cancer:

Answer 13

common, majority of deaths from female reproductive cancers

Question 14

MI: gyn exams, contraceptive medications, removal of ovaries, US, MRI
PT: strengthening

Answer 14

Ovarian cancer:

Question 15

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

Answer 15

Pelvic Floor Incompetence and Weakness

Question 16

• Genetic
• Post vaginal delivery
• Obesity
• Chronic cough
• Heavy lifting
• Straining with BM
• Surgeries
• Nerve injuries

Answer 16

Pelvic floor weakness

Question 17

• 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

Answer 17

Pelvic floor weakness

Question 18

-MI: diagnose by exam and history possibly MRI
**urge incontinence: medications
**Stress incontinence: bladder suspension/sling

-PT: estim and biofeedback, vaginal weights, kegel -exercises

Answer 18

Pelvic floor weakness

Question 19

-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

Answer 19

Uterine Prolapse

Question 20

-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

Answer 20

Uterine Prolapse

Question 21

-Used as form of birth control
**Can cause low back or abdominal pain if dysfunctions
**Cannot use Short waive diathermy over the area

Answer 21

IUD

Question 22

• 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

Answer 22

Breast Carcinoma

Question 23

• 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

Answer 23

Breast Carcinoma

Question 24

• Gestational diabetes
• Low Back Pain

Answer 24

Pregnancy related issues requiring physical therapy

Question 25

• 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

Answer 25

Gestational diabetes

Question 26

• Treat with exercise, diet, weight control, monitor blood sugar, may have to take insulin
• PT: may have to prescribe exercise

Answer 26

Gestational diabetes

Question 27

• 50% of pregnant women
• Ligamentous laxity, altered Center of Gravity stretch weakness of abdominal muscles

Answer 27

Low back pain

Question 28

• 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

Answer 28

Pregnancy related Low Back Pain

Question 29

• Decreased estrogen production
• Increased incidence of osteoporosis
• Hip, spine and forearm fractures
• Protection: calcium intake, vitamin D, healthy diet, weigh bearing exercise

Answer 29

menopause

Question 30

Disease symptoms between reproductive and urinary tract are often associated

Answer 30

Male Reproductive

Question 31

• Levator Ani Syndrome
• Prostatitis
• Pundendal nerve entrapment
• Constipation
• Post prostatectomy urinary incontinence

Answer 31

Pelvic Pain

Question 32

S/S burning, aching, pressure groin, low back, buttocks, abdomen or thigh
PT

Answer 32

Pelvic Pain

Question 33

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

Answer 33

Benign Prostatic Hyperplasia

Question 34

Prognosis: responds to medical treatment
MI: rectal exam, cystoscope, monitor, medications, TURP
PT: none

Answer 34

Benign Prostatic Hyperplasia

Question 35

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%

Answer 35

Prostate Cancer

Question 36

MI: regular screening: blood test: PSA, Digital rectal exam, ultrasound, biopsy, radiation, prostatectomy
PT: none

Answer 36

Prostate Cancer