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Second Developmental Exam > Pelvic Floor Through Life > Flashcards

Pelvic Floor Through Life Flashcards

1
Q

What is endometriosis?

A
  • Endometrial tissue grows outside uterus
  • Commonly in ovaries, fallopian tubes, connective tissue, vagina, cervix, bowel, rectum, and bladder
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2
Q

Endometriosis affects more than ___% of American women between 15 and 44, and is most common in woman aged ___ to ___

A

11%
Aged 30-40

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3
Q

What are common symptoms of endometriosis?

A

Pain
Bleeding & spotting
Infertility
Digestive disturbances

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4
Q

What are risk factors for endometriosis?

A
  • nulliparous
  • menstrual periods >7 days
  • menstrual cycles < 27 days
  • family history
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5
Q

What is primary dysmenorrhea? What are risk factors?

A
  • Most common type of dysmenorrhea
  • Pain is usually caused by contractions of the uterus (womb). The uterus contracts during menstruation to help the uterine lining leave the body. Teens may get dysmenorrhea soon after they get their first period. For most women, primary dysmenorrhea gets less painful as they get older. But some women get severe menstrual pain.
  • RiskFactors: menarche began before11, Long/heavy periods, Smoking, Stress
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6
Q

What is Secondary dysmenorrhea?

A

Caused by associated medical condition like:
- Endometriosis- In response to monthly changes in estrogen, the lining breaks down and bleeds outside of the uterus and can cause swelling and pain.
- Uterine fibroids are tumors that grow in or on the wall of the uterus (almost always benign)
- Ovarian cysts: usually don’t cause symptoms other than pain during your period or at ovulation.

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7
Q

What is Interstitial Cystitis/Painful bladder Syndrome?

A

Chronic pain that affects the bladder, and sometimes the pelvis and genitals
• Affects 3-8 million women in the US
• May affect white women more than other racial or ethnic groups
• Symptoms: pain, urinary frequency, bladder pressure, dyspareunia, dysuria, hematuria
• Differential diagnosis includes chronic urinary tract infection

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8
Q

What is Chronic Pelvic Pain Syndrome (CPPS) in Men?

A

Persistent pain in the perineal or genital region without evidence of bacterial infection
• Usually effects young men (mean age of 43)
• Prevalence is 2-16% in the US
• Symptoms: abdominal pain, frequent urination, ED, post- ejaculator, penile pain, testicular pain
• Comprises the most common form (up to 90%) of ‘prostatitis” cases
• Typically caused by hypertonicity and/or nerve irritation

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9
Q

What is Pudendal Neuralgia?

A
  • Chronic pain due to injury of pudendal n. (S2-S4)
  • typically caused by stretch/compression (ex. Forceps delivery, chronic straining, weightlifting, biking, prolonged sitting, hypertonic pelvic floor, pelvic girdle instability)
  • symptoms: shooting, stabbing, and burning pain and tenesmus
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10
Q

What is Persistent Genital Arousal Disorder (PGAD)?

A

Unwanted sensation of genital arousal that is not resolved with orgasm
• Symptoms: throbbing, tingling, pain, tension, or irritation in the genitals with or without spontaneous orgasm
• It’s generally caused by irritation of the dorsal branch of the pudendal nerve via compression or overstretch including by Tarlov cysts
• Reported in up to 4% of the population, although likely under-reported
• Reported in women more often than men

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11
Q

What is Vulvodynia & vestibulodynia?

A

• Vulvodynia: persistent, idiopathic vulvar pain. It can be in all areas of the vulva or localized to certain structures only, such as the clitoris, urthera, or vestibule.
• Vestibulodynia is idiopathic pain at the vestibule. It’s the most common form of vulvodynia.
• Mostly affects vulva-owners between age 20-60.

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12
Q

What is vaginismus (lavator ani syndrome)?

A

Muscles around the opening of the vagina and surrounding involuntarily contract/tighten, making insertion painful if not impossible.
• Impacts mostly 18-35 year-old vagina owners

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13
Q

What are some pregnancy-related MSK changes?

