Pelvic Health

Question 1

Storage phase - 1st stage of urination. sympathetic or parasympathetic

Answer 1

Sympathetic, Pudendal nerve stimulates external sphincter

Question 2

Emptying phase - 2nd stage. sympathetic or parasympathetic

Answer 2

Parasympathetic, Pudendal nerve relaxes external sphincter to void

Question 3

Normal bladder function
Frequency
Nightime
Quality

Answer 3

5-8x/day every 2-4 hours
0-1x/night
No pushing, uninterrupted, 500-650cc, no pain with storage nor emptying

Abnormal: >8x/day, >2x/night

Question 4

Abnormal bladder function

Answer 4

Hesitation
Staccato peeing - stop, go, stop, go
Post void dribble - more comes out after standing
Urgency out of the ordinary - difficulty delaying urge
Discomfort
Leakage - common, not normal

Question 5

Bladder habits to avoid

Answer 5

Hovering - PF muscles don’t relax in squat position
Just in case peeing
Power peeing - should empty w/o pushing
Self dehydrating - can cause bladder irritation

Question 6

Types of Urinary Incontinence

Answer 6

Stress SUI - physical, not mental stress E.g. increased intra-abdominal pressure caused by lifting, coughing, laughing, sneezing, bending, shouting, valsalva. SUI = pressure load failure
Urge UUI - leakage connected to urgency
Mixed - treat UUI first
Functional - continent capability, but don’t reach commode in time

Question 7

Caffeine, acidic foods, alcohol, carbonated fluids, artificial sweeteners, colorings, flavorings, diary, gluten, sugar, nicotine

Answer 7

bladder irritants

Question 8

Normal bowel function

Answer 8

3x/day to 3x/week, minimal strain, 1-2 pieces
Abnormal: 5x >/day or < 3x/week, straining, holding breath, >15min poop

Question 9

Risk factors for constipation

Answer 9

Standard American diet
Lack of activity
Stress/anxiety/depression (affects Vagal nerve)
Medications - opioids
Elderly

Question 10

Types of constipation

Answer 10

Normal Transit - difficult to pass d/t poor diet, dehydration, lack of veggies in diet, too many fries
Slow Transit - decreased rate d/t medications, thyroid, neuro MS or PD, anxiety or depression
Outlet Transit - difficult to pass d/t PF dysfunction @ gate, but cannot pass

Question 11

5 S’s - PF muscle function

Answer 11

Sphincteric
Supportive
Sexual
Stabilization
Sump pump (lymphatic function)

Question 12

Underactive PF

Answer 12

Hypotonic, inhibited, NOT weak

Question 13

Overactive PF

Answer 13

Hypertonic, tense/guarded, clenching