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Pathophysiology Quiz 1 > Pelvic Health > Flashcards

Pelvic Health Flashcards

1
Q

Functions of Pelvic Floor

A

Urination, sex and reproduction, evacuation of stool and gas

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2
Q

“S” Functions of Pelvic Floor

A

Supportive, Sphincteric, Sexual, Stabilization

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3
Q

Anterior Anatomy

A

Symphysis Pubis

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4
Q

Posterior Anatomy

A

Coccyx

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5
Q

Lateral Anatomy

A

Ischial Rami and Tuberosities

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6
Q

Anterolateral Anatomy

A

Inferior Pubic Rami

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7
Q

Posterolateral Anatomy

A

Sacrotuberous Ligament

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8
Q

Urogenital Triangle

A

Anterior, superficial muscle, first layer

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9
Q

Anal Triangle

A

Posterior, second and third layers of muscle, external anal sphincter

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10
Q

Levator Ani and Coccygeus

A

Largest muscle in group in PF
Responsible for most function/dysfunction
Innervated by S3-S5
Contract as a unit to support viscera and compress urethra, vagina, rectum

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11
Q

Third Muscle Layer

A

Includes 2 PF muscles and 2 LE muscles
Impairments in piriformis or OI muscles contribute to PFM issues and vice versa
PC fibers interdigitate with the OI, therefore hip problems may be related to bladder/bowel issues

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12
Q

Piriformis Problems

A

Muscle pads are posterior wall of pelvis, so they form a bed for the sacral plexus–sacral nerve roots can become affected

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13
Q

PF Muscle Fiber Types

A

Tonic- Type 1 (support, 70%-Levator Ani)

Physic- Type 2 (act intensely, fatigue quickly, 30%, decrease with aging)

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14
Q

Hip Adductors

A

Fibers interdigitate with Levator muscle

Can facilitate action of Levator muscles

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15
Q

Gluteals

A

Frequently tightened with Levator muscles

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16
Q

Abdominals

A

Play a role in IAP (pressure changes what is happening in the pelvic floor!)

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17
Q

Connection between PF and Breathing

A

As you exhale, PF rises

As you inhale, PF comes down

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18
Q

PF and Abdominal Connection

A

Transversus Abdominis is recruited to perform full PF contraction

Contraction of TA assists the pelvic floor to pull the bladder and urethra up and in

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19
Q

PFM Function

A

Support pelvic organs using ligaments above and PFM function below
Increase IAP and force of gravity encourage protrusion of pelvic organs –> PFM activity should increase with increased IAP

20
Q

PFM Voluntary Contraction

A

PFM shortens moving cranial lay (upward)

21
Q

Voluntary Relaxation

A

PFM lengthens moving caudally (downward)

22
Q

Involuntary Contraction of PFM

A

PFM shortens before increase in IAP during cough, laugh, “knack”

23
Q

Involuntary Relaxation of PFM

A

Automatic PFM lengthening before defecation

24
Q

Risk Factors for PFM Dysfunction

A

Pregnancy and vaginal childbirth (also C-section)
Obesity
Chronic or repetitive coughing, vomiting, straining
Pelvic Surgery
Pain
History of sexual abuse
Muscle imbalance- trunk ad pelvis

25
Q

Childbirth

A

Vaginal- nerve compression and traction

Cesarean- record high, causes implications for PT

26
Q

Low Tone PFM Dysfunction

A 
Under-active Pelvic Floor
Laxity, loss of support- weakness
Urinary Incontinence
Fecal incontinence
Pelvic organ prolapse
27
Q

High Tone PFM Dysfunction

A 
Overactive PF
Shortened muscle-weakness
Trigger points- connective tissue restrictions
Muscle guarding- poor relaxation 
Constipation
Urinary urgency and frequency 
Incomplete Emptying 
Pain
28
Q

Sensitive Issues with PFM Dysfunction

A 
Cultural, religious
Possibility of past sexual abuse
Ability to interpret nonverbal info
Terms for genitalia
Forms of sexual expression/identity
29
Q

Urinary Tract -Lower

A

Bladder, urethra, internal and external sphincters

30
Q

Urinary Tract- Upper

A

Kidneys and Ureters

31
Q

Continence Principle

A

Urethral Resistance pressure must be greater than bladder pressure

32
Q

Storage Phase- Adult Voiding

A

Bladder is relaxed, bladder files 15 drops/min, PFM are contracted

33
Q

Emptying Phase- Adult Voiding

A

At critical level of filling, strong sensation of dissension, PFM relax, bladder contracts

34
Q

Micturition Facts

A

Bathroom “just in case” is a bad habit
Squatting over toilet may result in incomplete emptying
Each urination street should last about 10 seconds

35
Q

Micturition Facts- Fluids

A

Decreasing fluids does not decrease incontinence and may increase urgency
Some fluid can irritate the bladder–causes urgency!

36
Q

Urinary Incontinence Treatment Categories

A

Behavioral, Pharm, surgical

Recommend the conservative option first!

37
Q

Prevalence of Incontinence

A

More than 15 million women in U.S. have SUI and 16 million have overactive bladder
1/10 women suffer from anal incontinence
11% of women likely to have pelvic surgery for UI and/or prolapse
29% will have multiple surgeries for PF dysfunction

38
Q

Urinary Incontinent Prevalence

A

25% of young women
57% of middle-aged women
75% of older women

39
Q

Urinary Incontinence in Athletes?

A

Athletes report significantly greater frequency of UI; must consider physical activity frequency and intensity related to UI

40
Q

Psycho-social Impact of Incontinence

A

QOL issues- avoidance, fear, limitations

Self-esteem, emotional, relationships, activity, safety, cost

41
Q

Urinary Incontinence Types

A 
Stress- outlet problem
Urge- bladder problem
Mixed- combo
Overflow- over-distension of bladder
Functional- inability to get to bathroom
42
Q

Stress Incontinence

A

Occurs with increase in IAP
Loss of small amount of urine associated with physical exertion
Cough, sneeze, lift, exercise, sex, position change

43
Q

Urge Incontinence

A 
Associated with abrupt sense of urgency
"Key in the Door"
May be triggers
Worsened by bladder irritants
Leads to frequency
44
Q

Overflow Incontinence

A

Destructor muscle is under active (low SCI, DM, Meds)

Urethral Obstruction (tumor, prolapse)

45
Q

Functional Incontinence

A

Inability to get to bathroom or remove clothing in time

Result of gross or fine motor impairment

46
Q

Male Urinary Incontinence

A

Radical Prostatectomy, damage to internal untether all sphinchter during surgery, stress UI, dependent on pads

Pathophysiology Quiz 1 (4 decks)

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