Pelvic Health

Question 1

Coordination of bladder and urinary sphincters occurs at

Answer 1

2

Question 2

Signs of bladder sensation appear around

Answer 2

18 months

Question 3

By the age of ____ they should be able to fully empty their bladder

Answer 3

3

Question 4

Median age of having no accidents during the day (daytime dryness)

Answer 4

3.5

Question 5

When should night time dryness occur?

Answer 5

6 months after daytime dryness

(around 4)

Question 6

Potty training readiness signs

Answer 6

Have bowel movement same time each day

No bowel movements at night

Dry diaper after nap

Dry diaper for atleast 2 hours at a time

They are squatting and climbing

Able to pull pants down

Emotional readiness

Question 7

What is the #1 cause of bed wetting

Answer 7

Constipation

Question 8

What is the ROME criteria for constipation

Answer 8

Straining 25% of the time

Lumpy/hard stool 25% of the time

Manual facilitation of defecation 25% of the time

Fewer than 3 per week

No loose stools without laxative

Sensation of incomplete emptying

(2 or more for over 3 months)

Question 9

What are clinical signs of constipation

Answer 9

Loose stool- because new stool is just going around the old hard stool

Bed wetting

Can be over 3 bowel movements in a day or under 3 in a week

Withholding

Child will only go in pull-up or in standing.

Question 10

Red/yellow flags for ped pelvic health

Answer 10

Withholding- scared to go poop

Primary or secondary incontinence

Frequent UTI

Nocturnal enuresis after 5

Straining or infrequent bowel movements

Infrequent or too frequent urination

Teens: giggle incontinence, incontinence when playing sports

Question 11

What’s the difference between primary and secondary incontinence

Answer 11

Primary- never completely potty trained

Secondary- dry for atleast 6 months and now they regress

Question 12

How does rolling relate to pelvic health development

Answer 12

obliques are needed to bear down

any asymmetries can lead to pelvic floor dysfunction

Question 13

how does crawling relate to pelvic health development

Answer 13

builds scapular stability, shapes diaphragm and develops pelvic floor

any asymmetries can lead to pelvic floor dysfunction

Question 14

how does standing relate to pelvic health development

Answer 14

balance reactions, stability, coordination

any asymmetries can lead to pelvic floor dysfunction

Question 15

how does walking relate to pelvic health development

Answer 15

need mature gait pattern to contract/relax pelvic floor

any asymmetries can lead to pelvic floor dysfunction

Question 16

how does the frog squat relate to pelvic health development

Answer 16

need hip ROM

any asymmetries can lead to pelvic floor dysfunction

Question 17

Why is squatting better than sitting for going poop

Answer 17

puborectalis doesn’t “choke” the rectum while squatting, the rectum is more closed when sitting

Question 18

Activating ________ helps activate the ascending and descending colon

Answer 18

psoas and trunk rotation

Question 19

You need ______ pelvic tilt for puborectalis alignment

Answer 19

anterior

Question 20

When _____ are activates, the pelvic floor contracts

Answer 20

plantarflexors

Question 21

Toe walking is a sign that

Answer 21

they might need to go to the bathroom

Question 22

How might a child sit if they need to go to the bathroom

Answer 22

with their bottom ontop of their foot

Question 23

How are kneeling activities important for pelvic development

Answer 23

need to be able to disassociate one side from other in order to have pelvic control

Question 24

What is a good assessment of pelvic floor coordination in children

Answer 24

assessing global coordination

• do they cross midline
  -can they jump and land symmetrically
  -can they isolate movements
  -can they coordinate jumping jacks

Question 25

what are the 4 parts to proper potty posture

Answer 25

1. feet on stable flat surface 2. knees above hips 3. elbows on knees (lean 35 degrees) 4. sit tall and breathe

Question 26

For a bowel routine, the pt should do what

Answer 26

sit on toilet after a meal DAILY (1-2 minutes) do relaxing activities like blowing bubbles Once they feel safe u can ask for pushes while sitting

Question 27

For a voiding routine, you want to schedule voids every

Answer 27

2-3 hours if only voiding every 4-6 hours theres a risk for UTI can use potty watch for reminder

Question 28

For a healthy bowel and bladder, the pelvic floor needs to:

Answer 28

Contract and shorten Relax at rest for slight mobility and breathing Lengthen and allow stool and urine to pass through

Question 29

What are good stretches for a tight pelvic floor

Answer 29

Childs pose Frog Squat Duck Walks Pair with deep breathes and a calming activity, perform prior to going to bathroom

Question 30

What are 3 activites to strengthen a pelvic floor

Answer 30

longsitting on wedge balancing SLS or uneven surface play Adductor activation (adductors overflow to PFM)

Question 31

When treating diastasis recti, we want to treat the ___ abdominals first

Answer 31

upper, followed by lower

Question 32

How long until diastasis recti should resolve

Answer 32

between ages 1-3, but can stay open with chronic constipation, bloating, poor posture may or may not be the cause of symptoms (can be asymptomatic)

Question 33

when measuring for diastasis recti, the rib angle is usually

Answer 33

larger than 100

Question 34

What is a good exercise to target the upper abdominals for diastasis recti

Answer 34

laying supine on wedge and moving weighted ball overhead

Question 35

Diastasis recti progression: Upper abs -> lower abs -> ________ ensure __________

Answer 35

Obliques ensure TrA activation throughout

Question 36

Bladder irritants include

Answer 36

Milk Tomatoes Chocolate Caffeine Citrus Carbonation

Question 37

What foods can cause constipation

Answer 37

Banana Apple sauce Cheese Milk Tapioca

Question 38

_______ is the prime component of keeping poop soft

Answer 38

water hydration most important when addressing constipation if baby is on Miralax for constipation this makes them dehydrated

Question 39

______ is key for constipation

Answer 39

Fiber and adequate water

Question 40

3 tips to stop bedwetting after the age of 5

Answer 40

eliminate bladder irritants no liquids 2 hours before bed calming activity and pee before bed

Question 41

what do we need to rule out for bed wetting

Answer 41

constipation sleep apnea diabetes genetic chronic kidney disease

Question 42

Key in on these 3 things during an exam for bed wetting:

Answer 42

Coordination Airway Constipation

Question 43

Bladder is full if they peed for more than ______

Answer 43

8 seconds

Question 44

Good bladder habits:

Answer 44

Dont pee just incase fully sit to pee (even for boys) Drink water throughout day