Reproductive and Urinary Systems Flashcards
What are the urology-genital-gyne RED FLAGS?
- Changes in bladder, bowel, and sexual function
2. Non mechanical low back pain, suprapubic or groin pion
______ ____ stores and secretes slightly alkaline fluid into urethra at ejaculation
prostrate gland
______ muscle contraction in the prostate gland helps expel semen
smooth
What are the 4 zones of the prostate?
- anterior
- central
- transition
- peripheral
What 2 zones in the prostate are muscular?
anterior and central
The ______ zone in the prostrate are the fibres surrounding the urethra.
transition
At what age does the rate of proliferation of the prostate gland surpass the rate of apoptosis?
25
Where is the cell growth located in the prostate?
transition zone
_______ = proliferation > apoptosis in the prostate gland
BPH
___% of men > 50 have BPH.
75
What are 3 symptoms of BPH?
- hesitancy
- intermittent stream
- PVR
What are 3 clinical implications if BPH is left untreated?
- UTI
- bladder distention
- renal failure
What is a risk factor of the medication used for BPH?
dizziness (=falls!)
What is the surgical management of BPH?
TURP (transurethral resection of the prostate)
Is BPH amendable to PT Rx?
No - refer to physician
What are 6 example questions to ask when screening for BPH?
- Do you urinate often?
- Do you have urgency?
- Do you have trouble starting your flow?
- Do you have weak or interrupted flow?
- Not emptying completely?
- Nocturia due to need to void?
What are 4 types of prostatodynia?
- acute bacterial
- chronic bacterial
- nonbacterial prostatodynia
- asymptomatic inflammatory
______ is the most common urological disorder in men > 50
prostatodynia
What is the presentation of prostatodynia?
Mix of…
- secondary to pelvic floor dysfunction
- history of sitting increasing pain (perineal pressure)
- urinary frequency, urgency, dysuria, nocturia
- pain in penis, testicles, perineum
- suprapubic pain
- painful ejaculation, decreased libido, ED
What are 3 factors of prostatodynia that are within PT scope when screening?
- non mechanical pain at onset
- sitting exacerbation (pudendal n. compression?)
- onset/presence of perineal, pubic, suprapubic or going pain possibly accompanied by change in genitals or genitourinary function
What are 3 common findings in pelvic floor examination of individuals with prostatodynia?
- increased PF resting tone
- decreased PF proprioception
- decreased PF motor control
How is prostate cancer detected?
PSA screening (blood test)
What are normal PSA levels ?
0-2.5 ng per mL
Prostate cancer can be present in the complete absence of an elevated PSA level (T/F).
TRUE
What are 2 major side effects of prostate cancer surgery (radical prostatectomy) relevant to PT practice?
- incontinence
2. ED
What are 4 red flags when screening for prostate cancer?
- non mechanical “MSK” pain
- night waking
- men > 50
- +/- urology signs and symptoms
What are 3 factors related to prostate cancer that fall within PT scope?
- prostatectomy (incontinence)
- radiation complications
- ADT (hormone therapy - OP, # fatigue, increase in body fat and decrease in lean tissue)
Disease accounts for __% of ED cases
70
____ can be first indicator of diabetes and heart disease
ED
How does pelvic floor rehab help in ED?
increases penile rigidity and tumescence
Endometriosis occurs with _______ menstruation
retrograde
Extent of endo lesson indicate extent of symptoms and pain (T/F).
FALSE - varies greatly
Presentation of endo depends on location of _____.
implants
Is there a cute for endo?
no
What are 3 factors in the screening for endo relevant to PT?
- cyclical LBP, hip, groin, nonmechanical
- dyspareunia, thrusting or deep, might bot be able to ID pain location
- differential - hip, groin, LP, dyspareunia
3 aspects of endo treatment for PT?
- education
- pain sensitization
- pacing and grading to return to activity
________ ______ = most common female reproductive organ cancer
endometrial carcinoma
What is the presentation of endometrial ca?
- abnormal vaginal bleeding
2. metastases (lymph, lung, liver, bones of LE)
What 2 findings in a screen test would be red flags for endometrial ca?
- abnormal vaginal bleeding
2. LE pain, non mechanical
Cervical ca is caused by ____ infection
HPV
Cervical ca early stage presentation is usually asymptomatic (T/F).
TRUE
Ovarian cancer actually arises in the fallopian tube _____, not on the surface of the ovaries.
fimbria
What are red flags when screening for ovarian cancer?
- gait disturbances
- dyspnea
- thoracic or shoulder girdle pain
- weight loss
- fatigue
What are the 4 types of pelvic organ prolapse?
- cystocele
- rectocele
- uterine prolapse
- enterocele
Pain rolling in bed = pubic _______ dysfunction
symphysis
______ = pain in one leg stance, kicking, sitting, standing
prolapse
What is the presentation of pelvic organ prolapse?
- vaginal or perineal pressure
- difficultly/ incomplete emptying bladder/bowel
- symptoms can increase with activity or at end of day
- may also present as back ache
What is the management for pelvic organ prolapse?
- PT
- Pessary
- Surgery
UTI’s may present with ________ pain.
suprapubic
You (can/cannot) differentiate cystitis from UTI without culture
cannot
If blood in the urine is present ever, what do you need?
cystoscopy
What are the types of incontinence?
- functional
- stress
- urge
- overflow
- mixed
_______ incontinence= normal bladder control, difficulty reaching toilet in time due to MSK/ joint / mobility problem
functional
_______ incontinence = most common type, leakage with cough, sneeze, lift, walk, jump, etc.
stress
What are the 3 management strategies for stress incontinence?
- PT
- pessary
- surgery
________ incontinence = hypotonic detrusor with inability to contract
overflow
If someone presents with overflow incontinence, what should a PT do?
refer to physician or emergency dep’t
_____ incontinence = pt has symptoms of both stress and urge incontinence, and it is the most common situation
mixed
______ frequency/urgency/incontinence = overactive bladder
urge
