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OPP IV midterm > OB patient, jons cox > Flashcards

OB patient, jons cox Flashcards

1
Q

What occurs in pregnancy to arterial venous system

A

venous system can not keep up with excess arterial supply so lymphatics play crucial role

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2
Q

hyperSAN tone causes what

A

constriction lymph flow

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3
Q

dysfunction in MSK system can increase E requirement by how much

A

300%

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4
Q

When is OMT avoided in pregnancy

A

PROM, premature labor, abruptio placenta, ectopic pregnancies

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5
Q

ddx Low back pain in OB patient

A 
biomechanical instability
lumbosacral plexopathy
neuropathy
spinal facet
spondylolisthesis
congenital disorders
discogenic
trauma
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6
Q

factors that contribute to low back pain in OB

A 
multifetal gestation
spinal curves (scoliosis)
leg length inequality
weight gain
ligamentous laxity
somatic dysfunction
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7
Q

most common cause low back pain in pregnacy

A

biomechanical instability

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8
Q

postural effects of pregnancy

A

increased anterior pelvic tilt
lumbar spin lordosis
thoracic spin kyphosis

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9
Q

compensatory posture in pregnancy

A 
shoulders back
head forward
sacrum nutates, ribs flare
feet flatten
stance widens in ambulation
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10
Q

what can occur with increased lumbar lordosis

A

increased load on facets
shearing intervertebral disc spaces
posterior paraspinal muscles shorten and unbalanced by overstretched abdominals
psoas mm shorten

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11
Q

what can occur with increased anterior elvic rotation

A

strain lumbar and SI joints

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12
Q

relaxin and Estrogen change pubic symphysis how

A

widens begining 10th-12th week

can refer to low back and medial thighs

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13
Q

which area is at hgiher risk for spondylolisthesis in women who have had children before

A

L4-5

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14
Q

What do you need to rule out for complaint of hip pain

A

transient osteoporisis and avascular necrosis of femoral head

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15
Q

clinical setting of transient osteoporisis

A

rare. 3rd trimester
pain increases with weightbearing
limited ROM
sudden or insidious

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16
Q

Tx for transient osteoporosis of hip

A

reduced weightbearing (bedrest or wheelchair)

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17
Q

Dx for transient osteoporosis of hip

A

XR
MRII
pelvic US

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18
Q

Sx avascular necrosis of femoral head

A

pain in hip, pelvis, groin with weight bearing in 3rd trimester
may radiate to knee thigh or back

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19
Q

Dx avascular necrosis femoral head

A

hip ROM

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20
Q

Tx avascular necrosis of femoral head

A

reduced weightbearing to allow revascularization

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21
Q

women who have lumbo pelvic pain in pregnancy are at icnreased risk for what

A

postpartum depression

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22
Q

what is meralgia paresthetica

A

burning and numbness at waistband and lateral thigh

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23
Q

Tx LBP in pregnant women

A 
avoid excess heat
nurtion- vit D, Ca, fish oil, Mg
exercise: gentle, normal temp
maternity back supports and sacroiliac support
accupuncture
OMT
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24
Q

indications for OMT in pregnancy

A

SD present
scoliosis or other structural condition
edema, congestion or other pregnancy assoc condition amenable to OMT

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25
Q

CI to OMT in pregnancy women

A 
unDx vaginal bleeding
threatened abortion
ectopic
placenta previa
placental abruption
PROM
preterm labor
prolapsed umbilical cord
severe preeclampsia and eclampsia
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26
Q

