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MSK IV > Pelvic Health > Flashcards

Pelvic Health Flashcards

1
Q

True or false: Pelvic Health includes muscles, viscera, nerves, joints, emotions, nutrition, hormones, fascia, and lymph.

A

True

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2
Q

True or false: The pudendal nerve only has sensory components.

A

False; motor and sensory

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3
Q

True or false: Pudendal nerve is the only peripheral nerve to have autonomic and somatic fibers.

A

True

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4
Q

What are the 5 S’s of the pelvic floor muscles?

A

Sphincteric
Supportive
Sexual
Stabilization
Sump Pump

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5
Q

Voluntary Skeletal Muscles are:

65% slow twitch fibers & 35% fast twitch fibers
70% slow twitch fibers & 30% fast twitch fibers
35% slow twitch fibers & 65% fast twitch fibers
30% slow twitch fibers & 70% fast twitch fibers

A

65% slow twitch fibers & 35% fast twitch fibers

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6
Q

The first layer of the pelvic floor includes what 6 structures?

A

Superficial Transverse Perineal
Bulbospongiosus
Ischiocavernosus
Perineal Body
External Anal Sphincter
Pudendal n.

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7
Q

The second layer of the pelvic floor includes what?

A

Urogenital diaphragm

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8
Q

The third layer of the pelvic floor includes what 5 structures?

A

Puborectalis/Pubovaginalis
Pubococcygeus
Iliococcygeus
Obturator Internus
Coccygeus

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9
Q

A droopy pelvic floor is ______active, ______, and _______.

A

Underactive, hypotonic, inhibited

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10
Q

A taut pelvic floor is ______active, and _______.

A

Overactive, taut

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11
Q

Risk factors for pelvic floor dysfunction are Surgery, trauma, hormonal, pregnancy/childbirth, central sensitization/Psychophysiological disorder, & ________________.

A

Aging

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12
Q

Why might we assess the abdominal canister for someone with pelvic dysfunction?

A

To see how well they can access their diaphragm and breathe. Also to look for scars, tension, contraction and relaxation.

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13
Q

Pelvic Floor muscle local assessment is done by biofeedback, manual, and which of the following:

MRI
Xray
Real Time Ultrasound

A

Real time ultrasound

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14
Q

Which of the following is not a Contraindication for Internal Assessment:

Lack of consent
Active infection
Post-op (<6-12wks)
Pediatric pt or pt w/o previous pelvic exam
Severe Vaginitis/vaginal atrophy
Third trimester of pregnancy
Severe pain/allodynia
First trimester of pregnancy

A

Third Trimester of pregnancy

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15
Q

Fill in the blank:
Internal Manual Local Assessment involves:
M______ F_______
P________
C_________ T_____
N____

A

Muscle Function
Palpation
Connective Tissue
Nerve

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16
Q

Using the Modified Oxford Scale for the Pelvic Floor, a person scores what on a scale from 0-5 if they have full motion against gravity?

A

3

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17
Q

Using the Modified Oxford Scale for the Pelvic Floor, a person scores what on a scale from 0-5 if they have no active contraction?

A

0

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18
Q

Using the Modified Oxford Scale for the Pelvic Floor, a person scores what on a scale from 0-5 if they have full motion against strong resistance?

A

5

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19
Q

Parasympathetic of Urination involves what nerve roots and what plexus?

A

S2-S4, Pelvic Plexus

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20
Q

Sympathetic of Urination involves what nerve roots and what plexus?

A

T10-L2; Hypogastric Plexus

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21
Q

Somatic of Urination involves what nerve roots and what plexus?

A

S2-S4; Pudendal

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22
Q

Parasympathetic is the ______ phase and Sympathetic is the _______ phase.

A

Storage; Emptying

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23
Q

During the storage phase the Cerebral Cortex says it is not time to go, the Pons inhibits the cortex, the Hypogastric n T10-L2 inhibits the ______ and stimulates the _____ ______, while the pelvic nerve is quiet and the pudendal nerve stimulates the external sphincter.

A

Detrusor, internal sphincter

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24
Q

Using the Modified Oxford Scale for the Pelvic Floor, a person scores what on a scale from 0-5 if they have a trace or a “flicker”?

A

1

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25
Q

During the emptying phase the cerebral cortex says it’s good to go, the Pons stimulates the pelvic nerve center, the Hypogastric nerve is ______, the Pelvic Nerve stimulates the _________ contraction, and the pudendal nerve relaxes the external sphincter.

A

quiet; detrusor

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26
Q

Using the Modified Oxford Scale for the Pelvic Floor, a person scores what on a scale from 0-5 if they a very slight or weak contraction?

A

2

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27
Q

Using the Modified Oxford Scale for the Pelvic Floor, a person scores what on a scale from 0-5 if they have full motion against slight resistance?