A
  • chin pushing forward
  • eyes focused down
  • slouching constricts rib cage so breathing more difficult and causes indigestion
  • slack muscles ollow out the back and tilts pelvis forward causing backache, strained abs, and excess pressure on bladder
  • knees pressed back so strain joints and push pelvis forward
  • weight on inner borders so strain foot arch and calves causing leg aches
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14
Q

What is Daistasis Rectus Abdominis

A

Separation and thinning of the rectus abdominus muscles and stretching of the linea alba by > 2 inches
• Prevalence: 33.1%, 60.0%, 45.4%, and 32.6% at gestation wk 21, 6 wks, 6 mo and 12 mo post partum

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15
Q

What is pregnancy-related pelvis girdle pain?

A

Specific form of LBP
• Affects the lumbo-sacral junction, SIJ, coccyx, and symphysis pubis
• Prevalence= 20% of pregnant women

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16
Q

What are symptoms of pelvic girdle pain?

A

• Pain with walking & running
• Pain with single leg WB activities (i.e.: dressing, stairs, lunges)
• Pain with bed mobility
• Pain with straddle movements
• Pain with lifting, bending, pushing, pulling
• Feeling “unstable” in pelvis
• Decreased tolerance to sit, stand, walk

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17
Q

What are signs of pelvic girdle pain?

A
  • Waddle gait pattern
  • Clicking/grinding in pubis area
  • Provoked pain with resisted ABD & ADD
  • Limited ABD AROM
18
Q

What are some high risk pregnancy conditions?

A

• Premature Rupture of Membranes
• Incompetent Cervix
• Placenta Previa
• Pregnancy Induced Hypertension
• Pre-eclampsia
• Gestational Diabetes
• Multiple Gestations
• Premature Labor
• Spinal Cord Injury

19
Q

What are pelvic floor dysfunctions? Examples? What causes this weakening?

A

Conditions that develop because of weakening of the support structures of the pelvic floor
• Examples: Pelvic organ prolapse, Stress urinary incontinence, Urge urinary incontinence or overactive bladder, Fecal incontinence or accidental bowel leakage

What causes that weakening to happen?
• Pregnancy/child birth
• Aging/menopause
• Genetics
• Obesity
• Smoking
• Chronic constipation
• Cancer treatment

20
Q

What is Pelvic Organ Prolapse?

A

• Weakening of the pelvic floor leads to the pelvic floor organs falling out the vagina
• This happens gradually. You won’t suddenly wake up one day with your uterus hanging out!
• This can occur in 1 in 3 women (~30%).

21
Q

What is Stress Urinary Incontinence?

A

• Support structures around urethra (tube that drains the bladder) are weakened.
• When you cough, sneeze, lift something heavy, or even just stand up, urine leaks out.
• This can occur in 1 in 3 women (~30%).

22
Q

What is Post Prostatectomy Urinary Incontinence?

A

• UI is not just a “woman’s disease”
• Treatment for prostate cancer is the leading cause of stress urinary incontinence in men
• Commonly caused by problems with nerves, the urinary sphincter, and obesity
• Urinary incontinence is associated with an increased risk of depression, sleep disruption, lost productivity in the workplace and sexual dysfunction.
• Incontinent men, compared with incontinent women, reported more restrictions on social activities, possibly because UI is considered more “normal” for women.

23
Q

What is an overactive bladder/urge incontinence?

A

• Affects up to 40% of men and 30% of women i
• The prevalence increases with age
• Sudden urge to urinate, sometimes followed by leaking
• Triggers include key in the door, running water, and seeing a toilet
• Occurs when the detrusor muscle contracts too often, and before the bladder is full

24
Q

What is the prostate?

A

•Size of walnut
• Produces fluid that makes up a part of semen
• Throughout a man’s lifetime the prostate normally increases in weight about 21 times, compared to its birth weight

25
Q

What is Benign Prostatic Hyperplasia (BPH)?

A

• BPH is benign enlargement of the prostate
• The enlargement of the prostate is believed to be due to decreasing levels of testosterone
• The risk of BPH increases with age
• 20% in 50s, 60% in 60s, 70% by 70
• The prostate grows inwards narrowing the urethra and decreasing urine flow
• BPH causes Lower Urinary Tract Symptoms (LUTS)- urgency/frequency (OAB), urge incontinence, nocturia, hesitancy, intermittent stream, dribbling, weak stream, urinary retention, chronic UTI

26
Q

What is accidental bowel leakage?