Stages of Tx in preganncy

A

structural
congestive
preparatory
Recovery and maintenance

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27
Q

what is the early structural stage of pregnancy

A

0-12 weeks

28
Q

what do you examine in early structural stage

A 
postural
thoracic inlet fascia
thoracic cage
pelvis and sacrum
viscerosomatic
chapmans
CRI
29
Q

what are the sympathetics to uterus

A

T10-L2

30
Q

parasympathetics to cervi

A

S2-S4

31
Q

anterior chapman stomach hyeracidity

A

5th intercostal space mid clavicular line to L of sternum

32
Q

anterior chapman liver/gallbladder

A

6th intercostal space from mid clavicular line to R of sternum

33
Q

posterior chapman stomach hyperacidity

A

intertransverse space, midway spinous and transverse processes
between 5th and 6th vertebrae on L

34
Q

posterior chapman liver gallbladder

A

intertransverse space midway spinous and transverse processes
between 6th and 7th on R

35
Q

ant chapman ovaries

A

round ligaments from upper border pubic bone to attachment of mm on lower border

36
Q

ant chapman uterus

A

laterally on sides pubic symphysis

37
Q

ant chapman broad ligament

A

trochanter down to outer aspect femur within 2 “ knee joint

38
Q

post chapman ovaries

A

intertransverse space between 9th and 10th vertebrae and 10th adn 11th vertebrae

39
Q

post chapman uterus

A

tip of TP or L5 toward iliac crest

40
Q

post chapman broad ligament

A

between PSIS and spinous process L5

41
Q

ant chapman fallopian tube

A

midway from acetabelum and sciatic notch

42
Q

chapman for spastic constipation or colitis

A

TP of L2, TP of L4 and traingular area reaching across to iliac crest

43
Q

Tx areas for hyperemesis gravidarum

A

C2 and T5-9

44
Q

expect what SD in late structual stage

A

pelvis rotated anterior
increase in lumbar lordosis
compensatoy thoracic kyphosis

45
Q

Tx for late structural stage

A 
fascial release (direct/indirect)
anterior counterstrain points L3-5 may help round ligament pain
Tx sacrum and pelvis with any modality comfortable to patient
46
Q

spinal changes in mid to late pregnancy

A

increased lumbar lordosis
increased thoracic kyphosis
increased cervical lordosis

47
Q

when is the congestive stage of pregnancy

A

28-36 weeks

48
Q

what occurs in congestive stage

A

gravitational effects on the uterus accentuate abdominal fascial drag on inguinal tissues
increase interstitial fluids
increase uterus size

49
Q

what cuases edema in congestive stage

A

the increased uterus can become a vlave to the vv of lower extremity
some some get hypotensice if supine

50
Q

common complaints during congestive stage

A

loss of balance, back pain, gait changes

GERD, constipation, hemorrhoids, leg edema

51
Q

techniques for congestive stage

A

myofascial, soft tissue, effleurage, petrissage

52
Q

viscerosomatics for upper GI

A

T5-9

53
Q

viscersomatics to adrenal, ovaries and uterus

A

T10-L2

54
Q

why avoid cranial Tx in congestive stage

A

may induce uterine contractions

55
Q

Tx what areas in congestive stage

A

sacral, lumbar, thoracic, cervical

56
Q

what typ eof lymph in congestive stage

A

pectroal traction

57
Q

how do you treat thoacolumbar jucntion in congestive stage

A

diaphragm and vertebrae

58
Q

goal of preparatory stage of pragnangcy

A

maintain good structural balance and lymphatic flow

59
Q

how do you influence contractions via sympathetics

A

work thoracic spine

60
Q

what will Tx sacral base do in labro

A

influence cervical dilation via parasypathetics

61
Q

what can be used to influence uterine contractions

A

CV4

62
Q

when do start recorvery and maintenance stage

A

post partum day 2

63
Q

goal of first recovery and maintenance visit

A

screen SD
assist body to return to normal state
evaluate sacrum

64
Q

a bilateral flexed sacrum and extended L5 is assoc with what Sx

A

fatigue, depression and low energy

65
Q

when is the final visit for recovery and maintenance

A

6 weeks post partum

66
Q

plan for final recovery and maintenance visit

A

screen SD
review strucutal changes
advise follow up for chronic problems

OPP IV midterm (6 decks)

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