A

4

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28
Q

“Normal” bladder function is voiding every __-__ hours or __-__ times a day and ___time(s) a night.

A

2-4; 5-8; 1

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29
Q

“Normal” bladder function is having no: ________, __________, or _____ for storing or for emptying.

A

pushing, hesitation, pain

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30
Q

Abnormal bladder function is:

Hesitation
Post void dribble
Difficulty delaying urge
Discomfort/pain
Leakage
_________ peeing

A

Staccato

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31
Q

What are 4 Bladder habits to avoid:

A

Just in case peeing (JICCING)
Hovering
Self Dehydrating
Power Peeing

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32
Q

Voiding dysfunction, pelvic organ prolapse, incomplete emptying, urinary urgency/frequency, urinary incontinence, Dysuria, and Painful Bladder Syndrome are all bladder issues with an overactive or underactive pelvic floor?

A

overactive

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33
Q

List the 7 Red Flags for pelvic dysfunction.

H________
P________ UTI
C________ Symptoms
Poor R_____ Function
S____ Anaesthesia
R______ B___ T_____
N____ P____

A

Hematuria
Persistent UTI
Constitutional Sx (malaise, fever)
Poor renal function
Saddle anaesthesia
Recent back trauma
Night pain

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34
Q

True or false: Urinary Incontinence is associated with fall risk in the elderly.

A

True

35
Q

What are the 4 types of Urinary Incontinence?

A

Stress
Urge
Mixed
Functional

36
Q

True or false: If someone has mixed Urinary Incontinence, you must treat the Stress Incontinence first.

A

False; Urge first

37
Q

Nocturia is defined as voiding more than ___ times a night.

A

2

38
Q

Common Characteristic of Urinary Incontinence:
B_______ Mappers
K__ I_ T___ Door Syndrome
Claim to have S___ B____ers
J____ers
T_____ers
A___ D____ Water
P_____ Pee-ers

A

Bathroom Mappers
Key in the door syndrome
Claim to have Small bladders
JICCERS
Triggers
Avoid drinking water
Panic Peers

39
Q

Which of the following is not a Risk factor for Urinary Urge Incontinence:

Hx of abdominal/pelvic surgery
Neurological
Sexually Active
Hx of UTI
General Anxiety Disorder
Clenchers
Medications

A

Sexually active

40
Q

What are 3 ways to suppress an Urge?

A

Diaphragmatic Breathing, Kegel, Brain inhibition

41
Q

Caffeine, Alcohol, Acidic Foods, Carbonated Fluids, Artificial flavors, Dairy, Gluten, Sugar, Nicotine are all…

A

Bladder irritants

42
Q

Bladder retraining includes:

A

Urge suppression techniques, Bladder diary

43
Q

What type of incontinence is involuntary loss of urine with increased intra-abdominal pressure

A

Stress Urinary Incontinence (SUI)

44
Q

Female genitalia Risk Factors for incontinence.
A_______
H_______
P______ & L____
P_____ S_____

A

Anatomical
Hormonal
Pregnancy and Labor
Pelvic Surgery

45
Q

Male Genitalia Risk Factors for Incontinence.

Post P_________
S_______

A

Post Prostatectomy
Surgeries

46
Q

ALL GENDERS Risk Factors for Incontinence

C_____ Constipation
A_____
A_____s
High B___

A

Chronic Constipation
Asthma
Allergies
High BMI

47
Q

KNACK Intra-Abdominal pressure Management involves
“SHHHHH” and what other 5 noises/actions?

A

Cough
Hahaha
Achoo
blow nose
Yell

48
Q

True or false: The following are all reasons to refer to a pelvic health PT?

Pt with multiple comorbidities
Pt doesn’t think you understand
No improvement/Worsening after 4-6 visits
Symptoms change (Pelvic pressure & pain)

A

True

49
Q

T or F:
There are more neurotransmitters in the gut than in the brain and spinal cord combined?

A

T

50
Q

“Normal” Bowel function is __times a day to __ times a week.

A

3;3

51
Q

Abnormal bowel function is __+ times a day or less than ___ times per week.

A

5;3

52
Q

The poop chart goes from a 1-7. What is “normal” on this chart? and describe them.

A

3-4
3= sauage-shaped, better formed, visible cracks
4= smooth sausage, well formed, easy to pass

53
Q

Stools that are very difficult to pass and resemble small nuts or hard lumps are what on the scale of 1-7 of the Poop Chat?

A

1

54
Q

“Normal” stool is _______ strain and __-___ pieces.

A

Minimal strain, 1-2

55
Q

Stool that is almost entirely liquid with no solid pieces is what on the Poop chart 1-7?

