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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
What do pudendal nerves control?
At s2-4 Voluntary urination: External urethral sphincter
26
2 Central pathways to control micturition?
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
Inj. above pontine center =>?
Hyperreflexive bladder
28
Inj. Below pontine center =>?
Detrusor/sphincter contraction | -Sphincter dyssynergia
29
Inj. of pelvic and pudendal nuclei
Areflexic bladder and urinary retention
30
Parasymp of kidney and prox. ureter?
Vagus
31
Parasymp of distal ureter and bladder?
Pelvic splanchnic nerves (S2-4)
32
Lymphatics of Renal capsule and parenchyma?
Preaortic nodes
33
Lymphatics help the kidney do what?
Concentrate urine
34
Increased lymphatic congestion =>
decrease flow btw plasma and interstitium
35
Treatment approach Postural considerations: Diaphragm massages kidneys at?
L1-L3
36
Treatment approach Postural considerations: Psoas can decrease ___ and ___ kidneys from flexed posture?
1. Lordosis | 2. Compress
37
Treatment approach Postural considerations: Also consider ___ ___ in post wall of soma?
1. Lower ribs | 2. Quadratus lumborum
38
If you have a sympathetic urological problem what do you do?
TX T10-L2 - Reduce HPT - Complet emptying - Reduce ureterospasms TX C2-C3 (Sup cervical ganglion Deals w/ Inf. Mesenteric ganglion Perform rib raising
39
TX for Lymphatics causing dysfunction?
1. Open thoracic inlet and diaphragm | 2. Rib raising and lymph pump
40
Tx. Parasymp problem?
OA/AA (Vagus) OM Suture Sacrum/pelvis -S2-S4 for pelvic splanchnic
41
BPH dysfunctions found at?
T11-L1
42
Nephrolithiasis: Pain found where?
Prox = flank/costovertebral Distal= groin, testicle, labia
43
How to preven Nephrolithiasis?
Hydration/diet
44
Nephrolithiasis: Common areas of dysfunction?
1. T12-L2 | 2. S2-4
45
Pyelonephritis?
Same as Nephrolithiasis

os Fall Midterm II (6 decks)

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