A

• Leakage of stool and/or gas
• Impacts men/women roughly the same, and
increases with age (15% of adults >70 report)

• Risk factors include:
• Vaginal delivery with Grade IV perineal tear
• Use of forceps or vacuum in Vaginal delivery
• Uncontrolled diabetes/dibetic neuropathy
• Radiation therapy
• Nervous system disorder (stroke, SCI, MS, etc)
• Severe chronic constipation
• Chronic diarrhea or IBD

27
Q

What is cervical cancer?

A

• Develops from the HPV virus in most cases
• 13,000 new cases and ~4,000 die annually
• Most frequently diagnosed between 35-44
• Hispanic women have the highest rates of developing cervical cancer, and Black women have the highest rates of dying
• Risk factors include- HIV, smoking, increased parity (>3), >5 years on oral contraceptive, and higher number of sexual partners

28
Q

What is Ovarian Cancer?

A

• Most common cancer of the female reproductive system
• Chance of developing in a lifetime is 1 in 78
• >1/2 of women diagnosed are > 63 yrs
• Affects White women most

29
Q

What are Ovarian Cancer risk factors?

A

• Are middle-aged or older
• Have close family members who have had
• Have a genetic mutation of BRCA1 or BRCA2, or one associated with Lynch syndrome
• Have had breast, uterine, or colorectal (colon) cancer
• Have Eastern European/Ashkenazi Jewish
background
• Have endometriosis
• Have never given birth or have had trouble getting pregnant

30
Q

What is Prostate Cancer?

A
  • Most common in older men and not likely to die from disease
  • RF: age, genetics, race
31
Q

What are symptoms of prostate cancer?

A
  • Difficulty starting urination
  • Weak or interrupted flow of urine
  • Frequent urination, especially at night
  • Difficulty emptying the bladder completely
  • Pain or burning during urination
  • Blood in the urine or semen
  • Persistent pain in the back, hips, or pelvis
  • Painful ejaculation
32
Q

What are Screening and Diagnostic Tests for Prostate Cancer?

A

Screening Tests
- Digital Rectal Exam (DRE): Size and tenderness of prostate, presence of lumps or nodules
- Prostate-specific antigen (PSA): PSA levels in the blood increase during prostate cancer

Diagnostic Tests
- Transrectal ultrasound Prostate biopsy

33
Q

What are 4 major cancer treatments?

A
  1. Surgery: remove cancer and surrounding tissues
  2. Radiation Therapy: Destroy cancer cells or prevent them from growing
  3. Hormone Therapy: Block sex hormones prevent cancer cells from growing
  4. Chemotherapy: Use special drugs to shrink or kill the cancer
34
Q

What is Genitourinary Syndrome of Menopause (GSM)?

A

collection of symptoms that can occur in women who are menopausal. It’s caused by decreased estrogen production and can affect the vulvovaginal area and lower urinary tract.

35
Q

What is Lichens Sclerosis?

A
  • chronic inflammatory autoimmune skin condition usually found in the genital region
  • impacts post-menopausal females more than any other population
  • Redness, itching, burning, discomfort or pain, smooth white patches, blotchy, wrinkled patches, tearing or bleeding
36
Q

What are recurrent UTIs?

A
  • 2+ infections in 6 months or 3+ in 1 year
  • Characterized by dysuria, urinary frequency, and hesitancy
  • Risk factors: Frequent intercourse, estrogen deficiency, pelvic organ prolapse, incomplete bladder emptying, urinary and fecal incontinence, and DM2
  • Due to estrogen changes recurrent UTI is more common in postmenopausal women
37
Q

What is Male “Menopause”?

A

Decreasing testosterone levels or a reduction of bioavailability of testosterone with aging (hypogonadism)

38
Q

What are sexual symptoms of male menopause?

A

• decreased libido
• decreased erections
• retarded ejaculation

39
Q

What are psychological symptoms of male menopause?

A

• loss of energy
• decreased concentration
• decreased well being
• irritability, depression
• insomnia, changes in sleep pattern

40
Q

What are physical symptoms of male menopause?

A

• decrease muscle mass
• increase visceral fat
• decrease bone mass
• decrease body hair
• hot flushes, tachycardia
• Swollen or tender breasts (gynaecomastia)

41
Q

What is constipation?

A

• Types of constipation include slow transit, obstructed defecation, and dyssynergic defecation
• Women suffer significantly more often than men (19.7% versus 10.6%, p < 0.001).
• Chronic constipation impacts 1-8% of North Americans

Second Developmental Exam (5 decks)

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