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A: pediatrics > Pediatric Pelvic Health - Guest Lecture > Flashcards

Pediatric Pelvic Health - Guest Lecture Flashcards

1
Q

When does coordination of bladder and urinary sphincters occur around

A

2 years old

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2
Q

When do signs of bladder sensation appear around

A

18 months

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3
Q

When should. A kid be able to fully empty their bladder

A

3 year old

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4
Q

What is the median age of day dryness

A

3.5 years

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5
Q

When should night time dryness happen

A

~ 6 months after dry days

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6
Q

infants initially void every ____. Voiding never happens during quiet sleep, but they urinate as they wake up.

A

Hour

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7
Q

What are potty training readiness signs

A
  • have bowel movement same time each day
  • no bowel movements at night
  • dry diaper after nap
  • dry diaper for at least 2 hours at a time
  • they are squatting and climbing
  • able to pull pants down
  • emotional readiness
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8
Q

Define urinary incontinence

A

Involuntary leaks of urine during day time

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9
Q

Define fecal incontinence

A

Involuntary leaks of stool

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10
Q

Define enuresis

A

Night time urine leaks

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11
Q

Define encopresis

A

Pooping at inappraote times and places

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12
Q

What is the number 1 cause of bed wetting

A

Constipation

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13
Q

What is the ROME 3 criteria for constipation

A
  • straining 25% of the time
  • lumpy of hard stool > 25% of time
  • fewer than 3 defecations per week
  • no loose stools without laxative
  • manual facilitation of defecation 25% of time
  • sensation of incomplete emptying
  • 2 or more fro > 3 months
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14
Q

What are u clinically looking for also for constipation

A
  • loose stools
  • fecal incontinence
  • bedwetting/urine leaks
  • > 3 bowels movements in a day or < 3 per week
  • withholding
  • child will only go in pull ip or in standing
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15
Q

What is primary incontinence vs secondary incontinence

A

Primary: nerver completely potty traiing

Secondary : dry for at least 6 months then regress

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16
Q

If a patient has nocturnal enuresis when are we able to help

A

If night time dryness doesn’t follow 6 months after day time dryness

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17
Q

When should u consider nocturnal enuresis

A

After age 5

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18
Q

When would voiding be a red or yellow flag

A

Infrequent ( <5x) or too frequent (> 8x)

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19
Q

T/F: giggle incontinence anf incontinence when starting playing sports is normal

A

F

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20
Q

why does rolling matter for development purposes

A

obliques are needed to bear down

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21
Q

why does crawling matter for development purposes

A

Builds scapular stability for stacking and shapes diaphragm and develops pelvic floor

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22
Q

why does standing matter for development purposes

A

Balcane reaction, stability , coordination

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23
Q

why does walking matter for development purposes

A

Need mature walking pattern to contract/relax pelvic floor

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24
Q

why does frog squat matter for development purposes

A

Need for hip range of motion

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25
What kind of **pelvic tilt** is needed for **puborectalis alignment**
Anterior pelvic tilt
26
Do PF or DF activate the pelvic floor
PF
27
What helps activate the **ascending and descending colon**
Activating psoas and trunk rotation
28
What are some **global coordination** u can assess
* does teh child cross midline * is jumping take off and landing symmetric * can they isolate movements * jumping jacks
29
What is the potty posture
1. Feet on stable surface and flat 2. Knees above hips 3. Elbows on knees (lean forward 35°) 4. Sit tall and breathe
30
For voiding what do u need to contract and relax
Involuntary detrusor contraction and relaxing sphincter coordination
31
**Rest and digest** requires ___ activation
Parasympathetic
32
What reflex tells the body if it is **gas or stool**
Automatic relax
33
What do u need **intacted for defecation**
Internal and external sphincters
34
What needs to be **activated and relaxed to defecate**
Abdominal activiation and PFM relaxation
35
What should be the bowel routine
* sit on potty after a meal daily —> use reflex loops to set the body ip for success * first start with just sitting and doing activity like blowing bubbles to create safe environments and decrease fear of pooping * once safe start to ask pateint for pushing while sitting
36
What is the voiding routine
* pair with time do day so easy to remember or use potty watch * scheduled voides every 2-3 hours (if voding every 4-6 hours high risk for UTI) * need to retain bran and bladder connection
37
What can to do to **increase colonic activity**
* IUL massage * potty posture * diaphragm scooping * sensory E stim 20 min a day x 4 weeks * stretch pelvic floor after theses for 5-10 mins
38
For healthy bowel and bladder health, the pelvic floor needs to be able to:
* contract and shorten * relax at rest for slight mobility with breathing - specifically inhalation * lengthen and open to allow stool or urine to pass through and exit the body
39
What should u do if a **pelvic floor** is **short , tense and immobile**
* stretch daily ( child pose , frog squat , duck walks) * deep breathing practice * pair with calm activity
40
What should u do if a **pelvic floor** is **weak and lengthened**
* long sit on wedge * adductor activation has overflow to PFM * balance SLS
41
When should **diastasis recti close**
Between ages 1-3
42
When can a **diastasis recti stay open**
With chronic constipation, bloating or poor posture
43
What is the **treatment** for **diastasis recti**
* upper and lower abdominals * TrA * obliques * functional * soft tissues restrictions
44
What is a rib flair or wide rib angle
> 90°
45
Where should u **start** with **diastasis recti**
Postiotns where u are stabilizing the scapula and there is not rib movement , coning or doming
46
How to **progress treatment for diastasis recti**
Upper abs > lower > obliques ** ensure TrA activation thruought
47
What is the **goal** for **pelvic floor coordination**
* pelvic floor relaxation with inhale and contraction with exhale * pelvic floor relaxation with both voding and defection
48
How to work **pelvic floor coordination**
* tall kneeling up and down * squats * breathing work
49
What is the **prime component** of keeping **poop soft**
Water
50
What are **bladder irritants** (6)
* milk * tomatoes * chocolate * caffeine * citrus * carbonation
51
What are the **top constipating foods** (5) *
* banana * applesauce * cheese * milk * tapioca
52
When is night time incontinence a thing
After age of 5
53
Define enuresis
Involuntary peeing at night
54
Is there a genetic cause with bedwetting
Yeah
55
What do u need to **rule out** with **bed wetting**
* constipation * sleep apnea * diabetes * genetic * chronic kidney disease
56
What do u key in on examination with **bed wetting**
* coordination * airway * constipation
57
What are some tips for patents if their kid bed wets
1. Eliminate bladder irritants at dinner , especially milk 2. No liquids 2 hours before bed 3. Calming activity and pee before bed
58
How long is a full bladder voiding
> 8 seconds
59
How long should u be able to go before having to void again
2-3 hours
60
What are tips for pateints if their kid has an over active bladder
1. Potty watch timer 2. List of acitvities when need to pee to distract for a few more minutes 3. Limit bladder irritants
61
What **diagnosis** are at increased **risk** from **bowel and bladder challenges** (7)
* Autism * ADHD * neuro deficits * sensory processing disorder * low tone * high tone * obesity
62

A: pediatrics (38 decks)

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