Week 10 Flashcards
the deepest muscle layer
the pelvic diaphragm
name the 6 core functions of the pelvic diaphragm.
- core-distal connectivity
- posture
- balance
- spinal stability
- shock absorption
- continence
name 7 functions of the pelvic floor.
- supports organs - vagina, bladder, rectum, and intestines
- maintain continence
- allow elimination
- stabilize and support joints of hips and pelvis
- sexuality
- birthing
- breathing
name 14 common causes of pelvic floor dysfunction.
- stress and tension
- childbirth injuries
- hormonal fluctuations
- couch potato syndrome
- surgeries
- obesity
- trauma due to accidents, fractures of hips or pelvis, sexual abuse
- excessive exercise, esp. abdominal crunches
- neuro conditions
- pain - low back pain
- musculoskeletal dysfunction
- pudendal neuralgia
- tension myalgia of pelvic floor
- sexual/emotional abuse
you need both ___ and ___ of the pelvic floor for functional strength.
contraction, relaxation
you need both contraction and relaxation of the pelvic floor for ___ ___.
functional strength
less active so overall muscle tone and strength decrease
couch potato syndrome
infection and inflammation in pelvic cavity
pelvic inflammatory disease
chronic vulvar discomfort - burning, irritation, pain with penetration
vulvodynia
inability to penetrate the vaginal opening due to spasms
vaginismus
painful intercourse
dyspareunia
descent of the vaginal wall, uterus, rectal organs
prolapse
tissue similar to uterine tissue is found outside the uterus - ovaries/fallopian tubes, bladder, bowel, intestines, colon, appendix, and rectum
endometrioses
also known as abdominal separation, happens when rectus abdominus pull apart from their attachment, the linea alba
diastasis recti
inflammation of the prostate gland
prostatitis
acute infection - fever, chills, pain in lower back and genital area, painful urination
acute bacterial prostatitis
recurrent infection - may be caused by incomplete urinary evacuation
chronic bacterial prostatitis
typically, due to myofascial pain syndrome or nerve inflammation - 3 months or more of pain in pelvic region
chronic nonbacterial prostatitis/chronic pelvic pain syndrome (CPPS)
no genitourinary symptoms, but higher levels of white blood cells
asymptomatic inflammatory prostatitis
what percent of men over age 70 have erectile dysfunction?
70%
urethral pain, burning, and sensitivity during urination
urethral syndrome
irritation of the bladder
urgency-frequency syndrome
encompasses a group of symptoms such as abdominal pain, bloating, frequent bowel movements
irritable bowel syndrome (IBS)
includes crohn’s disease and ulcerative colitis
inflammatory bowel disease (IBD)
what percent of women over 70 gave urinary incontinence?
40-50%
what percent of men over the age of 65 have urinary incontinence?
21%
- overcomes pelvic and urogenital muscles
- large amount of urine is released
- sudden strong need to toilet before an individual can reach the bathroom
- bladder contracts too frequently and too great an intensity
urge incontinence
name 7 causes of incontinence.
- chronic UTI, bladder stones, and polyps
- diuretics
- atropic vaginitis
- diet - caffeine, co2 beverages, alcohol, spicy and tomato based food
- neurogenic bladder - SCI, BI
- overhydration
- medications
- dribbling of urine due to an inability to empty bladder
- possible causes: damaged bladder, blocked urethra, nerve damage (diabetes) MS, SCI
overflow incontinence
- caused by damaged nerves that can’t warn your brain when your bladder is full (bladder contracts without warning)
- usually happens to people with severe neurological damage from: SCI, MS, radiation treatment
reflex incontinence
symptoms of more than one type of incontinence such as stress and urge incontinence
mixed incontinence
incontinence due to a physical or mental impairment such as severe arthritis (inability to unbutton pants quickly)
functional incontinence
name a societal effect of incontinence.
institutionalization
describe the gold standard in PFD rehabilitation.
combination of physical, environmental, and behavioral aspects
describe how an OT may address incontinence with regards to the physical aspect.
may provide preparatory activities to address underlying body structure issues
name 3 types of physical preparatory activities that an OT may use to address incontinence.
- manual therapies
- therapeutic exercises - strength, flexibility, coordination
- biofeedback
describe how an OT may address incontinence with regards to the environmental aspect.
- focus on mobility and environmental issues limiting quick, safe access to the bathroom
- height of toilet - squatty potty
- offer suggestions on garment management for clients dealing with arthritis or incoordination
describe how an OT may address incontinence with regards to the behavioral aspect.
- talk with client about modifying their medication schedule.
- planning voiding and liquid intake schedules - bladder retraining
- collaborating on strategies for engaging in social and leisure activities
- relaxation and pain management strategies
describe how an OT may address incontinence with regards to the cognitive aspect.
-problem solve effective toilet management strategies such as appropriate environmental adaptations and cueing - ex: red toilet seat in white bathroom
name 8 pelvic floor interventions.
- bladder training/timed voiding
- biofeedback
- pelvic floor exercises
- environmental adaptations
- clothing adaptations and management
- medications
- medical devices
- surgeries
increase intervals between voiding by instructing person to avoid urge - follow a planned time schedule
bladder training/time voiding
learn to relax the detrusor muscle and abdominal muscles, while contracting sphincter muscles
biofeedback
describe the correct position for opening your bowels.
- knees higher than hips
- lean forwards and put elbows on your knees
- bulge out your abdomen
- straighten your spine
name the 4 aspects of the PLISSIT Model.
- permission
- limited information
- specific suggestions
- intensive therapy
open the door to discussion
permission
addresses the client’s specific concerns - informative, educational approach
limited information
provide suggestions specific to the client’s situation (tips, directions, and exercises)
specific suggestions
refer to pelvic dysfunction specialist
intensive therapy
what is the duration of “Easy Does It: An OT Based Pelvic Health Program”
- 8-week program, 1x a week for 1.5 hours
- handouts provided on all of the lessons
limitations in daily activities, personal relationships, emotions, sleep/energy, general questions on how bladder performs
kings health questionnaire
participants select 2 activities that are important to them and rates their current satisfaction and performance
personal activity scale
- pelvic pain
- benefit of today’s session
- how many times did you experience leakage
- how would you rate the impact of your leakage on your everyday life
- how frequently have you practiced
weekly check-in
___ ___ is often connected to pelvic dysfunction.
hip dysfunction
the ability to lengthen and shorten
suppleness
affect both diaphragms and can exacerbate symptoms
tight abs
proximal stability gives us distal coordination and movement
core-distal connectivity
pelvic rehab can only help in which 2 stages of prolapse?
stages 1 and 2
if you cough, sneeze, or laugh, we feel internal pressure (intra-abdominal pressure) - muscles are weak, can’t protect or hold urine in so some drops come out
stress incontinence
- bladder starts to contract before it is full and a person starts to leak
- aka key in the lock syndrome
urge incontinence
bladder starts to contract sooner
overactive bladder
