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OMM II > OMM in Prego > Flashcards

OMM in Prego Flashcards

1
Q

What is the role of OMT in the treatment of pain in labor? How does it change the length of labor?

A

Reduces x2

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2
Q

What are the goals of OMT for the prego? (5)

A
  • Prevent complications by increasing homeostasis
  • Increase respiratory excursion
  • Venous return
  • allow easy delivery
  • Decreased discomfort
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3
Q

What is the cause of the mechanical stress that is added by pregnancy?

A

Change center of gravity

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4
Q

What are the physiological changes with pregnancy?

A

Increased fluids

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5
Q

What happens to the venous/lymphatic return with prego?

A

Decreased efficacy of lymphatic d/t changes in mechanics

Venous congestion of the CNS

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6
Q

What do hormones do to venous and lymphatic return?

A

Decrease

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7
Q

What fraction of pregos experience LBP with prego?

A

more than half

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8
Q

What are the risk factors for the development of LBP in prego? (3)

A

Heavy labor
Smoking
h/o LBP

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9
Q

Where does pain from LBP radiate to with LBP?

A

Thighs, but not legs

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10
Q

True or false: Most women who complain of LBP in pregnancy continue to have pain postpartum

A

True

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11
Q

What happens to the risk of sciatica with each subsequent pregnancy?

A

Increases

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12
Q

What are the things that aggravate LBP?

A

Prolonged standing and walking

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13
Q

What causes the LBP with prego? (per Osteopaths)

A

Thought is that untreated SDs that are exacerbated from prego

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14
Q

What causes the improvement of symptoms of RA with pregnancy? (2)

A
  • Increased cortisol secretion

- Increased alpha-glycoprotein in the maternal serum that decrease inflammation

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15
Q

What happens to ankylosing spondylitis with pregnancy?

A

Aggravated because of increased stress on the SI joint

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16
Q

What happens to the spinal curves with pregnancy? Why?

A

Compensation of anterior pelvic tilt causes an increased lumbar lordosis

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17
Q

Is there an increased rupture of lumbar discs with pregnancy?

A

No

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18
Q

What is the more common cause of radicular symptoms in prego?

A

Direct pressure on the nerve root or lumbar plexus by the uterus

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19
Q

What happens to the paraspinal muscles posteriorly with pregnancy?

A

Shorten

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20
Q

What is the most common muscle in the back that is affected with pregnancy?

A

Psoas

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21
Q

True or false: the psoas supports the growing fetus

A

True

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22
Q

What is the cause of sacroiliitis?

A

Excessive connective tissue stretch and microtrauma from the anterior pelvic tilt

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23
Q

Posterior pelvic pain often radiates where? Where should it NOT radiate to?

A

Below the knee, but NOT into the ankle or foot

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24
Q

How do you differentiate pelvic pain radiation in pregnancy from sciatica?

A

neuro exam normal with normal prego pelvic pain

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25
Q

What is the effect of scoliosis on pregnancy? Why?

A

If curvature is greater than 25 degrees, then increases chances of a premature birth d/t increased relaxin secretion

26
Q

The apex of the baby’s skull affects what joint motions in the mother?

A

pelvis and sacral

27
Q

What causes the plantar surface of the foot change with pregnancy?

A

Increased weight

28
Q

Why muscle fatigue with prego?

A

Moving more weight

29
Q

What causes the increased rib dysfunction with pregnancy?

A

increased breast weight

30
Q

What causes the increased incidence of HA with prego?

A

Decreased venous drainage

31
Q

What are the goals of OMM to the pelvis with pregnancy?

A

Increase circulation to pelvis to meet the metabolic needs of fetal development

32
Q

Back pain at night after lying in pregnancy?

A

Changes in osmotic forces

33
Q

What is the most important OMT treatment for prego women?

A

Address venous and lymphatics

34
Q

What causes hemorrhoids/varicosities with pregnancy?

A

Sluggish venous return

35
Q

What causes CNS congestion with prego?

A

Reversal of venous flow into vertebral and spinal membranes

36
Q

What is the name of the venous plexus that is contained within the spine? What is its drainage dependent on?

A
  • Valveless venous vertebral plexus

- Drainage dependent upon the testing pressure within the thorax and abdomen

37
Q

What is the effect of relaxin?

A

Increases the mobility of the SI joint and symphysis pubis AND increased laxity of the ligaments of the pelvis

38
Q

What structure secretes relaxin in pregnancy?

A

Corpus luteum

39
Q

What happens to the levels of relaxin throughout pregnancy?

A

Increased in 1st trimester, then decreases

40
Q

What structures produce progesterone in the 2nd and 3rd trimester?

41
Q

What is the effect of progesterone on fluid levels?

A

Increases retention

42
Q

What increases the tidal volume in pregnant women?

A

Changes in the thoracic cage and increased relaxin and progesterone levels

43
Q

What are the spinal SNS levels for the uterus?

44
Q

What is the parasympathetic innervation to the uterus?

45
Q

What causes the sacroiliitis with pregnancy?

A

Laxity produced by relaxin placing extra strain on the SI joints

46
Q

What are the areas to treat for hyperemesis gravidarum?

A

C2 and T5-T9

47
Q

What is the sacral dysfunction that is caused by birthing? Why?

A

BST

Flexion of the back

48
Q

What are the three stages of pregnancy prior to labor and delivery? When does each occur?

A
  1. Structural stage (1-28 wks)
  2. Congestive stage (28-36)
  3. Preparatory stage (36-delivery)
49
Q

What should be done in the structural stage (1-12 weeks) of pregnancy? What sort of OMM techniques are appropriate?

A

H and P
Address SDs

Any treatment style is appropriate

50
Q

What are the structural changes in the 12-28 weeks? (3)

A
  • anterior pelvic tilt
  • Increased lumbar lordosis
  • Compensatory thoracic kyphosis and cervical suboccipital strain
51
Q

What is the main goal of OMM treatment for the congestive stage of pregnancy?

A

Restoring motion of the diaphragms

52
Q

True or false: any treatment style is appropriate for the congestive stage

53
Q

What OMM motion should be optimized during the prep stage?

A

Craniosacral motion

54
Q

OMM for labor and delivery?

A
  • thoracic and lumbar spine
  • innominates
  • restrictions of the SI joint
55
Q

True or false: any treatment style is appropriate for the labor and delivery stage

A

False–aggressive styles are not well tolerated

56
Q

True or false: isolytic correction of the pubic bone during labor/deliver stage is NOT appropriate

57
Q

What area should be focused on in the recovery stage (postpartum stage)

A

SI joint

Sacrum

58
Q

True or false: smoking is a risk factor for the development of LBP in pregnancy

59
Q

True or false: race is a risk factor for the development of LBP i pregnancy

A

False– is not

60
Q

True or false: multiparous women generally complain more often of LBP

A

False–less

61
Q

What happens to the following in pregnancy:

  • Chest circumference
  • Subcostal angle
  • Diaphragm
A
  • Increased chest circumference
  • Increase subcostal angle
  • Diaphragm push superiorly 4 cm, but increases in excursion
62
Q

What is the OMT treatment that should be considered if labor is not progressing (prior to starting oxytocin)?

A

Thoracolumbar stimulation

OMM II (43 decks)

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