OAB Renal Flashcards
Behavioral Model for cystitis
- Increase fluid intake
- ABX
Behavioral Model for nephrolithiasis
- Increased fluid intake
- Diet modifications as prescribed
Behavioral Model for interstitial cystitis
- Modify diet
- Meds as directed
Behavioral Model for renal failure
- Diet modification
Behavioral Model for incontinence
- Bladder training
- Double voiding
- Scheduled toilet trips
- Fluids and diet management
- Pelvic floor muscle excerises
Behavioral Model to avoid renal calculus formation
- Minimum intake of 2 L water/day
- Avoid Strictly Vegetarian Diets
- Avoid Excessive: animal protein diets, salt consumption, Vitamin C/D consumption, soft drinks
- Consume phytate-rich foods (such as bran, legumes, beans, wild rice,
Referred pain from the ureter going where?
- Pain from ureter is reffered
Right kidney is related to the _____, _______ and ______ anteriorly
Left kidney is related to the _____, _____, ______ and ______ anteriorly
Right Kidney is Related to the Liver, Duodenum, and Ascending Colon Anteriorly
Left Kidney is Related to the Spleen, Pancreas, Stomach, and
Sympathetic innervation to GU does what
Vasoconstriction, uteroconstriction, constricts internal urethral sphincter
Parasympathetic innervation to GU does what
- Helps with peristalsis along ureters
- Contracts bladder to urinate
Due to an infectious process, _________ is required for presentation of antigens to make antibodies and removal of inflammatory and cellular waste products.
lymphatic drainage
_______________ is critical for the clearing of the bacterial and resulting inflammation.
Unimpeded lymphatic drainage is critical for the clearing of the bacterial and resulting inflammation.
Lymph vessels by the cortical radial arteries =>
- _______ arteries
- _______ arteries
- _______ plexi→
- _______ LN →
- ________ duct: ______ to ___________
Lymph vessels by the cortical radial arteries =>
- arcuate arteries
- interlobar arteries
- Intrarenal plexi→
- lateral aortic LN →
- thoracic duct: cysterna chyli to left subclavian vein
Osteopathic Approach to Treatment for Renal
- Indications
SD either primary or secondary to viscersomatic relexes related to disease
- Primary may be rib, diaphragm, thoracic, lumbar, pelvic dysfunctions that made the person more susceptible to their disease
- Secondary may be rib, spinal, or chapman’s reflexes due to viscerosomaticreflexes
Osteopathic Approach to Treatment for Renal
- CI
- Patient cannot to tolerate OMT d/t to pain or positioning
- Delaying more definitive care
Biomechanical
What areas previously mentioned affect or are effected by the kidneys?
Remove any mechanical restrictions around lower ribs, thoracolumbar spine, psoas, quadratus lumborum, pelvic floor muscles and/or their attachements
- Innominates
- Pubic bone
- Pelvic floor
- Sacrum
Treat the gut to treat the bladder
Why?
Constipation can cause the bladder to have spasms and not empty completely.
- It is very important to treat a child’s constipation so that bladder symptoms can improve.
Neurologic
What areas neurologic areas affect the kidney?
– OA (Vagus)
- parasympathetic
– T10-L2
- sympathetic
– Sacrum (pelvic splanchnics)
- parasympathetic
Respiratory Circulatory
- The Kidneys
- Thoracic inlet
-
Thoracoabdominal diaphragm (lympatetic + resp/circulatory)
- Treating the lower ribs => remove mechanical restrictions around the kidney and improve lymphatic drainage
- Next
- examine pelvic diaphragm and if tolerated, pedal pump
OMT is shown to be an effective manual approach towards improvement of kidney mobility and reduction of pain over the short-term, in individuals with _____
non-specific low back pain
How would performing counter-strain to the patient’s psoas help his condition?
A.It will improve lymphatic flow and decrease stasis to help clear his infection
B.It will allow for decreased tone in L3-L4 and allow for relaxation and passage of the stone
C.External rotation and flexion of the femur allows for decreased psoas tone and ureter tone aiding in the passage of the stone
D.By touching the patient there is a placebo effect
This patient has a stone in his ureter. Which somatic dysfunction could you expect to find related to the biomechanical model?
A. T11 ERS Left
B. Iliopsoas hypertonicity
C. OA E RrSl
D. Anterior Thoracic 9 tenderpoint
E. Right Diaphragm restriction
What technique most directly addresses her treatment from a neurologic perspective?
A. Treating T8 with muscle energy
B. Treating inhaled first rib on the right
C. Doming the diaphragm
D. Treating T10-L2 with soft tissue
E. Treating her quadratus lumborumspasm
How would performing counter-strain to the patient’s psoas help his condition?
A.It will improve lymphatic flow and decrease stasis to help clear his infection
B.It will allow for decreased tone in L3-L4 and allow for relaxation and passage of the stone
C.External rotation and flexion of the femur allows for decreased psoas tone and ureter tone aiding in the passage of the stone
D.By touching the patient there is a placebo effect
Which of the following accurately describes the mechanism of a viscerosomaticreflex?
A. Nociceptive signals are carried by spinal motor neurons
B. The signal is carried by the vagusnerve to the brain where there is a synapse with the motor cortex
C. Localized visceral stimuli produces a reflex response in segmentally related visceral structures
D. Irritation of a somatic structure causes facilitation of the spinal segment and thereby irritates a visceral structure of similar innervation
E. Nociceptors carry impulses via sympathetic nerve fibers that synapse with spinal interneurons that interact with spinal motor neurons
Which of the following techniques will improve lymphatic drainage of her kidney and bladder?
A. Ischiorectalfossa release
B. Muscle energy for a pubic shear
C. Counterstrainto Anterior thoracic 10 (AT10)
D. Muscle energy to L4
Which of the following techniques will the address the bladder from a biomechanical perspective?
A. Doming the diaphragm
B. Muscle energy for a pubic shear
C. Counter-strain to Anterior thoracic 10 (AT10)
D. Muscle energy to L4
Where would you expect to find a posterior Chapman’s reflex related to her bladder infection?
A. Upper edge of the transverse process of L2
B. A triangular region located posteriorly near L2-L4
C. The tip of rib 12
D. The inferior border of T12
What technique most directly addresses her treatment from a respiratory-circulatory perspective?
A. Treating L4 with muscle energy
B. Treating inhaled first rib on the left
C. Treating inferior pubic shear on the left
D. Treating T10-L2 with soft tissue
E. Treating her right scalenes
