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OS 4 Exam 1 > OB Patient Lecture > Flashcards

OB Patient Lecture Flashcards

1
Q

3 factors that influence SD in pregnant patients?

A

Change in structure and biomechanics
Bloody fluid circulation
Hormonal changes

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2
Q

How does pregnancy effect scoliosis, RA, and ankylosis spondylitis?

A

Curves don’t increase
Improve
Makes worse

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3
Q

4 major bio mechanical changes during pregnancy?

A

Increased lumbar lordosis, forward flexion of neck, downward movement of shoulders, and anterior tilt of pelvis

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4
Q

5 main causes of mechanical stress low back pain?

A 
Postural changes
Muscle weakness
Excessive CT stretching and micro trauma 
Posterior pelvic pain
Visceral disease
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5
Q

What 3 things are normal when an individual has posterior pelvic pain?

A

Strength, sensory and reflexes

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6
Q

3 PE findings that would warrant referred for further evaluation?

A

Severe debilitating pain
Increased pain with bearing down actions
Neuro deficits

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7
Q

2 causes of radicular pain and what is a big time sign/symptom?

A

Herniated and bulging disc

Lightning pains

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8
Q

7 risk factors for LBP during pregnancy?

A 
Previous back problems
Smoking
Age
Strenuous work
Menstrual pain
Multiparity
High BMI
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9
Q

What does increased levels of estrogen, progesterone, and adrenal hormones promote in the pregnant lady?

A

Retention of fluid, so edema

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10
Q

What happens to SVR and CO during first trimester?

A

SVR decreases and CO increases

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11
Q

What does SVR and CO do during second trimester?

A

SVR continues to drop until mid second trimester

CO continues to rise

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12
Q

What happens to BP during third trimester?

A

Returns to pre pregnancy levels

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13
Q

What happens to CO, SV and HR in pregnancy during supine?

A

Drop in CO, drop in SV, increase HR

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14
Q

What trimester are most lymphatic stresses presenting and what 2 conditions most commonly present?

A

3rd trimester

Hemorrhoids and vulvar/lower extremity varicosities

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15
Q

What are the 3 veins to remember for abdominal/thoracic venous drainage?

A

Azygous, hemiazygous, and SVC

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16
Q

Essentially, what are the two congestion problems going on because of pregnancy?

A

There is an imbalance of more blood to the tissues than blood/fluid that can be drained.
CNS congestion causing HA, nausea, and light-headedness

17
Q

When is relaxin first elevated during pregnancy, how long does it stick around, and what is its function? Also, what type of patient will have higher levels of relaxin?

A

First trimester
Remains stable throughout pregnancy
Widening and mobility of SI joints and pubic symphysis
Women incapacitated by LBP

18
Q

2 big effects of progesterone as a hormonal stressor?

A

Increases thoracic cage volume

Promotes fluid retention

19
Q

3 indications for OMT in the OB patient?

A

SD
Scoliosis or structural condition
Edema/congestion

20
Q

2 relative contraindications for OMT in the PB patient?

A

Premature rupture of membranes

Premature labor

21
Q

7 absolute contraindication for OMT in the OB patient?

A 
Vaginal bleeding
Prolapsed umbilical cord
Placental abruption
Ectopic pregnancy
Placenta previa
Abortion
Preeclampsia/eclampsia
22
Q

What areas of the spine do we treat for hyperemesis gravidarum?

A

C2 and t5-9

23
Q

What 4 structural/postural changes do we usually find in the second trimester pregnant lady?

A

Forward torsions
Increased pelvic tilt
Increased lumbar lordosis
Compensatory increase in thoracic kyphosis

24
Q

What is a condition found in second trimester commonly and why?

A

Carpal tunnel because of the high edema

25
Q

it is ok to treat mom in the supine position through which trimester?

A

Second

26
Q

What GI condition is commonly presented in second trimester ladies and what do we treat to help?

A

Constipation

Pelvic diaphragm

27
Q

What do we avoid in the third trimester patient and why?

A

CV4 because it can induce uterine contractions

28
Q

What GI condition presents in third trimester?

A

GERD

29
Q

What do we evaluate during the last 4 weeks of pregnancy?

A

Pelvic diameters

30
Q

How big is the gap in a rupture of the pubic symphysis?

A

Greater than 1 cm

31
Q

When should the first and second post partum visits be for OMT?

A

First day of post partum and 4 weeks later

32
Q

ACOG recommends what about exercise and pregnant ladies?

A

30 minutes or more of moderate exercise each day

33
Q

2 big time relative contraindications for exercise with a pregnant patient?

A

IUGR

Cardiac arrhythmias

OS 4 Exam 1 (4 decks)

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