OB Patient Lecture Flashcards
3 factors that influence SD in pregnant patients?
Change in structure and biomechanics
Bloody fluid circulation
Hormonal changes
How does pregnancy effect scoliosis, RA, and ankylosis spondylitis?
Curves don’t increase
Improve
Makes worse
4 major bio mechanical changes during pregnancy?
Increased lumbar lordosis, forward flexion of neck, downward movement of shoulders, and anterior tilt of pelvis
5 main causes of mechanical stress low back pain?
Postural changes Muscle weakness Excessive CT stretching and micro trauma Posterior pelvic pain Visceral disease
What 3 things are normal when an individual has posterior pelvic pain?
Strength, sensory and reflexes
3 PE findings that would warrant referred for further evaluation?
Severe debilitating pain
Increased pain with bearing down actions
Neuro deficits
2 causes of radicular pain and what is a big time sign/symptom?
Herniated and bulging disc
Lightning pains
7 risk factors for LBP during pregnancy?
Previous back problems Smoking Age Strenuous work Menstrual pain Multiparity High BMI
What does increased levels of estrogen, progesterone, and adrenal hormones promote in the pregnant lady?
Retention of fluid, so edema
What happens to SVR and CO during first trimester?
SVR decreases and CO increases
What does SVR and CO do during second trimester?
SVR continues to drop until mid second trimester
CO continues to rise
What happens to BP during third trimester?
Returns to pre pregnancy levels
What happens to CO, SV and HR in pregnancy during supine?
Drop in CO, drop in SV, increase HR
What trimester are most lymphatic stresses presenting and what 2 conditions most commonly present?
3rd trimester
Hemorrhoids and vulvar/lower extremity varicosities
What are the 3 veins to remember for abdominal/thoracic venous drainage?
Azygous, hemiazygous, and SVC
Essentially, what are the two congestion problems going on because of pregnancy?
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
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?
First trimester
Remains stable throughout pregnancy
Widening and mobility of SI joints and pubic symphysis
Women incapacitated by LBP
2 big effects of progesterone as a hormonal stressor?
Increases thoracic cage volume
Promotes fluid retention
3 indications for OMT in the OB patient?
SD
Scoliosis or structural condition
Edema/congestion
2 relative contraindications for OMT in the PB patient?
Premature rupture of membranes
Premature labor
7 absolute contraindication for OMT in the OB patient?
Vaginal bleeding Prolapsed umbilical cord Placental abruption Ectopic pregnancy Placenta previa Abortion Preeclampsia/eclampsia
What areas of the spine do we treat for hyperemesis gravidarum?
C2 and t5-9
What 4 structural/postural changes do we usually find in the second trimester pregnant lady?
Forward torsions
Increased pelvic tilt
Increased lumbar lordosis
Compensatory increase in thoracic kyphosis
What is a condition found in second trimester commonly and why?
Carpal tunnel because of the high edema
