OAT: Renal Patient Flashcards
cystitis: cause
usually bacterial
cystitis: population at highest risk
- sexually active women
- infants
- pregnant
- old
- catheter
cystitis: common symptoms
- dysuria
- hematuria
- frequency
- urgency
- fever
- lower abdominal pain
cystitis: tests
- midstream UA
- lloyds punch
UNEXPLAINED BLOOD IN THE URINE: what it?
malig until disprove
cystitis: treatment
- antibiotics
- increased fluid intake
- fuckin’ OMT i guess
cystitis: serious complications
can become pyelonephritits
what length urethras do women have?
short
what the most common disorder fo the urinary tract?
is this more common in males or females?
- kidney stones
- men
how do kidney stones present
severe colicky pain, flank pain that radiates to the groin
most common kidney stones
calcium oxalate and calcium phosphate
imaging study of choice for kidney stones
CT no contrast
how do you conservatively manage urolithiasis?
- aggressive hydration
- dietary modification
- if do not respond: then urologic intervention
Kidney stones: Behavioral management
- minimum 2L of water/day
- avoid starchy vegetarian diets
- avoid excessive animal protien, salt, vit C/D, soda
- eat phytate-rich foods (bran, legumes, beans, wild rice, brazil nuts)
which nerve makes the refered pain in kidney stones
GENITOFEMORAL
Kidneys live infront of which muscle
psoas
Interstitial cystitis/painful bladder syndrome: signs and symptoms
- pain between the vagina and anus
- pain between the scrotum and anus
- chornic pelvic pain
- always feel like u gotta pee
- frequent urintate, in smol amounts (like 60 a day)
- pain while bladder fills
- pain with sex
Interstitial cystitis/painful bladder syndrome: diagnosis
- fucking history and physical
- bladder diary
- pelvic exam
- UA w/ cytology
- cytoscopy w/ biopsy
- potassium sensitivity
Interstitial cystitis/painful bladder syndrome: treat
- pt
- nsaids
- tricyclic antidepressants
- antihistamine
- pentosan polysulfate sodium
- OMT
how does the kidney change with age?
- decrease in GFR
- changes in glomerular, vascular, and accompanying parenchyma
- decreased number of nephrons
what are the consequences of a decrease in the number of nephrons?
- decline in creatine clearence
- cant clear drugs too good
- have to be careful with drugs that are cleared via kidney bc they can accumulate and become toxic p fast.
incontinence: treatment
- bladder training, double voiding, schedule toilet trips
- pelvic floor muscle exercise
- electric stimulation
- anitcholinergics, alpha blockers
- urethral inserts
- surgery
- …omt
where is the upper pole of the kidney?
T12
where is the lower pole of the kidney
L3
how far do kidneys move with breatheing
~3cm
what is anterior to the right kidney
liver
duodenum
ascending colon
what is anterior to the left kidney
spleen
pancreas
stomach
descending colon
all them pelvic organs, what is up?
they are all covered in fascia
do you have to do internal manipulation do have a significant impact on GU organs?
no
SD in the GU myofasical system mechanically affects and is effected by what
the sacrum, innominates, and related muscle and fascia
in the GU myofasical system: what do u do if ther is a generalized sense of laxity?
use indirect methods
sympathetic innervation: kidney
T10-L1
sympathetic innervation: ureter
upper: T10-L1
Lower: L1-2
sympathetic innervation: bladder
T11-L2
sympathetic innervation: what it cause
- vasoconstriction
- ureteroconstriction
- constriction of internal urethral sphincter
parasympathetic innervation: kidney
vagus
parasympathetic innervation: ureter
upper: vaugs
lower: s2-4
parasympathetic innervation: bladder
s2-4
parasympathetic innervation: what it do?
- peristalsis along ureter
- contract bladder
CHAP: adrenals
A: 2-2.5in above and 1in lateral to belly button
P: spaces between TP of T11 and T12
CHAP: kidney
A: 1in above and 1in lateral to belly button
P: space between TP of T12 and L1
CHAP: ureter
A: 1in above and 1in lateral to belly button
P: space between TP of L1 and L2
CHAP: bladder
A: belly button
P: superior edge of L2 transverse process
CHAP: urethra
A: inner edge of the pubic ramus near the symphysis
P: superior edge of L2 transverse process
what is the lymphatic drainage path for the kidneys?
lymph vessesls by the cortical radial arteries»arcuate arteries»interlobar arteries»intrarenal plexi»lateral aortic nodes»thoracic duct: cysterna chyli to left subclavian vein
renal OAT is indicated for what?
SD primary or secondary to viscerosomatic reflexes because of disease
examples of SD primary to Viscerosomatic reflexes
rib, diaphragm, thoracic, lumbar, pelvic SD that make them more susceptible to their disease?!?!?!?
examples of SD secondary to viscerosomatic reflex
rib, spinal, or chapman
CONTRAINDICATIONS for OAT anything
- patient is unable to tolerate OMT secondary to pain or positioning
- delaying more definitive care
BIOMECHANICAL: what areas affect or are affected by the kidneys?
- lower ribs
- thoracolumbar spine
- psoas
- quadratus lumborum
- pelvic floor muscles
BONE attachments: innominants, pubic bone, pelvic floor, sacrum
treat the ____ to treat the ______
treat the gut to treat the bladder
what do you treat to fix the bladder
pubic shear?
how can we fucking help the kidneys move w/ breathing?
- check that thoracic inlet, focus on the left side
- then move to thoracoabdominal diaphragm
- treat the lower ribs
- then check that pelvic diaphragm
- PEDAL PUMP THAT BITCH if it be tolerated
what SD related to biomechanical model would you find in a patient with a stone in ureter?
Iliopsoas hypertonicity
what is the best explanation for finding “ tender congested nodule noted 1 inch above and 1 inch to right of umbilicus
reflex related to lymphatic and autonomic interactions (MOTHER FUCKIN CHAP)
OMT helps _____ autonomic tone
NORMALIZE
decreasing sympathetic tone (renal) might do what?
reduce ureteroconstriction
who do visceral afferents typically travel with?
sympathetic nerves
visceral affarents travel where?
enter sympathetic trunk and chain gangilia»>travel through white rami to dorsal root ganglia»>project to dorsal horn
what do alpha motor neurons do?
result in tissue texture changes and somatic dysfuntion
if u give antibiotics, what model is that
metabolic