A

7

56
Q

Abnormal stool is:
_____ hard
H____ your B______
Sitting on the toilet more than ___ Minutes.

A

Straining hard, holding your breath, 15 minutes

57
Q

Stools that are easy to pass but have many soft blobs with clear edges is what on the Poop Chart 1-7?

A

5

58
Q

Stools shaped like sausage , visible lumps, and somewhat difficult to pass are what on poop chart 1-7?

A

2

59
Q

Soft stools, fluffy and mushy with ragged edges are what on the poop chart 1-7?

A

6

60
Q

Underactive Pelvic Floor causes these Bowel issues:
F____ Incontinence
F_____ Incontinence
F_____ Smearing
Rectal P______
Rectocele

A

Fecal Incontinence
Flatus Incontinence
Fecal Smearing
Rectal Prolapse
Rectocele

61
Q

Rectocele is when B_____P _____ falls into the vaginal wall rather than the rectum.

A

Bowel Prolapse

62
Q

Overactive Pelvic Floor causes these Bowel issues:
C________
R____ Pain
Anal F_______
B______ Urgency
F____ Incontinence
I____B____ S_____

A

Constipation
Rectal Pain
Anal Fissures
Bowel Urgency
Fecal Incontinence
Irritable Bowel Syndrome

63
Q

What are the two types of IBS (Irritable Bowel Syndrome)?

A

Constipation and Diarrhea

64
Q

Is it “normal” to have a bowel movement during the middle of the night?

A

no

65
Q

What are the Red Flags for Bowel issues?
B____ in Stool
B____ T____ S____
F_____
A_________ Pain
Constitutional Sx
Saddle Anaesthesia
Recent B___ trauma
Recent P____ surgery
N____ pain
U_______ W____ Loss

A

Blood in stool
Black tarry stool
Fever
Abdominal pain
Consitutional Sx (Malaise)
Saddle Anaesthesis
Recent back trauma
Recent pelvic surgery
Night pain
Unexplained weight loss

66
Q

T or F: Women struggle with constipation more than men.

A

T

67
Q

Rome IV Criteria for Constipation involves what 5 things in 25% of your defecations?

And less than ___ spontaneous defecations per week.

A

Straining
Lumpy hard stools
Sensation fo incomplete evacuation
Sensation of anorectal obstruction
Manual maneuvers to facilitate defecation

3

68
Q

What are the 5 risk factors for Constipation?

A

Standard american diet
Lack of activity
Stress/anxiety/depression
Medication
Elderly

69
Q

What type of constipation is it when your stool is difficult to pass? What usually causes it?

A

Normal transit constipation; poor diet

70
Q

What type of constipation is it when stool moves at decreased rate? What usually causes it?

A

Slow transit constipation; medications, thyroid, neuro

71
Q

What type of constipation is it when stool is difficult to pass due to pelvic floor dysfunction?

A

Outlet constipation

72
Q

What manual therapy technique can you use as intervention for constipation?

A

I Love You Massage

73
Q

What 3 things can you educate a patient with constipation on?

A

Diet, Toilet Ergonomics, Nervous System Calming

74
Q

What 3 lifestyle modifications can people make if dealing with constipation?

A

more sleep, manage stress, nutrition

75
Q

What is the trio to avoid constipation ?

A

Water, Fiber, Exercise

76
Q

Recommended water intake to avoid constipation

A

1/2 your bodyweight in ounces

77
Q

___-___ mg of fiber/day is recommended to avoid constipation

A

25-30

78
Q

The Reverse Knack helps avoid Valsalva and includes:

N_____ Spine
Lean S____ F_____
R____
D______ B______
Jaw and Face R_____
M__ Breathing

A

Neutral spine
Lean slightly forward
Relax
Diaphragmatic breathing
Jaw and face relaxed
Moo Breathing

79
Q

Does the penis or the clitoris have more nerve endings?

A

clitoris (8000) compares to 4000

80
Q

The following list represents what?

Premature Ejaculation
Erectile dysfunction
Dyspareunia
Pain w orgasm
Persistent genital arousal disorder (PGAD)

A

Sexual issues for Assigned male at birth

81
Q

The following list represents what?

Dyspareunia
Pain w orgasm
Post coital pain
PGAD (Persitent genital arousal disorder)

A

Sexual issues for Assigned female at birth

82
Q

5 Risk factors for Sexual Dysfunction

A

Sexual Trauma
Surgical Trauma
Neurological Hx
Psychological Hx
Hormonal Imbalance

83
Q

The following is a list of Treatment Approaches for Pelvic Pain. Explain what each mean:

Top Down
Inside Out
Bottom Up

A

Top down= neuroscience, parasympathetic relaxation

Inside out= Food, nutrition

Bottom up= hands on, exercise

MSK IV (5 decks)

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