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os Fall Midterm II > Osteopathic Considerations in Genitourinary Pt > Flashcards

Osteopathic Considerations in Genitourinary Pt Flashcards

1
Q

Functional disorders of the GU pt involve?

A
  1. Poor Posture

2. Compromised body mechanics

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2
Q

Flex posture can lead to…?

A

Increased abdominal pressure => pressure on:
liver
Kidney
Renal Fat pad compromised

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3
Q

What can Renal fat pad compromise cause?

A
  1. Passive congestion
  2. Hydronephrosis
  3. Urinary Stasis/Stones
  4. kinked ureters
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4
Q

Vertebral levels of kidney?

A

T-12 to L3

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5
Q

What kidney is lower?

A

Right

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6
Q

Are kidneys retroperitoneal?

A

yes

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7
Q

Do adrenals contact diaphragm?

A

yes, on superior surface

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8
Q

Medial border of kidney contacts?

A

The psoas

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9
Q

Lymphatics of kidney rely heavily on optimal function of?

A

Diaphragm

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10
Q

diaphragmatic dysfunction causes?

A
  1. Lower thoracics
  2. Ribs
  3. Quadratus lumborum spasm
  4. Hyperlordosis of lumbar spine
  5. Phrenic nerve dysfunction (C3-5)
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11
Q

Fascia surrounds kidney except what pole?

A

Inferior pole

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12
Q

R. Kidney:
Ant. surface covered by?
What else contacts?

A
  1. Liver

2. Descending Duodenum

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13
Q

L. Kidney:

Ant. Surface covered by?

A
  1. Stomach, spleen, colon, jejunum
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14
Q

Kidney is also involved in?

A

RBC production

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15
Q

ureter crosses what fascia and nerve?

A
  1. Psoas (spasm can lead to problems)

2. Genitofemoral nerve

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16
Q

Male urethra, 3 parts

A
  1. Prostatic part
  2. Pars Membranacea
  3. Pars Spongiosa
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17
Q

Sphinter, trigone and urethral orifice are activated by?

Inhb by?

A
  1. Sympathetics (T-12-L2)

2. Parasymp (S2-3)

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18
Q

Bladder wall activation by?

A

Parasympathetics

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19
Q

What controls flow of blood to kidneys?

A

Celiac plexus: symp fibers to renal A.

20
Q

Pain from kidney stones goes to what V. levels and what plexus?

A
  1. T10 to L1

2. Ureteric Plexus

21
Q

Kidney and upper ureter at what V. Levels and where is synapse?

A
  1. T10 - L1

2. Sup. Mesenteric ganglion

22
Q

Where do fibers for lower ureter and bladder synapse?

A
  1. T12-L2

2. Inf. Mesenteric Ganglion

23
Q

What controls micturation (urination)?

A

Parasymp: Pelvic Splanchnic S2-S4

24
Q

What causes urine retention?

A

Sympathetics: Hypogastric plexus T10-L2

-Alpha adrenergic => relaxes detrusor

B2 => Closes Internal urethral sphincter

25
Q

What do pudendal nerves control?

A

At s2-4

Voluntary urination: External urethral sphincter

26
Q

2 Central pathways to control micturition?

A
  1. Corticopontine=mesencephalic
    - Frontal lobe inhb of parasympathetics
  2. Pontine mesencephalic sacral
    - Coordinates detrusor and sphincter interaction
  3. Pelvic and pudendal nuclei
    - mediates sacral parasymp reflex
27
Q

Inj. above pontine center =>?

A

Hyperreflexive bladder

28
Q

Inj. Below pontine center =>?

A

Detrusor/sphincter contraction

-Sphincter dyssynergia

29
Q

Inj. of pelvic and pudendal nuclei

A

Areflexic bladder and urinary retention

30
Q

Parasymp of kidney and prox. ureter?

A

Vagus

31
Q

Parasymp of distal ureter and bladder?

A

Pelvic splanchnic nerves (S2-4)

32
Q

Lymphatics of Renal capsule and parenchyma?

A

Preaortic nodes

33
Q

Lymphatics help the kidney do what?

A

Concentrate urine

34
Q

Increased lymphatic congestion =>

A

decrease flow btw plasma and interstitium

35
Q

Treatment approach Postural considerations: Diaphragm massages kidneys at?

A

L1-L3

36
Q

Treatment approach Postural considerations: Psoas can decrease ___ and ___ kidneys from flexed posture?

A
  1. Lordosis

2. Compress

37
Q

Treatment approach Postural considerations: Also consider ___ ___ in post wall of soma?

A
  1. Lower ribs

2. Quadratus lumborum

38
Q

If you have a sympathetic urological problem what do you do?

A

TX T10-L2

  • Reduce HPT
  • Complet emptying
  • Reduce ureterospasms

TX C2-C3 (Sup cervical ganglion

Deals w/ Inf. Mesenteric ganglion

Perform rib raising

39
Q

TX for Lymphatics causing dysfunction?

A
  1. Open thoracic inlet and diaphragm

2. Rib raising and lymph pump

40
Q

Tx. Parasymp problem?

A

OA/AA (Vagus)

OM Suture

Sacrum/pelvis
-S2-S4 for pelvic splanchnic

41
Q

BPH dysfunctions found at?

A

T11-L1

42
Q

Nephrolithiasis: Pain found where?

A

Prox = flank/costovertebral

Distal= groin, testicle, labia

43
Q

How to preven Nephrolithiasis?

A

Hydration/diet

44
Q

Nephrolithiasis: Common areas of dysfunction?

A
  1. T12-L2

2. S2-4

45
Q

Pyelonephritis?

A

Same as Nephrolithiasis

os Fall Midterm II (6 decks)

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